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Biomedical subjects

B M Kaplan

Publications and source records attributed to B M Kaplan.

31 records · Page 2Linked to original sources
PubMed1984

Zinc transport in pregnancy.

Although the importance of zinc nutrition during pregnancy has been well recognized, there have been few studies of zinc transport in maternal or fetal sera. We examined total serum zinc levels as well as zinc associated with its major transport proteins, albumin and alpha 2-macroglobulin, prospectively in 46 women during gestation and in 27 of their infants at term. In five women who developed preeclampsia during the third trimester, the mean total serum zinc level at 6 to 14 weeks was decreased by 14% compared to control values (p less than 0.05). Fetomaternal differences between the zinc transport proteins support the concept that each may have a specific role(s) in zinc homeostasis which is regulated to a greater extent by metabolic factors than by dietary zinc intake alone.

Adolescent↗
PubMed1984

Treatment of meningeal relapse in childhood acute lymphoblastic leukemia. I. Results of craniospinal irradiation.

Fourteen children were treated for isolated meningeal relapse occurring seven to 44 months (median, 14 months) after prophylactic cranial irradiation (2,400 rad/12 fractions) and intrathecal methotrexate (IT MTX, 12 mg/m2 for four doses during cranial irradiation). Eight had "high-risk" acute lymphocytic leukemia with age less than 2 years, white blood cell counts greater than 20,000, or T cell markers. Treatment for central nervous system leukemia included IT MTX (12 mg/m2 twice weekly until clearance of spinal fluid cytology) followed by craniospinal irradiation (CSI, 3,000 rad/20 fractions to the cranium and 1,800 rad/12 fractions to the spine). No maintenance IT MTX was given. Systemic chemotherapy was continued or reinstituted for a minimum of one year after CSI. No instance of second meningeal relapse has occurred. Five patients remain in secondary complete remission 66+, 54+, 36+, 26+, and 24+ months after meningeal relapse. Disease-free survival was limited by marrow relapse in eight patients (2-20 months after CSI) and testicular relapse in one. No acute toxicities were noted with CSI. Myelosuppression occurred in seven patients. Infections within two months of CSI were noted in five. No neurologic sequelae are apparent. Serial neuropsychometric studies in 10 patients revealed a significant decline in mean values on Global IQ scales. Long-term survival with acceptable toxicity is possible following aggressive, prompt treatment of meningeal relapse occurring after prophylactic cranial irradiation. Hematologic relapse remains the major obstacle to long-term disease-free survival.

Acute Disease↗
PubMed1984

Hereditary angioedema and pregnancy.

Hereditary angioedema is a relatively uncommon disease that may affect women during their reproductive years. A case report of a pregnancy complicated by hereditary angioedema, followed by a review of the literature, is presented. Although the disease usually follows a benign course, maternal mortality has been noted. Features unique to pregnancy are discussed. Knowledge of the pathophysiology and possible complications is essential for the proper management of the pregnancy.

Adult↗
PubMed1983

Treadmill exercise testing in hypertensive patients treated with hydrochlorothiazide and beta-blocking drugs.

Twelve patients with hypertension who did not become normotensive after treatment with hydrochlorothiazide alone were studied. Treadmill exercise testing was done before and after additional treatment to standing resting normotension with beta-blocker drugs. The double product (peak mean BP times peak heart rate) at peak performance fell significantly because of decreases in systolic arterial BP and heart rate, but diastolic pressures still rose with exercise in ten of the 12 patients, in seven of them to 100 mm Hg or higher. Thus, the data show that patients with hypertension treated to resting normotension with hydrochlorothiazide and a beta-blocker still often demonstrate a significant diastolic BP rise with exercise. In such patients, a rise in diastolic BP with exercise cannot be used as evidence of coronary atherosclerosis. The measurement of the arterial BP response to exercise is probably important in the assessment of the effectiveness of individual antihypertensive regimens.

Adrenergic beta-Antagonists↗
PubMed1982

Bilateral renal artery thrombotic occlusion: a unique complication following removal of a transthoracic intraaortic balloon.

An intraaortic balloon pump (IABP) was inserted through the ascending aorta during a coronary artery bypass operation. Five days later, after removal of the IABP and ligation of the end-to-side Dacron graft, the patient became acutely anuric. Abdominal aortography demonstrated a large "trapeze-shaped" thrombus which occluded both renal arteries. Following thrombectomy the patient recovered, with eventual return of renal function to the preoperative state.

Aged↗
PubMed1976

The tachycardia-bradycardia syndrome.

The tachycardia-bradycardia syndrome (paroxysmal atrial fibrillation, flutter, or tachycardia followed by sinoatrial block or sinus arrest resulting in Stokes-Adams attacks) is an important clinical entity that requires familiarity by the clinician. Pathologic studies and physiologic mechanisms as revealed in the electrocardiogram indicate multiple disturbances in the conduction system of the heart (sinus node, atria, and atrioventricular junctional tissues). The electrocardiogram establishes the diagnosis. Pacemaker implantation with supplementary drugs has provided a satisfactory means of therapy. With proper treatment the prognosis of patients with the tachycardia-bradycardia syndrome has improved to the extent that the primary determinant of mortality is no longer the arrhythmia, but the underlying cardiac and/or systemic pathology.

Anti-Arrhythmia Agents↗
PubMed1975

Persistent reversal of severe systemic hypertension after prolonged toxic reaction to hydralazine.

A patient with severe progressive hypertension was treated with parenteral hexamethonium and large dosages of hydralazine. He developed a 'hydralazine syndrome', the etiology of which was not recognized for approximately 9 months. Upon discontinuance of hydralazine the patient was easily kept normotensive for over 20 years, using only small dosages of cryptenamine, reserpine and/or bendroflumethiazide. Similar observations are cited in the literature in seven other patients who were treated with hydralazine for significant periods of time after toxic symptoms occurred.

Adult↗