The American journal of the medical sciences
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Historical Article
The continuing legacy of the Tuskegee Syphilis Study: considerations for clinical investigation.
The Tuskegee Study, an observational study of over 400 sharecroppers with untreated syphilis, was conducted by the U. S. ⋯ The study became the longest (1932-1972) nontherapeutic experiment on humans in the history of medicine, and has come to represent not only the exploitation of blacks in medical history, but the potential for exploitation of any population that may be vulnerable because of race, ethnicity, gender, disability, age or social class. It is important for physicians who will be caring for an increasingly diverse nation to understand the lasting implications of this study for their patients, but the effects of the Tuskegee Syphilis Study are demonstrated most strikingly by unsuccessful attempts at improving representation of minority patients in clinical trials.
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Editorial Comment Historical Article
Tuskegee: from science to conspiracy to metaphor.
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Review Case Reports
Metabolic acidosis with extreme elevation of anion gap: case report and literature review.
A patient with severe metabolic acidosis and an extremely elevated (57 mEq/L) serum anion gap (AG) is described, and the multiple factors that produced the patient's complex abnormalities are discussed in detail. These include renal failure, rhabdomyolysis, marked hyperphosphatemia, hemoconcentration, and an unidentified organic metabolic acidosis. A review of the literature indicates that the common thread observed in almost each instance of profoundly elevated AG values is a multifactorial pathogenesis that usually includes renal insufficiency, associated with a proven or likely cause of organic metabolic acidosis, or with exogenous phosphate intoxication.