Human Laterality Disorders: Pathogenesis, Clinical Manifestations, Diagnosis, and Management.

Human laterality disorders comprise a group of diseases characterized by abnormal location (situs) and orientation of thoraco-abdominal organs and vessels across the left-right axis. Situs inversus totalis is mirror image reversal of thoraco-abdominal organs/great vessels. Situs ambiguus, better known as heterotaxy, is abnormal arrangement of thoraco-abdominal organs across the left-right axis excluding situs inversus totalis.

Statin-Induced Necrotizing Autoimmune Myositis: Diagnosis and Management.

Statins are among the most frequently prescribed drugs as they effectively lower cardiovascular mortality. Atherosclerotic plaques are stabilized and lipid levels are lowered, as statins inhibit 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase. Patients placed on these drugs frequently report muscle aches, but true myositis that would call for discontinuance of the drug is actually uncommon.

CHTF18 ensures the quantity and quality of the ovarian reserve†.

The number and quality of oocytes, as well as the decline in both of these parameters with age, determines reproductive potential in women. However, the underlying mechanisms of this diminution are incompletely understood. Previously, we identified novel roles for CHTF18 (Chromosome Transmission Fidelity Factor 18), a component of the conserved Replication Factor C-like complex, in male fertility and gametogenesis.

Racial disparities in young women with endometrial cancer.

Objective: Although racial disparities in treatment and outcome for endometrial cancer are well recognized, little work has explored disparities in young women. We performed a population-based analysis to compare survival between black and white women with endometrial cancer at <50years of age.

Methods: We used the National Cancer Data Base to identify women <50years of age with endometrial cancer from 1998 to 2012.

Adolescent Female With Turner's Syndrome and 46,X,der(Y) del(Y)(p11.2)del(q11.2) Karyotype With Gonadoblastoma and Dysgerminoma.

Gonadal dysgenesis patients with Y chromosomal material are subject to increased risk for germ cell tumors. We report a case of an adolescent female presenting with Turner-like syndrome with primary amenorrhea and Tanner stage 1 breast development. Karyotype showed one X chromosome and a minute pericentromeric fragment of Y chromosome without any functional Y genes in all the cells, unlike a mosaic pattern, represented as 46,X,der(Y)del(Y)(p11.

The effect of population diversity on skin irritation.

The impact of many human variables on the response to skin irritating substances has been studied to varying degrees, including the impact of age, sex, and atopic status. However, the importance of ethnic origin has been more difficult to investigate, leading to a relative paucity of compelling data, either for or against the existence of differences. A primary reason for this lack is that studies on different ethnic groups often have to be undertaken in different locations thus introducing variables, e.

Right ventricular alterations in scuba divers: findings on electrocardiography and echocardiography.

Background: Scuba diving imposes uncommon environmental stresses. This study assesses the effects of recreational scuba diving on the electrocardiogram (ECG) and echocardiogram and compares them with those of normal controls.

Methods: We studied 50 recreational scuba divers and 50 age-matched and sex-matched normal control subjects.

Safety evaluation of wild apricot oil.

Wild apricot, a variety of Prunus armeniaca, grows in the hilly regions of India. The seeds yield 27% of kernels. The potential availability of the kernels is 40,000 tons/year and these yield 47% of oil.

The prevalence of rheumatologic disorders in patients with chest pain and angiographically normal coronary arteries.

The purpose of this study was to determine the prevalence of musculoskeletal disorders in patients with chest pain and angiographically normal coronary arteries. The authors studied 40 consecutive patients with chest pain presenting at an Internal Medicine Clinic who had undergone coronary angiography and were found to have < 30% stenosis of all major coronary arteries. Patients with any known noncardiac cause of chest pain were excluded from the study.

Pharmacotherapy of chronic pulmonary arterial hypertension: value and limitations. Part II: Secondary pulmonary hypertension.

Part I of this review discussed pharmacotherapy of primary pulmonary hypertension (PHT). Part II describes the value and limitations of oxygen and vasodilator therapy of secondary PHT, focusing on patients with PHT associated with selected connective tissue disease and chronic nonthrombotic hypoxic lung disease.

The challenge of sensorineural hearing loss in rheumatoid arthritis.

Patients with rheumatoid arthritis are exposed to a variety of pharmacologic agents capable of causing sensorineural hearing loss. We describe such a patient who was eventually found to have an acoustic neuroma. The case illustrates the difficulty of diagnosing acoustic neuroma and the need for a high index of suspicion when unilateral hearing loss is detected.

Pharmacotherapy of chronic pulmonary arterial hypertension: value and limitations. Part I: Primary pulmonary hypertension.

Efforts aimed at assessing pharmacotherapy of pulmonary arterial hypertension (PHT) have largely focused on patients with primary PHT, PHT associated with selected connective tissue diseases, and various forms of hypoxic secondary PHT. Part I of this review discusses the value and limitations of a wide variety of vasodilator drugs, oxygen, and warfarin in the treatment of primary PHT with special reference to their effects on pulmonary and systemic hemodynamics, functional capacity, and survival.

When the lungs are involved by connective tissue disease.

Pulmonary involvement by a connective tissue disease can result in clinically important complications. Pathogenic mechanisms vary from granulomatous reaction and interstitial inflammation to primary vasculitis and immune complex-mediated disease. Understanding the pulmonary complications of connective tissue diseases is challenging in that several distinct patterns of involvement are associated with the same disease but the same lung abnormalities are found with several different diseases.

Undifferentiated, overlapping, and mixed connective tissue diseases.

Undifferentiated connective tissue disease (UCTD) is a term used by many rheumatologists to define a group of diffuse connective tissue disorders that lack definitive characteristics of any particular well-defined disorder. Overlapping connective tissue disease is often used interchangeably with UCTD but they both refer to diseases that are in evolution before all the characteristic clinical and laboratory symptoms are manifested. However, the clinical features of some of the overlapping connective tissue diseases appear to be better defined.

Short- and long-term hemodynamic effects of captopril in patients with pulmonary hypertension and selected connective tissue disease.

To assess the pulmonary and systemic hemodynamic effects of oral captopril in patients with connective tissue disease and pulmonary hypertension, we performed right heart catheterization in eight patients with diffuse systemic sclerosis, the CREST syndrome, or mixed connective tissue diseases prior to and immediately following administration of captopril (dose range 12.5 to 50.0 mg, short-term study).

Acute and long-term effects of nifedipine on pulmonary and systemic hemodynamics in patients with pulmonary hypertension associated with diffuse systemic sclerosis, the CREST syndrome and mixed connective tissue disease.

Ten patients with pulmonary hypertension associated with diffuse systemic sclerosis (1 patient), the CREST syndrome (calcinosis cutis, Reynaud's phenomenon, esophageal dysmotility, sclerodactyl, telangiectasia) (6 patients) and mixed connective tissue disease (3 patients) were studied to assess the effect of oral nifedipine on pulmonary and systemic hemodynamics. Each patient underwent right-sided cardiac catheterization just before nifedipine administration. Thereafter, oral nifedipine was administered in 10 mg increments every 90 minutes until pulmonary vascular resistance normalized or a total dose of 30 mg was achieved.

Cardiovascular changes in athletes.

Athletic training commonly increases left ventricular and diastolic volume and left ventricular wall thickness within weeks to months of the beginning of vigorous conditioning. Bradycardia is usual and a third heart sound is frequently audible. A systolic heart murmur is present in 30 to 50 percent of athletes.