Women as prisoners of war.

American women are increasingly becoming involved in combat-related roles. Inevitably, our country will have several killed and taken prisoner. No National Academy of Science/National Research Council or VA study has ever been undertaken to examine the chronic sequelae of the experiences undergone by these captured women. This paper examines the after-effects of 3.5 years of incarceration on the 79 American women taken prisoner by the Japanese in the Philippines during World War II. Emphasis is given to their living conditions in a prisoner-of-war camp and their resulting long-term disabilities. Comparison of data reported in this paper with those of several epidemiological studies of male survivors of Philippine camps allows several novel points to be made. Overall, half of the women had a service-connected disability, exactly like the men. Furthermore, although the average degree of service-connected disability, 37%, is the same as that of the men, not one of the women in this study was service-connected for tuberculosis or peptic ulcer disease. This is a major finding, since, compared to age-matched combat controls, the men had a higher post-repatriation death rate for the first 7 years due to tuberculosis; likewise, peptic ulcer disease is so common in the male survivors that it is a presumptive service-connected disability.

Medical implications of obesity. Losing pounds, gaining years.

Through thousands of years of starvation and poor nutrition, the human body has become adept at storing scarce nutrients. Today, in the United States and Canada particularly, the combination of sedentary habits and excessive intake of calories is imposing a dual burden on a physiologic system that is ill-equipped to handle it. Unable to rid itself of calories, the body's only defense is to store them all. The end result is obesity, with all its deleterious effects on health and longevity.

Case report: frequent migraines with aura in a patient with a germ cell tumor.

Accelerated migraine with aura has not been previously described in association with germ cell tumor. The following case describes a likely rare paraneoplastic syndrome in a patient with a germ cell tumor with seminomatous elements.

Alzheimer's disease. Recognizing and treating a frustrating condition.

Alzheimer's disease is a costly illness affecting large numbers of older Americans, and its prevalence is increasing. The major symptom of the condition is progressive forgetfulness. The course is variable, depending on which areas of the brain are affected earliest and most severely. In diagnosing Alzheimer's disease, it is important to rule out other types of dementia that may be treatable, as well as systemic and affective disorders and other brain diseases. The Mini-Mental State Examination and the category fluency test are often diagnostically useful. There is no evidence that any of the therapeutic agents studied so far are of much value, but pharmacologic agents can be useful in treating the depression, psychoses, and anxiety that may accompany cognitive decline. Patients cared for at home need a structured, orderly environment that has been modified for their safety.

Medical management of symptomatic peripheral vascular disease.

As our society becomes older, peripheral vascular disease assumes greater significance. Many patients are not surgical candidates and, therefore, must opt for medical management. The podiatrist often assumes the role of primary health care provider, and a knowledge of the disease process, its consequences, and treatment alternatives becomes paramount. The authors detail the events leading to and the treatment options for symptomatic peripheral vascular disease.

Vitamin B deficiency neuropathy. Case reports.

Poor nutrition is common throughout the third world. The US also has examples among recent Asian and Latin American immigrants, alcoholics, the homeless, and former prisoners of war. All of these groups are susceptible to long-term pathologic damage, depending on the degree of malnutrition which they experience. The peripheral nervous system is quite vulnerable to impairment and damage from vitamin B loss.

Deficiency of vitamins A, B, and C. Something to watch for.

Although specific vitamin deficiency syndromes are relatively rare in the United States, primary care physicians may encounter them in elderly patients and persons who consume minimal diets. Knowledge of such deficiencies is crucial in the evaluation of these patients. The authors discuss manifestations of deficiency of vitamins A, B, and C and recommend appropriate methods of diagnosis and treatment.

Deficiency of vitamins A, B, and C.

Preview Although specific vitamin deficiency syndromes are relatively rare in the United States, primary care physicians may encounter them in elderly patients and persons who consume minimal diets. Knowledge of such deficiencies is crucial in the evaluation of these patients. The authors discuss manifestations of deficiency of vitamins A, B, and C and recommend appropriate methods of diagnosis and treatment.

Thiamine deficiency neuropathy. It's still common today.

Despite the fact that thiamine deficiency neuropathy is increasing in incidence in our society, it remains an underdiagnosed disorder. The typical complaints of weakness and burning feet are often regarded as trivial by the attending physician. Electrophysiologic studies are sensitive and often provide supportive evidence to aid in the diagnosis. Since chronic pain therapy is often ineffective, a high index of suspicion should be maintained to help ensure early diagnosis and successful intervention.