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Biomedical subjects

E R Eichner

Publications and source records attributed to E R Eichner.

At least 37 records · Page 2Linked to original sources
PubMed1985

Runner's macrocytosis: a clue to footstrike hemolysis. Runner's anemia as a benefit versus runner's hemolysis as a detriment.

This report of a runner in whom progressive macrocytosis developed with increasing mileage deals with the hematologic adaptations to exercise, introduces the concept of "runner's macrocytosis" as a compensated hemolysis of older red cells, and makes a case for "runner's anemia" as a benefit versus "runner's hemolysis" as a detriment. It presents the characteristic hematologic profile of footstrike hemolysis and explores the influence of racing, different levels of training, and different shoes. It shows that runner's hemolysis can be reduced by reducing mileage but not necessarily by changing shoes, and it suggests that runner's hemolysis can impair race performance by preventing the attainment of an optimal red cell mass and, in time, by evolving into iron-deficiency anemia.

Adult↗
PubMed1984

Platelets, carotids, and coronaries. Critique on antithrombotic role of antiplatelet agents, exercise, and certain diets.

"Antiplatelet" drugs and certain life styles seem to have an "antithrombotic" effect that may help protect against stroke and heart attack. This review of the experience with aspirin, dipyridamole, and sulfinpyrazone offers new interpretations of some of the major clinical trials, suggests guidelines for use of antiplatelet drugs, and integrates novel observations on diet and exercise into the "thromboxane-prostacyclin balance" hypothesis. It is argued that the Canadian stroke study showed that aspirin protects men with transient ischemic attacks from coronary death as well as from stroke, that type II errors may have been made in some clinical trials, that aspirin protects women as well as men, that aspirin benefits patients who have had a heart attack, that the effect of aspirin in angina varies with the type of angina, that the dose of aspirin used may not be critical, that guidelines for use of dipyridamole and sulfinpyrazone are still inconclusive, and that exercise and fish oil supplements may be "antithrombotic."

Angina Pectoris↗
PubMed1984

Erythroid karyorrhexis in the peripheral blood smear in severe arsenic poisoning: a comparison with lead poisoning.

Three men with severe arsenic poisoning were hospitalized with working diagnoses, respectively, of peptic ulcer, pancreatitis, and viral gastroenteritis. In the first two patients, correct diagnosis was delayed until the return of heavy-metal screening tests ordered because of painful peripheral neuropathy in one and sudden flaccid paralysis, resembling Guillain-Barré syndrome, in the other. Both patients had coarsely stippled red blood cells with markedly abnormal nuclei in their peripheral blood smears. These distinctive hematologic features led to an early diagnosis in the third patient. The author's review of past cases of lead poisoning showed that red blood cell karyorrhexis also tends to occur in patients who consume illicit whiskey ("moonshine"). Karyorrhexis or marked dyserythropoiesis in the peripheral smear, not heretofore described in arsenic or lead poisoning, may indeed be a unique hematologic clue. Scrutiny of the peripheral blood and/or buffy coat smear in patients with perplexing gastrointestinal or neurologic symptoms may enable earlier diagnosis and better therapy of arsenic poisoning.

Adult↗
PubMed1984

Spider bite hemolytic anemia: positive Coombs' test, erythrophagocytosis, and leukoerythroblastic smear.

The full hematologic profile of spider bite hemolytic anemia has not been documented in the literature. The two patients had brisk intravascular hemolysis with direct Coombs' tests positive for complement and with peripheral blood smears showing spherocytosis, erythrophagocytosis, and leukoerythroblastosis. The author's experience, along with that in the literature reviewed herein, suggests that the hemolytic anemia that can follow the bite of the brown recluse spider could be confused with autoimmune hemolytic anemia.

Adult↗
PubMed1984

Adult T-cell leukemia: clinical and immunologic characterization of a nonendemic case.

A 56-year-old black man with nonendemic adult T-cell leukemia is reported, who presented with severe hypercalcemia and leukemic leptomeningeal infiltration but had no evidence of bone marrow involvement. His malignant cells were characterized by light and transmission electron microscopy, cytogenetics, and flow cytometry. The cells demonstrated the deeply indented or convoluted nuclei characteristic of endemic human T-cell lymphoma virus-associated cases. Surface phenotyping indicated the cells' origin to be from the mature, helper/inducer subset of T-lymphocytes. However, there was no clinical or laboratory evidence that the malignant cells retained immunoregulatory function. The clinical and immunologic features of this and other nonendemic cases are compared with those of patients from the endemic regions of Japan, the Caribbean islands, and the southeastern United States.

Biopsy, Needle↗
PubMed1984

Aspirin and folate binding: in vivo and in vitro studies of serum binding and urinary excretion of endogenous folate.

To clarify the effect of aspirin on folate balance, we studied serum concentration, protein binding, and urinary excretion of endogenous folate. A healthy woman twice followed an 11-day protocol of constant diet, blood sampling twice daily, collection of all urine, and 650 mg of aspirin by mouth every 4 hours on the middle 3 days. As determined by equilibrium dialysis and Lactobacillus casei assay, aspirin induced a brisk, significant but reversible fall in total and bound serum folate and a small but insignificant rise in urinary folate excretion. Aspirin in vitro also displaced significant amounts of bound serum folate. Thus, aspirin in therapeutic doses can contribute to subnormal serum folate values, and if it increases urinary folate excretion even slightly, may impair folate balance.

Aspirin↗
PubMed1983

Exercise and heart disease. Epidemiology of the "exercise hypothesis".

The "exercise hypothesis" states that exercise protects against coronary heart disease. Reviewed herein is the epidemiologic evidence for and against the "exercise hypothesis." The weight of evidence supports the view that exercisers have a lower risk of coronary disease, but that vigorous exercise cannot always prevent progression of coronary atherosclerosis and does increase the risk of sudden death in persons with advanced coronary atherosclerosis. It is concluded that the "exercise hypothesis" is plausible, even likely, but still unproved.

Adult↗
PubMed1983

Acute leukemia after successful chemotherapy for oat cell carcinoma.

A report of acute myelomonocytic leukemia following successful therapy for oat cell carcinoma is presented. The patient had been treated with extensive cytotoxic and radiation therapy, and was without clinical evidence of disease at one year follow-up. Eighteen months later, a peripheral smear revealed numerous blasts with monocytoid characteristics. This unusual presentation is discussed and compared with several other cases appearing in the recent literature.

Aged↗
PubMed1980

The plasma cell dyscrasias: diverse presentations, pathophysiology, and management.

The plasma cell dyscrasias have in common the proliferation of a single clone of plasma cells, but have disparate manifestations and natural histories. Multiple myeloma can present in protean ways, and early diagnosis is vital because timely supportive therapy and chemotherapy can give patients longer, better lives. Waldenström's macroglobulinemia may be manifested by the hyperviscosity syndrome, which responds to plasmapheresis. Patients with benign monoclonal gammopathy as strictly defined fare very well without therapy, but some asymptomatic patients with a serum monoclonal protein have incipient myeloma, so periodic reevaluation is essential.

Adult↗
PubMed1979

Splenic function: normal, too much and too little.

This review is concerned with normal splenic function, mechanisms and consequences of splenomegaly, hypersplenism, the medical indications for splenectomy and the various aspects of hyposplenism. The potential probelm of lethal septicemia in hyposplenic or asplenic patients is also considered.

Animals↗
PubMed1979

Splenic infarction in a white man with sickle cell trait.

We report the third case of splenic infarction from sickle cell trait in a young white man traveling through mountains. Apparently the hypoxemia at 10,800 feet, along with a relatively high hemoglobin S concentration of 40%, interacted with the known conditions of splenic blood flow to cause sickling and infarction, even though our patient was not exercising. The optimal management for this rare complication of sickle cell trait remains unknown, but surgery may not be required for either diagnosis or therapy.

Adult↗
PubMed1978

Elevated serum levels of unsaturated folate binding protein: clinical correlates in a general hospital population.

We measured the capactiy of unsaturated folate binding protein to bind 3H-pteroylglutamic acid (UFBC) in serums from 489 general hospital patients. Of the patients 20% had mild-to-moderate elevations in UFBC (250 to 500 pg/ml), but only 6% had marked elevations (greater than 650 pg/ml), which correlated with metastatic cancer, active granulomatous disease, and especially with liver disease. The poor correlation of serum UFBC with folate status of the patient suggests that in many instances the elevated serum UFBC is neither the consequence nor the cause of folate deficiency. Although the role of folate binding protein remains unknown, it may be primarily an intracellular protein that is released into the serum as an index of activity of liver cells, granulocytes, and perhaps certain cancer cells.

Adult↗
PubMed1978

Concurrent primary pneumococcemia, disseminated intravascular coagulation, and sickle cell anemia.

Fulminant pneumococcal infections are rare in teen-agers with sickle cell anemia. A 16-year-old black male with sickle cell anemia was treated as an outpatient for cryptogenic pain crisis, which delayed antibiotic therapy for primary pneumococcal septicemia for seven hours. This patient did not appear ill upon initial presentation but rapidly developed disseminated intravascular coagulation and died.

Adolescent↗