The Dichloroacetate Dilemma: Environmental Hazard versus Therapeutic Goldmine—Both or Neither?

The Dichloroacetate Dilemma: Environmental Hazard versus Therapeutic Goldmine—Both or Neither?

BACKGROUND Dichloroacetate (DCA) is known to environmental scientists as a by-product of water chlorination and as a metabolite of industrial solvents, including Superfund chemicals. In contrast, DCA is studied by clinical investigators for its therapeutic potential in several life-threatening conditions, including genetic mitochondrial diseases, pulmonary arterial hypertension, and cancer. Thu...

The Dichloroacetate Dilemma : Environmental Hazard vs . Therapeutic Goldmine – Both or Neither ?

Tuberculosis or systemic lupus erythematosus? A diagnostic and therapeutic dilemma.

The diagnosis of patients with fever of unknown origin (FUO) is often problematic because the range of possible differential diagnoses is broad. We report on a case in which a patient presented with FUO and was subsequently found to have both a collagen vascular disease and an intercurrent infection. Treatment for the collagen vascular disease with corticosteroids exacerbated the intercurrent i...

Simultaneous death of twins: an environmental hazard or SIDS?

The sudden and simultaneous death of twin infants is described. The search for hazards in the home and the postmortem investigation provided an insight into the possible mechanism of death. Instead of a diagnosis of simultaneous sudden infant death syndrome (SIDS), the infants were determined to be victims of a combination of several environmental factors that led suddenly to death. Strong circ...

Pregnancy: a therapeutic dilemma

Treatment during pregnancy is problematic. The Food and Drug Administration established drug categories to help in the treatment process. First-generation antihistamines are considered safe but they have sedative properties. Second-generation antihistamines cause less adverse reactions but besides cetirizine and loratadine they belong to category C. All retinoids should be avoided during pregna...