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Carcinoid heart disease with severe hypoxia due to interatrial shunt through patent foramen ovale [Case Report]

Boglioli, L R; Gardiner, J; Gerstenblith, G; Taff, M L; Cameron, D E
Carcinoid heart disease occurs in approximately half of patients who have carcinoid syndrome and is the leading cause of death among these patients. It is typically manifest as right-sided valvular lesions, usually tricuspid insufficiency and pulmonary valve stenosis. This case report describes the unusual presentation of a patient with carcinoid heart disease and a large right-to-left shunt through a patent foramen ovale.
PMCID:325417
PMID: 9205988
ISSN: 0730-2347
CID: 471532

Controversies in shaken baby syndrome [Letter]

Taff, M L; Boglioli, L R; DeFelice, J F
PMID: 8789836
ISSN: 0022-1198
CID: 471542

The politics of death investigation [Letter]

Taff, M L; Boglioli, L R
PMID: 8838481
ISSN: 0195-7910
CID: 471552

Endoscopy is not autopsy [Letter]

Taff, M L; Boglioli, L R
PMID: 8838480
ISSN: 0195-7910
CID: 471562

Serum sickness reaction following multiple insect stings [Case Report]

Lazoglu AH; Boglioli LR; Taff ML; Rosenbluth M; Macris NT
BACKGROUND: Anaphylaxis is the most common systemic allergic reaction caused by stinging insects. Serum sickness reactions occur much less frequently. OBJECTIVE: To determine the level of venom-specific IgG and IgE antibodies during and after a serum sickness reaction to vespid venom. METHODS: Case report; ELISA determination of venom-specific IgG and IgE; complement levels and tests for immune complexes were performed. RESULTS: We report the case of a 66-year-old woman who developed a serum sickness reaction nine days after receiving multiple vespid stings. She developed urticaria, angioedema, fever, and arthralgias. She had elevated IgG and IgE venom-specific titers which declined during the recovery phase. Complement levels were normal and tests for immune complexes were negative. She was successfully treated with venom-specific immunotherapy without any serum sickness reaction. CONCLUSIONS: A serum sickness reaction with elevated venom-specific IgG and IgE is reported with successful immunotherapy
PMID: 8603283
ISSN: 1081-1206
CID: 22338

Physicians as judicial hangmen

Taff, M L; Boglioli, L R
PMID: 7644619
ISSN: 0033-8419
CID: 471572

Phenytoin-related immunodeficiency associated with Loeffler's syndrome [Case Report]

Lazoglu AH; Boglioli LR; Dorsett B; Macris NT
BACKGROUND: Phenytoin is one of the most commonly prescribed drugs in the United States. Its use is associated with a myriad of adverse reactions, including: eosinophilia, selective IgA deficiency and panhypogammaglobulinemia, pseudolymphoma, Stevens-Johnson syndrome, and interstitial pneumonia. OBJECTIVE: To report a case of immunodeficiency manifest by panhypogammaglobulinemia and a low helper-to-suppressor ratio secondary to phenytoin crossreactivity with phenobarbital and carbamazepine complicated by hepatotoxicity, eosinophilia, and fleeting pulmonary infiltrates. METHODS: Case report; immunoglobulin levels, T and B cell studies, and radiologic evaluation of patient. RESULTS: A 37-year-old Oriental female taking phenytoin and phenobarbital for seizure prophylaxis after resection of a grade IV astrocytoma of the left frontal lobe, developed a rash, elevated liver function tests, and cervical lymphadenopathy with parotid gland enlargement. The abnormalities resolved with discontinuation of the drugs and the patient was discharged on carbamazepine. Eight weeks later the patient was readmitted with fever, slowed mentation, elevated liver function tests, and panhypogammaglobulinemia. Clonazepam was substituted for carbamazepine and the patient subsequently developed a rash and further elevation of her liver function tests. The clonazepam was discontinued and the patient was treated with methylprednisolone. She subsequently developed Loeffler's syndrome and a T cell deficiency with a decreased helper-to-suppressor cell ratio. She was treated with increased doses of methylprednisolone and granulocyte stimulating factor with complete resolution of her symptoms. CONCLUSIONS: Phenytoin is associated with a myriad of side effects, including, rash, eosinophilia, panhypogammaglobulinemia, pseudolymphoma, Stevens-Johnson syndrome, immunosuppression in brain tumor patients, and rarely, pulmonary complications such as Loeffler's syndrome. Cross-reactivity with other anticonvulsant agents capable of forming arene oxide intermediates occurs in the cytochrome P-450 system
PMID: 7788513
ISSN: 1081-1206
CID: 22339

Death by fraternity hazing [Case Report]

Boglioli, L R; Taff, M L
Fraternity hazing can cause a variety of injuries and deaths. We recently had the opportunity to investigate a heat-related death that occurred during a college fraternity event. The original death investigation did not consider the circumstances of death, environmental conditions, or the subtle autopsy findings related to heat stroke. This case is intended to alert health care professionals that deaths on college campuses may be related to fraternity hazing and may require in-depth investigations. An analysis of the death and a discussion of heat-related injuries are presented.
PMID: 7771381
ISSN: 0195-7910
CID: 471582

Optical analyses of eyeglass lens fragments and the unexpected detection of oral sperm in a homicide case [Case Report]

Schwartz, E A; Vallaro, K E; Pool, T M; Adamo, R A; Taff, M L; Boglioli, L R
A homicide case in which intact spermatozoa were found in the oral cavity of the deceased forty days after his disappearance is reported. The victim's partially frozen body was found outdoors in a wooded area of upstate New York during the month of January. During a subsequent investigation, pieces of eyeglass lens fragments and bloodstains were found in the suspect's house and vehicle. Chemical and optical analyses of the lens fragments are presented as well as results of the serological tests.
PMID: 7602297
ISSN: 0022-1198
CID: 471592

The crash of an 83-year-old civilian pilot in upstate New York [Case Report]

Boglioli, L R; Taff, M L; Ingrassia, A J
PMID: 8201154
ISSN: 0002-8614
CID: 471612