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PubMedDate not supplied

Elephantiasis nostrum verrucosa of the abdomen: clinical results with tazarotene.

Elephantiasis nostras verrucosa represents an uncommon yet distinct clinical entity resulting from chronic lymphedema of an extremity or body region. Characterized by profound non-pitting edema with cobblestone-like papules, plaques, and nodules, it typically occurs secondary to infections, surgeries, tumor obstruction, radiation, congestive heart failure, and obesity. This progressively deformative disorder has been treated with various medical and surgical measures. In the following case report, the history, clinical, and pathologic appearance of elephantiasis nostras verrucosa are discussed, as well as newer treatment options.

Abdomen↗
PubMed1999

Patent medicines for the treatment of genitourinary diseases.

The present article addresses the nineteenth-century advertising of patent medicines in America, sold to "cure" diseases of the kidney and bladder, the "loss of manhood", and "debilitating conditions of the generative system." Most of the proprietary remedies made extravagant claims of effectiveness concerning a wide variety of ailments, and some claimed to cure every disease. Examples of promotional excesses demonstrate how the public was persuaded to buy a kaleidoscope of largely useless and occasionally harmful patent nostrums. The ephemera considered became a part of the history of medicine related to urology.

Advertising↗
PubMed2004

The evidence thing.

The methodology of evidence-based medicine (EBM) has become dominant in the clinical field to the detriment of historically validated paradigms. The philosophical background of EBM is considered and the strengths and flaws of its main tools (randomized trials and meta-analysis) are reviewed. The structural format of EBM speaks the language of regulators and health planners, satisfies the needs of the academic-industrial complex, and is favored by editors of medical journals. Specific problems of trials of medical versus surgical therapy are noted. The deductive-numerical approach of EBM is a methodology geared to ascertain the most effective management of a condition when the differences observed between the two entities being considered is small. EBM methodology is unlikely to lead to discovery of new diseases or treatments; the latter derive from alert observation and inductive inference. While its contribution to the rigorous analysis of effectiveness of some therapies is acknowledged, EBM is not the nostrum of clinical research. Observational and inductive clinical intelligence should be stimulated and published because a therapy needs to be invented before it is proven effective. Biomathematicians need to improve nonrandomized methodology as they did for randomized studies.

Evidence-Based Medicine↗
PubMed1994

Melaleuca oil (tea tree oil) dermatitis.

BACKGROUND: Melaleuca oil (tea tree oil) is the essential oil distilled from the leaves of Melaleuca alternifolia Cheel. Tea tree oil is popular for treating various cutaneous maladies. OBJECTIVE: Our purpose was to determine which constituent compounds of Melaleuca oil are responsible for allergic contact eczema in seven patients who became sensitized. METHODS: The seven patients were patch tested with Finn Chambers to a 1% solution (vol/vol) of melaleuca oil and 1% solutions (vol/vol) of 11 constituent compounds. RESULTS: Of seven patients reactive to the 1% melaleuca oil solution, six patients also reacted to limonene, five to alpha-terpinene and aromadendrene, 2 to terpinen-4-ol, and one each to p-cymene and alpha-phellandrene. d-Carvone, an autooxidative derivative of limonene, caused no reactions among the seven patients. CONCLUSION: d-Limonene was the most common allergen causing allergic contact eczema in our patients. Clinicians are likely to see more contact eczema caused by the increasing use of this popular nostrum.

Aged↗
PubMed1980

Nutrition--sense and nonsense.

Most physicians know far more about nutrition than they are given credit for. We know there is no such thing as a nutritionally perfect food. We know that variety in foods consumed is the key to good nutrition. We know that good nutrition is an important part of convalescence. We know that obesity in the presence of other risk factors is an added hazard. We know that fortified convenience foods contribute to good health and make life easier for those who prepare meals. We know that the woods are full of food faddists, nutritional charlatans, and peddlers of nutritional nostrums, whose scare tactics and sensationalism often sway the uninformed. Where many of us err is simply in not thinking about nutrition, in not asking our patients about what they eat, and in not counseling them on better nutrition. Thus, I urge you to think nutrition when you think about the health of your patients and yourself, to utilize the services of dietitians and nutritionists, and to speak out clearly and forcefully, but without malice, to combat nutritional and other health nonsense.

Cholesterol, Dietary↗
PubMed1999

John Collins Warren and his act of conscience: a brief narrative of the trial and triumph of a great surgeon.

On examination of the correspondence among the principals involved, as well as the original patent application being prepared by Morton, it has become possible to reconstruct some of the remarkable details attending the first use of ether anesthesia at the Massachusetts General Hos pital in the autumn of 1846. At the time that Warren invited Morton to demonstrate the use of his "ethereal vapor" for anesthesia in a minor operation on Oct. 16, 1846, the exact chemical composition of the agent used was being held secret by Morton; Warren was clearly disturbed by this unethical use of a secret "nostrum." When the time arrived 3 weeks later for its possible use for a serious "capital" operation, Warren employed a simple stratagem of public confrontation to discover from Morton the true nature of the substance to be used. On being informed that it was pure unadulterated sulfuric ether, not some mysterious new discovery labeled "Letheon," Warren gave approval for its first use in a "capital" operation (low thigh amputation) on Nov. 7, 1846. Despite this revelation to the immediate participants, a veil of secrecy continued to surround the substance for many months, an anomalous situation evidently traceable to Morton's desire for personal reward from the discovery. It was this matter of secrecy, rather than priority for its discovery, that surrounded the early use of ether anesthesia with controversy and recrimination both in this country and abroad.

Anesthesia, Inhalation↗
PubMed1991

Mosquitoes, leeches and medicine in Charleston, South Carolina (1670-1861).

Charleston, South Carolina, USA has a rich history extending over 300 years. The plantations of the Carolina Low Country produced rice, indigo and cotton. Mosquitoes, which abounded in the wetlands, transmitted diseases such as Yellow Fever and epidemics occurred almost every year. African slaves, however, had a natural immunity to the disease and, together with the climate and the nature of the work, this shaped the economic and social system of the area. Physicians offered all sorts of cures to deal with the medical problems of the area and apothecaries also sold many nostrums including leeches. Newspaper advertisements reveal that these bloodsuckers were extensively used for many decades.

Animals↗
PubMed2002

Extending life: scientific prospects and political obstacles.

Aging can be slowed in laboratory rodents by low-calorie diets, and changes in single genes can extend mouse life span by 40 percent or more. Therefore, despite its surface complexity and effects on multiple cells and intercellular systems, aging in mammals might also be retarded by both genetic and nongenetic means. If human aging could be slowed pharmacologically to the extent now possible in rodents, the effect on healthy life expectancy would exceed that of abolishing cancer, cardiovascular disease, and adult-onset diabetes. Why, then, is research on the biological control of aging and longevity poorly funded and shunned by both most scientists and those setting national research priorities? Economic disincentives, disease-specific lobby groups, scientific careerism, and ineffective nostrums, together with gerontologiphobia, must be overcome before such research can improve public health.

Aged↗
PubMed1986

Mossy leg--an unusual therapeutic success.

Elephantiasis verrucosa nostrum occurs when lymphatic obstruction of sufficient magnitude causes back pressure in the lymphatic channels forceful enough to produce superficial vessel dilation which has a "pebbly" or cobble-stone appearance. Unchecked this can progress to a marked verrucous or mossy appearance, frequently complicated by infection, with swelling and gross deformity. The patient presented here was both post-phlebitic and post-lymphatic with significant deformity. He showed dramatic improvement on a regimen of antibiotics and elevation followed by decompression and routine use of pressure-gradient support garments. This has not recurred and he has remained under control since 1979.

Aged↗