Archive for the ‘disorders’ Category

Time-Course of the Uterine Response to Estradiol: DISCUSSION(5)

It also is clear from the present data that microvascular growth cannot account for the early and substantial increase in uterine blood flow that occurs within 30-60 min after estrogen treatment in ovariectomized mammals and that is probably due exclusively to vasodilation of the uterine vascular bed. Nevertheless, the sustained increase in uterine blood flow that occurs throughout pregnancy is probably due primarily to growth of the entire uterine vascular bed, including the uterine arteries. In addition, a portion of the angiogenic response of the uterus, including the up-regulation of endometrial angiogenic factor expression, may be caused by the early increase in uterine blood flow, since sheer-stress resulting from increased flow has been shown to induce angiogenesis in a variety of tissues. buy flovent inhaler

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Pathologic Fracture Occurring 22 Years After Diagnosis of Hairy Cell Leukemia

HAIRY CELL LEUKEMIAHAIRY CELL LEUKEMIA (HCL) is a chronic В-cell lym-phoproliferative disorder that accounts for approximately 2% of all leukemias. The typical clinical picture consists of a man with a median age of between 50 and 55 years with splenomegaly, a varying degree of pancytopenia without lymphadenopathy, and characteristic hairy cells in peripheral blood and bone marrow. Bone lesions, having an incidence of 3%, are an uncommon complication of HCL. We present a patient who developed a pathologic fracture 22 years after his initial diagnosis. We also provide a review of the literature on this rare complication of HCL.

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Alternating transient dense hemiplegia due to episodes of hypoglycemia

ACUTE ONSET OF HEMIPLEGIA is a common presentation of cerebrovascular accident. Rapid reversal of this focal neurologic deficit may occur with transient ischemic attacks. However, hypoglycemia has been reported only rarely as a cause of reversible motor deficits. We now report the first case of a patient with alternating right and left dense hemiplegia related to episodes of hypoglycemia.

Report of a Case
A 69-year-old African American male with a medical history, congestive, chronic renal insufficiency, anemia, and myocardial infarction in 1988, was diagnosed as having type II diabetes mellitus. One week prior to admission, he was started on glyburide5 mg orally once a day. There was no prior history of cerebrovascular insufficiency, headache, or seizure disorder. His family history was noncontributory.

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Cocaine-Induced Intestinal Ischemia

cocaineCOCAINE, AN ALKALOID derived from the Erythroxylon coca plant, remains a popular recreational drug. Although its recreational use has decreased, the number of hard-core regular users remains unchanged at 476,000 according to the 1993 National Institute on Drug Abuse Household Survey. Cocaine-related complications are, therefore, of clinical importance. Bowel ischemia due to cocaine use is probably more common than is reported, but it may be overlooked because its presentation is similar to other acute abdominal conditions. A direct causal relationship between cocaine use and bowel ischemia is difficult to prove. Nevertheless, the patients described in published reports so far had been relatively young, had a positive urine toxicology screen for cocaine, and had no previous history of atherosclerosis. We report a case of acute small bowel ischemia in the oldest patient after smoking crack cocaine.

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Giant Cell Arteritis (Temporal Arteritis) and Polymyalgia Rheumatica

Temporal arteritis Classification & external resourcesDefinition

Giant cell arteritis (also called temporal arteritis) is an inflammation of medium – and large-sized arteries. The disorder most frequently involves one or more branches of the carotid artery, particularly the temporal artery. The disorder is a systemic disease which can involve arteries in multiple locations.

Incidence And Prevalence

Giant cell arteritis has a high incidence in Scandanavia and in regions of the United States with large Scandanavian populations, compared to a lower incidence in southern Europe. The annual incidence rates in individuals 50 years of age and older range from 0.49 to 23.3 per 100,000 population. It occurs almost exclusively in individuals older than 55 years; however, well-documented cases have occurred in patients 40 years old or younger. It is more common in women than in men and is rare in blacks. Familial aggregation has been reported, as has an association with HLA-DR4. In addition, genetic linkage studies have demonstrated an association of giant cell arteritis with alleles at the HLA-DRB1 locus, particularly HLA-DRB1*04 variants. The disease is closely associated with polymyalgia rheumatica, which is more common than giant cell arteritis. In Olmsted County, Minnesota, the annual incidence of polymyalgia rheumatica in individuals 50 years of age and older is 52.5 per 100,000 population. Read the rest of this entry »


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