Biomedical subjects
Publications and source records attributed to D M Morens.
More than 250 cases of this puzzling illness, first described in Japan a decade ago, have now been reported in the United States. The etiology, epidemiology, and true incidence remain to be determined. But since some 2% of victims develop severe cardiac complications and some may die suddenly months after apparent complete recovery, pediatricians must now consider this entity in the differential diagnosis of protracted, febrile illness.
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An 11-month-old girl had an unusual history of colocolonic intussusception associated with polyps that prolapsed through the rectum. Several months thereafter, characteristic brownish-black pigment spots of the lips were noted. The histologic appearance of the polyps was consistent with that of the Peutz-Jeghers syndrome. To our knowledge, this is the youngest reported case of symptomatic Peutz-Jeghers syndrome.
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CONTEXT: The projected expansion in the next several decades of the elderly population at highest risk for Parkinson disease (PD) makes identification of factors that promote or prevent the disease an important goal. OBJECTIVE: To explore the association of coffee and dietary caffeine intake with risk of PD. DESIGN, SETTING, AND PARTICIPANTS: Data were analyzed from 30 years of follow-up of 8004 Japanese-American men (aged 45-68 years) enrolled in the prospective longitudinal Honolulu Heart Program between 1965 and 1968. MAIN OUTCOME MEASURE: Incident PD, by amount of coffee intake (measured at study enrollment and 6-year follow-up) and by total dietary caffeine intake (measured at enrollment). RESULTS: During follow-up, 102 men were identified as having PD. Age-adjusted incidence of PD declined consistently with increased amounts of coffee intake, from 10.4 per 10,000 person-years in men who drank no coffee to 1.9 per 10,000 person-years in men who drank at least 28 oz/d (P<.001 for trend). Similar relationships were observed with total caffeine intake (P<.001 for trend) and caffeine from non-coffee sources (P=.03 for trend). Consumption of increasing amounts of coffee was also associated with lower risk of PD in men who were never, past, and current smokers at baseline (P=.049, P=.22, and P=.02, respectively, for trend). Other nutrients in coffee, including niacin, were unrelated to PD incidence. The relationship between caffeine and PD was unaltered by intake of milk and sugar. CONCLUSIONS: Our findings indicate that higher coffee and caffeine intake is associated with a significantly lower incidence of PD. This effect appears to be independent of smoking. The data suggest that the mechanism is related to caffeine intake and not to other nutrients contained in coffee. JAMA. 2000;283:2674-2679.
Cytomegalovirus (CMV) causes serious illness in immunocompromised patients and congenitally infected neonates. Knowledge of the epidemiologic characteristics of CMV remains limited, but specific and practical measures can help prevent the transmission of infection to persons in high-risk groups. Good personal hygiene, especially hand washing, is the most effective means of preventing the acquisition of CMV by pregnant women and by individuals who care for children and immunocompromised patients. Screening programs for the identification of seronegative pregnant women and female hospital employees or of asymptomatic children who are excreting CMV are not practical or beneficial; educational programs are recommended instead. Since CMV infection is endemic in the community, exclusion of known CMV excretors from schools is not indicated. Exposure of premature infants or of organ transplant recipients and other severely immunocompromised patients to exogenous sources of CMV, such as blood transfusions, should be minimized. These recommendations may need to be revised in the future as more specific knowledge of the epidemiology of CMV is gained.
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