Search PubMedSearch

Biomedical subjects

E Theodor

Publications and source records attributed to E Theodor.

16 recordsLinked to original sources

Life threatening hypophosphataemia in a patient with Philadelphia chromosome-positive chronic myelogenous leukaemia in acute blastic crisis.

Life-threatening hypophosphataemia developed in a 47 year old woman with blastic crisis of chronic myelogenous leukaemia. The patient's hospitalization was characterized by reciprocal relationship between her white cell count and the serum phosphorus levels. The patient did not demonstrate any of the usual causes of profound hypophosphataemia. The postulated mechanism of this patient's hypophosphataemia is uptake by the rapidly dividing leukaemic cells. To the best of our knowledge this is the first case in the English literature of hypophosphataemia associated with blast crisis of Philadelphia chromosome-positive chronic myelogenous leukaemia.

Blast Crisis

Intermittent administration of furosemide vs continuous infusion preceded by a loading dose for congestive heart failure.

Several reports have suggested that continuous intravenous administration of loop diuretics may be superior to intermittent administration. We performed a prospective randomized crossover study comparing intermittent intravenous administration (IA) of furosemide with continuous infusion following a single loading dose (LDCI) in nine patients with severe congestive heart failure. At the time of hospital admission, patients were randomly assigned to one of two treatment groups. One group (four patients) received an IV bolus injection of furosemide followed immediately by a continuous infusion for 48 h. The second group (five patients) was treated with three IV bolus injections a day for 48 h. Total doses of furosemide were equivalent in the two groups. After 48 h, each patient was crossed over to the other method and treated for an additional 48 h. LDCI produced significantly greater diuresis and natriuresis than IA (total urine output increased by 12 to 26 percent, total sodium excretion increased by 11 to 33 percent) (p less than 0.01). There were no significant differences in side effects between the two methods. These results indicate that LDCI may be a preferred method for administration of furosemide in patients with congestive heart failure.

Aged

Recombinant alpha-interferon may be efficacious in acute hepatitis B.

Whereas, in chronic type B hepatitis, the therapeutic effect of alpha-interferon has been studied extensively, data on the effect of interferon on the course and prognosis of acute hepatitis B are scarce in the literature. We report a case of acute type B hepatitis complicated by life-threatening extrahepatic manifestations where recombinant alpha-interferon facilitated clinical, biochemical, and serological recovery.

Acute Disease

Pregnancy and primary biliary cirrhosis.

Pregnancy is rarely encountered in patients with primary biliary cirrhosis. Ten pregnancies in nine patients have been reported in the literature. All five pregnancies that continued beyond the 31st week had increasing jaundice during late pregnancy. We describe a case of primary biliary cirrhosis with symptomatic onset at age 19, pregnancy a year later, with subsequent resolution of jaundice and pruritus. This course is different than most described by others.

Adult

Antinuclear autoantibodies in chronic liver diseases.

Circulating autoantibodies are often observed in liver disorders, especially in those thought to have an autoimmune etiology-such as primary biliary cirrhosis (PBC) and chronic active hepatitis (CAH). The pathophysiologic role of these antibodies, however, remains obscure. The present study was performed to evaluate the incidence and diagnostic value of different antinuclear antibodies in chronic liver diseases, and to assess whether the antibodies are a non-specific expression of the hypergammaglobulinemia observed in these disorders. We measured six different antinuclear and closely related antibodies (against ssDNA, dsDNA, Poly (I), Poly (dT), RNA and cardiolipin) and their IgG, IgA and IgM isotypes in the sera of 86 patients with autoimmune, as well as other chronic liver diseases--namely, PBC, CAH, alcoholic (AC) and cryptogenic cirrhosis (CC). Antibodies against all the various nuclear antigens were detected in all diseases studied. The incidence ranged from 4% (anti-cardiolipin-IgG in CC) to 74% (anti-Poly (dT)-IgM in PBC). Although the antibody profiles differed among the various disease entities, they were not distinct enough to be of any clinical diagnostic value. In alcoholic cirrhosis antibody levels correlated with corresponding immunoglobulin isotype levels (notably IgA), suggesting a non-specific expression of hypergammaglobulinemia. In the other liver diseases such a correlation was lacking, favoring the existence of an underlying specific antigenic stimulation, or some other more specific immune dysfunction.

Adult

The effect of propranolol on renal sodium handling in patients with cirrhosis.

Beta-adrenergic blockade by oral propanolol in five cirrhotic patients caused changes in the handling of an acute sodium load. Fractional sodium excretion following an acute saline load increased from 0.69% +/- 0.29 to 1.49% +/- 0.11 (103 microEq/min +/- 7.5 to 129 microEq/min +/- 18) before propranolol administration. After 3 days of oral propanolol 1 mg/kg day, the fractional excretion of sodium by saline loading increased from 0.52% +/- 0.19 to 2.17 +/- 0.19 (109 microEq/min +/- 9 to 178 microEq/min +/- 11). This change was not accompanied by changes in GFR, RPF or in the renin-aldosterone system. The possibility that these changes are caused by a change in the sodium transport at the tubular cell level induced by the beta-adrenergic blockade, is entertained.

Adult

The clinical course of subacute hepatic necrosis.

The clinical course is reported in 17 patients in whom the histological picture of subacute hepatic necrosis ("bridging hepatitis") was found on needle liver biopsy or at autopsy. The patients' ages ranged from 10-71 years, 12 patients being less than 40 years old. Ten patients were males. Jaundice lasted 2-4 months in nine cases and over six months in two, one of the latter having developed cirrhosis. In five patients a relapse of jaundice occurred within three months. Hepatitis B antigen was found in one of 13 patients tested. Two patients died in fulminant hepatic failure, one developed cirrhosis. These three patients and an additional two received prednisone therapy. Twelve of the remaining patients were followed for periods of 8-81 months; an additional two patients' follow-up was incomplete. None developed clinical evidence of chronic liver disease, and laboratory data at the last examination were normal except for slight elevation of alkaline phosphatase in six cases. Repeat biopsies showed persistent hepatitis in one case, slight portal fibrosis in one, cirrhosis in one and at autopsy in a patient who died of unrelated causes two years after hepatitis no evidence of chronic liver disease was found. This relatively good outome of subacute hepatic necrosis is probably due to the young average age of the patients, and the low incidence of B hepatitis in this series.

Adolescent

Rhinoscleroma.

Rhinoscleroma may present a diagnostic problem when encountered outside endemic region. Two young men from Gaza with tumor-like masses of scleroma in the nasal cavities and the nasopharynx are described. Histological examination of biopsy material from the nasal lesions showed pathognomonic Mikulicz cells, and cultures grew Klebsiella rhinoscleromatis. Both patients responded well to antibiotic treatment.

Adult

Protracted diarrhea of unknown etiology in Israeli soldiers.

Twenty-five Israeli soldiers, seen over a period of five years, suffered from diarrhea lasting from one month to three years. This was accompanied by weight loss and, in some cases, by evidence of malabsorption and/or mild abnormalities in small bowel and rectal biopsies. The etiology of the diarrhea is unknown, since a routine search for parasites or pathogenic bacteria was unrewarding. An infectious etiology is, however, most likely.

Adolescent