I am doing a case study where the pt didn't reveal accurate symptoms and past medical history and the outcome wasn't good. she ended up having permanent damage because the doctors didn't act quick enough. is this her fault for not describing the symptoms and past medical history? List some resources to support your answer please.

I believe so. Patients are responsible for reporting their medical history, allergies, current medications, etc. Granted, that stuff may be, and probably should be, found in medical records in a non-emergency situation. Also their symptoms should be accurately reported, and they assume all responsibility for that.

As a medical professional, you are responsible for observing signs that the patient presents with. Also, when the patient gives you allergies, medications, history, you need to be able to relate it to your diagnosis and treatment. That's pretty much the extent of it.

i dont wanna get into too much personal stuff but i have a friend who never used to have symptoms of the disease but recently i noticed alot of head twitching and other symptoms of Parkinson's…i just wanted to kno if its possible and if i should worry?

Your friend might have Tourette's Syndrome.

There is a juvenile form of the disease that is being investigated for cause, and is thought to be genetic. it is referred to as Idiopathic Parkinson's Disease. here is an article on it which presents a case study. the subject is a 13 1/2 year old girl…………………

neuro.psychiatryonline.org/cgi/co…

Researchers say Case Study Shows Parasitic Worm Eggs may Have use as Treatment

By Salynn BoylesWebMD Health News

Reviewed by Laura J. Martin, MD

Latest Digestion News

Dec. 1, 2010 — It sounds made up, but it’s true. a California man successfully treated his inflammatory bowel disease by self-medicating with parasitic worm eggs.

Now researchers at new York University say that by studying the man they have gained new insights into how worms promote intestinal healing.

The investigation could lead to potential targets for more conventional ways of treating bowel diseases like ulcerative colitis, parasitologist and researcher P’ng Loke, PhD, of NYU Langone Medical Center tells WebMD.

Research is also under way in the U.S. and Europe to determine if a pharmaceutical-grade worm egg liquid is useful for treating a range of health conditions, including Crohn’s disease, multiple sclerosis, and even food allergies.

“We have known for a while that these parasitic worms could be beneficial for treating ulcerative colitis, but we haven’t really understood why,” Loke says. “By analyzing this patient, we may have found some answers.”

Treating Bowel Disease with Worms

The patient, who preferred to remain anonymous, was in his mid-30s when he was diagnosed with severe ulcerative colitis in 2003.

He did not respond to steroid treatments, his condition progressed rapidly, and within a year his doctors told him that surgery to remove his colon or immune system-suppressing therapy were his only options.

Instead, after reading about early trials involving the parasitic pig whipworm Trichuris suis, the patient decided to infect himself with parasitic whipworm found in humans.

The main difference between the two worms is that the pig worm is eliminated from the body in just a few weeks, while the human version — Trichuris trichiura — makes its home in the large intestine for up to five years, Loke says.

“This patient did a lot of research,” the investigator says. “He may be one of the smartest people I know. He was very aware of the risks.”

Using worm eggs provided by a parasitologist in Thailand, the man ingested 500 eggs in late 2004 and 1,000 more eggs three months later.

Egg Treatment Led to Remission

His symptoms improved over the following months and by mid-2005 he had no symptoms at all and required no treatment for his disease.

He first contacted Loke in 2006, while Loke was working as a post-doctoral fellow at the University of California, San Francisco.

“He was in full remission at the time, and his main incentive was to stay in remission,” Loke says.

The man agreed to a series of colonoscopies over the next several years, and Loke and colleagues analyzed blood and tissue samples during this time.

What they found was that the worms seemed to stimulate the production of mucus in the gut. the mucus contained a large number of T cells that produced a protein that is important in healing, known as interleukin 22.

Loke and colleagues believe that the mucus is produced in an effort to expel the worms from the gut. instead of doing this it heals the lesions caused by the disease.

Experts: ‘Don’t Try this at Home’

The patient was lucky, Loke says, because the risks of deliberately colonizing the intestine with parasitic worms are not well understood.

“The patient reported no side effects, but that doesn’t mean this would be the case for someone else,” he says.

Joel Weinstock, MD, of Tufts University, agrees. Weinstock conducted some of the first pig whipworm research and is now involved in research to develop the pharmaceutical-grade worm treatment.

“It would not be wise for people to obtain eggs and take them the way this man did, because there is no way to be sure what you are getting,” he says. “We are developing a defined agent that can be delivered in a predictable way.”

Depending on the results of clinical trials that are now under way, a Trichuris suis egg drug could be available in a few years, he says.

Weinstock’s worm research stemmed from the observation that conditions like ulcerative colitis and other inflammatory bowel diseases were common in countries where infection with parasitic worms was rare and almost unheard of in countries where worm infections are endemic.

This may be because the parasites actually have a calming effect on inflammation within the body to avoid eviction from their host home.

“These organisms have co-evolved with us for hundreds of thousands of years, and they have been part of our GI tract forever,” Weinstock says.

SOURCES: Broadhurst, M.J. Science Translational Medicine, Dec. 1, 2010; vol 2.P’ng Loke, PhD, assistant professor of medical parasitology, NYU Langone Medical Center.Joel Weinstock, MD, professor of immunology, Tufts University Sackler School of Graduate Biomedical Sciences, Boston.News release, NYU Langone Medical Center.©2010 WebMD, LLC. All Rights Reserved.

Newswise — your child may be allergic to your holiday pumpkin pie, according to allergists at the annual scientific meeting of the American College of Allergy, Asthma and Immunology (ACAAI) in Phoenix, Nov. 11-16. Hot topics discussed in pediatric allergies include pumpkin and caterpillar allergies, and outgrowing childhood allergies.

Although pumpkin is not a food usually associated with allergic reactions, the Annals of Allergy, Asthma and Immunology, the scientific journal of the ACAAI, reported a case study of an 8-year-old boy with known asthma and food allergies who became sick after carving a pumpkin. his symptoms included itchy eyes, sneezing, eyelid swelling and chest tightness. Allergists say these symptoms can occur after carving or eating pumpkin.

“An allergic reaction to pumpkin can occur even if your child has had no prior reactions,” said pediatric allergist John Kelso, MD, of the ACAAI Pediatrics and Literature Review Committees.

And although your little one may want to catch a caterpillar and see it become a butterfly, case studies show caterpillars can also cause allergic reactions in some children. Direct contact with caterpillars or breathing airborne caterpillar hairs can cause hives or respiratory symptoms. Extensive or prolonged exposure can cause life-threatening anaphylaxis.

“These may be rare allergies, but it may also be that we are just becoming more aware of them,” said Dr. Kelso. Pediatric allergists also presented new ideas on childhood allergies and asthma topics including: • Outgrowing childhood allergies• Asthma management update• Paths of the “allergic march”

Outgrowing Childhood AllergiesThe life cycle of childhood allergies was examined to determine how children’s responses to airborne allergens – dust mite, cat, dog, grass and birch – changed over time. while it was known children can outgrow certain food allergies, airborne allergies were thought to only get worse with age. Researchers found that reactions to airborne allergies undergo tremendous changes throughout childhood; and mild allergies early in life frequently disappear as children grow.

“Not surprisingly, the stronger the existing allergic response, the less likely the allergy is to be outgrown,” said Dr. Kelso. “What we learned was that low level allergic sensitization to airborne allergens in early childhood tends to be lost with the passage of time.”

Asthma Management UpdateBecause asthma is a serious and sometimes life-threatening disease, allergists continue to focus on finding the right balance of therapies to keep asthma under control. Asthma sufferers should be able to feel good, be active all day and sleep well at night.

“Recent FDA label changes for Long-Acting Beta-Agonists (LABAs) mean possible changes for pediatric asthma management,” said allergist Bobby Lanier, MD, ACAAI executive medical director. the label changes specify that LABAs should only be used with a controller medication, and discontinued once control is achieved.

“In fact LABA use can decrease the total dose of inhaled steroids needed, which in childhood asthma is important.” said Dr. Lanier. “Allergists must weigh the risks and benefits for each patient.”

Path of the Allergic MarchIt had been previously thought that allergic children “marched” predictably from eczema to asthma to allergic rhinitis. But recent research, which analyzed a database of more than 24,000 children, found while this is the most common path, it is not as predictable as once thought. most children who develop one of these conditions will not develop the others. those who do can start with any one of them and may develop the others in any order. having eczema, asthma or allergic rhinitis makes children more likely to have one or more of the others, but there is not a conventional march from one to the next.

About ACAAIThe ACAAI is a professional medical organization headquartered in Arlington Heights, Ill., that promotes excellence in the practice of the subspecialty of allergy and immunology. the College, comprising more than 5,000 allergists-immunologists and related health care professionals, fosters a culture of collaboration and congeniality in which its members work together and with others toward the common goals of patient care, education, advocacy and research.

To learn more about allergies and asthma, take a relief test and find an allergist, visit AllergyAndAsthmaRelief.org

Follow the ACAAI annual meeting on Twitter at #ACAAI2010.

The ACAAI Press Room is located in Room 121B at the Phoenix Convention Center, November 12 – 15, 2010; phone 602-514-5360, .

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