A training course for the Israeli phase I written board examination in internal medicine increases the success rate of foreign graduate physicians.

BACKGROUND: Foreign graduate residents in internal medicine perform poorly on the Israeli phase I written board examination as compared to local graduates from Israeli medical schools. The aim of this study was to determine the effect of a preparatory course, aimed at foreign graduates, on their success rate in the Israeli phase I written board examination in internal medicine. METHODS: The preparatory course consisted of seven 4-h weekly meetings that took place 3 months before the board examination.

Waldenström's macroglobulinemia associated with AA amyloidosis.

It is widely accepted that amyloidosis in Waldenström's macroglobulinemia (WM) is exclusively due to amyloid light-chain deposition. However, only a small number of previous reports have actually characterized the type of amyloid in WM. We now report the third patient with WM and amyloid A protein (AA) amyloidosis.

The incidence of pseudothrombocytopenia in automatic blood analyzers.

Unlabelled: The aim of the present work was to undertake an assessment of the incidence of pseudothrombocytopenia (PTCP) in patients referred for evaluation of thrombocytopenia in an outpatient hematology clinic.

Methods: Prospective assessment of 60 consecutive cases with platelet count < 100 x 10(9)/l in a hematology clinic during a 2-year period.

Results: PTCP was the second most common cause for low platelet count, with an incidence of 17%.

Severe tumor lysis syndrome following splenic irradiation.

A 72-year-old man suffering from non-Hodgkin's lymphoma is described. After failing to respond to chlorambucil-prednisone regimen for three months, he was treated by splenic irradiation (total dose 500 cGY) in 10 consecutive daily doses. Two days after the last irradiation, the patient developed acute tumor lysis syndrome (TLS) with extreme blood levels of uric acid (33.

Adult onset Still's disease associated with Epstein-Barr virus infection in a 66-year-old woman.

Adult onset Still's disease (AOSD) is a distinct clinical entity which affects predominantly young adults aged 16-35 years. Onset in elderly individuals is exceptional. Several reports have suggested a viral trigger in the pathogenesis of this disease.

Primary biliary cirrhosis and systemic lupus erythematosus. A rare association.

Although the co-existence between primary biliary cirrhosis (PBC) and one or more autoimmune diseases is very common, the association with systemic lupus erythematosus (SLE) is believed to be rare. We describe a 37-year-old woman with PBC who developed clinical and serological features of SLE 4 years later. The anti-mitochondrial antibody (AMA) titers fell to undetectable levels during the acute phase of the SLE.

Recombinant human erythropoietin in the treatment of multiple myeloma-associated anemia.

Unlabelled: Multiple myeloma (MM) is commonly associated with anemia. Several causes have been implicated but inadequate erythropoietin (Epo) production appears to be important. This single-institute open-label, non-comparative clinical trial was undertaken in order to evaluate serum Epo levels in patients with MM and to study the efficacy and toxicity of recombinant human Epo (rHuEpo) in the treatment of MM-associated anemia.

Recombinant human erythropoietin in the treatment of myelodysplastic syndromes--response patterns.

Different response patterns to recombinant human erythropoietin (rHuEpo) administration to anemic patients with myelodysplastic syndromes (MDS) are described. The biology of rHuEpo effect on erythropoiesis in patients with MDS has not been elucidated. However, until more biological information is obtained, it could be prudent to consider these response patterns as guidelines in the treatment of MDS.

Secondary myelodysplastic syndrome in multiple myeloma--a study of nine patients with an attempt to detect myeloma patients at risk.

Over a follow-up period of ten years, nine of our 100 patients with multiple myeloma (MM), developed myelodysplastic syndrome (MDS, preleukaemia). MDS occurred 19-156 (median 35) months from the diagnosis of MM. Six patients presented with pancytopenia and no patients had active MM at the time of MDS diagnosis.

[Initial treatment of urinary tract infection with augmentin].

Urinary tract infections have been treated empirically according to the development of bacterial resistance, and semisynthetic penicillins have been out of favor. Only 12% (4/34) of our patients treated with augmentin failed to respond, compared with 20% of those on a combination of gentamicin and ampicillin.

Uveitis, a presenting symptom of malignant histiocytosis.

A patient presenting initially with bilateral uveitis was admitted 6 weeks later to the Department of Internal Medicine "A" because of fever, chills, and pancytopenia. Physical examination, ultrasonography and CT scan revealed hepatosplenomegaly only, without lymphadenopathy. A bone marrow trephine biopsy showed areas with a dense infiltrate of abnormal cells, displaying many mitotic figures.

[Sarcoidosis presenting with subcutaneous nodules].

Sarcoidosis is an uncommon disease with many types of presentation. A 32-year-old woman is described in whom subcutaneous nodules were the presenting symptom. This presentation is vary rare; the differential diagnosis includes rheumatic fever, rheumatoid arthritis, systemic lupus erythematosus and fungal infections.

Effect of an iron supplement on body iron status and aerobic capacity of young training women.

Serum iron deficiency has a high incidence in female athletes. We investigated the effects of a daily oral iron supplement, (160 mg) administered during an intensive 7-week physical training programme, on body iron status, and the maximal aerobic capacity (VO2max) of 13 women (group A) compared to 15 who took a placebo (group B). The subjects were 19 years old.

Hypouricemia due to familial isolated renal tubular uricosuria. Evaluation with the combined pyrazinamide-probenecid test.

A Jewish Iraqi woman with familial isolated renal tubular uricosuria, urate clearance of 60.5 +/- 5.7 ml/min and hypouricemia of 1.

Non-random chromosomal aberrations in a complex leukaemic clone of a Bloom's syndrome patient.

Bloom's syndrome is one of the congenital disorders known to have increased frequency of acute leukaemia. The complex cytogenetic findings in the leukaemic cells of a 39-year-old male with Bloom's syndrome are described. These included a translocation t(7;17), missing 7q and 17p, a reciprocal translocation t(4;22); del 3q, del 8q22, del 20q, missing 12 and missing Y.

Dipyridamole-induced epistaxis.

The case history of a patient treated with dipyridamole who developed severe epistaxis, accompanied by alteration of the platelet aggregation tests, is presented. The bleeding did not respond to local therapy and stopped only after discontinuation of the drug and normalization of the platelet aggregation. Hemorrhage, especially in elderly patients, should be considered as a possible complication of dipyridamole administration.

Rectal bleeding induced by Dipyridamole.

Nineteen patients treated continuously with Dipyridamole were evaluated for rectal bleeding. Thirteen suffered from overt rectal bleeding and six served as controls. Hemorrhoids were found in all patients.