The American journal of medicine
-
Thirty percent of Americans report insomnia. After eliminating obvious causes, the best therapy for insomnia is cognitive behavioral therapy, but this is not widely available. ⋯ Recently, a new class of safe, nonaddicting, mechanism-based hypocretin blockers have been developed. Herein we review the information not only for insomnia but also for narcolepsy.
-
Sera from patients from a single medical institution in New York State with human granulocytic anaplasmosis established by a positive polymerase chain reaction test (PCR) for Anaplasma phagocytophilum were used to assess the performance of serologic testing. All cases were also confirmed by culture in order to eliminate any false positive PCR samples. ⋯ PCR testing is the most commonly used direct diagnostic test to diagnose human granulocytic anaplasmosis. Our findings demonstrate that only approximately 55% of the PCR and culture positive cases were also seropositive on blood samples obtained at the same time point, indicating that serologic testing performed at the time of presentation has limited sensitivity. However, all of the 16 evaluable seronegative patients developed antibodies to A. phagocytophilum during convalescence.