Search PubMed⌕ Search

Biomedical subjects

Alan Rubinow

Publications and source records attributed to Alan Rubinow.

13 recordsLinked to original sources
PubMed2006

Posttraumatic stress disorder, tenderness, and fibromyalgia syndrome: are they different entities?

OBJECTIVES: Many features of fibromyalgia syndrome (FMS) resemble those of posttraumatic stress disorder (PTSD). The goal of this study was to investigate the comorbidity of FMS and PTSD in a cohort of men following an intensive, initial, defined traumatic event. METHODS: One hundred twenty-four males (55 patients with PTSD, 20 patients with major depression, and 49 controls) were evaluated for the presence of FMS. The major traumatic events in all PTSD patients were combat-related. Each individual completed questionnaires characterizing his disease, disabilities, and quality of life. RESULTS: Forty-nine percent of PTSD patients, compared to 5% of major depression patients and none of normal controls, fulfilled the American College of Rheumatology criteria for FMS (P<.0001). Significant correlations were detected between tender points and measured parameters in the PTSD group. CONCLUSIONS: In male patients, PTSD is highly associated with FMS. The degree and impact of these disorders are also highly related.

Adolescent↗
PubMed2006

Equitable resource allocation in the intensive care unit: a descriptive ethical case.

A patient with respiratory failure due to undiagnosed tuberculosis in the presence of HIV infection presents to the ICU in a foreign country. This raises many ethical questions, quite apart from the medical management issues raised by the patient's serious condition. Six of these ethical questions have been presented to leading physicians and an ethicist, from a range of national, cultural and religious backgrounds, for their comment.

Adult↗
PubMed2004

Hypertrophic pulmonary osteoarthropathy: control of pain and symptoms with pamidronate.

This case presents a patient with hypertrophic osteoarthropathy of the lower extremities that developed secondary to congenital cyanotic heart disease. The major clinical manifestation was severe bilateral leg pain. The pain that was debilitating in nature completely resolved following a single administration of 60 mg pamidronate. Hypertrophic osteoarthropathy (HOA) is an acquired, uncommon disorder of obscure etiology. It has been described mainly in association with chronic suppurative pulmonary diseases, bronchogenic carcinoma and lung metastases, cystic fibrosis, and cyanotic congenital malformations of the heart.

Anti-Inflammatory Agents↗
PubMed2004

Low-dose aspirin and prevention of cranial ischemic complications in giant cell arteritis.

OBJECTIVE: Cranial ischemic complications such as cerebrovascular accidents (CVAs) and acute visual loss are among the leading causes of giant cell arteritis (GCA)-related morbidity. In this retrospective study, we evaluated the effect of treatment with low-dose aspirin on the incidence of cranial ischemic complications in GCA. METHODS: Charts of 175 consecutive patients in whom GCA was diagnosed between 1980 and 2000 were reviewed for medical data. Data for 166 patients who were followed up for at least 3 months were also available. RESULTS: At the time of the diagnosis of GCA, 36 patients (21%) had already been receiving low-dose aspirin (100 mg/day). In all cases, the indication for this treatment was ischemic heart disease. There were no significant differences between the aspirin-treated and non-aspirin-treated groups regarding the mean age of patients, the male-to-female ratio, duration of GCA-related symptoms, rates of headaches, systemic symptoms, and jaw claudication, and the mean erythrocyte sedimentation rate, hemoglobin count, and platelet count. Cerebrovascular risk factors (hypertension, hyperlipidemia, or diabetes mellitus) were more common in the aspirin-treated group (38.9% versus 20%; P= 0.03). Cranial ischemic complications were diagnosed in 43 patients at presentation: 30 patients had acute visual loss, 11 had CVAs, and 2 had both conditions simultaneously. Only 3 of the aspirin-treated patients (8%) presented with cranial ischemic complications, compared with 40 (29%) of the non-aspirin-treated patients (P = 0.01). Despite the use of steroid therapy, cranial ischemic complications developed in 14 of the 166 patients followed up for 3 months or longer. However, cranial ischemic complications developed in only 3% of the aspirin-treated patients, compared with 13% of the patients treated with prednisone only (P = 0.02). CONCLUSION: These data suggest that low-dose aspirin decreases the rate of visual loss and CVAs in patients with GCA.

Aged↗
PubMed2004

General medicine practitioners' attitudes towards "do not attempt resuscitation" orders.

OBJECTIVE: To examine whether "all-or-none" guidelines for cardiopulmonary resuscitation (CPR) are being applied by practitioners on general medical wards (GMWs). HYPOTHESIS: Do not attempt resuscitation (DNAR) orders are rarely related to patient preferences. Limited resuscitation efforts are being practiced to circumvent the need for DNAR orders. DESIGN: A surprise opinion survey (presented below), based on case vignette and practice description, and performed by remote control votes. SETTING: The multi-centre forum for practitioners on GMWs within the greater Jerusalem district. PARTICIPANTS: 79/85 clinicians practicing/training on GMWs in six teaching hospitals, who attended the forum and responded within 3 min to the survey. RESULTS: Fifty-eight practitioners (73%) assigned a DNAR order for a patient unable to express a preference and only 43 (55%) complied with the request of a competent patient for a DNAR order (P < 0.05]; 95% CI: 2-34). During the past year, only five practitioners (9% of respondents) had performed CPR solely when pathophysiological benefit was expected, 31 (59%) had performed limited CPR efforts and only 13 (28%) had discussed the subject of DNAR with patients and their next of kin >5 times. CONCLUSIONS: (1) DNAR orders are rarely discussed with patients and their next of kin in GMWs within the region examined; (2) even when DNAR is discussed, physicians tend to confer DNAR orders based on their personal value judgements rather than on patient preferences; (3) practitioners on GMWs perform CPR when no pathophysiological benefit is expected; (4) limited resuscitation efforts are performed frequently in GMWs.

Attitude of Health Personnel↗
PubMed2004

The coexistence of Sweet's syndrome and Still's disease--is it merely a coincidence?

Sweet's syndrome has a wide range of clinical manifestations. It may appear as a solitary cutaneous disorder but often it is associated with systemic signs and symptoms. This disorder might be idiopathic but it often is paraneoplastic or associated with medications or autoimmune diseases. In its systemic manifestation Sweet's disease resembles adult-onset Still's disease in many aspects. We present a case of a young man in whom Sweet's syndrome and Still's disease developed. Although the diagnosis of adult-onset Still's disease is made by exclusion, he fulfilled all the criteria of both conditions. Considering the clinical similarities of these diseases, it may be presumed that similar patients may have been overlooked in the past.

Adult↗
PubMed2004

Risk factors for cranial ischemic complications in giant cell arteritis.

Cranial ischemic complications (CICs) are among the presenting manifestations of giant cell arteritis (GCA). Yet patients with GCA may develop CICs at a later stage, despite steroid therapy. In the current report we delineate risk factors for CICs, both at presentation and during follow-up, and review the relevant literature. We reviewed charts of 175 patients with GCA. Follow-up data were available for 166 patients. CICs at presentation or developing within 2 weeks of GCA diagnosis were considered GCA related. CICs developing later were considered GCA related only when associated with other GCA-related manifestations or acute-phase reactions. Associations between CICs and other variables were tested by multivariate analysis. At presentation, 43 patients (24.6%) had CICs. Risk factors were transient cerebro-ophthalmic ischemic episodes (COIEs) (odds ratio [OR] 4.3) and male sex (OR 2.5), while the presence of systemic symptoms was "protective" (OR 0.3). During follow-up 8.4% of patients with GCA developed new CICs. Risk factors in these cases were previous CICs at presentation (OR 5.6) and transient COIEs developing during follow-up (OR 14.8). The use of low-dose aspirin was protective (OR 0.2). These data, together with data from the literature review, suggest that GCA patients with transient COIEs and without fever or other systemic symptoms are at increased risk of presenting with CICs. Risk factors for late-developing CICs were CICs at presentation and late-developing transient COIEs.

Aged↗