We describe a patient who became cushingoid as a result of receiving steroid therapy for thrombocytopenia purpura and who then developed spinal epidural lipomatosis 4 months after he started receiving ritonavir as part of his therapy for human immunodeficiency virus infection. We believe that ritonavir may have contributed to the development of epidural lipomatosis and that clinicians should be aware of this possible association.

No abstract

The effect of depot parenteral injections of zinc (110 mg Zn/kg body weight) on copper metabolism in young, male rats was investigated. Individually caged rats, fed known amounts of stock diet and deionized-distilled water, were injected s.c. weekly for the first 4 weeks and biweekly for the next 17 weeks with zinc in sesame oil or the oil vehicle only. No significant differences in body weight, hemoglobin, hematocrit and fecal copper excretions were observed between treatments. However, 2 weeks after the initial injections, urinary copper excretion was elevated in the zinc-injected animals and remained elevated throughout the rest of the study. Plasma copper concentrations were significantly higher in the zinc-injected animals from week 2 to 8 of the study, and plasma zinc concentrations of these injected animals were elevated (P less than 0.05) from week 2 and throughout the remainder of the study. Zinc concentrations were significantly higher in the liver, heart, kidney and spleen (P less than 0.05) and copper concentrations were lower in the liver (P less than 0.07), kidney and spleen (P less than 0.05) of zinc-injected animals compared to the vehicle-treated control animals. The data indicate that when zinc is administered by a non-gastrointestinal route, the fecal excretion of copper, the major route of copper excretion, is not altered. Thus, a negative copper balance is not initiated by high levels of zinc administered by the depot technique, in contrast to the negative copper balance stimulated by the gastrointestinal administration of zinc.

Dear Editor:For most of us, the first exposure to the concept of medical conferences dates back to the times when we were resident physicians. It used to be exciting and filled with a sense of pride that we would be attending our first medical conference with so many inventive minds sharing their innovations. But at the back of our minds, it was part of our escapism routine wherein we would enjoy the day's work without doing the day's work. The theme was simple: that we would get to go on an 'educational' tour with no surety of getting educated. Still, it would be a win-win situation, as we would get to visit a new city with a laid-back education-vacation. Everybody wonders why educators turn a blind eye to this perspective followed by students of medicine when there is a huge investment (both economic as well as personnel) made by the educators in ensuring good-to-great conference attendance by these students.The reasons are simple. While pursuing the goal of continuing medical education, the education administrators have gone overboard in their well-intentioned pursuits of education, and the booming 'business' of medical conferences is the brainchild of this overkill. It is certain that there is a constant need for keeping up with the updates in medicine; but the bigger question is how many practitioners change their practice of medicine based on the conference didactics. It can be certainly said that it is not very often. 1 However, these medical conferences assure the attendees that depending on their individual skills, they will be able to better their social networking possibilities by putting up their inventive-innovative face-and-mind in front of the audience formed by their peers. Times have changed since the 1990s when medical literature was beaming with reports of different benefits of conferences 2 that were not limited to medical education's promotion, innovative research inspirations, available data's evaluation, and a podium to share medical presentations. The reflections of these changes are evident in a recent publication 3 that has questioned whether medical conferences are serving any purpose besides recreation and social networking platforms for busy and enterprising physicians.The next question is what good these medical conferences do for the cities organizing these medical conferences. These medical conferences attract the pedants, scholastics, and ardent researchers to present their discoveries and inventions: the bookworms and lab rats who possibly would have never left their classes or labs to enjoy the charms of sunlight and the chills of snowfall. With the backdrop of educational presentations, the medical conferences provide them the much-needed vacation for realigning their internal and external energies so as to resume their future academic pursuits with new zeal and enthusiasm. Hence, effectively, it is our understanding that the majority of the attendees are nurturing a culture of conference tourism and the remaining of them are just tourists at their hearts who are attending thes...