Kikuchi-Fujimoto disease: an unusual presentation of meningitis in a returning traveller.

A 19-year-old, previously healthy woman developed a pruritic erythematous maculopapular rash on her bilateral palms and wrists, right-sided tender cervical lymphadenopathy and nightly fevers and headaches 5 days after returning from a 1-month trip to Cambodia. She presented 2 weeks after her trip due to ongoing nightly fevers to a maximum of 38.8°C. She was given empiric doxycycline for possible rickettsial disease, though an extensive infectious workup returned without positive findings. Lumbar puncture was performed on hospital day 4, and spinal fluid analysis was consistent with aseptic meningitis. On hospital day 5, core biopsy and fine-needle aspiration were performed on the largest anterior cervical lymph node. Her fever curve gradually improved, and she was discharged on hospital day 6. Results of the lymph node biopsy were finalized 5 days after discharge and were compatible with Kikuchi's lymphadenitis. Symptoms had completely resolved on follow-up with infectious disease and rheumatology.

Lack of correlation between antiobesity policy and obesity growth rates: review and analysis.

OBJECTIVE: To review federal, state, and local antiobesity policies and to assess their relationships with obesity growth rates. METHODS: We performed a literature review, acquired data from governmental Internet sources, and assessed the statistical correlation between state antiobesity policies and the concavity in obesity growth rates. RESULTS: State-by-state antiobesity policies in 3 categories-taxation of sugared beverages and snacks, physical education and physical activity in schools, and funding for bicycle trails-were found to have no significant immediate correlation with the change in obesity growth rates. CONCLUSIONS: Ineffective antiobesity legislation may be attributable to shortcomings in policy implementation. Behavioral economics and addressing large-scale cultural issues may have critical roles in promoting more healthful lifestyles. We propose that a systems-based paradigm evaluating complex interactions among pathophysiological, cultural, political, economic, and behavioral components can improve antiobesity policy implementation and should therefore be a research focus.

Serum low-molecular-weight protein fractionation for biomarker discovery.

Protein biomarkers provide the key diagnostic information for the detection of disease, risk of disease progression, and a patient's likely response to drug therapy. Potential biomarkers exist in biofluids, such as serum, urine, and cerebrospinal fluid. Unfortunately, discovering and validating protein biomarkers are hindered by the presence of high-molecular-weight proteins, such as serum albumin and immunoglobulins, which comprise 90% of the proteins present in these samples. High-abundance, high-molecular-weight proteins mask the low-molecular-weight (LMW) proteins and peptides using conventional protein detection methods. Candidate biomarkers are believed to exist in very low concentrations and comprise less than 1% of serum proteins, and may be highly labile as well. Therefore, it is imperative to isolate and enrich LMW proteins from complex mixtures for biomarker discovery. This chapter describes a continuous -elution electrophoresis method, based on molecular weight sieving, to isolate specific molecular weight fractions for mass spectrometric, western blotting, or protein array analysis.

Vitamin D in the Persian Gulf: integrative physiology and socioeconomic factors.

Countries of the Persian Gulf region--Bahrain, Iran, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates--have become increasingly modernized, resulting in a transformation of lifestyle based on technology, sedentary activity, lack of sunlight, and unhealthy dietary patterns. These factors have led to a higher prevalence not only of vitamin D undernutrition, but also chronic obesity, insulin resistance, prediabetes, and type 2 diabetes. This review explores the integrative physiologic effects of vitamin D with socioeconomic factors and propose a hypothesis-driven model for their contributions to obesity and diabetes in the Persian Gulf. Further research into these interactions may ultimately lead to novel preventive strategies and therapies for metabolic disorders in this geographic region.