J Natl Med Assoc
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Our objective is to present a case of symptomatic lead toxicity (plumbism) with abdominal colic and hemolytic anemia following a gunshot wound. It is a retrospective case report and the setting is in a teaching hospital in south central Los Angeles. The case report is that of a patient who presented with abdominal pain, generalized weakness, and hypertension following multiple gunshot wounds, 15 years previously. ⋯ Because of a recurrent rise in the blood lead levels, the patient was again treated with Succimer and underwent surgery to remove two bullet fragments from the face. We conclude that lead toxicity should be ruled out in patients presenting with abdominal cramps and a history of a gunshot wound. Prompt therapy--including environmental intervention and chelation therapy--is mandatory, and surgical intervention may be necessary.
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Over the last decade, the role of nonoperative management has revolutionized the specialty of trauma. However, this management paradigm has generated substantial controversy in several areas, including penetrating neck and abdominal trauma. ⋯ To prevent the pendulum from swinging too far, there should always exist a high index of suspicion to possible complications associated with the nonoperative approach. Also, the specific choice of management should be institution- and resource dependent.
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Menstrual characteristics may serve as surrogate measures of endogenous estrogen and may be related to breast cancer risk. No previous studies have systematically investigated menstrual factors in relation to the disease in African-American women. This case-control study is aimed to assess the relationship between menstrual factors and breast cancer in African-American women. ⋯ Results by menopausal status revealed an inverse relationship was shown only in postmenopausal women. No significant associations were observed for other menstrual factors. Findings suggest that cycle length has an inverse association with breast cancer in African-American women that may primarily exist for post-menopausal tumors.
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To assess the cardiac disturbances in African-American patients treated with paclitaxel. ⋯ Paclitaxel was not associated with significant symptomatic cardiac disturbances during infusion in our study population. Caution should be exercised in patients with underlying cardiac disease and risk factors for coronary artery disease. However more prospective studies with closer follow-up during paclitaxel infusion are needed to assess its cardiotoxicities.