The American journal of the medical sciences
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Comparative Study Clinical Trial
Carbonic anhydrase I, II, and VI, blood plasma, erythrocyte and saliva zinc and copper increase after repetitive transcranial magnetic stimulation.
Repetitive transcranial magnetic stimulation (rTMS) has been used to treat symptoms from many disorders; biochemical changes occurred with this treatment. Preliminary studies with rTMS in patients with taste and smell dysfunction improved sensory function and increased salivary carbonic anhydrase (CA) VI and erythrocyte CA I, II. To obtain more information about these changes after rTMS, we measured changes in several CA enzymes, proteins, and trace metals in their blood plasma, erythrocytes, and saliva. ⋯ rTMS induced biochemical changes in specific enzymatic activities, trace metal concentrations, and induction of novel salivary proteins, with sensory improvement in patients with taste and smell dysfunction. Because patients with several neurologic disorders exhibit taste and smell dysfunction, including Parkinson disease, Alzheimer disease, and multiple sclerosis, and because rTMS improved their clinical symptoms, the biochemical changes we observed may be relevant not only in our patients with taste and smell dysfunction but also in patients with neurologic disorders with these sensory abnormalities.
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Human immunodeficiency virus (HIV) infection among women in the southern United States is on the rise. This study examined sociodemographic profile and behavioral risk factors for HIV and sexually transmitted infections and assessed factors associated with HIV-1 viral control in a cohort of 280 HIV-infected Alabama women aged 17 to 66 years. ⋯ Poorer HIV-1 viral control in black women at enrollment may indicate suboptimal access to HIV testing, delays in receipt of medical care after HIV-1 diagnosis, and/or some underlying biologic or social race-related influence.
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Non-Hodgkin lymphoma can produce a number of metabolic derangements including, in rare instances, lactic acidosis. This case illustrates an example of significant lactic acidosis and hypoglycemia secondary to diffuse large B-cell lymphoma with hepatic involvement in a patient with hepatitis C infection. A review of the literature on the occurrence of lactic acidosis and lymphoma, including the risk factors for its development and the resultant prognosis, are discussed. In addition, the evidence linking hepatitis C infection and lymphoma are reviewed.
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Case Reports
Generalized tetanus despite prior vaccination and a protective level of anti-tetanus antibodies.
Because of the success of widespread vaccination, tetanus rarely occurs in developed countries such as the United States. Vaccination, however, is not entirely protective even if patients develop an adequate antibody response. We discuss a case of generalized tetanus in an individual with both a history of prior vaccination and a measurable level of anti-tetanus antibodies at the time of presentation. We speculate that the patient's preexisting antibodies may have moderated his course of illness.