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Biomedical subjects

A Pines

Publications and source records attributed to A Pines.

At least 181 records · Page 10Linked to original sources
PubMed1986

A community-based program of colorectal screening in an asymptomatic population: evaluation of screening tests and compliance.

The incidence of colorectal cancer in Ashkenazi Jews is two to three times higher than in non-Ashkenazis. For a community colorectal screening program 1339 asymptomatic Ashkenazis over 40 yr old were asked to participate. Of these 1012 (75%) took Hemoccult II kits [fecal occult blood tests (FOBT)], and 614 (46%) personally returned them. Screenees were interviewed regarding family and personal medical history. Fourteen persons (2.3%) had positive tests, in whom colonoscopy revealed two with cancer (Dukes' B,C) and two with a greater than 2 cm polyp. The remaining 600 persons were invited for flexible sigmoidoscopy (FS) but only 287 (48%) appeared. The mean depth of insertion of the instrument was 50.3 cm (range 30-120), but was poorer for women. FS identified lesions in 28 (9.7%) persons: three had Dukes' A carcinomas and 25 had less than 2 cm adenomatous polyps. Significantly more women than men accepted FOBT, but among those completing FOBT, there was no difference by sex for use of FS. Middle-aged persons (50-69 yr) found screening more acceptable than young or older persons. Among screenees who agreed to undergo FS, a significantly larger fraction had a first relative with colon cancer, or a personal history of colon or female genital neoplasia, compared to those not agreeing to FS. There were no differences in screenees with relatives with noncolon cancer. Eighty-eight couples completed FOBT and were invited for FS. The decision whether or not to participate was made for both members in 81 (92%) couples. In conclusion, effective screening programs have to take into consideration compliance patterns of the target population.

Adult↗
PubMed1986

Common bile duct obstruction caused by hydatid daughter cysts--management by endoscopic retrograde sphincterotomy.

Four patients with cholestatic jaundice due to ruptured hydatid liver cyst into the biliary tract underwent endoscopic retrograde sphincterotomy with clearance of the bile ducts. Prompt relief of jaundice followed the produced and no complications occurred. After the procedure all patients received medical treatment (Mebendazole) for 3-4 months and were well at a mean follow-up of 8 months. We conclude that endoscopic retrograde sphincterotomy is a safe and effective treatment for cholestatic jaundice caused by hydatid daughter cysts obstructing the bile ducts. This method may serve as an alternative to surgery in selected, high risk, patients.

Adult↗
PubMed1985

Urolithiasis in acromegaly.

Hypercalcemia, hypercalciuria, and hyperphosphatemia are common findings in acromegaly, yet there are only a few reports on the occurrence of urinary stones in these patients. We reviewed the files of 64 patients with acromegaly. A total of 8 patients had evidence of renal calculi: 4 patients underwent nephrolithotomy, 3 had stones which were seen on intravenous pyelography, and 1 patient voided a stone. Moreover, 2 other patients suffered from recurrent typical episodes of renal colic. In view of the high incidence of urolithiasis in our series we believe that more attention should be paid to detection of urinary stones in acromegalics to avoid further complications and suffering.

Acromegaly↗
PubMed1985

Pericardial effusion as the sole manifestation of infectious mononucleosis.

A 56-year-old patient presented with fever, dyspnoea and large pericardial effusion, which were the only features of infectious mononucleosis. Atypical cases or infectious mononucleosis are common in older patients. Such a well documented case of effusive pericarditis, however, has not been previously recorded.

Dyspnea↗
PubMed1985

Positive serological tests for infectious mononucleosis in a patient with Mediterranean spotted fever.

The Monospot test is an accurate and reliable test for infectious mononucleosis. False positive reactions have been seldom recorded. We report the conversion of the Monospot test from negative to positive during the course of Mediterranean spotted fever. Changes in the titre of the Paul-Bunnell test were observed also. The importance of measuring IgM antibodies as part of the routine investigation of infectious diseases is emphasised.

Adult↗
PubMed1985

Apathetic thyrotoxicosis due to hemorrhage into a hyperfunctioning thyroid nodule after excessive anticoagulation.

Hyperfunctioning thyroid nodule was diagnosed in a 72-year-old woman. When the nodule reached a diameter of 3.5 cm, overt thyrotoxicosis of the apathetic type was precipitated by hemorrhage into the nodule during a period of excessive anticoagulation. All abnormal physical signs and symptoms as well as laboratory findings returned to normal within a month, without any specific treatment. It was possible to follow this process by repeated B-mode sonographic examinations and thyroid scans.

Adenoma↗
PubMed1985

Rates of sickness absenteeism among employees of a modern hospital: the role of demographic and occupational factors.

Sickness absenteeism, of hospital employees particularly, is a problem of concern due to its negative economic and morale impacts. The aim of the first stage of the study was to identify according to some demographic (sex, age, marital status) and occupational (occupational group, duration of hospital employment) variables those groups of hospital employees who are at higher risk of sickness absenteeism. A comparison with the data of the study performed in the same hospital about 15 years ago showed a rise in the duration of absences with a simultaneous reduction in their incidence. Sickness absenteeism was higher among female, mainly unskilled, workers, presently or previously married, aged from 45 to 60, and employed in the hospital for over ten years. Continuous social and medical surveillance of these employees is suggested as a promising way of reducing sickness absenteeism.

Absenteeism↗
PubMed1985

Unusual echocardiographic pattern in Gaucher's disease.

Described in this paper is a 73-year-old Ashkenazi Jew affected with adult type 1 (nonneuronopathic form) Gaucher's disease. This was diagnosed at the age of 46 during an investigation of hepatosplenomegaly. No other members of his family were known to be affected with this disorder. The patient has been periodically examined at our Institute and has been free of all cardiopulmonary symptoms. This description emphasizes his echocardiographic pattern which revealed left ventricular hypertrophy, a septal muscular hump, and an extended area of apical akinesis. Myocardial involvement in Gaucher's disease has seldom been reported in the past.

Aged↗
PubMed1985

Pleuro-pulmonary manifestations of systemic lupus erythematosus: clinical features of its subgroups. Prognostic and therapeutic implications.

Correct identification of the subsets of pulmonary lupus has an unquestioned importance in planning the proper therapeutic regimen in this extremely variegated disease. Asymptomatic pulmonary lupus needs no treatment; however, pulmonary involvement in lupus may be life threatening, in which case prompt and aggressive treatment is mandatory. The different aspects of pulmonary lupus are demonstrated through the clinical histories of patients who suffered from pleuro-pulmonary lupus. The following entities are presented: lupus pneumonitis, lymphocytic interstitial pneumonia, pulmonary hypertension, pulmonary hemorrhage, pulmonary embolism associated with circulating lupus anticoagulant, lupus pleuritis and weakness of the diaphragm.

Adult↗
PubMed1985

Colonoscopic findings in patients with hemorrhoids, rectal bleeding and normal rectoscopy.

Within a period of 18 months, 387 patients were referred to the Proctologic Service at the Chaim Sheba Medical Center because of recurrent rectal bleeding. Hemorrhoids were found in 194 of these patients and further investigation showed that 45 of the 194 patients (23.2%) had other coexisting colonic pathology (12 cancers, 28 polyps, 4 inflammatory bowel diseases and 1 angiodysplasia). Sixteen of 40 patients with diverticulosis and 13 of 30 patients with hemoglobin less than 11 g/dl had additional colonic pathology. Single-contrast barium enema, which was used in this survey for screening of the colon, proved to be inaccurate. In view of the issue of cost-effectiveness, this study suggests that patients with recurrent rectal bleeding and hemorrhoids (Grades II and III) who had normal rectoscopy should be further investigated by double-contrast barium enema if they are greater than 40 years of age. All patients with anemia, diverticulosis or abnormal findings in barium enema should undergo total colonoscopy.

Adult↗
PubMed1985

Anorexia nervosa, laxative abuse, hypopotassemia and distal renal tubular acidosis.

A case of anorexia nervosa in a 28-year-old woman with laxative abuse, hypopotassemia and severe metabolic acidosis, is described. The diagnosis of classical renal tubular acidosis, Type I, was confirmed by our inability to decrease urinary pH beyond 5.5 and to increase ammonia excretion during an ammonium chloride loading test. A bicarbonate loading test and normal plasma aldosterone with high renin activity excluded proximal renal tubular acidosis, hyporeninemic-hypoaldosteronemic renal tubular acidosis and Bartter's syndrome. The inability to increase ammonium excretion during severe metabolic acidosis following ammonium chloride loading did not favor the possibility of a transient physiological adaptation of ammoniagenesis at the tubular cell level, related to potassium depletion. Although mental disorder, laxative abuse, abstinence from food intake and severe potassium depletion intermingled in a vicious cycle, we assume that one of the following possibilities may explain the clinical presentation in our patient: either two separated and unrelated disorders, or laxative abuse as the cause of renal tubular acidification impairment.

Acidosis, Renal Tubular↗
PubMed1985

Gastrointestinal tumors in acromegalic patients.

More than 30 years ago the association between growth hormone and certain tumors was established in animal studies. However, the few clinical studies on acromegalic patients usually failed to demonstrate such a link. It was only recently that acromegaly was found to be associated with other endocrine tumors and with a high incidence of colonic polyps. In a retrospective study we looked for gastrointestinal cancer in 48 acromegalic patients. Five were identified, two cancers of the stomach, two of the colon, and one of the rectum. One patient with stomach cancer and one with sigmoid carcinoma also had recurrent colonic polyps. It is postulated that in our patients, by some yet to be identified mechanisms, the incidence of gastrointestinal cancer is significantly increased in acromegaly.

Acromegaly↗
PubMed1985

Spectrum of extracolonic gastrointestinal tract involvement in Gardner's syndrome.

To define the prevalence of extracolonic gastrointestinal tract neoplasms in association with Gardner's syndrome, 17 patients with the syndrome underwent a systematic endoscopic and radiologic investigation. Adenomas were found at one or more sites in the upper gastrointestinal tract in all patients, most frequently at the papilla of Vater (64.7% of patients). Focal adenomatous changes in normal-appearing mucosa were seen in five patients, at the ampulla of Vater and in the duodenum in four, and in the gastric antrum in two patients. Adenomas were also seen in the duodenum (47%), stomach (29.4%) and small intestine (23.5%). Hyperplastic polyps were found in the gastric antrum, duodenum or small bowel in five patients. Adenomas of the papilla of Vater showed greater degrees of dysplasia than did adenomas of the stomach or small bowel, which might explain the more frequent occurrence of malignancy at the papilla of Vater in patients with Gardner's syndrome. A systematic investigation of the gastrointestinal tract is mandatory in all patients with Gardner's syndrome prior to surgery, and at periodic follow-up thereafter.

Adenoma↗