A recent paper by a research group from the University of Kentuckyhas shed new light on the pathophysiology of burning mouth syndrome(BMS), an enigmatic disorder causing chronic pain of the intra-oralsoft tissues.1 The researchers used functional magnetic resonanceimaging (fMRI) to show that patients with BMS have a specificqualitative and quantitative pattern of brain activation, leadingto a net brain hypo-activity. Their findings suggest that BMSpatients may have impaired brain network dynamics essentialfor descending inhibition, leading to diminished inhibitorycontrol of sensory experience; as a consequence they may experienceintra-oral proprioception as burning pain.1 These results mayhave significant clinical relevance; the pathophysiology ofBMS has been ill-understood, causing difficulties in providingeffective therapies. But what exactly is  相似文献   

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Strongyloidiasis can present with a wide variety of symptoms and can lead to a potentially fatal hyperinfection. Although any factors that suppress the host defense mechanisms can potentially trigger hyperinfection, prolonged steroid use has been quite well described. A patient with disseminated small cell lung cancer suffered a Strongyloides stercoralis hyperinfection syndrome complicating ectopic adrenocorticotropic hormone (Cushing syndrome). Evaluation revealed lymphopenia, elevated levels of adrenocorticotropic hormone in the setting of elevated cortisol levels, a normal pituitary, and metastatic malignancy. S. stercoralis larval forms were seen in the stool and sputum. At autopsy, S. stercoralis larval forms were seen in the lung along with evidence of metastatic small cell lung carcinoma.  相似文献   

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Eight of 15 patients with acquired immunodeficiency syndrome (AIDS) and six of nine patients with lymphadenopathy syndrome (LAS) had paraproteins in their sera. Twelve of these 14 were IgG kappa; the other two had no demonstrable light chains. The relationship of the paraprotein to the pathogenesis of AIDS is not clear, but we discuss its relation to derangements of B-cell immune regulation and function and to B-cell tumors in AIDS patients.  相似文献   

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This review article on acquired immunodeficiency syndrome (AIDS) covers its epidemiology, clinical spectrum, and etiology. Despite intensive efforts, the cause and pathogenesis of this syndrome remain unknown and effective therapy is not yet available. In addition, the clinical presentation of AIDS is variable, ranging from generalized lymphadenopathy to dermatologic lesions, pneumonias, enteritis, ophthalmologic lesions, disseminated disease, malignancies, neurologic conditions, paresthesias, radiculopathies, seizures, and psychiatric manifestations. The population at risk for AIDS icludes homosexual or bisexual men (71% of cases), intravenous drug abusers (17%), those born in Haiti who recently migrated to the US (5%), and hemophiliacs (1%). 6% of cases reported to the US Centers for Disease Control (CDC) fall in none of these categories. 47% of AIDS patients are 30-39 years of age at time of diagnosis. The CDC's strict surveillance definition of AIDS represents only 1 end of the clinical spectrum and could result in an underestimate of the size of the problem. It ignores the prodromal or milder forms of AIDS-related illnesses that have less clearly defined clinical courses. The persistent, irreversible immunosuppression characteristic of this syndrome creates a complex management problem for physicians, but the early recognition of AIDS by emergency and primary care physicians may improve the grim prognosis for AIDS victims.  相似文献   

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