Annals of the New York Academy of Sciences
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Ann. N. Y. Acad. Sci. · Oct 2006
Ticks, tick-borne rickettsiae, and Coxiella burnetii in the Greek Island of Cephalonia.
Domestic animals are the hosts of several tick species and the reservoirs of some tick-borne pathogens; hence, they play an important role in the circulation of these arthropods and their pathogens in nature. They may act as vectors, but, also, as reservoirs of spotted fever group (SFG) rickettsiae, which are the causative agents of SFG rickettsioses. Q fever is a worldwide zoonosis caused by Coxiella burnetii (C. burnetii), which can be isolated from ticks. ⋯ Rhipicephalus (Rh.) bursa, Rh. turanicus, Rh. sanguineus, Dermacentor marginatus (D. marginatus), Ixodes gibbosus (I. gibbosus), Haemaphysalis (Ha.) punctata, Ha. sulcata, Hyalomma (Hy.) anatolicum excavatum and Hy. marginatum marginatum were the species identified. C. burnetii and four different SFG rickettsiae, including Rickettsia (R.) conorii, R. massiliae, R. rhipicephali, and R. aeschlimannii were detected using molecular methods. Double infection with R. massiliae and C. burnetii was found in one of the positive ticks.
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Asbestos inhaled into the lung is recognized as a potential causal agent for the development of diseases in man. The diseases induced by asbestos include lung cancer, fibrosis of the lung (asbestosis), and extrapulmonary tumors including mesothelioma (a tumor of the serosal membrane), as well as fibrosis and other changes in the pleura linings. ⋯ In either of these cases the quality of information is directly dependent on the preparative techniques and instrumentation used in the analysis. The present article will discuss the significance of findings of tissue burden based on both these variables.
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Paragangliomas are rare tumors that arise from extra-adrenal paraganglia. The effective diagnosis and management of the paraganglioma patient involves the close collaboration of endocrinologists, endocrine surgeons, anesthesiologists, geneticists, laboratory specialists, radiologists, oncologists, and pathologists. Paragangliomas are diagnosed in the following clinical settings: signs and symptoms related to catecholamine hypersecretion, mass effect symptoms (e.g., with head and neck paragangliomas), incidental finding on imaging, or family screening for hereditary paraganglioma. ⋯ Genetic testing should be considered in all patients with paraganglioma. The treatment of choice for paraganglioma is surgical resection; most tumors are benign and can be excised totally. Following surgical cure, annual biochemical testing assesses for metastatic disease, tumor recurrence or delayed appearance of multiple primary tumors.
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Ann. N. Y. Acad. Sci. · Aug 2006
ReviewAn overview of pheochromocytoma: history, current concepts, vagaries, and diagnostic challenges.
Tragically as many as 50% of pheochromocytomas are discovered at autopsy, mainly because the diagnosis of this neuroendocrine tumor was not considered. Missing the diagnosis almost invariably results in devastating cardiovascular complications or death. ⋯ Very rarely, familial pheochromocytomas may cause no hypertension, symptoms, or signs. But biochemical testing can always establish the presence or absence of a pheochromocytoma, and localization with magnetic resonance imaging, computed tomography, or 131I or 123I-MIBG is almost always possible.
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Ann. N. Y. Acad. Sci. · Jul 2006
ReviewEfficacy of hydrocortisone in preventing posttraumatic stress disorder following critical illness and major surgery.
Like other humans exposed to extreme trauma, patients who have been treated in an intensive care unit (ICU) often report traumatic memories. Extremely traumatic memories from the ICU in some of these patients are associated with the development of posttraumatic stress disorder (PTSD), which results in significant impairments in health-related quality of life (HRQL) outcomes of ICU therapy. ⋯ We performed several controlled trials in ICU patients with suspected CIRCI from septic shock or cardiac surgery, which indicated that the administration of glucocorticoids (stress doses of hydrocortisone) during ICU treatment results in a significant reduction of PTSD symptoms in long-term survivors as well as improvements in HRQL outcomes. Stress doses of hydrocortisone could help to surmount impaired glucocorticoid signaling from CIRCI during critical illness resulting in a downregulation of the stress response as well as inhibition of traumatic memory retrieval and facilitated extinction of aversive information.