Search PubMed⌕ Search

Biomedical subjects

A Adunsky

Publications and source records attributed to A Adunsky.

51 records · Page 3Linked to original sources
PubMed1987

Stevens-Johnson syndrome associated with Mycoplasma pneumoniae infection.

The Stevens-Johnson syndrome is a relatively uncommon, severe form of erythema multiforme. A case is presented in which Mycoplasma pneumoniae infection was established as the causative agent. Clinicians need to be aware of this uncommon association. We emphasize the need to consider M. pneumoniae infection as one of the many agents responsible for the Stevens-Johnson syndrome.

Adolescent↗
PubMed1981

[Diabetes insipidus induced by post-resuscitation hypoxia].

A 13-year-old girl was admitted with meningeal signs. A lumbar puncture was followed shortly by cardiorespiratory arrest. In spite of intensive resuscitation she remained comatose and severe polyuria diagnosed as diabetes insipidus appeared. The differential diagnosis of dehydration and polyuria in patients after cardiorespiratory arrest and resuscitation should include hypothalamic injury causing diabetes insipidus.

Adolescent↗
PubMedDate not supplied

Rehabilitation outcomes in patients with full weight-bearing hip fractures.

Evaluation of the functional outcome for hip fractured elderly patients has been controversial due to a typical casemix containing both weight bearing and non weight bearing postoperative fractures. The purpose of this study was to investigate factors associated with rehabilitation outcomes in patients who are able to fully weight bearing following surgical repair of femoral neck fracture. We studied 217 consecutive patients admitted for rehabilitation after surgery for hip fracture. Age, gender, marital status, type of fracture and admission Functional Independence Measure (FIM) were evaluated as possible predictors of rehabilitation outcome. Functional gains were evaluated according to FIM. Dependent outcome variables were calculated as absolute (total FIM gain and daily FIM gain) as well as relative (to potential). Results showed a significant improvement in absolute total and daily FIM gains (19.32+/-8.29, and 0.87+/-0.44, respectively). Relative total functional gain was 0.40+/-0.19. Absolute total functional gain did not depend on FIM admission, whereas all other parameters were significantly correlated with FIM scores on admission, indicating a relatively adverse rehabilitation in patients with an admission FIM of 40 points or lower. The majority (83.9%) of patients were discharged home. A significant association exists between the ability to go home and marital status (P=0.009), as well as with admission FIM (P<0.0001). We conclude that encouraging outcome results are achieved in the elderly with full weight bearing fractures. The absolute functional gains do not depend on FIM admission scores and argues for inclusion of patients with low admission FIM scores to rehabilitation programs. However, the relative gains are significantly better in patients with higher admission FIM scores, thus supporting inclusion of selected patients. This poses serious ethical issues for healthcare policy-makers.

Journal Article↗
PubMedDate not supplied

Clock drawing task, mini-mental state examination and cognitive-functional independence measure: relation to functional outcome of stroke patients.

The use of reliable and valid brief cognitive screening instrument for selecting the appropriate candidates for stroke rehabilitation is crucial. Clinicians often face the question which test should be preferred, that will best correlate with functional outcome. The objective of this study was to compare the clock drawing task with other cognitive tests used for the evaluation of discharge functional outcome in elderly stroke patients. We conducted a retrospective chart study including 151 consecutive patients, admitted for inpatient comprehensive rehabilitation following acute stroke. The clock drawing task (CDT), mini-mental state examination (MMSE) and the cognitive-functional independence measure (cognFIM) were used to assess the cognitive status. Functional status outcome was evaluated by the functional independence measure (FIM), using absolute and relative parameters of efficacy and efficiency. Correlation coefficients (Pearson correlation) between the three cognitive tests resulted in r-values ranging from 0.51 to 0.59 (P<0.001). All three tests correlated significantly with motor outcomes. MMSE did not confer additive value to CDT. It is concluded that CDT is similar to mini-mental and both are somewhat better than cognFIM with respect to the evaluation of functional status outcome following stroke. The correlations between the tests as well as the simplicity of administration favor the use of either CDT or MMSE in the initial assessment of elderly stroke patients.

Journal Article↗
PubMedDate not supplied

Binding of platelet-activating factor to platelets of Alzheimer's disease and multiinfarct dementia patients.

The binding of 1-O-alkyl-2-acetyl-sn-glycero-3-phosphocholine (platelet-activating factor, PAF) to platelets was studied in 22 patients with probable Alzheimer's disease (AD), 11 with multi-infarct dementia (MID), 22 age-matched normal old controls, and 20 young subjects. The results showed a significantly lower degree of PAF binding to platelets of AD and MID patients than in those of the old controls and young subjects (133.3 +/- 8.5, and 123.4 +/- 16.5 vs. 202.3 +/- 11.6 and 206.7 +/- 17.3 receptors/cell, respectively; p < 0.01). These differences were due to reduced Bmax, while Kd remained unchanged. No significant difference was observed between the PAF binding to platelets of AD and MID patients nor between that of old and young controls. No correlation was found between age and binding in the various elderly groups. However, a significant correlation was found between PAF binding and degree of cognitive impairment in the AD patients. This is the first evidence to support a possible involvement of PAF in dementing disorders.

Adult↗
PubMedDate not supplied

The effect of intravenous fluid infusion on blood and urine parameters of hydration and on state of consciousness in terminal cancer patients.

This prospective study was undertaken to assess the state of hydration in terminal cancer patients with and without intravenous fluids during the last 48 hours of their lives and to correlate various measures of hydration with their state of consciousness. We examined indicators of hydration in the plasma and urine of 68 consecutive patients for whom data were available at 48 hours or less before death. Thirteen of the patients were being treated with intravenous (IV) fluids. Nearly all of the patients studied were found to be dehydrated, as determined by laboratory measurements. State of consciousness correlated inversely with serum sodium (p < 0.001) and urine osmolality (p < 0.02). Patients receiving intravenous fluids were not better hydrated than those without IV therapy, nor was their state of consciousness improved. In light of these findings, which suggest there is no clinical benefit from intravenous infusions, decisions regarding intravenous fluid therapy during the last hours of life should be guided by the preferences of the dying patient and his family.

Coma↗