May-Hegglin anomaly (MHA) is a rare type of autosomal dominant platelet disorder associated with mutations in the gene encoding nonmuscle myosin heavy chain 9 (MYH9). It is characterized by the presence of large platelets, leukocyte inclusions, and thrombocytopenia. The bleeding tendency is usually mild, but severe hemorrhages have been reported. This is the first reported case of a patient with MHA who underwent craniotomy for intractable seizure disorder of temporal lobe origin. Patients who have thrombocytopenia have a higher likelihood of developing intraoperative or postoperative intracranial hematoma and bleeding complications. The patient was administered desmopressin (DDAVP) prior to the neurosurgical procedure and had no complications. With this approach, the use of platelet concentrates could be avoided. We discuss the role of DDAVP in MHA and related platelet disorders and review the current literature. Am.

Gemfibrozil monotherapy of hyperlipidemia may predispose to rhabdomyolysis with acute renal failure. Patients using gemfibrozil should be cautioned regarding strenuous exertion, dehydration, and the need for prompt evaluation of myalgias.

BACKGROUND.Immigrants from India and Pakistan comprise about 1.5% of the total United States population. To the author' knowledge, this is the first study analyzing epidemiologic data on Indian and Pakistani patients with newly diagnosed cancer.METHODS. The Surveillance, Epidemiology, and End Results (SEER) database has reported cancer incidence from 1973 to 2003. Since 1988, the Indian and Pakistani population has been reported separately under race and ethnicity. Frequency and survival analyses with SEER data were performed, and descriptive parameters were calculated along with overall survival in common cancers.RESULTS. In total, 6889 cases were reported between 1988 and 2003, and those cases included 51% men and 49% women (P 5 .821). Among men, 30% of cases were prostate cancers, 10% of cases were lung cancers, and 9% of cases were colorectal cancers. Among women, 38% of cases were breast cancers, 15% of cases were genital cancers, and 7% of cases were colorectal cancers. When overall survival with common cancer was compared between immigrants and non-Hispanic whites in the United States, it was better among Indian and Pakistani immigrants.CONCLUSIONS. In a United States-based Indian and Pakistani population, prostate and breast cancers were the most common malignancies in men and women, respectively. This differed from the incidence in India and Pakistan, where oral cavity cancer in men and breast and cervical cancers in women were the most common. These immigrant cancer patients also had better survival. This change in demographics may be attributed to multiple factors, and the current data have implications on cancer screening and intervention.

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