Alexander C. Chester

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This autosomal dominant disorder usually appears in middle life. The most common findings are proteinuria, abdominal pain and palpable kidneys, followed by hematuria, hypertension, pyuria, uremia and calculi. In 15% of patients, death is due to cerebral aneurysm. Family counseling and the detection of "at risk" family members are important elements of(More)
In a review of 45 patients who started receiving hemodialysis (HD) after the age of 70 years (mean, 75 years), compared with a control of 70 HD patients (mean age, 42 years), the two-year survival for elderly patients was 42% and 58% for controls. In the elderly group, age did not correlate with survival. Nine elderly patients were over 80 years old and had(More)
PURPOSE OF REVIEW To summarize recent studies exploring the response of chronic rhinosinusitis (CRS) symptoms to endoscopic sinus surgery (ESS). RECENT FINDINGS ESS symptom outcomes were reported using various symptom scoring systems and more than 18 survey instruments. When individual symptom scores were pooled by meta-analysis, most major CRS symptoms(More)
Sick building syndrome (SBS) is usually characterized by upper respiratory complaints, headache, and mild fatigue. Chronic fatigue syndrome (CFS) is an illness with defined criteria including extreme fatigue, sore throat, headache, and neurological symptoms. We investigated three apparent outbreaks of SBS and observed another more serious illness (or(More)
BACKGROUND Recent otolaryngologic studies document significant fatigue and bodily pain (BP) in patients with chronic rhinosinusitis. Studies of general medical patients are lacking. METHODS A case-control study of 297 consecutive general medical outpatients. RESULTS Sixty-five patients noted unexplained chronic fatigue (UCF), 33 reported BP, and 26 had(More)
We describe a case of a woman who developed a peripheral polyneuropathy shortly after completing 4 weekly doses of mefloquine hydrochloride (250 mg) malaria prophylaxis. Although mefloquine-related central nervous system neuropathy is well described in the literature, peripheral polyneuropathy similar to this case has been documented only once before, to(More)
BACKGROUND Although multiple studies have demonstrated that symptoms of chronic rhinosinusitis (CRS) improve after endoscopic sinus surgery (ESS), a systematic large-scale evaluation of specific symptom response has not been performed. OBJECTIVE To analyze the relative effectiveness of surgery in the improvement of individual CRS symptoms. STUDY DESIGN(More)
Natural selection results in adaptations. I suggest that unexplained fatigue may be an adaptive response to nasal impairment. For macrosmatic animals, intact olfaction is necessary to detect predators. In such animals, any reflex (e.g., fatigue) triggered by nasal dysfunction that limited exposure would offer great survival advantage. The "fatigued" animal(More)