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Biomedical subjects

A Rabinowitz

Publications and source records attributed to A Rabinowitz.

At least 19 recordsLinked to original sources
PubMed1999

Adverse events associated with balloon rupture during percutaneous coronary intervention.

BACKGROUND: Balloon rupture is a potential complication of coronary angioplasty. The literature is inconsistent regarding associated adverse consequences. The experience of St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, with balloon rupture is reviewed. PATIENTS AND METHODS: All patients who underwent percutaneous coronary intervention complicated by balloon rupture at St Paul's Hospital from April 1992 to March 1996 were identified from the hospital's database (Seattle Systems, Seattle, Washington). Procedural logs, database records, clinical charts and all cineangiograms were reviewed in detail. RESULTS: A total of 2984 patients had percutaneous coronary revascularization and 110 patients experienced balloon rupture. These occurred in 101 (92%) native coronary arteries and 9 (8%) occurred in saphenous vein grafts. Stents were deployed in 44 (40%) patients; 34 of the stents used were half Johnson & Johnson PS153 stents (Johnson & Johnson Interventinal Systems, Peterborough, Ontario). An event-free postangioplasty course during the index hospitalization was observed in 102 patients (93%); eight patients (7%) had one or more important adverse events postprocedure. These included three deaths (one following a dissection and out-of-catheterization laboratory occlusion, a second following an abrupt occlusion of another target artery and emergency bypass surgery, and another with cardiogenic shock postmyocardial infarction and an unaltered course following angioplasty); one urgent bypass surgery after a left main dissection; and two nonfatal myocardial infarctions (one patient had tamponade and one patient experienced congestive heart failure). Four of the eight events were directly related to the procedure. The rate of death and emergency bypass surgery with balloon rupture did not differ from that of patients without balloon rupture in the authors' centre (1.8% versus 1.4%, not significant). CONCLUSIONS: The majority of patients did not experience any adverse clinical outcomes and demonstrated good angiographic results after balloon rupture. The data did not detect an excess of major adverse events beyond that expected in a diverse general angioplasty population.

Angioplasty, Balloon, Coronary↗
PubMed1997

Usefulness of coronary stenting for cardiogenic shock.

Coronary stenting was performed in 15 selected patients with cardiogenic shock, with favorable clinical and angiographic outcomes. This experience suggests that coronary stenting may play an important adjunctive role in the management of cardiogenic shock and may improve outcome beyond that achieved with balloon angioplasty alone.

Aged↗
PubMed1997

Pullback atherectomy with the Arrow-Fischell atherectomy device.

The Arrow-Fischell pullback atherectomy catheter is designed to circumferentially debulk and retrieve coronary atheroma. We performed pullback atherectomy before balloon angioplasty or stenting in 41 patients. The device crossed the target lesion in 38 (93%) and obtained tissue in 36 (88%). All procedures were completed successfully and without myocardial infarction, emergency cardiac surgery, or death. Complications included major spasm in 8 patients, postprocedural abrupt closure in 1, and otherwise uncomplicated arterial perforation in 2. Pullback atherectomy can be performed relatively safely, but is more difficult than balloon angioplasty, obtains less tissue than directional atherectomy, and is associated with significant limitations.

Aged↗
PubMed1997

Early and late assessment of the Micro Stent PL coronary stent for restenosis and suboptimal balloon angioplasty.

This prospective study represents the initial assessment of the Micro Stent PL (Arterial Vascular Engineering, Inc.) coronary stent. From one to three radiopaque stainless steel stents, each measuring 4 mm long, were premounted onto specially designed balloon catheters. A total of 123 stents were implanted in 41 patients without procedural failure or complications. Stent dislodgment proved a concern, with 7 of 123 stents (5.7%) moving > 3 mm from the site of placement and late downstream migration occurring in an additional patient. Subacute stent thrombosis occurred in two patients (5%). Six-month angiographic follow-up was available in 37 of 41 patients (90%). Minimal lumen diameter at baseline was 0.93 +/- 0.51 mm, increasing to 2.74 +/- 0.49 mm after stenting, and falling to 1.66 +/- 0.89 mm at 6 months; this represents a late loss of 60% of the initial gain. Restenosis, based on a binary definition of > 50% diameter stenosis, was documented in 18 patients (49%). Advantages of the Micro Stent PL include its radiopacity and marked ease of distal delivery. The potential for stent dislodgment has implications for future stent designs. The role of the Micro Stent PL in managing restenosis is unclear, but it appears useful in the management of dissection and threatened closure after balloon angioplasty.

Aged↗
PubMed1996

Stenting for treatment of coronary vasospasm.

Following an acute anterior myocardial infarction, a 56-yr-old female underwent two balloon angioplasty procedures for a recurrent proximal left anterior descending artery stenosis. She had recurrent angina pectoris. Angiography showed a noncritical restenosis with marked provocable superimposed vasospasm. Despite repeat balloon dilatation and stenting of the lesion, she developed recurrent symptoms. One month later, angiography showed progressive fixed disease and reversible spasm proximal and distal to, but not involving, the stented arterial segment. She underwent single-vessel coronary artery bypass grafting, and is asymptomatic at 6-mo follow-up.

Angioplasty, Balloon, Coronary↗
PubMed1993

Transfusion practice in medical patients.

OBJECTIVE: Blood transfusion raises serious issues of safety and economics. We therefore examined blood usage and its characteristics in medical inpatients, given the relative scarcity of existing data. DESIGN: During a 1-year period, transfusion episodes on two medical services were reviewed by five specialists for justifiability on the basis of generally agreed on guidelines. SETTING: The study was conducted at two institutions, a municipal teaching hospital where house staff deliver care and a community hospital where patients are under the direct care of private physicians. PATIENTS: Four hundred thirty-eight randomly selected transfusion episodes on the medical services of the two institutions were reviewed. MAIN OUTCOME MEASURES: The prevalence of unjustifiable transfusions based only on the information available to the managing physician at the time of transfusion. RESULTS: Eighteen percent of the 438 randomly selected transfusion episodes were viewed as not justifiable by at least four of five reviewers; another 17% were classified as equivocal because two or three reviewers judged them to be not justifiable. The most striking observation was the greater prevalence of nonjustifiable transfusion episodes at the community hospital (26% vs 16% at the teaching institution; P = .0121). Other observations included a tendency for physicians to prescribe transfusions by the numbers (at least 11% of nonjustifiable transfusions) and to overtransfuse. The routineness with which transfusion was viewed by managing physicians was also identifiable by the absence of written transfusion notes in 39% of all episodes reviewed, which incidentally raises questions about the adequacy of the medical chart's documentary functions today. CONCLUSIONS: The rate of nonjustifiable or equivocal transfusion on medical services may be as high as 35%. Reliance on numbers rather than clinical status seems to be a major problem. Education is obviously a critical issue and should also target private practitioners, who seemed to perform less well than physicians in training. Transfusion guidelines that use specific hematocrit values also need to be reexamined.

Blood Transfusion↗
PubMed1993

Racial differences in blood pressure among urban adolescents.

The purpose of this study was to determine if there are racial differences in the blood pressure patterns among urban adolescents. Blood pressure (BP) was measured according to Task Force guidelines in health-screening and education sessions conducted in urban public and parochial high schools. The prevalence of BP > or = 95th% (HBP) on initial screening was determined in a population of 3,349 students. Differences in prevalence of HBP among race, sex, and age groups were tested for significance by chi 2 analysis. The overall prevalence of HBP in this urban adolescent population was 8.1%. Significant race differences were present in females (blacks = 6.6% versus non-Hispanics = 2.9%, p < 0.01). Within the black females, HBP occurred more frequently among the girls attending predominantly black public schools (7.7%) compared to an interracial parochial school (2.0%) p < 0.001. This difference could not be explained by weight, height, or the occurrence of obesity. The observed BP differences within black females, by school, may reflect a family-environment effect on cardiovascular risk.

Adolescent↗
PubMed1991

Cerebrospinal fluid beta-endorphin and cortisol study in Rett syndrome.

An evaluation of cerebrospinal fluid and plasma beta-endorphin and cortisol levels was performed in 15 girls affected with classic Rett syndrome. There were no differences between the patient group and the control group in plasma cortisol and beta-endorphin levels. But in Rett syndrome, a significant increase in beta-endorphin was noted in the cerebrospinal fluid, with an elevation of the cerebrospinal fluid/plasma beta-endorphin ratio and a decrease in cerebrospinal fluid cortisol. A substantial overlap between patients and control group diminishes the diagnostic value of cerebrospinal fluid beta-endorphin assay in girls suspected of having Rett syndrome.

Adolescent↗
PubMed1990

Detection of occult CNS involvement of follicular small cleaved lymphoma by the polymerase chain reaction.

A patient with follicular small cleaved lymphoma presented with an unusual clinical relapse in the central nervous system (CNS) without morphologic evidence of lymphoma cells in the cerebral spinal fluid (CSF). Molecular genetic analysis of the small number of cells in the CSF after in vitro DNA amplification by the polymerase chain reaction demonstrated the presence of an abnormal translocation sequence between chromosomes 14 and 18. A similar translocation could be detected from the original fixed archival lymph node biopsy and from a small proportion of circulating mononuclear cells. These results indicated that occult lymphoma cells were present in the CSF and peripheral blood. Secondary CNS lymphoma involvement was identified at autopsy. This case demonstrates the enhanced sensitivity of lymphoma diagnosis from poorly cellular specimens after in vitro DNA amplification.

Aged↗
PubMed1989

Human T-cell lymphotropic virus type I (HTLV-I)-associated adult T-cell leukemia-lymphoma in a patient infected with human immunodeficiency virus type 1 (HIV-1).

A patient had adult T-cell leukemia-lymphoma in the unusual setting of coinfection with human immunodeficiency virus type 1 (HIV-1) and human T-cell lymphotropic virus type I (HTLV-I). The leukemic cells were CD4 positive and showed clonal genetic rearrangement of the T-cell receptor complex. Cytogenetic analysis showed three clonal karyotypic abnormalities: trisomy 3 and two translocations [t(1;15), (X;1)]. The patient was seropositive for HIV and HTLV-I; HTLV-I and HIV-1 DNA sequences were detected in peripheral blood leukocytes by the polymerase chain reaction. The HTLV-I sequences were detected in a relatively high proportion of mononuclear cells (at least 1 in 30 cells), whereas HIV-1 sequences were detected in a smaller proportion of cells (at least 1 in 3000 cells). Clinical remission was achieved after chemotherapy. There was a decrease in the proportion of HTLV-I positive mononuclear cells (at least 1 in 1000 cells), whereas the proportion of HIV-1 positive cells was relatively unchanged (at least 1 in 1000 cells). Adult T-cell leukemia-lymphoma in the setting of HIV coinfection may become increasingly common because asymptomatic retroviral coinfections are frequent.

Adult↗
PubMed1988

Molecular cloning and preliminary genetic analysis of the men gene cluster of Bacillus subtilis.

The Bacillus subtilis chromosomal locus that contains the genes encoding the menaquinone biosynthetic enzymes (the men genes) was cloned by using an integrable plasmid vector. The men cluster was reconstituted on three overlapping recombinant plasmids, and a tentative gene order was derived. Evaluations of the direction of transcription and of transcriptional boundaries suggested that the men genes are expressed in the form of at least one polycistronic message. In addition, a spectrum of Men phenotypes resulting from the integration of different internal fragments of the cluster indicate transcriptional complexities, possibly including an internal promoter. The size of cloned DNA fragments required to encompass the transcription unit, as well as the locations of known men mutations within these fragments, suggests that a gene(s) not previously identified with the men system is also located within the cluster. The cloned men sequences make available probes to examine the patterns of transcription from the men locus in response to changing environmental conditions and during the developmental sequence represented by endospore formation.

Bacillus subtilis↗
PubMed1986

A coprological survey of parasites of wild neotropical felidae.

In conjunction with an ecological study of jaguars in the Cockscomb Basin of Belize, Central America, fecal samples from jaguars (Panthera onca), jaguarundis (Felis yagouaroundi), ocelots (Felix pardalis), and pumas (Felix concolor) were examined for parasite products (eggs, larvae, and oocysts). Of the 45 samples examined, 39 (86.7%) were positive for parasite products, 23 of 25 (92%) jaguar samples were positive, as were all of the puma (4/4) and ocelot (8/8) samples. Four of 6 samples from unknown species were positive (66.7%). Two jaguarundis samples were negative. The following were identified in the samples: Paragonimus sp. eggs, Taeniidae eggs, Strongylate eggs, Toxocara cati eggs, Toxascaris sp. eggs, Capillaria sp. eggs, Spiruridae eggs, Aelurostrongylus sp. larvae, Oncicola sp. eggs, Hammondia pardalis oocysts, Isospora sp. oocysts, Toxoplasma gondii-like oocysts and Sarcocystis sp. sporocyst.

Animals↗
PubMed1985

Data acquisition using a scintillation detector interfaced to a personal microcomputer.

A method is described for interfacing a cadmium telluride semiconductor nonimaging detector to a personal microcomputer in order to store and display nuclear medicine data. There was virtual identity between the count rates stored in the computer and those recorded from the detector's display, demonstrating that the computer accurately acquired data from the probe without erroneous loss or addition of data. Interfacing a nonimaging detector to a microcomputer may provide an extremely versatile method of acquiring, storing, and displaying nuclear medicine data.

Computers↗
PubMed1984

Parental influence on adolescents' imagination.

It was hypothesized that a permissive democratic parental attitude towards childrearing and favorable accepting attitude towards children's imagination are conducive to the development of their adolescent children's imaginative ability. It was also hypothesized that the mothers' role is more crucial than that of the fathers. The subjects were 104 adolescent Israeli boys and girls and their parents. The subjects were administered four scales of the Imaginal Processes Inventory and the Children's Report of Parental Behavior Inventory. The parents filled out a questionnaire devised to study their attitude to children's imagination. The first two hypotheses were not confirmed. The data point in the opposite direction as regards the first hypothesis. There was partial conformation for the third hypothesis. The data were also discussed in relation to healthy and neurotic daydreaming.

Adolescent↗
PubMed1980

Genetic analysis of bacteriophage P4 using P4-plasmid ColE1 hybrids.

A set of plasmids that contain fragments of the bacteriophage P4 genome has been constructed by deleting portions of a P4-ColE1 hybrid. A P4 genetic map has been established and related to the physical map by examining the ability of these plasmids to rescue various P4 mutations. The P4 virl mutation and P4 genes involved in DNA replication (alpha), activation of P2 helper genes (delta and epsilon), polarity suppression (psu) and head size determination (sid) have been mapped, as has the region responsible for synthesis of a nonessential P4 protein. One of the deleted plasmids contains only 5900 base pairs (52%) of P4 but will form plaques if additional DNA is added to increase its total size to near that of P4. This plasmid is also unique in that it will not form stable associations with P2 lysogens of E. coli which are recA+. P4 alpha mutants can be suppressed as a result of replication under control of the ColE1 part of the hybrid.

Chromosome Mapping↗