Search PubMed⌕ Search

Biomedical subjects

A Pines

Publications and source records attributed to A Pines.

At least 163 records · Page 9Linked to original sources
PubMed1987

Prolonged rectal bleeding associated with hemorrhoids: the diagnostic contribution of colonoscopy.

We studied 387 patients with prolonged rectal bleeding and hemorrhoids (grades 2 and 3) routinely examined by anoscopy, proctoscopy, single contrast barium enema, and hemoglobin measurements. Normal results were obtained in 86 patients above the age of 40. Total colonoscopy in these patients revealed one patient (1.2%) with cancer, 19 (22.1%) with colorectal polyps, and one (1.2%) with angiodysplasia. These findings indicate that in patients above age 40, a full investigation of the large bowel should be done in every case of prolonged rectal bleeding despite the presence of substantial hemorrhoids. Double contrast barium enema or colonoscopy must be used, rather than single contrast barium enema, which proved to be an inaccurate method of investigating prolonged rectal bleeding.

Barium Sulfate↗
PubMed1987

Survival and prognostic factors in chronic lymphocytic leukemia.

The survival of 137 consecutive chronic lymphocytic leukemia patients, diagnosed between 1960 and 1982 and followed up at the Hematology Clinic of the Chaim Sheba Center, was correlated with demographic, clinical and laboratory data. The median survival time of the whole group was 104 months. Older age, hepatomegaly, anemia, thrombocytopenia and increased percent of lymphocytes in the peripheral blood at diagnosis were all associated with shorter survival. On the other hand, splenomegaly or lymph node enlargement did not influence survival. When divided according to both Rai's and the International Workshop staging systems, the survival of our patients seemed to be better than that reported in most previously published series of similar patients. We assume that this is related to a conservative approach to the treatment of chronic lymphocytic leukemia patients in this center.

Adult↗
PubMed1987

Induction of cutaneous plasma cell tumor as a complication of adjuvant immunotherapy with methanol extraction residue of bacillus Calmette-Guérin.

Methanol extraction residue (MER), a cell wall fraction of bacillus Calmette-Guérin, has been reported to exhibit immunomodulating properties which permit its successful use as an adjuvant of immunotherapy in cancer patients. Its beneficial immunostimulatory effects are generally thought to be due to nonspecific stimulation of cell-mediated immunity. Little attention has been focused on its humoral stimulating properties. A case is presented of a patient undergoing treatment with adjuvant immunotherapy with MER for malignant lymphoma who developed a cutaneous plasma cell tumor at the injection site of the drug. This complication may represent the result of enhanced humoral immunity induced by the MER treatment. The development of a cutaneous plasma cell tumor must be added to the list of known MER toxicities, and may constitute an indication for the discontinuation of treatment with this agent.

Adjuvants, Immunologic↗
PubMed1987

Neutrophilic dermatosis and myelodysplastic syndrome.

Acute febrile neutrophilic dermatosis (AFND) is sometimes associated with leukemia. We present a patient with myelodysplastic syndrome who subsequently developed AFND, and we briefly review the association of AFND and myeloproliferative disorders.

Fever↗
PubMed1987

Exercise testing in juvenile borderline hypertension.

Exercise testing has emerged as an important method for improved evaluation of the cardiovascular system. However, juvenile patients presenting resting borderline hypertension have not been extensively studied. Therefore, this study evaluated the response to exercise in this group of patients. Nine hundred men aged 16 to 29 years performed a multistage near-maximal exercise test. The control group consisted of 338 age- and weight-matched, asymptomatic, healthy, normotensive individuals. Mean physical working capacity (+/- SD) was 129 +/- 28 W (82 +/- 18% of the normal according to our standardization) in the hypertension group, and 153 +/- 29 W (102 +/- 18%) in the control group (P less than 0.001). Mean systolic blood pressures at termination of exercise were 181 +/- 25 and 164 +/- 25 mm Hg in the hypertensive and the control groups, respectively; the mean diastolic values at termination of exercise were 49 +/- 32 and 32 +/- 29 mm Hg, respectively. The magnitude of the changes in blood pressure from rest to near-maximal values was smaller in the borderline-hypertensive individuals demonstrate a clear hypertensive pattern of reaction to physical activity, thus emphasizing the importance of exercise testing as part of the routine workup of such patients. The relationship between borderline hypertension and the risk of myocardial events has been established, and early hygienic or even pharmacological measures are necessary.

Adolescent↗
PubMed1986

Colorectal adenomatous polyps and carcinoma in Ashkenazi and non-Ashkenazi Jews in Israel.

In Israel, the incidence of colorectal cancer among European-American-born Jews is approximately 2.5 times that of African-Asian-born Jews. To determine the risk of all colorectal tumors for the two ethnic groups, 335 patients with colorectal adenomatous polyps and 295 with colorectal cancer, diagnosed between 1980-1984 at the Sheba Medical Center, were compared to the 35,094 persons attending the outpatient clinics at the same hospital, during September and October 1984. Ashkenazi patients (European-American-born) had a 2.5-fold risk (95% confidence interval 1.9-3.3) of colorectal polyps compared to non-Ashkenazi patients (African-Asian-born). The risk was similar for males (odds ratios [OR] = 2.3) and females (OR = 2.8). Ashkenazis also had a significantly enhanced risk of carcinoma: OR = 3.1; 95% confidence interval 2.2-4.3. The risk ratio was slightly higher for males (OR = 3.5) than females (OR = 2.7). Age-specific analyses demonstrated an elevated risk of both malignant and benign neoplasms among Ashkenazi patients at all ages at diagnosis. Among the polyp patients, the highest risk ratio was for patients between 30 and 49 years old, while among the cancer patients the risk was highest in the group of 60-69-year-olds. The distribution by size of polyps, number of polyps, as well as polyp subsite, was similar for Ashkenazi and non-Ashkenazi patients; however non-Ashkenazis tended to have slightly more right-sided colon cancer.

Adult↗
PubMed1986

Levels of some organochlorine residues in blood of patients with arteriosclerotic disease.

This study aims to elucidate if any association exists between the development of arteriosclerotic disease and contamination of the internal human environment with certain organochlorine compounds (OCCs). For this purpose the levels of DDT isomers and their metabolites, and of lindane, dieldrin, heptachlor epoxide, and polychlorinated biphenyls (PCBs) were determined in blood serum of 11 patients suffering from slight to moderate (group A), and 24 patients with moderate to severe (group B), arteriosclerotic lesions. The control group consisted of 27 patients with no obvious manifestations of arteriosclerosis. The main findings of the study in comparison with the control group were: Mean OCC residue levels in blood were slightly higher in group A and markedly so in group B; The variability and the extent of departure from normality of distributions of organochlorine insecticides (OCIs) decreased, whereas those of PCBs increased, in arteriosclerotic patients (more markedly in group B); The degree of correlation between blood serum levels of various OCCs was elevated in group A and low in group B. It remains to be ascertained whether changes in the body burden of OCCs are primary, resulting from increased exposure to and absorption of these compounds which thus contribute to the development of arteriosclerosis, or are of secondary origin, due to inhibition of xenobiotic metabolism caused by interference of the arteriosclerotic process with the functions of drug metabolizing enzymes of liver microsomes.

Arteriosclerosis↗
PubMed1986

Ultrasonography in the staging of Hodgkin's disease: lymphangiographic correlation.

The contribution of ultrasonography (US) to the staging of Hodgkin's disease was studied in 45 patients. US findings were compared with lymphangiograms (LAG) performed in the same period. In 93% of the patients there was good correlation between the two examinations. In 7% (three patients) there was a discrepancy: LAG showed retroperitoneal node involvement while with US this was negative. There were no false-positive US examinations. We therefore suggest that US be used as the primary method in the initial evaluation of Hodgkin's disease and LAG be performed only when US is negative.

Hodgkin Disease↗
PubMed1986

Thiazide-induced hyponatremia: an unusual neurologic course.

We have presented a case of thiazide-induced hyponatremia that followed an unusual course after the patient, suffering from extreme lethargy, was admitted with a serum sodium concentration of 104 mEq/L. Although the electrolyte imbalance was essentially corrected within 20 hours and there was clinical improvement, three days later the patient suddenly lost consciousness. She was comatose for more than a month, apparently from extrapontine myelinolysis. After a dramatic improvement, the patient was discharged with almost no neurologic deficit.

Acute Disease↗
PubMed1986

Pressure/volume ratio and pressure/volume ratio exercise quotient: an echocardiographic comparative study of left ventricular function indicators.

Noninvasive evaluation of left ventricular function (LVF) has been performed with two-dimensional echocardiography (TDE). Ejection fraction (EF), end systolic volume index (ESVI) and systolic blood pressure/end systolic volume index ratio (PVR)--an indicator which is independent of preload and afterload changes in a wide physiologic range--were assessed at rest and after exercise. Twenty-seven postmyocardial infarction (MI) patients were compared to 27 normal controls in an attempt to examine the above parameters of LVF in each group, measured by TDE. Correlation of TDE EF with radionuclide angiography EF proved the reliability of TDE. Rest and postexercise values of EF and PVR showed highly significant differences between the two groups. Using ESVI, a relatively lesser significant difference was found. PVR values at rest were 4.86 mm Hg/ml/m2 in the study group and 9.51 in the control group. These values increased to 5.34 and 15.15, respectively, after exercise. The ratio of PVR after exercise to PVR at rest, expressed as percentage change (PVREQ), seemed to be an additional tool in separating between both groups. This indicator merges pressure, volume, and the influence of exercise on both; a PVREQ of at least 145% correlated well with absence of MI in most of our patients.

Adolescent↗
PubMed1986

Left-ventricular exercise echocardiographic abnormalities in patients with sarcoidosis without ischemic heart disease.

We performed postexercise two-dimensional echocardiography in 21 patients with sarcoidosis but no signs of ischemic heart disease and in 24 normal control subjects. This was done to assess global and regional left-ventricular (LV) function and to try to identify the presence of occult myocardial involvement among sarcoidosis patients. All 21 sarcoidosis patients had a normal resting left-ventricular ejection fraction (LVEF) and echocardiogram. An abnormal LV response to exercise was detected in 10 sarcoidosis patients in the form of a significant decrease in mean LVEF with exercise without concomitant clinical and ECG evidence of myocardial ischemia. Seven of these 10 patients were found to have a pathological increase in LV and systolic volume with exercise, although it did not achieve statistical significance. In addition, markedly abnormal regional septal wall motion was noted in two of these patients. In the remaining 11 sarcoidosis patients, mean LVEF increased significantly with exercise. This is the normal ejection fraction response to stress. These 11 patients also showed that LV end-systolic volume decreased with exercise; the decrease was from 40.8 to 27.9 ml (P = 0.0004). In the control group, the mean LVEF increased from 69.5 +/- 7.2 at rest to 78.5 +/- 7.6 with exercise (P less than 10(-6)). We conclude that postexercise echocardiography is a noninvasive, simple, and safe method to detect and to follow the course of possible occult myocardial sarcoidosis.

Adult↗
PubMed1986

Mitral valve prolapse in psoriatic arthritis.

Twenty-five patients with psoriatic arthritis were studied by echocardiography in view of the known association of related seronegative arthropathies with aortic-valve lesions. The study group included 15 men and ten women with a mean age of 46.5 +/- 14.6 years. Twenty-two patients suffered from peripheral disease whereas three also had axial involvement. No aortic-valve lesions were found; however, mitral-valve prolapse (MVP) was detected in 14 patients (56%), nine men and five women. The mean age, mean duration of psoriasis, and mean duration of arthritis were similar in patients with and without MVP. HLA tissue typing, which was done in nine patients with MVP, revealed only one patient with HLA-B27. There was no predominance of any of the typical antigens found in psoriasis (HLA-B13, HLA-Cw6). In a control group of 32 psoriatic patients without arthritis, only two (6.4%) suffered from MVP.

Adult↗