Subject(s)
Anticholesteremic Agents/adverse effects , Drug Monitoring/methods , Gemfibrozil/adverse effects , Liver Function Tests/standards , Patient Selection , Transaminases/blood , Dose-Response Relationship, Drug , Evidence-Based Medicine , Humans , Muscular Diseases/chemically induced , Muscular Diseases/diagnosis , Muscular Diseases/metabolism , Practice Guidelines as Topic , Time FactorsSubject(s)
Gastroesophageal Reflux/diagnosis , Infant Food , Vomiting/prevention & control , Weight Gain , Humans , InfantABSTRACT
When a toxic newborn or young infant presents with fever and lethargy or irritability, it is important to consider the diagnosis of meningitis even if the classic localizing signs and symptoms are absent. Cerebrospinal fluid should be obtained (unless lumbar puncture is clinically contraindicated) to enable initial therapy to be planned. Initial results of cerebrospinal fluid testing may not conclusively differentiate between aseptic and bacterial meningitis, and antimicrobial therapy for all likely organisms should be instituted until definitive culture results are available. Comprehensive therapy, including antibacterial and antiviral agents, should continue until a cause is identified and more specific therapy is initiated, an etiology is excluded or the patient improves considerably and the course of antimicrobial therapy is completed. Group B streptococcus is the most common bacterial etiologic agent in cases of meningitis that occur during the first month after birth. Etiologies of aseptic meningitis include viral infection, partially treated bacterial meningitis, congenital infections, drug reactions, postvaccination complications, systemic diseases and malignancy. Long-term sequelae of meningitis include neuromuscular impairments, learning disabilities and hearing loss. Prompt diagnosis and treatment are essential to improved outcome.
Subject(s)
Meningitis, Aseptic , Combined Modality Therapy , Decision Trees , Diagnosis, Differential , Humans , Infant , Infant, Newborn , Male , Meningitis, Aseptic/blood , Meningitis, Aseptic/cerebrospinal fluid , Meningitis, Aseptic/complications , Meningitis, Aseptic/diagnosis , Meningitis, Aseptic/drug therapy , Meningitis, Aseptic/etiologyABSTRACT
Cellular lipids were extracted from three species of Oomycete plant pathogens (Pythium ultimum, Phytophthora infestans, and Ph. capsici) and analyzed via normal-phase high-performance liquid chromatography with flame-ionization detection. The most abundant polar lipids in each of the three species were the polar membrane lipids, phosphatidylethanolamine (PE), phosphatidylcholine, and a phosphosphingolipid that eluted soon after PE. Structural analysis via mass spectrometry and nuclear magnetic resonance spectrometry revealed that the phosphosphingolipid was ceramide phosphorylethanolamine (Cer-PE). The most abundant molecular species of Cer-PE in P. ultimum had a molecular weight of 670.5, contained an unusual 19-carbon branched triunsaturated sphingoid (C19-delta 4, 8, 10, 9-methyl long-chain base) and palmitic acid as the amide-linked fatty acid. The most abundant molecular species of Cer-PE in Ph. infestans had a molecular weight of 714.5, contained a common 16-carbon 1,3 di-OH sphingoid, and erucic (cis 13-docosenoic, C22-delta 13) acid as the amide-linked fatty acid. The Cer-PE in Ph. capsici comprised a mixture of each of the two molecular species found in P. ultimum and Ph. infestans.
Subject(s)
Phytophthora/chemistry , Pythium/chemistry , Sphingomyelins/analysis , Ceramides/analysis , Chromatography, High Pressure Liquid , Fatty Acids/chemistry , Lipids/analysis , Magnetic Resonance Spectroscopy , Mass Spectrometry , Molecular Structure , Oomycetes/chemistry , Oomycetes/pathogenicity , Phospholipids/chemistry , Phytophthora/pathogenicity , Pythium/pathogenicity , Sphingolipids/chemistrySubject(s)
Abortion, Induced , Physician's Role , Pregnancy, Unwanted , Family Practice , Female , Humans , Pregnancy , United StatesABSTRACT
Helping a patient to quit smoking requires accurate identification of the problem, development of an individualized management plan and careful follow-up of the patient's response to treatment. Tools such as the Fagerstrom Test for Nicotine Dependence can help the physician learn about the patient's smoking habit and develop an effective treatment plan. Support from physicians, health care providers, family and smoking cessation groups can help patients quit smoking and maintain long-term abstinence. Nicotine replacement therapy, available in a variety of forms, is most effective when it is used as part of a smoking cessation program for the nicotine-dependent patient.
Subject(s)
Smoking Cessation/methods , Smoking/psychology , Tobacco Use Disorder , Humans , Motivation , Nicotine/administration & dosage , Tobacco Use Disorder/diagnosis , Tobacco Use Disorder/therapySubject(s)
Abortion, Induced/adverse effects , Ethics, Medical , Attitude of Health Personnel , Family Practice , Female , Humans , PregnancyABSTRACT
A computer program called MSCOPOL has been developed to aid in the interpretation of copolymer mass spectra. The program reads the mass spectrum, calculates the most likely monomer masses via correlation or Fourier transform methods, determines possible end group masses based on the monomer masses, and can then search monomer and end group data bases for likely chemical moieties. Refinement of the end group result is possible by calculation of the monomer ratio and degree of polymerization as a function of end group mass. The program is written in Microsoft Visual Basic and runs on an IBM compatible PC. Applications are shown for polystyrene, poly(N-vinyl pyrrolidone/vinyl acetate), and poly(ethylene oxide/propylene oxide).
