150 likes | 605 Views
Case Series (Reports). Case Series (Reports). Usually only a descriptive account Unusual features Unexpected occurrences Side effects Experience with procedures. Most often, no comparison (control) group. Generate hypotheses Lead to future studies. A famous case-series.
E N D
Case Series (Reports) Usually only a descriptive account Unusual features Unexpected occurrences Side effects Experience with procedures Most often, no comparison (control) group Generate hypotheses Lead to future studies
A famous case-series. Lancet. 1981 Sep 19;2(8247):598-600. Hymes KB, Cheung T, Greene JB, Prose NS, Marcus A, et al. Kaposi's sarcoma in homosexual men-a report of eight cases. Dan McGee
What was known. Kaposi's sarcoma -- a cancer that causes patches of abnormal tissue to grow under the skin. Predominantly in the lower limbs KS usually developed slowly. Hence was usually diagnosed late in life (70s). Survival usually 8-13 years.
“The clinical findings in eight young homosexual men in New York with Kaposi's sarcoma showed some unusual features.”
Unlike the form usually seen in North America and Europe, it affected younger men (4th decade rather than 7th decade); the skin lesions were generalized rather than being predominantly in the lower limbs, and the disease was more aggressive (survival of less than 20 months rather 8-13 years).
All eight had had a variety of sexually transmitted diseases.
This unusual occurrence of Kaposi's sarcoma in a population much exposed to sexually transmissible diseases suggests that such exposure may play a role in its pathogenesis.”
1983 -- Human immunodeficiency virus (HIV) described. 1985 -- Blood test for HIV antibodies became available. 1987 -- FDA approved azt (zidovudine) for treatment of AIDS. More treatments are available today and often involve highly active antiretroviral therapy (HAART) -- a combination of at least three drugs.
John Snow and the Broad Street Pump Dan McGee
1854 Cholera Outbreak In London Miasma Theory