Drug Induced Churg Strauss Syndrome
Drug induced Churg Strauss Syndrome can be triggered by Leukotriene antagonists like Monteleukast.
Reference: http://thorax.bmj.com/content/63/10/883.full

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Drug Induced Churg Strauss Syndrome
Drug induced Churg Strauss Syndrome can be triggered by Leukotriene antagonists like Monteleukast.
Reference: http://thorax.bmj.com/content/63/10/883.full
Propellants for MDIs
Hydrofluoroalkanes are now replacing chlorofluorocarbons as propellants for drugs delivered using Metered Dose Inhalers. Not only are they more environmentally safe, due to their smaller particle size, only half the volume needs to be sprayed in order to deliver the required amount of drug.
Wegener's Granulomatosis: Buzzwords
The combination of pulmonary and renal involvement combined with a history of chronic sinusitis (or epistaxis) almost always points towards a diagnosis of Wegener's granulomatosis.
P.S.: Incredibly rare in the real world.
Primary Biliary Cirrhosis
Primary biliary cirrhosis - the M rule
IgM
anti-Mitochondrial antibodies, M2 subtype
Middle aged females
Need to remember for stubs, Itching in a middle aged female.
Exactly what I am looking for, here///
That's some brilliant note-making right there!
Premenopausal bone health assessment
The World Health Organization criteria for classification of bone mineral density (BMD) cannot be applied to premenopausal women because the relationship between BMD and fracture risk is not the same as in postmenopausal women. Approximately 2.5% of premenopausal women have BMD that is more than 2.0 standard deviations below the mean BMD of an age-, gender-, and ethnicity-matched reference population. Most premenopausal women with low BMD have low peak bone mass and low 5- to 10-year probability of fracture. The management of these patients involves nonpharmacologic lifestyle measures and reassurances that fracture risk is low. A minority of premenopausal women with low BMD have significant elevation of fracture risk, usually a result of contributing diseases, conditions, or medications that may be identified and treated. Premenopausal women with fractures are at increased risk for postmenopausal osteoporosis and fractures later in life.
Lewiecki EM. Premenopausal bone health assessment. Curr Rheumatol Rep. 2005 Mar;7(1):46-52. Review. PubMed PMID: 15760580.
The American College of Rheumatology 1990 criteria for the classification of polyarteritis nodosa
Abstract
Criteria for the classification of polyarteritis nodosa were developed by comparing 118 patients who had this disease with 689 control patients who had other forms of vasculitis. For the traditional format classification, 10 criteria were selected: weight loss greater than or equal to 4 kg, livedo reticularis, testicular pain or tenderness, myalgias, mononeuropathy or polyneuropathy, diastolic blood pressure greater than 90 mm Hg, elevated blood urea nitrogen or serum creatinine levels, presence of hepatitis B reactants in serum, arteriographic abnormality, and presence of granulocyte or mixed leukocyte infiltrate in an arterial wall on biopsy. The presence of 3 or more of these 10 criteria was associated with a sensitivity of 82.2% and specificity of 86.6%. A classification tree was also constructed, with 6 criteria being selected. Three of these, angiographic abnormality, biopsy-proven granulocyte or mixed leukocyte infiltrate in arterial wall, and neuropathy, were criteria used in the traditional format. The other 3 criteria used in the tree format included the patient's sex, weight loss greater than 6.5 kg, and elevated serum aspartate aminotransferase or alanine aminotransferase levels above the range of normal. The classification tree yielded a sensitivity of 87.3% and a specificity of 89.3%.
Reference:
Lightfoot RW Jr, Michel BA, Bloch DA, Hunder GG, Zvaifler NJ, McShane DJ, Arend WP, Calabrese LH, Leavitt RY, Lie JT, et al. The American College of Rheumatology 1990 criteria for the classification of polyarteritis nodosa. Arthritis Rheum. 1990 Aug;33(8):1088-93. PubMed PMID: 1975174.
Guerilla Open Access Manifesto
Information is power. But like all power, there are those who want to keep it for themselves. The world’s entire scientific and cultural heritage, published over centuries in books and journals, is increasingly being digitized and locked up by a handful of private corporations. Want to read the papers featuring the most famous results of the sciences? You’ll need to send enormous amounts to publishers like Reed Elsevier.
There are those struggling to change this. The Open Access Movement has fought valiantly to ensure that scientists do not sign their copyrights away but instead ensure their work is published on the Internet, under terms that allow anyone to access it. But even under the best scenarios, their work will only apply to things published in the future. Everything up until now will have been lost.
That is too high a price to pay. Forcing academics to pay money to read the work of their colleagues? Scanning entire libraries but only allowing the folks at Google to read them? Providing scientific articles to those at elite universities in the First World, but not to children in the Global South? It’s outrageous and unacceptable.
"I agree," many say, "but what can we do? The companies hold the copyrights, they make enormous amounts of money by charging for access, and it’s perfectly legal — there’s nothing we can do to stop them." But there is something we can, something that’s already being done: we can fight back.
Those with access to these resources — students, librarians, scientists — you have been given a privilege. You get to feed at this banquet of knowledge while the rest of the world is locked out. But you need not — indeed, morally, you cannot — keep this privilege for yourselves. You have a duty to share it with the world. And you have: trading passwords with colleagues, filling download requests for friends.
Meanwhile, those who have been locked out are not standing idly by. You have been sneaking through holes and climbing over fences, liberating the information locked up by the publishers and sharing them with your friends.
But all of this action goes on in the dark, hidden underground. It’s called stealing or piracy, as if sharing a wealth of knowledge were the moral equivalent of plundering a ship and murdering its crew. But sharing isn’t immoral — it’s a moral imperative. Only those blinded by greed would refuse to let a friend make a copy.
Large corporations, of course, are blinded by greed. The laws under which they operate require it — their shareholders would revolt at anything less. And the politicians they have bought off back them, passing laws giving them the exclusive power to decide who can make copies.
There is no justice in following unjust laws. It’s time to come into the light and, in the grand tradition of civil disobedience, declare our opposition to this private theft of public culture.
We need to take information, wherever it is stored, make our copies and share them with the world. We need to take stuff that’s out of copyright and add it to the archive. We need to buy secret databases and put them on the Web. We need to download scientific journals and upload them to file sharing networks. We need to fight for Guerilla Open Access.
With enough of us, around the world, we’ll not just send a strong message opposing the privatization of knowledge — we’ll make it a thing of the past. Will you join us?
Aaron Swartz
July 2008, Eremo, Italy
(Some will say this is not the time. I disagree. This is the time when every mixed emotion needs to find voice.)
Since his arresting the early morning of January 11, 2011 — two years to the day before Aaron Swartz ended his life — I have known more about the events that began this...
Reiter's syndrome and reactive arthritis
Abstract
Reactive arthritis is an infection-induced systemic illness characterized by an inflammatory synovitis from which no viable microorganisms can be cultured. The paradigm of reactive arthritis is an infectious trigger that occurs in a genetically susceptible individual in whom the immune system continues to be stimulated or "react" to an ongoing or cleared infection, resulting in intermittent exacerbations of a variety of immune-mediated signs and symptoms. Although the terms Reiter's syndrome and reactive arthritis are sometimes used interchangeably, Reiter's syndrome is actually the complete clinical triad of urethritis, conjunctivitis, and arthritis. Some patients will never fulfill all three components of Reiter's triad, however, and although the term incomplete Reiter's syndrome is often used in such cases, the authors believe that the term reactive arthritis should be used, as it is less confusing and is inclusive of any extra-articular manifestations.
Parker CT, Thomas D. Reiter's syndrome and reactive arthritis. J Am Osteopath Assoc. 2000 Feb;100(2):101-4. Review. PubMed PMID: 10732393.
Reiter's syndrome: the classic triad and more
Abstract:
Reiter's syndrome, also known as reactive arthritis, is the classic triad of conjunctivitis, urethritis, and arthritis occurring after an infection, particularly those in the urogenital or gastrointestinal tract. Dermatologic manifestations are common, including keratoderma blennorrhagicum, circinate balanitis, ulcerative vulvitis, nail changes, and oral lesions. Epidemiologically, the disease is more common in men, although cases have also been reported in children and women. The pathophysiology has yet to be elucidated, although infectious and immune factors are likely involved. Clinical presentation, severity, and prognosis vary widely. Treatment is difficult, especially in HIV-positive patients. Prognosis is variable; 15% to 20% of patients may develop severe chronic sequelae.
Wu IB, Schwartz RA. Reiter's syndrome: the classic triad and more. J Am Acad Dermatol. 2008 Jul;59(1):113-21. doi: 10.1016/j.jaad.2008.02.047. Epub 2008 Apr 23. Review. PubMed PMID: 18436339.
Procrastination
When the exam comes close, I start to find reasons galore for procrastinating stuff. The MRCP exam is in less than 4 days' time and I spent all day today doing bank work and watching cricket on the internet. And now I am on Tumblr.
#fml
Time to get back to the books.
Tips for Step 1:
Tried and Tested. I just took my Step 1 Medical Board exam a week ago, so the entire experience is pretty fresh in my head. Because I am kind, I thought I would share some tips on how to get a 99 because …..then you will owe me. First, take off your underwear, fold...
This is undoubtedly THE MOST AWESOME set of USMLE instructions I have ever read. Must read. Must follow. I think I shall take up using make-up just to be able to follow these advice.
In 1962, a new English rock-and-roll band named The Beatles signed a recording contract with Electric & Music Industries (EMI). The Beatles were so financially successful that EMI was able to fund research and development in other divisions of the company; in particular, the work of an enterprising young engineer named Godfrey Hounsfield. His groundbreaking work in x-ray imaging produced the first commercially available head-only CT scanner, and a Nobel Prize.
What is scombroid poisoning?
Scombroid poisoning is a type of food intoxication caused by the consumption of scombroid and scombroid-like marine fish species that have begun to spoil with the growth of particular types of food bacteria. Fish most commonly involved are members of the Scombridae family (tunas and mackerels), and a few non-scombroid relatives (bluefish, dolphin or mahi-mahi, and amberjacks). A few additional species have been implicated, but they are of less concern relative to popular fish consumption. The suspect toxin is an elevated level of histamine generated by bacterial degradation of substances in the muscle protein. This natural spoilage process is thought to release additional by-products which potentiate the toxic effect. The potential toxins are not destroyed by freezing, cooking, smoking, curing or canning.