Search PubMed⌕ Search

Biomedical subjects

D Yeshurun

Publications and source records attributed to D Yeshurun.

At least 127 records · Page 7Linked to original sources

Compensated cardiogenic shock: a subset with damage limited to liver and kidneys. The possible salutary effect of low-dose dopamine.

A variant of compensated cardiogenic shock occurring in patients with chronic congestive heart failure following an episode of pulmonary edema, and in the absence of hypotension, is described. The clinical picture is characterized by combined renal and hepatic injury and a severe, often fatal, course and is distinct from other subsets of cardiogenic shock. When the splanchnic vasodilator dopamine was added to the patients' management, the outcome was uniformly favorable. This variant of compensated cardiogenic shock requires early diagnosis and treatment. The apparently beneficial effect of low-dose dopamine needs further evaluation.

Aged↗

Massive hepatic steatosis complicating adult celiac disease: report of a case and review of the literature.

Hepatomegaly, chronic diarrhea, and weight loss in a middle-aged woman were found to be due to massive hepatic steatosis and adult celiac disease. After she was on a gluten-free diet for 1 yr, improvement in clinical, laboratory, and pathological parameters was witnessed. Massive hepatic steatosis complicating adult celiac disease is an uncommon occurrence, differing from other, more frequently encountered hepatopathies in this disease, insofar as pathogenetic and prognostic aspects are concerned.

Adult↗

Spontaneous colosplenic fistula complicating immunoblastic lymphoma.

Immunoblastic lymphoma of the colon, complicated by colosplenic fistulization, is reported. It is suggested that ulceration and extensive coagulative necrosis of a bulky large cell lymphoma in the absence of a desmoplastic reaction are the prerequisites for fistula formation.

Aged↗

Intrathoracic amyloid lymphadenopathy.

2 patients with intrathoracic lymph node enlargement as their presenting symptom, were found to have amyloid lymphadenopathy. Both also had peripheral involved lymph nodes. The demonstration of amyloid deposits in the peripheral lymph nodes did not suffice to deduce that the intrathoracic nodes were of the same nature. A biopsy of the intrathoracic nodes was needed for final diagnosis. An additional 11 cases of intrathoracic amyloid lymphadenopathy from the literature are reviewed.

Aged↗

A comparison of auditory brain stem evoked potentials in hyperlipidemics and normolipemic subjects.

Twenty-five hyperlipidemic, neurologically and audiologically asymptomatic patients were compared to 20 normolipemic control subjects regarding different interpeak latency differences (IPLD) of auditory brain stem evoked potentials (ABEP). ABEP were recorded in response to click stimuli presented at a rate of 10/sec and 55/sec. The net effect of increasing stimulus rate (ISR) on IPLD of ABEP was significantly greater in the hyperlipidemic patients for IPLD (V-I) and IPLD (III-I). ISR of ABEP indicates a trend of subclinical impairments of brain stem function in hyperlipidemic patients, probably due to ischemia accelerated by their condition.

Acoustic Stimulation↗

Unilateral chest wall edema in carcinomatous pleurisy.

21 patients with protracted unilateral pleural effusion were studied with respect to the etiology of their pleurisy. 13 presented with unilateral chest wall edema (UCE). These were classified as group A patients. 8 group B patients suffered from unilateral pleural effusion without UCE. A malignant cause of the effusion was established in 8 out of the 13 patients in group A, and in 2 patients from group B. Empyema was present in 4 additional patients, all of them belonging to group A. The diagnosis of purulent pleural effusion could be made promptly by microscopic examination of the pleural fluid. If excluding the empyema patients, the presence of UCE was significantly associated (p less than 0.025) with a malignant etiology of the pleural effusion. It seems that careful examination of the chest wall skin texture can be a simple and useful method in the initial evaluation of patients with pleurisy.

Adult↗

Lipid and lipoprotein levels following pure estradiol implantation in post-menopausal women.

8 post-menopausal, post-oophrectomy and hysterectomy women had a 100-mg pure 17 beta-estradiol pellet installed in their subcutaneous abdominal tissue. The pellet caused a marked systemic hormonal effect in these patients causing an up to 30-fold increase in plasma estradiol and a marked decrease in follicle-stimulating hormone levels. It showed a significant increase in plasma high density lipoprotein (HDL) and HDL to total cholesterol ratio levels, no change in plasma triglycerides and very low density lipoprotein levels and some decrease in total cholesterol and low density lipoprotein cholesterol concentrations. These results differ from the previously reported influence of synthetic hormonal preparations on the same plasma lipids and lipoproteins.

Adult↗

Occult infection in the facial area presenting as fever of unknown origin.

Dental infections, otitis media or sinusitis may present as fever of unknown origin (FUO), lacking local symptoms and signs. Physicians are often unaware of this possibility, since current textbooks and major articles do not mention occult facial infections among the causes of FUO. Patients with FUO typically undergo a laborious series of uncomfortable, time-consuming, expensive and often unnecessary investigations in the search for the cause of pyrexia. We report five such patients from a community hospital, representing 14% of cases in a series of patients with FUO. In most of these patients local signs were absent, laboratory investigations were noncontributory, and antibiotic treatment was ineffective. Surgical drainage of pus collections was followed a few days later by defervescence. We suggest that occult infections in the facial area should be considered among the common causes of FUO, and careful dental examination, otoscopy and X-rays of the teeth and sinuses should be included early in the investigation of these patients.

Adult↗

Isolated amyloid lymphadenopathy.

An elderly patient presented with supradiaphragmatic lymphadenopathy due to massive amyloid deposits. No other organ was involved. The urine contained minute amounts of monoclonal light chains. This isolated amyloid lymphadenopathy with monoclonal gammopathy is of obscure nature and pathogenesis.

Aged↗

A comparison of plasma cholesterol, triglycerides and high density lipoprotein cholesterol levels in women using contraceptive pills and a control group.

Plasma cholesterol, triglycerides and HDL cholesterol levels were compared in a group of 45 young, normotensive, nonobese and nondiabetic women who used modern combined minidose contraceptive pills, to a matched group of 39 women who did not use any hormonal preparations. Our results show an increase in triglyceride levels as well as significant increase in cholesterol level in the 'pill' users group. We failed to show a significant change in HDL cholesterol levels and HDL cholesterol to total cholesterol ratio between the two groups. Our results concerning triglyceride levels are in consent to previous studies in the medical literature, while the elevation in cholesterol levels has rarely been reported in contemporary papers about minidose pill users. It seems that the contradicting effect of estrogen and progesterone on plasma HDL levels neutralizes each other's effect on this lipoprotein fraction. The elevation in plasma triglycerides and cholesterol may have importance in the vascular abnormalities seen in such pill users.

Adult↗

Delayed initial QRS forces of intraventricular pacing: unreliability of the scalar ECG in their diagnosis.

Delta waves, similar to those observed in the Wolff-Parkinson-White syndrome, are currently observed in the ECG tracings of patients with endocardial pacing. With the aid of standard ECG and vectorcardiography (VCG), we studied the initial QRS forces during right endocardial pacing in 20 patients. More details were obtained by VCG concerning the amplitude duration, electrical axis and shape of the delta waves of paced ventricular beats, than by ECG. It is remarkable that delayed initial QRS forces, diagnosed by VCG analysis, were present in only 9 of 20 patients with delta waves in their ECG. In other patients, the slurring or thickening at the onset of the R waves in the ECG resulted from the perpendicular direction of the initial QRS vectors to the lead axis, or from multiple changes in the direction of the early, nondelayed QRS vectors. The superiority of VCG in the study of the initial QRS forces, particularly in the diagnosis of delayed initial QRS forces, is discussed.

Cardiac Pacing, Artificial↗