Mayo Clinic proceedings
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Although the cause of multiple sclerosis (MS) is unknown, epidemiologic studies support both genetic and environmental components of susceptibility. Reports of clusters, small "epidemics," geographic variation in prevalence, and alteration of MS susceptibility by migration support an environmental factor (or factors). ⋯ Findings from epidemiologic studies are most consistent with an environmental influence occurring on a background of genetic susceptibility as the cause of MS. Currently, there is little evidence for a single or unique environmental cause of MS.
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Mayo Clinic proceedings · Aug 1997
Review Case ReportsHypercalcemia in a patient with hypoparathyroidism and Nocardia asteroides infection: a novel observation.
Hypercalcemia is associated with numerous chronic granulomatous processes and chronic infections. Increased production of 1,25-dihydroxyvitamin D by activated macrophages has been shown to be the cause in most cases. In this article, we describe a case of hypercalcemia related to infection with Nocardia asteroides. ⋯ After successful treatment of the Nocardia infection, the patient required supplemental calcium and vitamin D. Her hypercalcemia was temporally related to the duration of the N. asteroides infection. We believe this is the first reported case of hypercalcemia associated with N. asteroides infection.
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Mayo Clinic proceedings · Jul 1997
Randomized Controlled Trial Clinical TrialProphylactic intravenous administration of caffeine and recovery after ambulatory surgical procedures.
To determine whether prophylactic intravenous administration of caffeine, to daily caffeine users, decreases the frequency of postoperative headache and shortens recovery time. ⋯ We conclude that prophylactic intravenous administration of caffeine was beneficial for those patients at risk for symptoms of caffeine withdrawal. For patients who consume caffeinated beverages on a daily basis, we recommend prophylactic administration of caffeine on the day of an ambulatory surgical procedure and anesthesia.
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Mayo Clinic proceedings · Jul 1997
Review Case ReportsEosinophilic myocarditis manifesting as myocardial infarction: early diagnosis and successful treatment.
To report a case of eosinophilic myocarditis with remarkable initial clinical manifestations and outcome. ⋯ This unusual clinical picture and outcome demonstrate that eosinophilic myocarditis may simulate acute myocardial infarction and should be considered in patients with a history of allergies or acute left ventricular dysfunction, even in the absence of pronounced eosinophilia in the peripheral blood. With appropriate medical therapy, recovery for these patients can be complete.
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Mayo Clinic proceedings · Jul 1997
Case ReportsOrganizing diffuse alveolar damage associated with progressive systemic sclerosis.
Diffuse alveolar damage (DAD) is a relatively nonspecific pattern of acute lung injury that can be observed in a wide range of clinical circumstances. DAD has often been recognized in association with various connective tissue diseases; however, to our knowledge, it has not been previously reported in the setting of progressive systemic sclerosis. ⋯ Open-lung biopsy specimens from both patients showed a histologic pattern of DAD with no identifiable cause other than their progressive systemic sclerosis. Our results suggest that DAD should be added to the list of pleuropulmonary complications of progressive systemic sclerosis.