Subject(s)
Bacillus anthracis/metabolism , Chemistry Techniques, Analytical/methods , Chromatography, Gas/methods , Esters/chemistry , Fatty Acids/chemistry , Agar/chemistry , Calibration , Culture Media/pharmacology , Methylation , Models, Statistical , Quality Control , Glycine max/chemistry , Spores, Bacterial/metabolism , Time FactorsABSTRACT
Estrogen replacement therapy (ERT) is recommended for postmenopausal women primarily for reduction of menopausal symptoms and prevention of osteoporosis and cardiovascular disease. However, only 35% to 40% of women ever start ERT, and many do not continue it. One of the reasons women are reluctant to receive postmenopausal ERT is that they perceive prescription estrogens as being "unnatural." Because of this, there is increasing interest in the use of plant-derived estrogens, also known as phytoestrogens. This article reviews the evidence for the potential of phytoestrogens, either in dietary or supplemental form, to replace traditional forms of ERT. A comprehensive search of the English-language literature identified more than 1000 articles published in the past 30 years about phytoestrogens. In total, 74 studies were selected for inclusion in this review based on relevance, inclusion of human subjects wherever possible, and study design. The studies examine phytoestrogens' inhibition of the growth of cancer cell lines in vitro and in animals. They also look at the role of phytoestrogens in the reduction of cholesterol levels, and the use of one phytoestrogen derivative, ipriflavone, in the prevention of osteoporosis. Some small studies examine the role of phytoestrogens in the prevention of menopausal symptoms. Evidence for the potential health benefits of phytoestrogens is increasing. However, the clinically proven health benefits of prescribed ERT far outweigh those of phytoestrogens. Therefore, there is insufficient evidence to recommend the use of phytoestrogens in place of traditional ERT, or to make recommendations to women about specific phytoestrogen products.
Subject(s)
Breast Neoplasms/prevention & control , Cardiovascular Diseases/prevention & control , Estrogen Replacement Therapy/methods , Estrogens, Non-Steroidal/therapeutic use , Isoflavones , Osteoporosis, Postmenopausal/prevention & control , Postmenopause/drug effects , Cell Division/drug effects , Female , Humans , Phytoestrogens , Plant Preparations , PrognosisABSTRACT
We are presenting this case to emphasize that the symptoms of Addison disease are very similar to those of pregnancy and, although this disease is rare, the consequences can be catastrophic if it is overlooked, particularly in pregnancy.
Subject(s)
Addison Disease/diagnosis , Adrenocorticotropic Hormone/blood , Hydrocortisone/blood , Postpartum Period , Vomiting/etiology , Addison Disease/blood , Addison Disease/complications , Adult , Diabetes Mellitus, Type 1/diagnosis , Diagnosis, Differential , Female , Humans , Vomiting/bloodABSTRACT
Early institution of therapy with acyclovir is essential for the successful outcome in herpes simplex encephalitis. Brain biopsy remains the only conclusive means of establishing the diagnosis, but many fear possible biopsy complications. Thus, therapy is often instituted when the diagnosis is clinically suspected, even though cerebral computed tomography and other diagnostic studies may be inconclusive. Nuclear magnetic resonance imaging (MRI) has proven to be a sensitive tool for diagnosing presumptive herpes simplex encephalitis, and this case presentation demonstrates the superiority of cerebral MRI over computerized tomography for detecting early temporal lobe changes consistent with acute herpes simplex encephalitis.
Subject(s)
Encephalitis, Arbovirus/diagnosis , Herpes Simplex/diagnosis , Adolescent , Humans , Magnetic Resonance Imaging , MaleABSTRACT
The use of SPECT in conjunction with I-123 HIPDM is a promising scintigraphic approach to the assessment of regional cerebral tissue perfusion.
Subject(s)
Cerebral Angiography , Cerebral Revascularization , Iodobenzenes , Tomography, Emission-Computed , Adult , Carotid Artery Diseases/diagnosis , Carotid Artery Diseases/surgery , Cerebrovascular Circulation , Cerebrovascular Disorders/diagnosis , Cerebrovascular Disorders/surgery , Encephalomalacia/diagnosis , Female , Humans , Male , Middle Aged , Postoperative CareABSTRACT
Four cases of cerebrospinal fluid (CSF) ascites secondary to ventriculoperitoneal shunting are described. It is possible to differentiate CSF ascites from a CSF-filled pseudocyst by the characteristic bowel gas pattern on films of the abdomen and by the presence of shifting dullness. Two of the patients had active shunt infections, and had ascitic fluid with a protein level greater than 3 gm% and a white blood cell (WBC) count greater than 1000/cu mm. Both were treated successfully with antibiotics and removal of the shunt from the peritoneum. Two other patients had no evidence of infection, protein levels of less than 2 gm%, and WBC count less than 100 cu mm. These disorders resolved spontaneously. A review of 18 cases reported in the literature shows that the etiology of CSF ascites in the absence of shunt infection is multifactorial, and no features are consistently present in all cases. Ascites without infection may resolve spontaneously without surgical intervention.
Subject(s)
Ascites/etiology , Peritoneal Cavity , Adult , Ascites/surgery , Cerebrospinal Fluid Shunts , Child , Child, Preschool , Female , Humans , Male , Peritoneal Cavity/surgeryABSTRACT
Legionella pneumophila postoperative pneumonia may be an important cause of morbidity and mortality in selected surgical patients. This report presents five postoperative neurosurgical patients in whom the diagnosis of Legionnaires' disease was made. Their clinical course and treatment are presented. Clinical manifestations, methods of diagnosis, and treatment of L. pneumophila pneumonia are discussed. It is pointed out that neurosurgical patients who have received high doses of corticosteroids and who develop nosocomial postoperative pneumonias should be suspected of having Legionnaires' disease.
