Severe eosinophilic syndrome associated with the use of probiotic supplements: a new entity?

Severe eosinophilic syndromes related to the administration or use of unsuspected immunogenic substances have been described previously. Many of these diseases presented initially as clusters or isolated cases. The spanish toxic oil syndrome, the eosinophilia myalgia syndrome, and nephrogenic systemic fibrosis are examples of such diseases. We describe 2 cases of a severe eosinophilic syndrome characterized by marked peripheral blood eosinophilia (\u3e15,000 cells/ml), mononeuritis multiplex, and necrotizing vasculitis which developed in a close temporal association with the recent onset use of nonprescription probiotics. There was no history of a prior autoimmune disease. Although both cases had prompt response to immunosuppression with rapid resolution of peripheral blood eosinophilia and accompanying constitutional symptoms, they remained with permanent neurological deficits

Familial Recurrence of Cerebral Palsy with Multiple Risk Factors

The recurrence of cerebral palsy in the same family is uncommon. We, however, report on two families with two or more affected siblings. In both families, numerous potential risk factors were identified including environmental, obstetric, and possible maternal effects. We hypothesize that multiple risk factors may lead to the increased risk of recurrence of cerebral palsy in families. Intrinsic and maternal risk factors should be investigated in all cases of cerebral palsy to properly counsel families on the risk of recurrence. Recent studies of genetic polymorphisms associated with cerebral palsy are considered with reference to our observations in these two families

Montana v. Wyoming: Sprinklers, Irrigation Water Use Efficiency and the Doctrine of Recapture

In 2007, Montana filed an original action with the United States Supreme Court asserting that certain water uses in Wyoming violated the Yellowstone River Compact (“Compact”). The litigation was triggered by severe drought in the basin between 2000 and 2006, during which period there was inadequate water available for Montana appropriators in the Tongue River and Powder River sub-basins. Montana raised four primary issues: irrigation of new acreage in Wyoming; new and expanded storage facilities; new groundwater pumping, especially associated with coalbed methane development; and increased consumption of water due to improved irrigation efficiency on existing irrigated acreage. In 2011, the U.S. Supreme Court decided the first substantive issue in this litigation: “Is a switch to more efficient irrigation with less return flow within the extent of Wyoming’s pre-1950 users’ existing appropriative rights, or is it an improper enlargement of that right to the detriment of Montana’s pre-1950 water users?” The Court held that such improvements are permitted under the Compact. This Article takes a careful look at this decision. It begins with an introduction to the physical setting, focusing on the Tongue and Powder sub-basins within the Yellowstone basin. It discusses Montana’s arguments why the Compact precludes improved irrigation efficiency that increases consumption and the Special Master’s rejection of those arguments. Next, the Article looks at the U.S. Supreme Court’s opinion. Finally, it offers some observations triggered by this litigation, critiques the doctrine of recapture in western water law, and supports the Court’s embrace of water use efficiency over protection of the status quo. We begin with a look at the Yellowstone River basin