[Geriatric aspects of drug-induced disease].
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Biomedical subjects
Publications and source records attributed to E M Tareev.
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A study of 64 patients with erythema nodosum (EN), including 53 females, showed sarcoidosis diagnosed in 65% of the cases to be the principal cause of EN. It was followed by drug disease (10%), tuberculosis (3%), pregnancy or labor (5%), tumors (3%) and other underlying diseases (Behcet's diseases, streptococcal infection, histoplasmosis, nonspecific aorto-arteritis, chronic active hepatitis). The cause of EN could not be identified in 5% of patients only. Two or three possible etiologic factors were identified in 17%. Sarcoidosis combined with EN regressed without treatment in 82% of cases. Corticosteroid therapy was only given in cases of pulmonary lesion or other systemic manifestations. Purposeful investigation is believed to be capable of establishing etiology of EN in virtually all cases.
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During 5 years, the authors followed up 129 patients referred to the clinic with a diagnosis of fever of unclear genesis. In 36.4% of cases, fever masked malignant neoplasms. Hyperthermia was ahead of the emergence of the symptoms of a tumor (maximally up to 12 years), dominated or was the only symptom for a time being. However, in most cases it combined with other paraneoplastic masks (rheumatic, hematological, hepatological, etc), was resistant to the treatment and disappeared after radical treatment.
During 5 years the authors followed up 35 patients with bronchogenic carcinomas. Of these, 34.3% had diverse paraneoplastic manifestations. The paraneoplastic reactions determined by ectopic production of different hormones and other substances as well as so-called "masks" of the systemic diseases are reviewed. An attempt is made to specify the basic mechanisms of the pathogenesis of each paraneoplastic sign.
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With no intention of belittling the importance of chronic ischemic heart disease (CIHD) in modern cardiology, the article focuses the attention on primary alcoholic heart disease--alcoholic cardiomyopathy (ACMP)--which arouses a far from causal interest due to the prevalence of alcoholism. It is suggested to distinguish three main clinical forms of ACMP: valence of alcoholism. It is suggested to distinguish three main clinical forms of ACMP: (1) "classical", manifested by dilatation of the heart and signs of its failure; (2) "quasi-ischemic" manifested by cardialgia and changes in the ECG, resembling those in CIHD; (3) "arrythmic", characterized by variants of disorders of myocardial excitability and conduction. The ACMP diagnostic criteria, methods for its identification and differential diagnosis from CIHD, modern conceptions of ACMP pathogenesis, and the main principles of treatment are discussed.
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