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Biomedical subjects

A Ansari

Publications and source records attributed to A Ansari.

At least 163 records · Page 9Linked to original sources
PubMed1986

Vascular manifestations of systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is a well-known acute and/or chronic multisystem disease of complex autoimmune nature, having predilection for cardiovascular system. While its cardiac manifestations have been adequately studied, there is paucity of information on its vascular manifestations. Accordingly, we studied the incidence of vascular manifestations in 50 consecutive SLE patients seen at our institutions and in private practice during the past 12 years. Systemic hypertension (44%) was the most common vascular manifestation followed by vasculitis (30%), Raynaud's phenomenon (26%), telangiectasis (20%), premature coronary atherosclerosis (6%), digital ulceration (6%), thrombophlebitis (6%), pulmonary hypertension (4%) and portal hypertension (4%). Diffuse systemic vasculitis similar to polyarteritis nodosa was rare (2%). Often more than one lesion was found in the same patient. The clinical diagnosis of these vascular manifestations in the context of the primary disease (SLE) usually does not pose any difficulty except when they antedate it. We also studied the pathology and pathogenesis of some of these vascular lesions in both autopsy and biopsy specimens by both light microscopy and immunofluorescent techniques. Our results as well as those of others who also studied these lesions indicate that immune complex deposition and subsequent complement activation play an important role in the pathogenesis of vasculitis, coronary arteritis and premature coronary atherosclerosis. Corticosteroids and vasodilators remain the drugs of choice for the management of the majority of the symptoms arising from the vascular lesions of SLE.

Adolescent↗
PubMed1985

The "straight back" syndrome: current perspective more often associated with valvular heart disease than pseudoheart disease: a prospective clinical, electrocardiographic, roentgenographic, and echocardiographic study of 50 patients.

Fifty consecutive patients (36 male, 14 female, mean age 28 years) who had heart murmurs and clinical and radiographic evidence of straight upper dorsal spine (straight back syndrome, SBS) underwent detailed clinical, electrocardiographic, roentgenographic, and echocardiographic evaluation. Palpable systolic thrill noted in one (2%) and widened S2 with persistent splitting in 2 (4%) patients were uncommon. Murmurs were invariably systolic in nature. Those located at the base of the heart in 19 (38%) patients were ejection in type and best heard during expiration. Those located at the apex in 26 (52%) patients were either mid-, late-, or pansystolic, and often associated with midsystolic click. Five (10%) patients had both types of murmurs. Diastolic murmurs were not heard in any patient. EKGs were normal in the majority. Cardiomegaly (C:T greater than 55%) was present in only 5 (10%) and dilatation of the main pulmonary artery in 2 (4%) patients. Thus the incidence of pseudoheart disease (PsHD) was small (14%). Echocardiograms were normal in 18 (36%) and abnormal in 32 (64%) patients. There was evidence of mitral valve prolapse (MVP) in 29 (58%) patients and 3 (6%) had evidence of bicuspid aortic valve (BAV). In a control group of 40 age- and sex-matched patients (26 male, 14 female, mean age 29.5 years), who also had heart murmurs but lacked straight upper dorsal spine, only 7 (17.5%) had MVP and none had BAV. The difference is both clinically and statistically significant (p less than 0.001). It is concluded that SBS is more often associated with valvular heart disease (MVP and BAV) than PsHD. Therefore, the diagnosis of SBS should remain presumptive until echocardiography has been performed to exclude MVP and BAV. SBS patients who have valvular heart disease should receive infective endocarditis prophylaxis.

Adolescent↗
PubMed1985

M-mode echocardiography in supine and standing position in control subjects and patients with auscultatory evidence of mitral valve prolapse but negative supine echocardiography: does sensitivity improve?

Approximately 10-20% of patients with auscultatory evidence of mitral valve prolapse (MVP) have "false negative" echocardiograms. Pharmacological maneuvers do not significantly improve the sensitivity and may cause side effects. It is well known that auscultatory features of MVP change and not uncommonly can be heard only in the standing position. Therefore M-mode echo was performed in both supine and standing positions in 10 normal control subjects and 25 patients of comparable age and sex who had auscultatory evidence of MVP but negative echo in supine position. All 10 control subjects had normal echo in both supine and standing positions. No instance of false positive MVP was noted. Of the 25 patients with "false negative" supine echo, 5 showed evidence of MVP (3 pansystolic and 2 late systolic) in standing position. Based on these results the following conclusions were reached. In normal individuals the MVE remains uninfluenced by change in posture. There is modest (20%) improvement in sensitivity of detecting MVP when M-mode echo is performed in standing position in addition to supine position. Change in posture is preferable to the use of pharmacological maneuver to improve the sensitivity of detecting MVP because it is physiological, devoid of any cost, and does not produce side effects. M-mode echo in standing position or two-dimensional echo in supine position can be used to confirm the diagnosis of MVP in those patients who have "false negative" and/or nondiagnostic supine echo in the presence of auscultatory features of midsystolic click and mid- or late-systolic murmurs.

Adult↗
PubMed1985

Protein states and proteinquakes.

After photodissociation of carbon monoxide bound to myoglobin, the protein relaxes to the deoxy equilibrium structure in a quake-like motion. Investigation of the proteinquake and of related intramolecular equilibrium motions shows that states and motions have a hierarchical glass-like structure.

Biophysical Phenomena↗
PubMed1985

Heart disease in systemic lupus erythematosus: diagnosis and management.

Most patients suffering from systemic lupus erythematosus develop secondary heart disease at some time during the course of the primary illness. The most common forms of this type of heart disease are acute fibrinous pericarditis and hypertension. By means of echocardiography, an increased incidence of pericardial effusion has been demonstrated. Although commonly noted at autopsy, myocarditis is often clinically silent. However, endomyocardial biopsy may confirm its presence during life. Libman-Sacks endocarditis, although encountered in 40 to 50% of hearts at autopsy, is rarely diagnosed during life. When significant valve dysfunction such as aortic insufficiency or mitral regurgitation develops during the course of systemic lupus erythematosus, then Libman-Sacks endocarditis should be strongly suspected. Cardiac arrhythmias, first degree AV block, and acquired complete heart block may develop either de novo or in association with lupus pericarditis, myocarditis, vasculitis, etc. Complete congenital heart block has been reported in newborns of mothers with systemic lupus erythematosus, particularly those who have an antibody to a soluble tissue ribonucleoprotein antigen called RO(SS-A). Coronary arteritis and premature coronary atherosclerosis manifesting in either angina pectoris or myocardial infarction in young adults, particularly women suffering from systemic lupus erythematosus, have received attention recently. The development of hypertension and hyperlipidemia while such patients are receiving prolonged corticosteroid therapy has been incriminated as the significant risk factor in premature coronary atherosclerosis. Longstanding hypertension and congestive heart failure have unfavorable prognoses. This report is based on a cumulative review of 50 patients with acute and chronic systemic lupus erythematosus seen at our institution and in private practice during the last 10 years.

Journal Article↗
PubMed1984

Mallory-Weiss syndrome. Experience in a community hospital.

The Mallory-Weiss syndrome is characterized by repeated bouts of retching and/or vomiting followed by the sudden onset of hematemesis or melena. Bleeding arises from linear, nonperforating mucosal lacerations at the cardia, cardioesophageal junction, distal esophagus, or a combination of these sites. Hiatal hernia is often a coexisting finding. Severity of hemorrhage can vary from mild to severe (100 to 2,000 ml). The clinical course is usually benign. The diagnosis can be suspected from the history and confirmed by upper gastrointestinal endoscopy. In the majority of patients, medical management controls the bleeding. About 10% to 20% of unselected patients require surgical intervention. With the proper, prompt use of fiberoptic endoscopy in the diagnosis of upper gastrointestinal hemorrhage has come an increase in the number of cases of Mallory-Weiss syndrome being identified. This is true even in community hospitals. The result has been a decrease in surgical intervention and overall mortality.

Adult↗
PubMed1982

Immunogenetic studies in essential hypertension among black patients. I. Correlative studies of serum autoantibody formation.

Serum antinuclear antibody (ANA) and HLA phenotype frequency were studied in 100 black subjects with essential hypertension and 100 normotensive black controls matched for age and sex. 11% of hypertensive individuals had a positive serum ANA test compared with 2% of controls (p less than 0.01). Among the hypertensive patients, positive serum ANA test was seen exclusively in patients who were receiving treatment with methyldopa. Although ANA also correlated with hypertensive vascular damage as assessed by retinal and EKG abnormalities, this was believed to have been due to the higher dose of methyldopa that may have been required to treat hypertension in these more severe cases. A statistically significant correlation of HLA-A11 and HLA-B12 with hypertension was observed, but only studied when uncorrected for the number of HLA specificities. It was concluded that autoantibody formation in essential hypertension is most likely to have been a consequence of antihypertensive drug therapy. In addition, further studies using larger number of patients and controls might more clearly establish the question of whether or not HLA is associated with essential hypertension.

Adult↗
PubMed1982

Rapid differentiation of bacterial meningitides by direct gas-liquid chromatography.

Rapid identification of Haemophilus influenzae and other bacillary meningitides was attempted by gas-liquid chromatography (GLC) of the metabolic by-products in broth cultures and in cerebrospinal fluid (CSF) samples obtained from experimental meningitis produced in New Zealand White male rabbits. These results were correlated with the GLC of CSF of meningitis patients. A major peak with retention time of succinic acid was found in the broth cultures of all bacilli tested including H. influenzae, Escherichia coli, Enterobacter cloacae, Klebsiella pneumoniae, Proteus mirabilis, Citrobacter freundii, Pseudomonas aeruginosa, and Listeria monocytogenes. Succinic acid was also found in the CSF of experimental meningitis and in the CSF of all patients with H. influenzae and Esch. coli meningitis. This peak was not detected in the blood samples of experimental animals. It was also absent in the broth cultures of all of the gram-positive and gram-negative cocci tested, such as Streptococcus pneumoniae and Neisseria meningitidis. Succinic acid, which appears to be a by product of fermentation, persisted as a clear cut marker in H. influenzae meningitis for at least 3 d after the initiation of treatment. In one patient, the succinic acid peak disappeared during treatment and reappeared with a clinical relapse. Clearly, the presence of succinic acid that can be rapidly detected by GLC in the CSF excludes pneumococcal or meningococcal meningitis and strongly suggests H. influenzae or other bacillary meningitides.

Animals↗
PubMed1980

Myoglobinuric acute renal failure in phencyclidine overdose: report of observations in eight cases.

Eight cases of myoglobinuric acute renal failure that developed following exposure to phencyclidine were seen in the emergency department of the Martin Luther King Jr. General Hospital during a period of 36 months. All eight survived with complete recovery of renal function. Dialysis was necessary in three patients. Acute renal failure is an uncommon complication of phencyclidine abuse.

Acute Kidney Injury↗
PubMed1980

Fracture of distal medial femoral epiphysis with subluxation of the knee joint.

A case of complete posterior displacement of a Salter-Harris Type III distal medial femoral epiphysis fracture with posterior subluxation of the knee is reported. Invagination of the gastrocnemius muscle by the displaced fragment was blamed for failure of closed reduction. No significant ligamentous injury of the joint occurred.

Adolescent↗