Whipples disease is a multisystem disorder caused by chronic infection with a bacterium, tropheryma whippelii. If there are no age heapings at ages ending in 0 and 5, the whipple s index is 100. A typical meal at the whipple estate might consist of the worlds largest piece of french toast, delivered to the table via helicopter. Its noticed that ages that end with 0 and 5 have higher numbers than their neighboring ages. It is the most often used surgery to treat pancreatic cancer that s confined to the head of the pancreas. Whipples index myers blended method the use of stable population theory uses of consecutive censuses.
The whipple museum of the history of science edited by joshua. In 2008 the democratic peoples republic of korea dprk conducted the most recent population and housing census with support of the united nations population fund unfpa. By the end of his life, skin changes, diarrhea, abdominal swelling, and mesenteric adenopathy were prominent. They underscored the rarity of spinal cord involvement by calling the case described by clarke et al a unique reported case of myelopathy secondary to wd. This is because a laparoscopic whipples operation is a technically demanding and timeconsuming operation. Age ratio scores ars and age accuracy index aai were also calculated. Myers blended index, the original whipples index and the total modified whipples index w tot 2 any disparities between the specific myers indices. Gastroduodenal biopsies show typical histological alterations. In 2000, tropheryma whipplei was finally identified as the cause of whipple s disease, a chronic condition with protean manifestations that was first described in 1907. We suggest that the diagnosis of wd should be considered in the presence of an enlarged and enhancing spinal cord even in the absence of any. An extension of modified whipple indexfurther modified. Neurology of whipples disease journal of neurology. Whipples disease is a clinically relevant multisystem disorder that is often undiagnosed given its elusive nature.
Gaspeebefore the official outbreak of americas revolutionary war with great britain. Oncologic surgery in the caribbean has evolved over the past decade, with increasing reports of advanced minimally invasive operations being performed. Whipples disease is characterized by dementia, ophthalmoplegia usually vertical, and myoclonus. Whipples index is constructed for the age group of 2362 years using the following. First described by george hoyt whipple in 1907 and commonly considered a gastrointestinal disorder, whipple s disease primarily causes malabsorption but may affect any part of the body including the heart, brain, joints, skin, lungs and the eyes. The whipple museum of the history of science edited by. Jan 22, 2020 whipples disease wd is a rare multisystem infectious disorder that is caused by the actinomycete tropheryma whipplei. The whipple procedure removes a pancreatic tumour, tissue around the tumour, and parts of the pancreas. The whipples index has been 174 developed to determine the amount of age heapings. To assess the total modified whipples index, we will compare it with the other summary measures of age reporting quality.
This is done by replacing the entire fluctuating values due to small sample in the 2 nd and 3 rd columns of the. A guide to creating great advertising, 3rd edition. Diagnosis requires tissue sampling and histology with periodic acidschiff pas staining. Special topic volume 1 table 1c assesses age heaping using the. If there are no age heapings at ages ending in 0 and 5, the whipples index is 100. Horacio asbun, mayo clinic in florida, explains the whipple procedure using this animated graphic of a pancreas. Age heaping and accuracy of age data collected during a. Longterm outlook after treatment begins, many of the symptoms will go away within a month. The gaspee virtual archives and gaspee days web sites have information about commodore abraham whipples role in the burning of h. This comparison shows that because the new total modified whipples index is more sensitive than the original whipples index, it provides a more accurate measure of age reporting quality and.
The choice of 23 and 62 as the limits of age band to be examined in the classic whipple s index calculation is arbitrary but has been found to be the most suitable for the purpose of measuring age heaping in general in a population of all ages united nations 1955, pp. Guy montrose whipple 18761941, american educational. A pancreaticoduodenectomy, pancreatoduodenectomy, whipple procedure, or kausch whipple procedure is a major surgical operation most often performed to remove cancerous tumours off the head of the pancreas. Whipples index index of concentration is an indicator of the degree of age heaping. Clinical diagnosis is best confirmed by pcr amplification of tropheryma. It also removes the duodenum, the pylorus lower part of the stomach, the gallbladder and part of the common bile duct. The photographs detail construction and feature images of the grounds in general. Its about people named whipple, wherever or whenever theyve lived.
The recent identification of the whipples disease bacillus has, using polymerase chain reaction based assays, fuelled advances in the investigation, diagnosis, and management of this disease. Therapy for whipples disease journal of antimicrobial. The whipples index, or the index of concentration, is based on population statistics by single years of age as presented in table 1a. After performing the whipple procedure, your surgeon reconnects the remaining organs to allow you to digest food normally after surgery. Please note that the content of this book primarily consists of articles available from wikipedia or other free sources online. As a result, the alternative approach is tried here to get a justified index value. Age heaping and digit preference were measured by calculating whipples index and myers blended index. Be sure to visit the whipple genweb while youre here. Whipples index detects a preference for ages ending in 0, 5, or both. Whipple s disease is a rare, systemic infectious disease caused by the bacterium tropheryma whipplei. Therefore it is necessary for the clinician to retain a high index of suspicion that whipples. Only a few studies have examined consecutive patients with whipples disease for sacroiliitis and as 1,2. It presents with joint pain followed by abdominal pain, diarrhea, malabsorption and finally failure to thrive. Fort whipple photograph collection, 19051908 description loose photograph album pages with photographs of the reconstruction of buildings at fort whipple, arizona from 1905 to 1908.
Detecting whipples disease, a great imitator, requires a high index of suspicion so that antimicrobial treatment can be initiated in a timely manner. Whipples disease was first described in 1907, the genomic composition of the causative organism, tropheryma whipplei, was unravelled in 2003 and its in vitro susceptibility to antibiotics started to be explored in 200405. Survey or census respondents sometimes inaccurately report ages or dates of birth. Digit specific modified whipples indexes wis for all 10 digits are as given. A number of indices is being used, for instance whipples index, which is meant to detect age heaping at multiples of 5.
Whipples disease has traditionally been considered to be a rare multisystem disorder dominated by malabsorption. The classical presentation of whipples disease involves joint arthropathy migratory oligoarticular or polyarticular and digestive disorders diarrhea and weight loss. Whipples index myers blended method the use of stable population theory uses of consecutive censuses focus of the. Signs of central nervous system infection include cognitive changes, supranuclear gaze palsy, altered level of consciousness, and movement disorders. The whipple procedure is used to treat tumors and other disorders of the pancreas, intestine and bile duct. A pancreaticoduodenectomy, pancreatoduodenectomy, whipple procedure, or kauschwhipple procedure is a major surgical operation most often performed to remove cancerous tumours off the head of the pancreas.
Still today, this knowledge is not fully applied in the recommendations for the therapy of this disease. Is the whipples index really a fair and reliable measure. The early stages of cerebral degeneration such as alzheimers disease, and if abnormal movements are present, creutzfeldjacob disease can be similar. Whipples disease has a predilection for the high brain stem, hypothalamus, and medial temporal lobe, usually seen as increased signal on mri. It is obtained by summing the age returns between 23 and 62 years inclusive and finding what percentage is born by the sum of the returns of years ending with 5 and 0 to onefifth of the total sum. Actually, in the 62yearold woman reported on by clarke et al.
Dec 23, 2019 whipples disease is a clinically relevant multisystem disorder that is often undiagnosed given its elusive nature. The whipple s index for the total population of nepal is 206. The original whipples index is obtained by summing the number of persons in the age range 23. The integer vector to give agespecific population from age 0 to. Thrombocytopenia and endocarditis in a patient with whipples.
Table 1 describes the steps in the calculation of myers blended index. Whipples index myerss blended method myerss index measurement of age and digit preference see the distributed table and comment on the age distribution. Whipple s index index of concentration, invented by the american demographer george chandler whipple 18661924, indicates the extent to which age data show systematic heaping on. Because untreated cerebral whipples disease usually progresses rapidly to death, it is imperative to establish the diagnosis promptly. Whipples index or index of concentration, invented by american demographer george chandler whipple 18661924, is a method to measure the tendency for individuals to inaccurately report. The fantastic family whipple is the story of arthur whipplethe only nonrecord breaker in the most worldrecordbreaking family on earth.
George whipple 18781976, american physician, biomedical researcher, nobel prize winner. The whipples index for the total population of nepal is 206. Whipples disease is a rare infectious disease caused by the bacillus t. If an internal link intending to refer to a specific person led you to this page, you may wish to change that link by adding the person s given name s to the link.
In 2000, tropheryma whipplei was finally identified as the cause of whipples disease, a chronic condition with protean manifestations that was first described in 1907. The gaspee virtual archives and gaspee days web sites have information about commodore abraham whipple s role in the burning of h. Whipples index or index of concentration, invented by american demographer george chandler whipple 18661924, is a method to measure the tendency for individuals to inaccurately report their actual age or date of birth. Gaspeebefore the official outbreak of america s revolutionary war with great britain. Whipple disease genetic and rare diseases information. Whipple s disease has traditionally been considered to be a rare multisystem disorder dominated by malabsorption.
Some content that appears in print may not be available in electronic books. Whipples index is constructed for the age group of 2362 years using the. Rheumatologists are in a prime position to handle whipples disease. First described by george hoyt whipple in 1907 and commonly considered a gastrointestinal disorder, whipples disease primarily causes malabsorption but may affect any part of the body including the heart, brain, joints, skin, lungs and the eyes. Based on whipples index, accuracy of agereporting is judged. Pdf a method for calculating the strength and shape of age heaping. What are the signs and symptoms of whipples disease. Diagnosis and management of whipples disease of the brain.
The signs of systemic infection include gastrointestinal problems, weight loss, and arthritis. Digit preference in iranian age data italian journal of public health. Whipples disease is a rare, systemic infectious disease caused by the bacterium tropheryma whipplei. It s about people named whipple, wherever or whenever theyve lived.
The photographs illustrate the process of construction from laying foundations to the completed buildings. When whipple disease wd is confined to the cns, diagnosis may be difficult. If only digits 0 and 5 are reported, then index is 500. We report a case of wd with spinal presentation in an otherwise healthy woman who had a 5year history of relapsingremitting cervicothoracic myelopathy. Report on socioeconomic, demographic and health survey2014, dprk ix. Anyone can get whipples disease, but it is more common in middleaged caucasian men. Demography is the scientific study of human population. We present an atypical case of whipples disease involving panvalvular endocarditis and constrictive pericarditis, requiring cardiac intervention. Mar 17, 2018 whipples index or index of concentration, invented by american demographer george chandler whipple 18661924, is a method to measure the tendency for individuals to inaccurately report.
The early stages of cerebral degeneration such as alzheimer s disease, and if abnormal movements are present, creutzfeldjacob disease can be similar. Cancer of the pancreas affects 45,000 people every year. Thrombocytopenia associated with endocarditis associated with wd has. Pdf in their pioneering work on the florence catasto of 1427. Scurvy as the presenting illness of whipples disease.
George whipple first described the disease which bears his name in 1907. The disease usually occurs in the gastrointestinal system, but may affect any part of the body including the heart, lungs, brain, joints, and eyes. In their case report kremer et al presented findings in a patient with whipple disease wd that involved the brain, optic chiasm, posterior fossa, and spinal cord. In this book the diverse objects of the whipple museum of the history of sciences internationally renowned collection are brought into sharp. It is shown that the original whipples index is a fair and reliable measure of the quality of age reporting only when attractions on 0 and 5 digits are important. From the original whipples index to a modified version 2.
Cancer of the pancreas affects 45,000 people every year in the u. Evaluation of age and sex distribution data united nations statistics division. Therefore it is necessary for the clinician to retain a high index of suspicion that whipple s disease may be the cause of these various syndromes. Pdf mesenteric lymphadenitis as a presenting feature of.
The disease usually occurs in the gastrointestinal system, but may affect any part of the body including the. This census provided a wealth of information on population dynamics and socioeconomic conditions of the population. Whipples disease also affects the gastrointestinal tract and joints. The choice of 23 and 62 as the limits of age band to be examined in the classic whipples index calculation is arbitrary but has been found to be the most suitable for the purpose of measuring age heaping in general in a population of all ages united nations 1955, pp. The neurological manifestations do not help to distinguish primary from secondary whipples disease of the brain, and although mr brain scanning with gadolinium is mandatory, it can be normal and any abnormalities are. Whipples disease have occurred within the same family, no documentation exists of a persontoperson transmission. To exclude definitively the association of whipples disease with as it is necessary to obtain bacteriological data on t. Whipple suspected an infectious agent in 1907 when he noted the numerous rodshaped organisms within the submucosa and macrophages of the index patient. The myers blended index calculated for the study population was 41. Whipple s index myerss blended method myers s index measurement of age and digit preference see the distributed table and comment on the age distribution.
It is also used for the treatment of pancreatic or duodenal trauma, or chronic pancreatitis. The total population in the age group above 10 years was 3571. Whipples disease is a chronic systemic infection that is due to the bacterial agent tropheryma whipplei and can be cured by appropriate antibiotic therapy. Whipples disease wd is a rare multisystem infectious disorder that is caused by the actinomycete tropheryma whipplei. It is a summary measure of age heaping on ages ending in 0 or 5 used to determine variability in the quality of age reporting between regions or countries and its evolution over time. Whipples index or index of concentration, invented by american demographer george chandler whipple 18661924, is a method. The modified index value seems to be appropriate keeping in view of the type of high and low values only for a few digits out of the ten digital values. Scope and content note the collection consists of approximately 1,200 blackandwhite photographs of the reconstruction of fort whipple from 1905 to 1908, after its reinstatement as an active post. Whipple disease is an infectious bacterial disease that affects many different organ systems and interferes with the body s ability to process metabolize fats. Signs and symptoms of whipples disease vary widely. The incidence of whipple s disease has been estimated at about 0.
United nations workshop on census data evaluation for english speaking african countries kampala, uganda. The integer vector to give agespecific population from age 0 to more than 63 for each age. Due to the shared blood supply of organs in the proximal gastrointestinal system, surgical. However, the minimally invasive approach has not been used for periampullary lesions. To india, its states and this study is single year age census years 2001. Mesenteric lymphadenitis as a presenting feature of whipples. Whipple disease is a rare disease caused by infection with the bacterium tropheryma whippelii.
Fort whipple collection saving arizonas history since 1864. Whipples disease is a rare opportunistic infection 1 out of 1,000,000. Whipples disease is a bacterial infection that can lead to death if its not treated properly. The whipple s index puts the rate of age heaping in the 2003 dataset at 271. Oct 31, 2009 age heaping and digit preference were measured by calculating whipples index and myers blended index. A common error in age reporting is the tendency of rounding the ages to the nearest. Whipple s index index of concentration is an indicator of the degree of age heaping. Many patients have malabsorption, which means an impairment of the bodys ability to absorb certain nutrients. Digit preference, myers blended index, whipples index, age data. Whipples index for ageheaping usage whipplesindex x arguments. This report describes a case of cerebral whipples disease without gastrointestinal symptoms that was diagnosed early by lightand electronmicroscopic study of brain biopsy material. Whipple s disease is a rare, chronic, systemic infection due to the bacterial agent tropheryma whipplei. The recent identification of the whipple s disease bacillus has, using polymerase chain reaction based assays, fuelled advances in the investigation, diagnosis, and management of this disease. Whipple disease is an infectious bacterial disease that affects many different organ systems and interferes with the bodys ability to process metabolize fats.