This experience suggests that management of immune dysfunction with intravenous immunoglobulin is safe and effective for treatment of primary pulmonary dysfunction/multiorgan failure syndrome after cardiac surgery. Expanded application seems indicated.

Objective-This study explores self-reported perception of asthma symptoms in AfricanAmericans. Methods-Qualitativemethodology was used to analyze the responses from African-Americans within focus groups from Nashville, Tennessee.

This case report describes a patient who presented with symptoms and signs of longstanding fibromyalgia. Routine laboratory tests revealed an elevated anion gap. Evaluation of the elevated anion gap demonstrated elevated lactate and pyruvate levels and a lactate-to-pyruvate ratio greater than 20:1. A muscle biopsy was performed, exhibiting red ragged fibers, pathognomonic for a mitochondrial disorder. The patient was diagnosed with mitochondrial encephalomyopathy with lactic acidosis and strokelike episodes (MELAS). This is the first report describing fibromyalgia as the initial presentation of MELAS. This article outlines the diagnostic process that can assist the physician in distinguishing mitochondrial disorders from other muscular diseases, particularly fibromyalgia.

Objective-This pilot study explores the reported symptoms in African Americans and Caucasians with asthma.Methods-Asthma patients in an inner-city pulmonary clinic were given a brief questionnaire of asthma symptoms and the BORG scale, followed by spirometry.Results-African Americans were less likely to report nocturnal awakenings (67% vs. 100%; p = 0.037), complain of dyspnea (33% vs. 75%; p = 0.038), or experience chest pain (13% vs. 75%; p=0.002) than Caucasians.Conclusions-This is the first study to demonstrate that there are clinically significant differences in the reporting of asthma symptoms between African Americans and Caucasians.