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Biomedical subjects

M B Jacobs

Publications and source records attributed to M B Jacobs.

At least 19 recordsLinked to original sources

Orbital tuberculoma masquerading as an orbital malignancy.

BACKGROUND: Orbital tuberculosis is exceedingly rare in areas where tuberculosis is non-endemic. A case of childhood orbital tuberculosis is reported, which the authors believe to be the first reported case of orbital tuberculosis in the Australasian region. METHODS/RESULTS: The patient a 6-year-old boy presented with proptosis and was initially mistaken to have an orbital malignancy. Treatment with antituberculous drugs resulted in resolution of the condition. CONCLUSION: This case served as a timely reminder of the need to keep awareness of the extrapulmonary manifestations of tuberculosis alive even in developed countries. A high index of suspicion for this eminently treatable disease in the appropriate clinical situation is particularly important when migrant communities from high-prevalence areas are involved.

Antitubercular Agents

Quartz crystal microbalance detection of Vibrio cholerae O139 serotype.

A piezoelectric (PZ) quartz crystal microbalance (QCM) biosensor for the rapid detection of Vibrio cholerae serotype O139 has been developed. The antibody to this serotype was immobilized on the gold transducer surface of a 10 MHz AT cut PZ crystal. Solutions containing known antigen concentrations were then incubated for 1 h on the antibody-bound transducer. The biosensor was able to detect 10(5) cells per ml of O139 versus a background of O1 (Ogawa) serotype.

Antigen-Antibody Reactions

Enhancing the training of internal medicine residents at Stanford by establishing a model group practice and raising its clinical educators' status.

The education of residents is shifting to the ambulatory care setting. In addition, there is a growing trend toward managed care and increasing competition for patients to be served by "real-world" practices. The authors describe the formation and operation of a program that was established in 1981 at the Stanford University School of Medicine to respond to these changes: the Stanford Medical Group (SMG), a model group practice in internal medicine that operates within the academic medical center. Because raising the status of the clinician-educator faculty was a critical issue for the SMG, the authors also describe the Medical Center Professoriate, a separate faculty track created in 1989 to recognize and reward Stanford's clinician-educators. The authors conclude that the SMG has succeeded in its training and patient care goals and has weathered the great changes in the health care environment that have taken place since 1981. They also report that the separate faculty track is serving its purpose well. They hope that educators and program directors at other academic medical centers may find the descriptions of the SMG and the professoriate useful in solving similar problems.

California

Gynecomastia. A bothersome but readily treatable problem.

Although breast enlargement in boys and men can cause both psychological and physical distress, the disorder is rarely serious and is readily treatable. Several factors can lead to the estrogenic excess that causes growth of breast tissue. Dr Jacobs describes a patient with gynecomastia related to cirrhosis of the liver who responded promptly to a brief course of tamoxifen citrate therapy.

Adult

Treating the progressive stages of Parkinson's disease.

Parkinson's disease affects thousands of Americans, men and women equally and apparently with little regard to race. Its diagnosis depends largely on repeated clinical observations of representative signs, such as resting tremor, rigidity, bradykinesia, and gait disturbances. Patients progress through stages: Early disease involves only one limb or side and confers minimal disability, but advanced disease restricts patients to full care. Treatment is chosen on the basis of disease stage and patient response. Combination carbidopa-levodopa (Sinemet) is appropriate for any significant degree of disability, and other antiparkinsonian drugs and anticholinergic agents may be used as adjuncts. Electroconvulsive therapy, use of selegiline hydrochloride (Eldepryl), and surgery are still undergoing investigation but may hold promise.

Amantadine

Iatrogenic disease and the primary care physician.

Primary care physicians need to be aware of iatrogenic disease and its causes. Adverse drug reactions, including drug-drug interactions, and certain diagnostic procedures may lead to iatrogenic complications. Hospitalized patients, especially the elderly, face increased risks of such complications. Physicians who are aware of common adverse reactions to drugs, drug combinations, and medical procedures may be able to help patients avoid unnecessary distress and morbidity.

Aged

Local subcutaneous atrophy after corticosteroid injection.

Subcutaneous atrophy developed in a 36-year-old woman at the site of a triamcinolone acetonide (Kenalog) injection for subdeltoid bursitis. Occurrence of local atrophy after corticosteroid injection is relatively frequent yet unappreciated. It is more common in young women and girls who are given preparations with a lesser degree of water solubility. Although the condition is often reversible, instances of long-term disfigurement are well documented. This complication of a useful treatment method can be avoided by following a set of precautions for local injection of corticosteroids.

Adrenal Cortex Hormones