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Biomedical subjects

A Rubinow

Publications and source records attributed to A Rubinow.

102 records · Page 6Linked to original sources
PubMed1978

Skin involvement in generalized amyloidosis. A study of clinically involved and uninvolved skin in 50 patients with primary and secondary amyloidosis.

A punch or excisional biopsy of the skin was done in 50 patients with generalized amyloidosis: In 46, clinically normal skin, usually the forearm, was biopsied and in four, only cutaneous lesions. Amyloid was seen in the skin of 21 of 38 patients with primary and multiple myeloma-associated amyloidosis. Sixteen of 34 biopsies from clinically uninvolved skin were positive. Five of 12 patients with secondary amyloidosis had amyloid deposits in clinically normal skin. Overall, amyloidosis was definitively diagnosed on skin biopsy examination in 26 patients. A punch biopsy of clinically involved or uninvolved skin is an innocuous, simple procedure with a high diagnostic yield and can be done in an office setting.

Amyloidosis↗
PubMed1976

Amyloidosis.

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Amyloid↗
PubMedDate not supplied

Alveolar hemorrhage in cryoglobulinemia--an indicator of poor prognosis.

OBJECTIVE: Alveolar vasculitis is an unusual event in the course of cryoglobulinemia (CG). The inflammatory process involving the alveolar capillary walls may result in severe alveolar hemorrhage and consequently lead to a grave outcome. The objective of this study was to evaluate the occurrence of this unusual finding in CG. METHODS: We reviewed the records of all patients with CG who developed acute alveolitis, registered their associated clinical and laboratory parameters and evaluated the possible impact these parameters may have on their prognosis. In addition we scanned the Medline for similar cases. RESULTS: Of the 125 patients with CG who were hospitalized in our medical center during the last 23 years, 4 (3.2%) developed alveolar hemorrhage. All patients exhibited extreme fatigue, fever with clinical and radiological evidence of alveolitis. Of the 4 new cases, 1 had type II CG and 3 had type III CG. Of our 4 patients, 3 developed concomitant acute renal failure necessitating hemodialysis. A literature survey resulted in 6 additional cases. All 10 patients experienced acute respiratory insufficiency and eight had at least one episode of hemoptysis. In the other 2 patients the bronchoalveolar lavage (BAL) fluid contained hemosiderin laden macrophages. Five of the 10 patients had concomitant hepatitis C virus (HCV) infection; 2 patients were seen prior to modern identification of the HCV; however, liver abnormalities were not described. Of the 10 patients 5 patients had type II CG and 5 others had type III. Of the 7 patients in whom outcome was available, 6 died from their illness. Acute renal failure or exacerbation of antecedent glomerular disease occurred in 8 patients. CONCLUSIONS: Alveolitis is a rare manifestation of CG, presenting as an overwhelming systemic illness and portends a poor prognosis with a high mortality rate.

Adult↗
PubMedDate not supplied

Coexistence of systemic lupus erythematosus and myasthenia gravis: two distinct populations of anti-DNA and anti-acetylcholine receptor antibodies.

A woman with a four-year history of systemic lupus erythematosus (SLE) developed myasthenia gravis (MG). The clinical features of lupus disappeared slowly while the myasthenic syndrome became predominant. However, her serum was positive for anti-DNA and anti-acetylcholine receptor antibodies. Cross-reactivity between anti-DNA antibodies and anti-acetylcholine receptor antibodies was not demonstrated, suggesting the presence of two different populations. A cellular immunology profile was normal as expected in MG and in contrast to SLE. Conceivably, SLE and MG might represent two opposite extremes in the spectrum of autoimmune diseases.

Adult↗
PubMedDate not supplied

Evaluation and management of hypersensitivity to local anesthetics in pediatric dentistry.

The clinical histories of four children with a history of adverse reactions to local anesthesia and who required dental treatment are reviewed retrospectively. The children described had been referred to the allergy unit for evaluation between 1984 and 1985 and are representative of the dilemma of cases of suspected hypersensitivity to local anesthetics. The first two cases had been previously treated without the use of regional anesthesia because of a family history of atopic reactions as well as equivocal skin testing to local anesthetic. The third child had experienced bizarre adverse reactions to a variety of foods and detergents erroneously interpreted as possible deterrents to the use of local anesthetics. All four children were challenged with progressively increasing concentrations of lidocaine according to a described protocol. In three cases no reaction was observed and dental procedures were performed without difficulty using lidocaine for local anesthetics. A history of bronchoconstriction in the fourth child and the contradictory results of skin tests to local anesthetics, prompted the administration of pretreatment medication aimed at preventing bronchial hyperactivity related to dental anesthesia.

Adolescent↗
PubMedDate not supplied

Septic arthritis in a Charcot joint.

Two patients with Charcot joints developed septic arthritis. The infection in the first patient was treated successfully by repeated needle aspirations and parenteral oxacillin administration. In the second patient closed drainage and parenteral penicillin were not successful in eradicating the infection, and surgical incision with suction drainage was required. Technical difficulties achieving arthrodesis in a Charcot joint suggest that repeated needle aspirations are the preferred method of initial joint drainage. Surgical drainage is advised for loculated, grossly purulent parts of the joint.

Adolescent↗
PubMedDate not supplied

Efficacy and adverse effects of different corticosteroid dose regimens in temporal arteritis: a retrospective study.

OBJECTIVE: To define the optimal corticosteroid dose regimen in the initial treatment of temporal arteritis (TA). METHODS: We conducted a retrospective long-term evaluation of the efficacy and toxicity of corticosteroid treatment in 77 TA patients treated with three different dose-regimens: group A starting at 30-40 mg/d of prednisone, group B > 40-60 mg/d, and group C > 60 mg/d. RESULTS: The 3 patient groups were similar with regard to the mean age, male/female ratio, mean duration of follow-up, percentage of positive temporal artery biopsies, and rate of steroid tapering. There was a positive correlation between the starting dose and the cumulative dose of steroids at one year. Treatment efficacy was similar among the groups: cumulative cure rates (i.e. patients off steroids without exacerbation of TA for 6 months or more) were 11-13%, 29-35%, and 48-50% after 1, 2, and 3 years, respectively. In addition, the rates of disease flare were similar among the groups after 3 years of follow up, although group C patients tended to have fewer TA exacerbations during the first year compared to the other groups. In contrast, group A patients developed significantly fewer steroid side effects: 36% compared to 78% and 88% in groups B and C. CONCLUSION: The group A steroid regimen, starting with 30-40 mg/d and tapering to 10 mg/d within 6 months and to 5-7.5 mg/d within 1 year, was effective and less toxic in this patient population, than the two higher dose regimens.

Aged↗