ABSTRACT
We prospectively evaluated 62 adults referred for coronary arteriography, using a systematic physical examination protocol to identify musculoskeletal sources of chest pain. In seven patients (11%) the chest pain was reproduced on physical examination; six of them ultimately had a diagnosis of nonanginal chest pain made by their cardiologist, based on history and data from noninvasive and coronary arteriographic studies. Five had normal coronary arteriograms. These patients described their pain in terms often associated with true angina. Musculoskeletal tenderness that did not reproduce the pain was common and was unrelated to coronary artery disease. Demonstration of musculoskeletal tenderness that reproduces chest pain, when combined with noninvasive findings suggesting low probability of coronary artery disease, may be useful in decreasing the incidence of unnecessary invasive cardiac evaluation, and appropriately directing initial therapy.
Subject(s)
Chest Pain/etiology , Myofascial Pain Syndromes/complications , Physical Examination/methods , Adult , Aged , Angina Pectoris/diagnosis , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Myofascial Pain Syndromes/diagnosis , Prospective StudiesABSTRACT
Serum from 422 healthy subjects prior to and four weeks after multiple immunizations was studied for rheumatoid factors (RF) by an enzyme-linked immunosorbent assay (ELISA). Increase in IgM RF was detected in 22% of subjects by ELISA, but was not detectable by a standard sheep-cell agglutination test. Immunization may be a cause of RF positivity by a sensitive assay such as ELISA; it is not likely to be detected by standard clinical methods.
Subject(s)
Immunization , Rheumatoid Factor/analysis , Adult , Female , Humans , Immunoglobulin A/analysis , Immunoglobulin G/analysis , Immunoglobulin M/analysis , MaleABSTRACT
The procedure for neomycin residues used a surfactant to improve extraction, a centrifuge step to eliminate solids that interfere with the diffusion of the antibiotic, and a heat treatment to destroy interfering lysozyme activity. The use of Bcillus stearothermophilus and a 65 degree C incubation yielded a rapid assay with a sensitivity of 0.2 microgram neomycin activity/g egg. Frying eggs caused little or no loss of activity, poaching resulted in 25% loss, and soft boiling and hard boiling caused little or no loss of applied activity. Neomycin residues in eggs were quite stable to normal egg preparation procedures.
Subject(s)
Eggs/analysis , Neomycin/analysis , Cooking , Drug Stability , Hot Temperature , Poultry Products/analysisABSTRACT
A pregnancy complicated with idiopathic thrombocytopenic purpura is described. Treatment consisted of primary ceasarean section, tubal ligation, and splenectomy with good results for mother and infant. Subsequent successful pregnancies may be anticipated if the thrombocytopenia-complicated pregnancy is managed as described.
