Alcohol Abuse and Alcoholism: A New Era in an Old Campaign

1975 ◽  
Vol 5 (3) ◽  
pp. 201-206 ◽  
Author(s):  
Morris E. Chafetz ◽  
Marc Hertzman
Keyword(s):  
Alcohol Abuse ◽  
Adequate Treatment ◽  
New Era ◽  
Rehabilitation Act ◽  
Rule Out

On May 14, 1974 the President signed into law the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act Amendments of 1974. This legislation renews and extends the Federal commitment to the fight against alcoholism. This article reviews the major provisions of the Act and suggests how it can be implemented. The Amendments incorporate features of the Model Uniform Act with an incentive for their adoption by the States, an historic first. The essential features include decriminalizing the drunkenness offense and assuring adequate treatment for all alcoholic people. The Amendments also strongly rule out discrimination against alcoholic people and protect the confidentiality of records.

TSH-secreting pituitary adenoma: late diagnosis and effectiveness of therapy

2017 ◽  
Vol 63 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Galina G. Petrik ◽  
Elena D. Kosmacheva ◽  
Ulya I. Polyakova ◽  
Svetlana V. Butaeva ◽  
Ludmila Ya. Rozhinskaya ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Clinical Manifestations ◽  
Thyroid Status ◽  
First Line ◽  
Free T4 ◽  
Adequate Treatment ◽  
First Line Therapy ◽  
Thyroid Hormone Resistance Syndrome ◽  
Rule Out

The modern therapeutic and diagnostic algorithms allow timely detection of pituitary disorder to prescribe adequate treatment. Meanwhile, when interpreting the thyroid status, physicians need to take into account the extremely rare but the actually existing possibility of central thyrotoxicosis. The worldwide practice shows that diagnosis of this condition is rather challenging. We report a clinical case of a TSH-secreting pituitary adenoma in a 47-year-old female who received a long-term thyrostatic therapy for thyrotoxicosis. The patient was diagnosed with Graves’ disease; however, thyrotoxicosis was actually caused by TSH-oma. The key laboratory signs of central thyrotoxicosis included the combination of episodes of normal or elevated TSH level with the high or normal free T4 level. MRI showed a pituitary macroadenoma. The clinical manifestations of thyrotoxicosis made it possible to rule out the thyroid hormone resistance syndrome. The attempted therapy with octreotide eliminated the clinical and laboratory signs of thyrotoxicosis, so the conservative method was selected as first-line therapy. The features of clinical and laboratory signs, as well as the principles of differential diagnosis and modern methods for treating TSH-secreting pituitary adenomas are discussed.

Unbiased estimation of particle number and sizes using the new stereological tools: the disector, the fractionator, the selector, and the nucleator — or just point-sampled intercepts

1988 ◽  
Vol 46 ◽  
pp. 428-429
Author(s):  
H.J.G. Gundersen
Keyword(s):  
Particle Number ◽  
Small Distance ◽  
Parallel Plane ◽  
Unbiased Estimation ◽  
Severe Problem ◽  
New Era ◽  
Size And Shape ◽  
Distinct Property ◽  
Sectioned Tissue

Previously, all stereological estimation of particle number and sizes were based on models and notoriously gave biased results, were very inefficient to use and difficult to justify. For all references to old methods and a direct comparison with unbiased methods see recent reviews.The publication in 1984 of the DISECTOR, the first unbiased stereological probe for sampling and counting 3—D objects irrespective of their size and shape, signalled the new era in stereology — and give rise to a number of remarkably simple and efficient techniques based on its distinct property: It is the only known way to obtain an unbiased sample of 3-D objects (cells, organelles, etc). The principle is simple: within a 2-D unbiased frame count or sample only cells which are not hit by a parallel plane at a known, small distance h.The area of the frame and h must be known, which might sometimes in itself be a problem, albeit usually a small one. A more severe problem may arise because these constants are known at the scale of the fixed, embedded and sectioned tissue which is often shrunken considerably.

Drug Induced Changes in Cell Organelles

1968 ◽  
Vol 26 ◽  
pp. 110-111
Author(s):  
Sarah A. Luse
Keyword(s):  
Clinical Medicine ◽  
Cell Organelles ◽  
Riboflavin Deficiency ◽  
Drug Induced ◽  
New Era ◽  
Health And Disease ◽  
In The Beginning ◽  
Cellular Pathology ◽  
Induced Changes ◽  
The Impact

In the mid-nineteenth century Virchow revolutionized pathology by introduction of the concept of “cellular pathology”. Today, a century later, this term has increasing significance in health and disease. We now are in the beginning of a new era in pathology, one which might well be termed “organelle pathology” or “subcellular pathology”. The impact of lysosomal diseases on clinical medicine exemplifies this role of pathology of organelles in elucidation of disease today.Another aspect of cell organelles of prime importance is their pathologic alteration by drugs, toxins, hormones and malnutrition. The sensitivity of cell organelles to minute alterations in their environment offers an accurate evaluation of the site of action of drugs in the study of both function and toxicity. Examples of mitochondrial lesions include the effect of DDD on the adrenal cortex, riboflavin deficiency on liver cells, elevated blood ammonia on the neuron and some 8-aminoquinolines on myocardium.

A rapid method for the direct identification of paramyxovirus in canine CSF by ultracentrifugation and negative staining as a rule out for distemper

1990 ◽  
Vol 48 (3) ◽  
pp. 594-595
Author(s):  
W.L. Steffens ◽  
M.B. Ard ◽  
C.E. Greene ◽  
A. Jaggy
Keyword(s):  
Subacute Sclerosing Panencephalitis ◽  
Clinical Signs ◽  
Viral Disease ◽  
Etiologic Agent ◽  
Mucosal Inflammation ◽  
Worldwide Distribution ◽  
Negative Stain ◽  
Viral Particles ◽  
Systemic Manifestations ◽  
Rule Out

Canine distemper is a multisystemic contagious viral disease having a worldwide distribution, a high mortality rate, and significant central neurologic system (CNS) complications. In its systemic manifestations, it is often presumptively diagnosed on the basis of clinical signs and history. Few definitive antemortem diagnostic tests exist, and most are limited to the detection of viral antigen by immunofluorescence techniques on tissues or cytologic specimens or high immunoglobulin levels in CSF (cerebrospinal fluid). Diagnosis of CNS distemper is often unreliable due to the relatively low cell count in CSF (<50 cells/μl) and the binding of blocking immunoglobulins in CSF to cell surfaces. A more reliable and definitive test might be possible utilizing direct morphologic detection of the etiologic agent. Distemper is the canine equivalent of human measles, in that both involve a closely related member of the Paramyxoviridae, both produce mucosal inflammation, and may produce CNS complications. In humans, diagnosis of measles-induced subacute sclerosing panencephalitis is through negative stain identification of whole or incomplete viral particles in patient CSF.

An evaluation of two primary care interventions for alcohol abuse among Mexican-American patients

Addiction ◽  
1997 ◽  
Vol 92 (12) ◽  
pp. 1705-1716 ◽  
Author(s):  
Sandra K. Burge ◽  
Nancy Amodei ◽  
Bernice Elkin ◽  
Selina Catala ◽  
Sylvia Rodriguez Andrew ◽  
...  
Keyword(s):  
Primary Care ◽  
Alcohol Abuse ◽  
Mexican American

Impairment Questions and Answers

1999 ◽  
Vol 4 (4) ◽  
pp. 4-4
Keyword(s):  
Symptom Validity ◽  
Validity Testing ◽  
Symptom Validity Testing ◽  
Negative Results ◽  
Tunnel Vision ◽  
Questions And Answers ◽  
Blurry Vision ◽  
Fatigue Evaluation ◽  
Choice Testing ◽  
Rule Out

Abstract Symptom validity testing, also known as forced-choice testing, is a way to assess the validity of sensory and memory deficits, including tactile anesthesias, paresthesias, blindness, color blindness, tunnel vision, blurry vision, and deafness—the common feature of which is a claimed inability to perceive or remember a sensory signal. Symptom validity testing comprises two elements: A specific ability is assessed by presenting a large number of items in a multiple-choice format, and then the examinee's performance is compared with the statistical likelihood of success based on chance alone. Scoring below a norm can be explained in many different ways (eg, fatigue, evaluation anxiety, limited intelligence, and so on), but scoring below the probabilities of chance alone most likely indicates deliberate deception. The positive predictive value of the symptom validity technique likely is quite high because there is no alternative explanation to deliberate distortion when performance is below the probability of chance. The sensitivity of this technique is not likely to be good because, as with a thermometer, positive findings indicate that a problem is present, but negative results do not rule out a problem. Although a compelling conclusion is that the examinee who scores below probabilities is deliberately motivated to perform poorly, malingering must be concluded from the total clinical context.

Case Exercise: Toxic Exposure-Related Illness: Causation, Diagnosis, and Permanent Impairment

2007 ◽  
Vol 12 (2) ◽  
pp. 4-8
Author(s):  
Frederick Fung
Keyword(s):  
Concentration Level ◽  
Treatment Plan ◽  
Toxic Exposure ◽  
Dose Response Relationship ◽  
Specialty Board ◽  
History Of ◽  
Subjective Complaints ◽  
Based Medicine ◽  
Illness Causation ◽  
Rule Out

Abstract A diagnosis of toxic-related injury/illness requires a consideration of the illness related to the toxic exposure, including diagnosis, causation, and permanent impairment; these are best performed by a physician who is certified by a specialty board certified by the American Board of Preventive Medicine. The patient must have a history of symptoms consistent with the exposure and disease at issue. In order to diagnose the presence of a specific disease, the examiner must find subjective complaints that are consistent with the objective findings, and both the subjective complaints and objective findings must be consistent with the disease that is postulated. Exposure to a specific potentially causative agent at a defined concentration level must be documented and must be sufficient to induce a particular pathology in order to establish a diagnosis. Differential diagnoses must be entertained in order to rule out other potential causes, including psychological etiology. Furthermore, the identified exposure at the defined concentration level must be capable of causing the diagnosis being postulated before the examiner can conclude that there has been a cause-and-effect relationship between the exposure and the disease (dose-response relationship). The evaluator's opinion should make biological and epidemiological sense. The treatment plan and prognosis should be consistent with evidence-based medicine, and the rating of impairment must be based on objective findings in involved systems.

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