Bromide intoxication secondary to pyridostigmine bromide therapy

Article Abstract:

Some medications used for their hypnotic and sedative effects contain large amounts of bromide, which can be toxic to the human body. Bromide intoxication was once very common but is now rare because many bromide-containing drugs have been discontinued and replaced with newer medications. In other countries, many non-prescription sedatives contain bromide as an ingredient. Now that bromide intoxication is fairly infrequent in the United States, it may be easily misdiagnosed. The case of a 59-year-old woman with myasthenia gravis, a disease characterized by extreme muscle weakness and fatigue, is discussed. Her physician prescribed high doses of pyridostigmine bromide for this condition. While hospitalized after a surgical procedure, removal of the thymus gland, she developed confusion, paranoia and hallucinations. Initially physicians believed she had intensive care unit psychosis, but with the aid of laboratory tests it became clear that she had developed bromide intoxication from the medication. The test result that first suggested this diagnosis was a dramatic negative anion gap; this was followed up with a blood bromide level that confirmed the diagnosis. Bromide intoxication is most frequently seen in patients who use or abuse medications that contain bromide salts; its symptoms include neurological and dermatologic abnormalities. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Case studies, Drug therapy, Myasthenia gravis, Bromides, Psychoses, Psychotic disorders, Bromides (Chemistry)

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Multiple myeloma: new approaches to therapy

Article Abstract:

Multiple myeloma is cancer of the bone marrow and accounts for 1% of cancers in the US. The bone disease it causes can be painful and disabling, and it can also cause kidney failure and neurological damage. Because of reduced production of normal immunoglobulins, the immune system is compromised and patients are subject to many infections. Patients are usually treated with the drug melphalan, which relieves symptoms but cannot cure the cancer. Therapeutic approaches currently being studied include bone marrow transplantation, gene therapy and immunotherapy. Using gene therapy, disabled viruses that carry a new gene are injected into patients. The viral DNA is incorporated into the person's DNA, and the new gene enriches the patient's immune system. Using principles of immunotherapy, monoclonal antibodies against interleukin 6, which is overproduced in myeloma, are injected into the patient.

Care and treatment, Innovations, Gene therapy, Immunotherapy, Multiple myeloma

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Transmission of primary and secondary syphilis by oral sex-Chicago, Illinois, 1998-2002

Article Abstract:

The STD/HIV Prevention and Care Program of the Chicago Department of Public Health (CDPH) recorded 1,582 cases of primary and secondary syphilis in the United States during the year 1998-2002. Although case numbers and overall rates remained stable in Chicago during this period, patterns of transmission changed substantially.

Illinois, Risk factors, Surveys, Oral sex, Syphilis

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