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Biomedical subjects

B Raphael

Publications and source records attributed to B Raphael.

At least 109 records · Page 6Linked to original sources
PubMed1989

[Cystic lymphoid hyperplasia of the parotid in relation to acquired immunodeficiency syndrome (HIV+). Apropos of 2 cases].

Cystic lymphoid hyperplasia of the parotid, a rare disease, was recently described in patients with acquired immunodeficiency syndrome. We reported here 2 new cases of this illness. The 2 HIV+ patients showed an enlargement of parotid gland. A superficial parotidectomy was performed. The histological and immunohistochemical studies were completed in one case by a histoenzymological and ultrastructural study. We could see numerous cystic cavities lined with a cylindrical or metaplastic malpighian epithelium and surrounded by a lymphoid tissue, similar to a true lymph node with germinal centers. In these lymphoid structures, we could find some epithelial remnants and numerous epimyoepithelial islands. Besides, anomalies similar to those described in persistent generalized lymphadenopathies were obvious: hyperplastic germinal centers with multiplication of B lymphocytes and thin mantle zone, perifollicular hypervascularization, numerous macrophages, plasmocytes and T lymphocytes with increase of T8 cytotoxic subset in interfollicular and paracortical areas. An early opportunist infection is suggested in the histogenesis of this disease.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Thrombotic thrombocytopenic purpura associated with human immunodeficiency virus type 1 (HIV-1) infection.

The cases of 14 patients with thrombotic thrombocytopenic purpura admitted to one institution after 1980 were reviewed. Three of the fourteen cases occurred in patients with the acquired immunodeficiency syndrome (AIDS)-related complex and one occurred in a patient with probable human immunodeficiency virus (HIV) infection. The diagnosis in all four cases had been made after 1985. The association of thrombotic thrombocytopenic purpura with HIV infection was judged to be statistically significant on the basis of the proportion of patients with AIDS among the general population of patients admitted to the same institution during the same period. The fact that this association is only now being recognized suggests that there may be a long incubation period for thrombotic thrombocytopenic purpura or that the association is a rare one recognized now only because of the increased number of persons with AIDS.

AIDS-Related Complex↗
PubMed1988

After the horror.

Explore the source record for details and available documents.

Disasters↗
PubMed1988

Lymphoid neoplasia associated with the acquired immunodeficiency syndrome (AIDS). The New York University Medical Center experience with 105 patients (1981-1986).

We identified 105 patients with lymphoid neoplasia associated with the acquired immunodeficiency syndrome (AIDS) at the New York University Medical Center from 1981 through 1986: 89 had non-Hodgkin lymphoma; 13, Hodgkin disease; and 3, chronic lymphocytic leukemia. Immunophenotypic and antigen receptor gene rearrangement analysis showed the B-cell origin of all non-Hodgkin lymphomas studied and the clonal suppressor-cytotoxic T-cell subset origin of the chronic lymphocytic leukemias. We classified 69% of the non-Hodgkin lymphomas as high grade (small, noncleaved and large cell, immunoblastic-plasmacytoid) and 31% as intermediate grade (diffuse large cell). Each histopathologic category was correlated with distinct clinical features, including a statistically significant difference in median survival. Patients with Hodgkin disease had an atypical, aggressive clinical course, whereas patients with T-cell chronic lymphocytic leukemia had an indolent clinical course. These studies show the clinical, morphologic, and immunophenotypic spectrum of AIDS-associated lymphoid neoplasia, that the natural history of Hodgkin disease is altered in patients with AIDS, and support the Centers For Disease Control's recent revision in diagnostic criteria for AIDS to include intermediate-grade diffuse, aggressive non-Hodgkin lymphomas occurring in patients seropositive for human immunodeficiency virus.

AIDS-Related Complex↗
PubMed1988

The prognosis and therapy of chronic lymphocytic leukemia under age 50 years.

Twelve percent of patients with CLL studied by the Eastern Cooperative Oncology Group (ECOG) were under age 50 years. Except for clinical stage (more unfavorable presentations), and sex distribution (all but one being male), presenting clinical and laboratory features were identical to the whole population. The response rates and response duration were similar as well. Despite the more advanced stage these patients appear to have a survival advantage over their older counterparts.

Adult↗
PubMed1987

Depressive disorder associated with physical illness. The impact of stroke.

The consultation-liaison psychiatrist is confronted time after time with depression in the context of physical illness, and the link between the two is of practical and theoretical interest. In addressing this topic, current classification systems are ambiguous. The advent of research diagnostic criteria and the primary/secondary depression dichotomy have not clarified the problem as was hoped. The conventional view that physical illness only precipitates depression in the genetically predisposed has been challenged by recent studies in patients with stroke. These studies point to a specific role for factors such as lesion location, severity of disability, and social support. In addition, the process of adjustment to serious physical illness can be understood in terms of personal vulnerability including low self-esteem, conflict within close relationships (particularly marital), and negative experiences in the developmental history. Acting on this vulnerability is the stressful life event (e.g., illness) that can have particular force if "matched" to the subjects existing psychologic conflicts. A modifying factor on the outcome of the adjustment is the influence of social support in protecting the individual from the life event. A list of potential factors influencing the occurrence of depression with physical illness is proposed. Variables likely to have an important place include 1) family history of psychiatric disorder, 2) a past personal history of depression, 3) the premorbid personality, 4) the impact of life events including the illness, 5) the degree of disability from the illness, 6) the presence of brain pathology and neuroendocrine abnormalities, and 7) the quality of social support during the time of illness.(ABSTRACT TRUNCATED AT 250 WORDS)

Adjustment Disorders↗
PubMed1987

Mental health responses in a decade of disasters: Australia, 1974-1983.

Between 1974 and 1983, Australia experienced the Darwin cyclone, the Granville rail disaster, and the Ash Wednesday bush-fires, each of which killed more than 60 people and caused significant emotional distress. Mental health response systems developed in the wake of the disasters varied in their level of sophistication and degree of acceptance, but they generally became better orchestrated and appreciated with each disaster. Lessons learned from research and review following one disaster were often applied in responding to the next. Research and review were particularly crucial in uncovering the presence of significant morbidity, including posttraumatic stress disorder, among relief workers and children and in highlighting the need for coordination of mental health services with other relief efforts. Many jurisdictions in Australia have since modified their disaster relief plans to include mental health services.

Australia↗
PubMed1987

Minor psychiatric morbidity in a casualty population: identification, attempted intervention and six-month follow-up.

The prevalence of minor psychiatric morbidity (MPM) was investigated in 523 adults presenting to the casualty section of an Australian public hospital. Relationships between subject characteristics and the level of MPM were also examined, together with the acceptability of an offer of short-term intervention and the effectiveness of this intervention in reducing distress. Threshold morbidity on initial presentation to casualty was 41% (using the GHQ-12 with the customary 1/2 cut-off point) and the probable prevalence was estimated to be about 27%. The intervention was initially offered to a random sample of those identified as being 'under stress' (GHQ of three or above), but as there was a 90% rejection rate, it was offered to all symptomatic subjects. Overall, 26% accepted our offer of intervention. Those who accepted intervention and those who rejected it did not differ in their improvement in MPM during the subsequent six months. However, these groups improved slightly more than the group that was eligible for intervention but to whom it was not offered. Forty-seven per cent of subjects who were 'under stress' on initial presentation to casualty fell below the GHQ-12 threshold at the six-month follow-up; this compared with a shift of only 26% in the opposite direction (i.e., non-stressed to stressed). Regression to the mean offered the most parsimonious explanation for these GHQ changes.

Adult↗
PubMed1987

Bereavement. State of the art and state of the science.

For bereavement research to fulfill its potential, its practical applications with defined patient groups needs to demonstrate a superiority over treatment based largely on intuition and common sense. The "art" of the therapist needs science to move beyond the present impasse in the management of bereavement.

Aged↗