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Biomedical subjects

E Albu

Publications and source records attributed to E Albu.

At least 19 recordsLinked to original sources
PubMed2000

Malignancy in HIV/AIDs: a single hospital experience.

BACKGROUND AND OBJECTIVES: Our hospital serves an area with a significant number of patients seropositive for the human immunodeficiency virus (HIV). Intravenous drug abuse and heterosexual exposure are by far the predominant risk factors for HIV and acquired immunodeficiency syndrome (AIDS). Seven percent of these patients develop malignancies. Our aim was to study the types of tumor, their distribution, and to evaluate the patients' outcome. METHODS: Of 3,578 patients with HIV infection or AIDS treated between 1993 and 1998, 245 had 1 or more malignancies. Information was collected on age, sex, race, predisposing risk factors for AIDS, malignancies, symptoms at presentation, the time of the onset of AIDS, CD4 cell counts, pathology findings, and mortality. RESULTS: Although aspects of our patients resembled those of previously studied groups of patients with AIDS, there also were ways in which our patients differed from those other groups. Of our patients, 21. 6% had non-AIDS-defining (NAD) invasive malignancies. This was considerably higher than the rate in most studies. Twenty-seven patients with such malignancies died during the study. Forty-two other patients had pre-invasive cancers. Among patients having AIDS-defining (AD) malignancies, 55.9% died, a fact that was related to patients' low CD4 cell counts and late presentation. Our 97 patients with Kaposi sarcoma included 22 women, a relatively high number that may be related to the fact that most of our patients were intravenous drug abusers or had become infected by heterosexual transmission of HIV. CONCLUSIONS: AIDS is associated with a high risk of malignancy and an unusual spectrum of tumors. Patients with invasive tumors have advanced disease at the time of initial presentation. Those with AD tumors have a worse prognosis than patients with NAD tumors. The impact of highly active antiretroviral therapy on both AD and NAD tumors needs to be further evaluated.

AIDS-Related Complex↗
PubMed2000

Gastric stromal tumor.

Gastric stromal tumors display a bewildering array of immunohistological and ultrastructural features as well as variable biological behavior. These tumors are rare as compared with ones that arise from the gastric epithelium. Moreover, they have been the subjects of controversy because of their uncertain histogenesis. We report the pathological features of gastric stromal tumors we recently encountered in three patients.

Humans↗
PubMed1999

Acute acalculous cholecystitis in young patients without predisposing factors.

We report the atypical presentation of acute acalculous cholecystitis in four young, otherwise healthy patients. These cases emphasize the fact that the traditional concept of this disease as being associated with trauma, major surgery, or other pathology may no longer be true, and an important number of cases may appear de novo in patients without any predisposing factors.

Acute Disease↗
PubMed1999

Emergency surgery for generalized peritonitis caused by cytomegalovirus colitis in a patient with AIDS.

Cytomegalovirus infection of the colon is a late and severe complication in human immunodeficiency virus patients. Despite availability of medical treatment, occasional life-saving emergency surgery must be performed. The controversial surgical aspects of treatment are discussed based upon an unusual case of aseptic generalized peritonitis without perforation. The feasibility and value of limited resection are emphasized.

AIDS-Related Opportunistic Infections↗
PubMed1999

Predictors of the severity of acute pancreatitis in patients with HIV infection or AIDS.

We retrospectively reviewed the charts of 54 human immunodeficiency virus (HIV) infected patients or acquired immunodeficiency syndrome (AIDS), who were hospitalized at the Bronx-Lebanon Hospital Center with acute pancreatitis between January 1993 and December 1995. Nineteen were female and 35 were male patients. Thirty-five (65%) of 54 patients were younger than 40 years (average age, 42 years). Forty-eight (89%) of the patients had a CD4 count of <200 units/ml of blood. Seventeen (32%) patients died either of complications of acute pancreatitis or of underlying disease. The conventional prognostic criteria used to assess the severity of pancreatitis, including Ranson's and Imrie's criteria and the APACHE II system, were applied. We determined that these criteria were not appropriate to our HIV/AIDS patients. Only serum calcium levels at 48 h after admission and serum creatinine and blood urea nitrogen (BUN) at admission and at 48 h after admission had significant p values (<0.05). We believe that the predictors commonly used to identify the severity of pancreatitis were not useful in these patients because of their low CD4 counts and preexisting liver and renal disease.

APACHE↗
PubMed1999

Modern management of postoperative pain.

In the last 10 years there has been an increased awareness of the need for improved pain management, especially in the postoperative period, to a large extent stimulated by the US Agency for Health Care Policy and Research (AHCPR), which published its clinical practice guidelineS for pain management in 1992. Teams of surgeons, nurses and anesthesiologists now are combining modalities for managing pain so as to provide the most comfortable postoperative course possible for their patients.

Journal Article↗
PubMed1997

Acute appendicitis in minority communities: an epidemiologic study.

This study examines the incidence and epidemiological factors of acute appendicitis in various ethnic groups in an urban minority community. The charts of 278 consecutive patients who underwent appendectomy at The Bronx-Lebanon Hospital Center, Bronx, New York, between January 1988 and December 1990 were reviewed. Thirty-eight patients who underwent incidental appendectomy and one patient who had an interval appendectomy were excluded. The remaining 239 patients, all of whom had acute appendicitis, constituted the study population. The incidence of appendicitis for each ethnic group was calculated as a percentage of the total emergency surgical admissions for that group. Acute appendicitis constituted 3.1% of all emergency admissions to the surgical service over the period studied and represented 4.5% of surgical service admissions from the emergency department in Hispanics, 1.9% in African Americans, 1.5% in whites, and 21% in Asians. These differences were statistically significant except some comparisons involving whites. There were no significant differences in the pathological findings regarding the diseased appendix in different racial groups. These results indicate that acute appendicitis is responsible for a higher incidence of emergency admissions among Hispanics than among African Americans. This finding was statistically significant. High white blood cell counts indicated inflammation of the appendix, but had no predictive value for the type of pathology. Surgical findings were similar in all groups.

Acute Disease↗
PubMed1996

Chemical pleurodesis for spontaneous pneumothorax in a patient with AIDS.

Persistent air leak and failure of the lung to expand completely after closed thoracostomy complicate the course of spontaneous pneumothorax in patients with AIDS. In such cases, attempts to discontinue chest tube drainage may fail. The following is a case of a patient with AIDS and spontaneous pneumothorax who responded to chemical pleurodesis with tetracycline.

AIDS-Related Opportunistic Infections↗
PubMed1996

Primary non-Hodgkin lymphoma presenting as ileocolic intussusception.

We report the case of an HIV-seropositive patient with non-Hodgkin lymphoma of the small intestine who presented with an ileocolic intussusception. This lesion fulfilled the diagnostic criteria for primary gastrointestinal lymphoma. Such a neoplasm in an immuno-compromised patient is usually more aggressive and less responsive to treatment than in an HIV-seronegative patient.

Adult↗
PubMed1995

Perforated solitary jejunal diverticulum.

We report a case of perforated solitary jejunal diverticulum in an 80-year-old woman. Jejunal diverticulosis occurs in 0.07% to 2.0% of the population. Jejunal diverticulitis with perforation is rare and is associated with high mortality. Treatment is surgical resection of the involved segment. Several theories to explain the pathogenesis of jejunal diverticula may relate to manometric or histologic abnormalities of the small bowel.

Abdomen, Acute↗
PubMed1995

Intramural abscess of the duodenum resulting from perforated peptic ulcer.

Even in this age of effective medical treatment for peptic ulcers, their complications remain the same. Many require prompt surgical intervention. We present an unusual case of postbulbar duodenal ulcer complicated by intramural perforation and abscess formation. Such complications have a high mortality rate because of frequent delays in diagnosis and treatment caused by a lack of peritoneal signs or other specific clinical findings.

Abscess↗
PubMed1995

Sarcoidosis presenting as obstructive jaundice.

Sarcoidosis is an uncommon disorder characterized by a multi-systemic granulomatous disease of undetermined etiology and pathogenesis. The diagnosis is established by the presence of a compatible clinical illness and by histologic demonstration of noncaseating epithelioid cell granulomas in the affected organs. Accurate diagnosis requires a thorough evaluation to exclude infectious and neoplastic diseases that can mimic sarcoidosis. Although all organs and systems can be affected, the lungs and intrathoracic lymph glands are the most common sites of involvement. We describe an unusual case of extrapulmonary sarcoidosis presenting as obstructive jaundice.

Adult↗
PubMed1994

Diagnostic value of C-reactive protein in acute appendicitis.

Serum C-reactive protein was measured in 56 patients hospitalized with a suspected diagnosis of acute appendicitis. Based on these determinations, four groups of patients were defined: Group A = 26 patients with acute appendicitis who had a C-reactive protein level higher than 2.5 mg/dl. Group B = 4 patients with a C-reactive protein level lower than 2.5 mg/dl who, after surgery based on a presumed diagnosis of acute appendicitis, were found to have a normal appendix. Group C = 22 patients with nonspecific abdominal pain, 18 (72 percent) of whom had an elevated C-reactive protein level, although in only 4 (7.1 percent) were these levels higher than 2.5 percent mg/dl. Group D = 4 patients who had diseases other than acute appendicitis. It is concluded that an increase in C-reactive protein levels to more than 2.5 mg/dl is not a definite indicator of acute appendicitis. However, if the C-reactive protein level in blood drawn 12 hours after the onset of symptoms is less than 2.5 mg/dl, acute appendicitis can be excluded.

Acute Disease↗
PubMed1993

Metastatic leiomyosarcoma of the uterus: unusual presentation of a case with late endobronchial and small bowel metastases.

A 56-year-old woman, 8 years after a total abdominal hysterectomy for leiomyosarcoma of the uterus, presented with simultaneous metastatic tumors to the bronchus and the small bowel. The former presented as atelectasis of a lung lobe and the latter as an ileoileal intussusception. Both lesions were resected and proved to be similar to the original tumor. The patient died of metastatic liver disease, 10 years after the hysterectomy and 2 years after resection of the metastases.

Bronchi↗
PubMed1993

Delayed splenic rupture in a drug addict.

We present the case of a drug addict who was admitted with abdominal pain but gave no history of trauma. He subsequently left the hospital against medical advice, only to be readmitted a few days later with persistent abdominal pain. He was found to have splenic rupture. This case emphasizes the importance of ruling out intra-abdominal trauma in any drug addict presenting with acute abdomen.

Abdominal Injuries↗