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Biomedical subjects

E B Silberstein

Publications and source records attributed to E B Silberstein.

At least 37 records · Page 2Linked to original sources
PubMed1998

Prevalence of adverse reactions to positron emitting radiopharmaceuticals in nuclear medicine. Pharmacopeia Committee of the Society of Nuclear Medicine.

UNLABELLED: This study was undertaken to determine the prevalence of adverse reactions to positron emitting radiopharmaceuticals as well as to nonradioactive drugs used in interventional nuclear medicine during PET studies. METHODS: A prospective 4-yr study was performed with 22 collaborating institutions using a questionnaire, which indicated for each month of the study the number of PET procedures performed, the number of adverse reactions to PET radiopharmaceuticals as well as the number of adverse reactions to interventional nonradioactive pharmaceuticals used for PET. RESULTS: A total of 33,925 radiopharmaceutical doses were recorded in a retrospective examination of records by the 22 participating institutions. In addition, the total prospective number of administered doses recorded by the participants was 47,876, for a total number of positron emitting radiopharmaceutical administrations of 81,801. No adverse reactions were found from any PET radiopharmaceutical dose. There were no deaths or hospitalizations caused by nonradioactive interventional pharmaceuticals used adjunctive to PET studies. CONCLUSION: PET radiopharmaceuticals have an extraordinary safety record with no adverse reactions reported in over 80,000 administered doses in this study.

Humans↗
PubMed1997

Radiobiological evaluation of immigrants from the vicinity of Chernobyl.

Eighty individuals (55 adults and 25 children) who were residents of four cities (Kiev, Mozyr, Gomel and Bobrujsk) located 100-200 km from Chernobyl at the time of the accident in 1986 were tested after immigrating to the US from 1989-1991. A whole-body counter was employed to quantitate radiocesium content. In addition, two biological measures of radiation effects, namely, chromosomal integrity using the micronucleus assay and somatic mutation analysis of erythrocytes at the glycophorin A (GPA) locus, were applied to this group. Radiocesium activity in the body ranged from 0 to 56.8 Bq/kg with a mean and standard deviation of 5.0 +/- 8.2 and a median value of 2.0 Bq/kg. Mean radiocesium content by groups was highest in adult males (9.0 +/- 11.7; range 0.21-56.8 Bq/kg) followed by adult females (3.3 +/- 4.5; range 0-21.3 Bq/kg), male children (3.0 +/- 5.7; range 0-20.2 Bq/kg) and lowest in female children (1.6 +/- 3.5; range 0-12.7 Bq/kg). Individuals with the highest radiocesium content in each group belonged to one family that lived in Mozyr (100 km from Chernobyl) until emigrating in 1989. The frequency of lymphocyte micronuclei and erythrocyte GPA allele-loss (O/N) somatic mutations were both significantly correlated with radiocesium content (r=0.57, p=0.002; r=0.75, p=0.002, respectively). The micronucleus frequency also correlated with the estimated internal absorbed dose from radiocesium in a subset of 20 immigrants for whom this calculation was possible (r=0.71, p=0.0005). Altogether, the biomonitoring data indicate that some subjects had radiation doses sufficient to produce gene and chromosomal mutations in blood cells, although these effects cannot be attributed solely to radiocesium exposure.

Adolescent↗
PubMed1996

Intense uptake of In-111 satumomab pendetide in an inflammatory mass.

Intensely increased upper abdominal uptake of In-111 labeled anti-tumor associated glycoprotein in a patient with a history of pancreatic carcinoma persisted over 6 days in the same location. At laparotomy chronic inflammation, fibrosis, calcification, and lymph node granulomas were found, but no tumor. The patient remained tumor free 8 months later.

Antibodies, Monoclonal↗
PubMed1996

Prevalence of adverse reactions in nuclear medicine. Pharmacopeia Committee of the Society of Nuclear Medicine.

UNLABELLED: This investigation sought to determine the prevalence of adverse reactions to radiopharmaceuticals and to nonradioactive drugs used in interventional nuclear medicine. We also tabulated all adverse reactions reported to manufacturers of radiopharmaceuticals commercially available in the United States. METHODS: A prospective 5-yr study was performed of 18 collaborating institutions using a questionnaire which enumerated monthly the number of procedures used and adverse reactions noted. An algorithm to determine the level of etiologic probability of an adverse reaction from an administered radiopharmaceutical was developed. We reviewed all available literature on adverse reactions in nuclear medicine. RESULTS: During this period, 783,525 radiopharmaceutical and 67,835 nonradioactive drug administrations were analyzed. Ten of the 18 adverse reactions to radiopharmaceuticals were rashes. No patient experiencing an adverse reaction to a radiopharmaceutical required hospitalization or had significant sequelae. Reproducibility of the adverse reactions algorithm was validated by independent evaluation of 30 adverse reaction reports from the U.S. Pharmacopeia-Society of Nuclear Medicine adverse reaction reporting system. All adverse reactions to 49 commercially available radiopharmaceuticals were tabulated and referenced. CONCLUSION: Radiopharmaceuticals have an excellent safety record. An algorithm to evaluate putative radiopharmaceutical reactions is highly reproducible.

Adverse Drug Reaction Reporting Systems↗
PubMed1995

Perfusion and ventilation scans in patients with extensive obstructive airway disease: utility of single-breath (washin) xenon-133.

UNLABELLED: The presence of extensive obstructive airway disease in many patients leads to an interpretation of intermediate or indeterminate probability for pulmonary emboli using ventilation/perfusion lung scans. We observed that patients with extensive obstructive airway disease having perfusion abnormalities matching those on a single-breath xenon image usually have a normal pulmonary angiogram. This study's objective was to further assess the utility of a single-breath image in evaluating patients with extensive obstructive airway disease and abnormal perfusion studies categorized as having intermediate or indeterminate probability of pulmonary embolism in an attempt to decrease the number of nondiagnostic studies. METHODS: We studied retrospectively 33 patients with extensive obstructive airway disease, with abnormal perfusion scans and no infiltrates on chest x-ray categorized as having intermediate or indeterminate probability of pulmonary embolism. We established the presence or absence of matching ventilation and perfusion abnormalities by comparing perfusion scan and single-breath images. RESULTS: Among 25 patients with perfusion abnormalities matching the initial ventilation pattern on single-breath images, only 1 (4%) had pulmonary emboli as documented by pulmonary angiogram. Four out of the remaining 8 patients with no matching perfusion and single-breath ventilation pattern had pulmonary emboli (50%). CONCLUSION: Patients categorized by ventilation/perfusion scintigraphy as having intermediate or indeterminate probability for pulmonary emboli due to the presence of extensive obstructive airway disease can be further subclassified using single-breath images. Patients with matching perfusion and single-breath ventilation pattern should be categorized as having low probability for pulmonary embolism, regardless of the extent of the ventilation abnormalities.

Administration, Inhalation↗
PubMed1994

Radon update: facts concerning environmental radon: levels, mitigation strategies, dosimetry, effects and guidelines. SNM Committee on Radiobiological Effects of Ionizing Radiation.

The risk from environmental radon levels is not higher now than in the past, when residential exposures were not considered to be a significant health hazard. The majority of the radon dose is not from radon itself, but from short-lived alpha-emitting radon daughters, most notably 218Po(T1/2 3 min) and 214Po (T1/2 0.164 msec) along with beta particles from 214Bi (T1/2 19.7 min). Radon gas can penetrate homes from many sources and in various fashions. Measuring radon in homes is simple and relatively inexpensive and may be accomplished in a variety of ways. Although it is not possible to radon-proof a house, it is possible to reduce the level. In high radon areas, if the average level is higher than 4-8 pCi/liter (NCRP recommended level is 8 pCi/liter; EPA recommended level is 4 pCi/liter), appropriate action is advised. The shape of the dose response curves for miners exposed to alpha-emitting particles in the workplace is consistent with current biologic knowledge. It is linear in the low dose range and saturates in the high dose range. No detectable increase in lung cancer frequency is seen in the lowest exposed miners (those with exposures < 120 WLM, the relevant dose interval for most homes). Evidence for a health effect from radon exposure is based on data from animal studies and epidemiologic studies of mines. Extensive radiobiologic data predict a linear dose-response curve in the low dose region due to poor biological repair mechanisms for the high density of ionizing events that alpha particles create. However, no compelling evidence for increased cancer risks has yet been demonstrated from "acceptable" levels (< 4-8 pCi/liter).

Air Pollutants↗
PubMed1993

Fibrosing mediastinitis causing nonvisualization of one lung on pulmonary scintigraphy.

An interesting case of fibrosing mediastinitis, which is a rare cause of total nonvisualization of one lung on pulmonary scintigraphy, is presented. Scintigraphy with Tc-99m MAA showed a severe deficit of perfusion in the right lung, with normal perfusion of the left lung. Ventilation images were normal. CT and MRI each demonstrated the mediastinal nodal enlargement and MRI demonstrated the "flow void" signal phenomenon in the right pulmonary artery indicating its patency. Confirmation of actual patency without pulmonary artery emboli and with poor venous opacification was documented with angiography. Multiple complementary imaging modalities were helpful in correctly diagnosing fibrosing mediastinitis from an extensive list of differential possibilities for unilateral non-visualization of the lung on perfusion scanning.

Adult↗
PubMed1993

Studies in red blood cell preservation. 7. In vivo and in vitro studies with a modified phosphate-ammonium additive solution.

Studies were conducted to examine whether an experimental additive solution (EAS-2) containing, in mM: 20 NH4Cl, 30 Na2HPO4, 2 adenine, 110 dextrose, 55 mannitol, pH 7.15, would be useful to extend the storage shelf life of human RBCs. With 6 pairs of split units, ATP concentrations were better maintained for 12 weeks with EAS-2 than with Adsol (1.8 vs. 1.1 mumol/g Hb, respectively, p = 0.002). Autologous 24-hours 51Cr viability values for split units in the same donors were: on 6 paired units at 8 weeks, EAS-2 87.0 +/- 4.5%, Adsol 72.6 +/- 2.3%, p = 0.004; on 11 paired units at 9 weeks, EAS-2 79.5 +/- 7.1%, Adsol 68.2 +/- 10.1%, p = 0.0003. The data suggest that packed RBCs stored for 9 weeks with EAS-2 will be suitable for transfusion following the removal of supernatant with a single washing step.

Adenine↗
PubMed1993

The treatment of painful osseous metastases with phosphorus-32-labeled phosphates.

32P orthophosphate administered in a wide range of activity reduces or relieves the pain from osteoblastic metastases in approximately 80% of patients treated. The efficacy of this agent is equal to that of newer agents and of wide field radiotherapy, as documented in a literature review of 28 series reporting the use of 32P orthophosphate over a 50-year period. There is no dose-response relationship between the activity of 32P given and the percentage of patients experiencing pain reduction who received that activity. Only one death has been attributed to this radiopharmaceutical.

Adrenalectomy↗