Biomedical subjects
Publications and source records attributed to A F Posteraro.
Image-guided radiofrequency (RF) ablation is an emerging alternative therapy for treatment of cancer in patients who can not undergo surgical resection. We have performed RF ablation on patients to locally treat and palliate painful osseous metastatic disease for several years. We present an overview of various applications of RF ablation for treating osseous metastatic disease.
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BACKGROUND: Antiretroviral induced lactic acidosis and hepatic steatosis is a rare syndrome caused by inhibition of deoxyribonucleic acid (DNA) polymerase gamma by the Nucleoside Reverse Transcriptase Inhibitor (NRTI) class of antiretrovirals. There have been recent reports of NRTI-induced lactic acidosis treated with high-dose riboflavin. INTERVENTION AND RESULTS: We report a case of NRTI lactic acidosis reversed with high-dose riboflavin. Treatment with 50 mg of riboflavin per day was initiated on hospital day 10 after the patient developed respiratory failure. Arterial lactate decreased from 11.9 mmol/dL to 2.1 mmol/dL. Despite lactic acidosis reversal the patient developed acute respiratory distress syndrome (ARDS) and expired. Autopsy confirmed extensive hepatic steatosis with no infectious agents identified. CONCLUSION: Nucleoside Reverse Transcriptase Inhibitor lactic acidosis will likely become more prevalent with the trend toward aggressive antiretroviral treatment. This report provides additional support for the efficacy of riboflavin treatment to reverse this serious complication of antiretroviral therapy. Clinicians should have a high index of suspicion for lactic acidosis in a patient on NRTIs and the medications should be stopped at the earliest sign of toxicity.
Papillon-Lefèvre syndrome, also known as hyperkeratosis palmaris et plantaris or hyperkeratosis palmoplantaris, is a devastating dermatological disease characterized by a thickening of the stratum corneum of the skin on the palms of the hands and soles of the feet. In addition, some patients manifest excessive sweating (hyperhidrosis), the growth of fine body hair and the development of dirty-colored skin on the affected parts. Calcification of the falx cerebri of the dura mater, as well as other areas of the brain, have been reported. From a dental standpoint, young patients with Papillon-Lefèvre syndrome have juvenile or precocious periodontosis, with severe destruction of the alveolar bone in both deciduous and permanent dentitions. Bone loss has been observed as early as two years of age, with premature exfoliation of the teeth. There is usually gingival enlargement, gingival ulceration and the formation of deep periodontal pockets; but in some cases, there is no inflammatory reaction and only the periodontium of the secondary teeth is affected. This disease eludes all known forms of therapy and results in edentulousness after only a few years.
Papillon-Lefèvre syndrome is a particularly devastating disease that eludes all forms of therapy. It challenges researchers to find a connection between the dermatologic aspects of the disease and the severe periodontosis resulting in an edentulous patient in just a few years.
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Two long-term survivors with nodular sclerosing Hodgkin's disease were found to have adenocarcinoma of the breast sixteen and twenty years after limited field radiotherapy. Examination of the axillary nodes at radical mastectomy showed both metastatic adenocarcinoma and clinically inapparent Hodgkin's disease. The occurrence of persistent but clinically inactive Hodgkin's disease as well as the development of secondary malignancies in this disease has important clinical ramifications. Skin testing and in vitro lymphocyte transformation studies in these two patients were also done.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.