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Biomedical subjects

D Yeshurun

Publications and source records attributed to D Yeshurun.

At least 145 records · Page 8Linked to original sources
PubMed1983

Reversible diminished insulin requirement during acute renal failure.

Very little is known concerning insulin requirements in diabetic patients who develop acute renal failure, although decrease in daily insulin requirement in patients with chronic renal failure is recognized. A 46-year-old diabetic patient is described, whose daily insulin requirement decreased from 56 to 8 units per day during an episode of acute post-streptococcal glomerulonephritis causing acute reversible renal failure. The insulin requirement returned to its previous level after the patient recovered.

Acute Kidney Injury↗
PubMed1983

Quinidine induced sicca syndrome.

Two weeks after initiation of therapy with 1.2 gm/day quinidine sulphate, a 67 year old patient developed clinical and laboratory features of sicca syndrome. These subsided upon discontinuation of the treatment, but reappeared on a second challenge with this drug. Sicca syndrome represents a previously undescribed hypersensitivity reaction to quinidine.

Aged↗
PubMed1982

Electrocardiography vs. vectorcardiography in the diagnosis of left anterior hemiblock associated with inferior wall myocardial infarction: a critical analysis.

The ECG criteria of isolated left anterior hemiblock (LAHB) are well established. However, associated inferior wall myocardial infarction (IMI) can obscure the ECG characteristics of LAHB. In an attempt to evaluate various ECG signs of LAHB in the presence of IMI, three groups of patients were examined. Group I comprised 20 patients with unequivocal vectorcardiographic (VCG) signs of isolated LAHB; Group II included 30 patients with VCG-documented IMI; and the 20 patients in Group III had VCG evidence of IMI with LAHB. Four ECG criteria were evaluated and their average performances in the diagnosis of LAHB were determined. QRS axis above -30 degrees, the presence of terminal S wave in lead II and terminal R wave in lead AVR and delayed intrinsicoid deflection in lead AVL showed average performances of 86.2, 76.7, 68.7 and 60.8% respectively. The ECG criteria in the diagnosis of LAHB are highly sensitive but do not reach the high specificity claimed by other authors.

Adult↗
PubMed1981

Arterial hypoxemia following the administration of sublingual nitroglycerin in patients with ischemic heart disease and pneumonia.

Nitroglycerin (Ng) is a potent and short-acting coronary and systemic vasodilator, widely used in anginal pain treatment. When given to patients with pneumonia or chronic lung disease, Ng was found to cause a further decrease in arterial oxygen tension (PaO2) by increased perfusion of poorly ventilated territories in the lungs. In order to investigate the potential hazard in Ng decreasing the PaO2 in ischemic heart disease patients, who develop acute pneumonia, we administered 0.4 mg Ng sublingually to 11 patients who suffered concomitantly from ischemic heart disease and acute pneumonia. Arterial blood gases were monitored before, 2, 5 and 10 min following Ng administration, as well as a standard 12-lead electrocardiogram that was monitored as the same time. 8 out of the 11 patients showed a decrease in PaO2 which was mild to moderate, during the study period of time, none of them showed an increase, and there was tendency for the lower (less than 60 mm Hg) initial PaO2 to show a lesser decrease in the PaO2 in comparison to the higher (greater than 60 mm Hg) initial PaO2. There was no statistical significant correlation between the decrease in PaO2 and patients' age, sex, coexisting chronic obstructive lung disease and severity of systemic heart failure. Our conclusion is that the hazard in lowering PaO2 by Ng in ischemic heart disease patients who develop acute pneumonia is minimal, but the drug should be used with caution.

Adult↗
PubMed1980

Eosinophilic pleural effusion with high anti-DNA activity as a manifestation of systemic lupus erythematosus.

A patient, known to have systemic lupus erythematosus (SLE), presented with an eosinophilic pleural effusion. It is believed that SLE was the cause of her pleural effusion as increased levels of anti-DNA activity were found in the pleural fluid. Eosinophilic pleural effusion is a previosuly unreported observation in SLE patients (so far as the authors are aware), and the existence of increased anti-DNA activity in the pleural fluid may have value as an additional aid in the diagnosis of this disease.

Antibodies, Antinuclear↗
PubMed1980

Primary hyperparathyroidism: possible cause of primary hyperaldosteronism in a 60-year-old woman.

Hypertension and hypokalemia were found in a 60-yr-old woman suffering from primary hyperparathyroidism. Laboratory investigations in this patient disclosed 1) elevated levels of plasma aldosterone (PA) which could not be suppressed by a high sodium diet alone or in combination with fludrocortisone (Florinef); 2) a decline of the elevated PA levels after 4 h of ambulation; and 3) low PRA which was unresponsive to stimulation by a low sodium diet coupled with diuretic-induced volume depletion and 4 h of ambulation. These findings were consistent with the diagnosis of primary hyperaldosteronism. Extirpation of a parathyroid adenoma reduced the patient's serum calcium level to normal, and subsequently, a normalization of her blood pressure, serum electrolytes, PA, and PRA were observed. On the basis of these data is is suggested that in this case hyperaldosteronism may have been caused directly or indirectly by primary hyperparathyroidism.

Adenoma↗
PubMed1980

Effects of saturated and polyunsaturated fat diets on the chemical composition and metabolism of low density lipoproteins in man.

This study examined the effects of dietary saturated and polyunsaturated fat on the chemical composition and metabolism of low density lipoproteins (LDL) in eight normal male subjects. The influence of these diets on fecal sterol excretion was also measured in four of the subjects. When compared with the saturated fat diet, the polyunsaturated diet lowered both plasma cholesterol polyunsaturated diet lowered both plasma cholesterol (23%, P less than 0.001) and triglyceride (14%, P less than 0.001) levels. Sixty-seven percent of the reduction in the former lipid resulted from a fall in LDL cholesterol (23%, P less than 0.001), although very low density (VLDL) and high density lipoprotein (HDL) cholesterol levels also fell (by 27% and 20% of their respective control value). These changes were accompanied by significant alterations in LDL composition. Specifically, during polyunsaturated fat feeding, the relative percentage cholesterol in the LDL fraction fell while that of phospholipid rose. There was no change in the percentage protein or triglyceride. The fatty acid components of LDL triglyceride, cholesteryl esters, and phospholipid were also affected by dietary fat saturation level. Overall, polyunsaturated fat feeding produced an enrichment in linoleate with reciprocal changes in palmitate, stearate, and oleate which affected triglycerides more than cholesteryl esters and phospholipids. The above changes in LDL composition were associated with alterations in the metabolism of LDL apoprotein (apoLDL). The polyunsaturated deit lowered plasma apoLDL by 13% (P less than 0.05). This resulted from an increase in the fractional catabolic rate of LDL (whether determined by plasma decay curve analysis (P less than 0.05) or urine/plasma radioactivity ratios (P less than 0.001) without significant alteration of its corporeal distribution or synthetic rate. The polyunsaturated fat diet did not cause a consistent change in fecal neutral or acidic steroid excretion. We conclude that the hypocholesterolemic action of polyunsaturated fat diets is effected by multiple mechanisms whose expression may vary from patient to patient.

Adult↗