Case report: recurrent hematuria and hematospermia due to prostatic telangiectasia in classic von Willebrand's disease.

A previously healthy 32-year-old man presented with recurrent exercise induced painless gross hematuria and hematospermia. An extensive evaluation demonstrated classic von Willebrand's disease associated with vascular telangiectasia of the prostate gland as the locus of hemorrhage. The bleeding resolved spontaneously and without recurrence. The coexistence of von Willebrand's disease and vascular telangiectasia has been described previously, although it is a rare occurrence. However, a review of the English literature revealed no report of vascular telangiectasia involving the prostate gland, and therefore is the subject of this report. The prostate gland now should be added to the list of viscera associated with vascular telangiectasia and von Willebrand's disease.

Accidental chronic salicylate intoxication in an elderly patient: major morbidity despite early recognition.

Chronic salicylate intoxication represents an unappreciated form of self-poisoning in the elderly and therefore poses a diagnostic challenge. This report describes an elderly female with chronic salicylism who presented with unexplained delirium, dysarthria, diminished short-term memory and hearing, and urinary and fecal incontinence. She was treated with intravenous hydration, urinary alkalinization, and subsequent hemodialysis for persistent aciduria, acidemia and impending circulatory collapse. Major morbidity included myocardial infarction, life-threatening dysrhythmias, and mixed bacterial urosepsis. This report highlights the need to maintain a high index of suspicion for salicylate poisoning in the elderly, who commonly present with nonfocal neurologic features.

Polychlorinated biphenyls: an overview of metabolic toxicologic and health consequences.

Polychlorinated biphenyls (PCBs) are complex mixtures of chlorinated aromatic hydrocarbons which are classified as lipophilic xenobiotics in vivo. Because of their unusual thermal and insulating properties, widespread use in industry was commonplace. They eventually gained entry into the biota, and their diffuse distribution represents both a potential and actual risk to humans and animals due to their bioconcentration in the food chain and toxicity secondary to accidental occupational or environmental exposure. Experimental poisoning in various animal models demonstrates that PCBs are potent inducers of hepatic microsomal enzyme systems, transmitted transplacentally and produce reproductive dysfunction. They alter immune function by decreasing the cell-mediated response and, in addition to producing myriad manifestations, are tumorigenic. Human exposure to PCBs has been associated with similar abnormalities, but because of limited data their chronic toxicity has not been well established. This is the key problem to evaluating possible untoward health effects in humans.