In pursuit of doctor Whipple's nemesis.
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Antibodies, Bacterial↗
Biomedical subjects
M C Flemmer
Publications and source records attributed to M C Flemmer.
Evidence-based therapy for type 2 diabetes. The best and worst of times.
Type 2 diabetes, which is increasing in prevalence, is a multifaceted disease that presents a challenge to the primary care physician. In this article, Drs Flemmer and Vinik review the significant findings of several important clinical trials and present a method of comprehensive staged management to improve the quality of patient care.
Aged↗
Toward a new understanding of Whipple's disease.
Since the first successful antibiotic treatment of Whipple's disease in 1952, many breakthroughs have occurred in the diagnosis and treatment of this disease that was once thought fatal. This article provides a historic overview and highlights recent encouraging discoveries regarding this underdiagnosed disease, including the use of polymerase chain reaction techniques and the recent cultivation of the Tropheryma whippelii bacterium.
Actinobacteria↗
Deep venous thrombosis: prediction by D-dimer?
The utility of D-dimer as an inexpensive, noninvasive method of diagnosing deep venous thrombosis (DVT) is debated. We sought to determine whether a qualitative D-dimer assay would have a high correlation with DVT in 65 hospitalized patients who were randomly referred for diagnosis of DVT by venous duplex and duplex Doppler ultrasonography. Patients were excluded from the study if they had any inflammatory, infectious, or malignant condition associated with elevation of D-dimer. The mean level of D-dimer in patients with DVT (16 of 65 patients) was 5,141 ng/mL, compared with 3,024 ng/mL in those without DVT, but there was considerable overlap between the two groups. No patients with a D-dimer level < 2,000 ng/mL had DVT. We conclude that the qualitative D-dimer assay is an excellent exclusionary test for DVT at levels less than 2,000 ng/mL. Limitations of the D-dimer assay and cost-effective issues are discussed.
Adolescent↗