Lyme carditis: An atypical cause of syncope.

With the rising prevalence of Lyme disease over the last 2 decades comes an increase in cases of Lyme carditis, a consequence of early disseminated infection. This case report focuses on a young man with a complicated case of Lyme carditis that required advanced therapy.

Granulocyte/macrophage-colony-stimulating factor autoantibodies and myeloid cell immune functions in healthy subjects.

High levels of granulocyte/macrophage-colony-stimulating factor (GM-CSF) autoantibodies are thought to cause pulmonary alveolar proteinosis (PAP), a rare syndrome characterized by myeloid dysfunction resulting in pulmonary surfactant accumulation and respiratory failure. Paradoxically, GM-CSF autoantibodies have been reported to occur rarely in healthy people and routinely in pharmaceutical intravenous immunoglobulin (IVIG) purified from serum pooled from healthy subjects. These findings suggest that either GM-CSF autoantibodies are normally present in healthy people at low levels that are difficult to detect or that serum pooled for IVIG purification may include asymptomatic persons with high levels of GM-CSF autoantibodies.

Resident perceptions of the impact of work hour limitations.

Background: Mandatory work hour limitations for residents began in July 2003. There has been little evaluation of the impact of the new limitations on Internal Medicine residency training.

Objective: To assess Internal Medicine residents' perceptions of the impact of work hour limitations on clinical experiences, patient care, resident education, and well-being, and their compliance with the limitations.

GM-CSF autoantibodies and neutrophil dysfunction in pulmonary alveolar proteinosis.

Background: Increased mortality from infection in patients with pulmonary alveolar proteinosis occurs in association with high levels of autoantibodies against granulocyte-macrophage colony-stimulating factor (GM-CSF). We tested the hypothesis that neutrophil functions are impaired in patients with pulmonary alveolar proteinosis and that GM-CSF autoantibodies cause the dysfunction.

Methods: We studied 12 subjects with pulmonary alveolar proteinosis, 61 healthy control subjects, and 12 control subjects with either cystic fibrosis or end-stage liver disease.

Residents' perceptions of the effects of work hour limitations at a large teaching hospital.

Purpose: To assess residents' perceptions of the impact of resident work hour restrictions on patient care, education, and job satisfaction.

Method: Four focus groups of internal medicine residents at Barnes-Jewish Hospital at the Washington University School of Medicine were conducted during February and March 2004. Twenty-six housestaff from the first three years of residency participated; all were volunteers.