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Biomedical subjects

F Rosner

Publications and source records attributed to F Rosner.

At least 235 records · Page 13Linked to original sources

Cancer and secondary leukemia.

Acute myeloid leukemia or one of its variants is being reported with increasing frequency as a second neoplasm in patients being treated for multiple myeloma, Hodgkin's disease, non-Hodgkin's lymphoma and a variety of other primary neoplasms and non-neoplastic diseases. Although many of these patients were treated with both chemotherapy and radiotherapy, many received no radiotherapy at all. Drugs most frequently implicated in the causation of acute leukemia and other second neoplasms are the alkylating agents, procarbazine and the nitrosoureas. The frequency of this syndrome varies from less than 1 per cent to 7 per cent in many reported series of patients. There could develop a reluctance to use cytotoxic agents to treat malignant neoplasms for fear of inducing acute leukemia. Although one has to consider this complication, one should not, however, withhold these drugs from a patient with a neoplasm or other potentially fatal disease in whom such therapy is the treatment of choice. We seem to be faced with the paradox that patients benefiting most from chemotherapy may be at highest risk of suffering its undesirable consequences. Although the risk of leukemogenesis or carcinogenesis in man may be small, these drugs should be used with caution in patients with indolent non-neoplastic diseases such as rheumatoid arthritis.

Adolescent↗

Alcoholism in the elderly: an analysis of 50 patients.

The personal, demographic, and socioeconomic aspects of alcoholism in 50 elderly and 50 young alcoholics were examined. A higher number of elderly alcoholics were veterans, widowed, and had a long history of alcoholism when compared with younger alcoholics. During drinking bouts, the younger alcoholics had more blackouts, hallucinations, sleeping difficulties, and loss of appetite than did the elderly alcoholics. These findings must be interpreted with caution in view of the small sample size and the fact that geriatric alcoholics are not a homogeneous group.

Age Factors↗

Specialty choices and board certifications of 'fifth pathway' graduates.

We studied the specialty choices and board certification status of 258 graduates over a ten-year period of a single "fifth pathway" program. Not including obstetrics and gynecology as a primary care specialty, 54% of our graduates chose primary care specialties. Including obstetrics and gynecology, the number increased to 63%. Thirty-five of 158 graduates through 1978 are specialty board certified and another 49 are board eligible. We believe that our program has fulfilled the need of assisting Americans studying medicine abroad, primarily in Mexico, to overcome their clinical deficits and become integrated into the mainstream of American medicine. The future role of fifth pathway programs must be reevaluated in light of the 1980 Graduate Medical Education National Advisory Committee report, which concluded that by 1990, there will be an overabundance of physicians in the United States.

Career Choice↗

Acute myeloid leukemia following treatment of Hodgkin's disease: a review.

Risk factors were analyzed and searched for possible predictive parameters for the development of acute myeloid leukemia in 216 reported patients previously treated for Hodgkin's disease. The distribution of histologic subtypes and the stage at diagnosis were similar to that of all patients with Hodgkin's disease. Seventy-five percent of the 216 patients in whom acute myeloid leukemia developed had received both radiotherapy and chemotherapy, 15% chemotherapy only, and 10% radiotherapy only. Of those receiving radiotherapy, 66% were given multiple courses or total nodal irradiation. Of the patients receiving chemotherapy, 77% had received more than eight months of single or combination drug therapy; only 4% had not been exposed to alkylating agents. When acute leukemia developed, 78% of the patients showed no clinical or pathologic evidence of residual Hodgkin's disease. A period of pancytopenia preceded the onset of overt leukemia in at least one-third of the patients. Complete or partial remission of the acute leukemia was achieved in 25% of the patients treated with antileukemic chemotherapy. On the basis of these findings, it is deemed advisable to reexamine the intensity of treatment presently being administered to achieve cure of Hodgkin's disease. Unnecessary or unproved programs of combined radiation therapy and chemotherapy should be avoided. An optimal balance between the risks and benefits of treatment needs to be applied.

Adolescent↗

Noninvasive cardiac evaluation in chronic alcoholic patients with alcohol withdrawal syndrome.

Cardiac function was evaluated by noninvasive techniques in 50 patients hospitalized during acute alcohol withdrawal treatment. All patients had ingested large amounts of alcohol for at least five years, but discontinued alcohol intake 24 to 72 hours prior to admission. There was no clinical history of heart disease in any of the patients. Our study employed 12-lead electrocardiograms (daily) and 24-hour Holter monitoring. M-mode echocardiography and systolic time intervals were evaluated in 24 patients. The results indicate that marked electrical irritability of a depressed myocardium during the acute phase of alcohol withdrawal indicates the need for close cardiac observation of such patients in order to avoid potential life-threatening arrhythmias.

Adult↗

Moses Maimonides' treatise on asthma.

This paper contains an analysis and appreciation of one of Moses Maimonides' authentic medical works, his Treatise on Asthma. After a brief biographical section, passages from the work are cited and analysed to illustrate the approach of this medieval physician who organised the knowledge of Greeks and others who preceded him. Maimonides presents a logical and systematic approach to the prevention, diagnosis, and treatment of disease, an approach which is clearly evident in his Treatise on Asthma.

Asthma↗