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Biomedical subjects

D A Bennahum

Publications and source records attributed to D A Bennahum.

16 recordsLinked to original sources

Minocycline-associated tooth staining.

OBJECTIVE: To describe a case of tooth discoloration in an adult after minocycline treatment for arthritis. CASE SUMMARY: A 68-year-old white women presented with blue-black staining of her lower anterior teeth after 4 months of minocycline therapy for arthritis. Her other medications are not known to cause discoloration of teeth. While the patient continued taking minocycline, her dentist was not able to remove the discoloration. Within 1 month after discontinuation of the minocycline, the dentist was able to remove the discoloration entirely. DISCUSSION: Minocycline, a synthetic derivative of tetracycline, has been shown to cause abnormal pigmentation of the skin, thyroid gland, nails, bone, sclera, and conjunctiva in adults. It also has been shown to cause tooth discoloration in a few patients. This case is unusual in that the tooth discoloration disappeared after discontinuing minocycline therapy. CONCLUSIONS: This complication of minocycline is more commonly thought of in the pediatric population. However, clinicians need to be aware of this adverse drug reaction, as this agent may be used increasingly in the treatment of adults with arthritis.

Aged↗

Life expectancy, comorbidity, and quality of life. A framework of reference for medical decisions.

The treatment of cancer in the elderly can benefit from increasingly sophisticated methods that measure a patient's quality of life. These measures are both general and cancer specific and herald a new and enlightened approach to patient care. The care of the older patient must be seen in light of what is known about life expectancy, the outcome of treatment, an awareness of comorbidity, and the importance of informed consent and respect for the values and preferences of the individual patient. This article reviews the growing literature on quality of life research in cancer patients.

Aged↗

Assessment of ethical decisions and values.

The development and pilot testing of the Professional Decisions and Values Test (PDV) is described. The PDV is designed to assess how ethical conflicts are dealt with by medical and law students and which moral values motivate them. Data from two consecutive classes of entering medical and law students are presented and their action tendencies and ethical values are compared. The findings support the construct validity of the test. Regarding reliability, stability over time is present for action tendencies but not for values. Perhaps the ethical values of entering medical and law students do not become stable until later. Change in ethical values can be studied with the PDV for groups, not individuals, during the first year of professional education.

Attitude↗

Environmental forces affecting CME professionals.

In 1986 the immediate past president of the Alliance for Continuing Medical Education (ACME), Dr. David Fink, appointed a task force to prepare a report on present and future health care environments as they might affect CME. Each member of the task force prepared an environmental analysis. Their reports were then summarized and submitted to the ACME council. What follows is an abbreviated and edited version of that report.

Delivery of Health Care↗

Recent observations on central nervous system lupus erythematosus.

The recent literature on CNS-SLE has been reviewed. An improved prognosis is noted that is thought to be due to the use of high-dose corticosteroids. The frequencies of the various neurologic and psychiatric findings are discussed, and a distinction is noted between organic psychoses and functional psychiatric complaints. The question of corticosteroids versus cerebral vasculitis as the cause of the neuropsychiatric symptomatology in SLE is examined, and the necessity of clear psychiatric diagnosis and treatment is stressed. Recent observations on HL-A antigens, complement, immunoglobulins, virus, and immunocomplexes suggest that the latter are prominent in CNS-SLE, but that an infectious agent may be etiologic in the genesis of SLE. Fifty-four patients not previously reported are discussed. Thirty-eight of them had neuropsychiatric manifestations. The treatment of CNS-SLE with cytotoxic agents, in addition to corticosteroids, is considered, and the experience of the authors with such treatment is presented.

Animals↗