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Biomedical subjects

G Kaplan

Publications and source records attributed to G Kaplan.

At least 361 records · Page 20Linked to original sources
PubMedDate not supplied

Resolving appendicitis: role of CT.

BACKGROUND: We assessed the role of computed tomography (CT) in the resolution of appendicitis. METHODS: This was a retrospective study over 2.5 years involving 155 patients and 172 CT scans for suspected appendicitis in an emergency setting. RESULTS: Sixty-nine studies were positive for appendicitis by CT criteria. Of these, 53 underwent surgery: 48 were positive for appendicitis, four had other pathologies (two with colon cancer, one with colitis, one with infectious enteritis), and one had a normal appendix that was removed. Three of the 69 patients were released or left the emergency room against medical advice. Twelve patients demonstrated acute appendicitis by CT criteria but were treated conservatively because their clinical conditions were stable; four of those patients had follow-up CT that showed resolution of findings. Six patients were followed clinically, without recurrence of symptoms, and two were lost to follow-up. CONCLUSION: Resolving appendicitis is an entity that should be considered in a patient who has signs positive for appendicitis on CT but is doing well clinically. CT positive for appendicitis does not necessarily indicate surgery, and the decision for operation should depend on clinical and radiologic features.

Acute Disease↗
PubMedDate not supplied

[Systemic lupus erythematosus in a woman with primary 47XXX hypogonadism].

The authors report the case of a 26-year old woman who presented with systemic lupus erythematosus remarkable for its numerous visceral localizations, for the presence of several antinuclear antibodies and for the unusually high serum levels of IgG and IgA. This woman also had primary hypogonadism with ovarian and uterine atrophy, poorly developed secondary sex characteristics and a 47XXX karyotype without mosaic. This case, which may be compared to the association between systemic lupus erythematosus and Klinefelter 47XXX syndrome, suggests a relationship between sex hormones and autoimmune pathology and a possible role of chromosome X in the regulation of immunity.

Adult↗
PubMedDate not supplied

Relationship between premature mortality and socioeconomic factors in black and white populations of US metropolitan areas.

OBJECTIVE: examined the association of mortality with selected socioeconomic indicators of inequality and segregation among blacks and whites younger than age 65 in 267 US metropolitan areas. The primary aim of the analysis was to operationalize the concept of institutional racism in public health. METHODS: Socioeconomic indicators were drawn from Census and vital statistics data for 1989-1991 and included median household income; two measures of income inequality; percentage of the population that was black; and a measure of residential segregation. RESULTS: Age-adjusted premature mortality was 81% higher in blacks than in whites, and median household income was 40% lower. Income inequality, as measured by the Gini coefficient, was greater within the black population (0.45) than within the white population (0.40; p < 0.001). To confirm that the proxy socioeconomic variables were relevant markers of population health status, regression analysis was performed initially on data for the total population. These variables were all independently and significantly related to premature mortality (p < or = 0.01; R(2) = 0.74). Income inequality for the total population was significantly correlated with premature mortality (r = 0.33). Black (r = 0.26) and white (r = 0.20) population-specific correlations between income inequality and premature mortality, while still significant, were smaller. Residential segregation was significantly related to premature mortality and income inequality for blacks (r = 0.38 for both); among whites, however, segregation was modestly correlated with premature mortality (r = 0.19) and uncorrelated with income inequality. Regional analyses demonstrated that the association of segregation with premature mortality was much more pronounced in the South and in areas with larger black populations. CONCLUSION: Social factors such as income inequality and segregation strongly influence premature mortality in the US. Ecologic studies of the relationships among social factors and population health can measure attributes of the social context that may be relevant for population health, providing the basis for imputing macro-level relationships.

Adolescent↗
PubMedDate not supplied

Hip function and gait in patients treated for bladder exstrophy.

Patients with bladder exstrophy demonstrate pubic diastasis with external rotation of the ilia and posterolateral orientation of the acetabula. Iliac osteotomy is performed to approximate the pubis and thus facilitate the genitourinary repair. The role of iliac osteotomy in the correction of gait abnormalities is controversial. Our goals in this study were to define the presence of hip pathology and gait abnormalities in patients treated for bladder exstrophy and to evaluate the effect of iliac osteotomy. We reviewed pelvic radiographs and gait studies in 15 children. The treatment included bilateral iliac osteotomy in nine of 15 of these patients. We found minor hip dysplasia in two patients, but we saw no evidence of subluxation or dislocation. Pubic diastasis increased with age and was not related to osteotomy. Patients had slightly less passive hip internal rotation than age-matched controls. There was no correlation between the restriction of hip internal rotation and the amount of pubic diastasis. Two thirds (10 of 15) of the patients exhibited increased lower extremity external rotation during gait. None of the subjects demonstrated a waddling gait (gluteus medius lurch) described in the literature. Based on our results, iliac osteotomy does not affect gait patterns in children with bladder exstrophy. However, we believe that it is indicated to improve the results of genitourinary repair.

Adolescent↗
PubMedDate not supplied

Marked elevation of serum N-acetyl-beta-D-hexosaminidase activity in rheumatoid rheumatoid arthritis.

OBJECTIVE: To study N-acetyl-beta-D-hexosaminidase (NAHase) activity in the sera of rheumatoid arthritis (RA) patients and to determine its source. METHODS: NAHase activity in the serum and synovial fluid of RA patients was measured with p-nitrophenyl beta-N-acetylglucosaminide as substrate. The p-nitrophenol released was measured spectrophotometrically in an ELISA reader. Rabbit articular chondrocytes in primary culture were stimulated with interleukin-1 beta (IL-1 beta). RESULTS: Serum NAHase activity was higher in 35% of the RA patients than in healthy patients. The median activity was about twice that of the serum of healthy volunteers. RA patients with high serum NAHase activity also had more joint destruction (85%) than those with normal NAHase activity (57%, p < 0.05), but their inflammatory status was similar. The source of NAHase in RA was investigated by assaying it in RA synovial fluids (SF) and measuring its release from articular chondrocytes in primary culture. NAHase activity was detected in all 23 RA SF, at a median concentration that was 2 times that of the serum. NAHase activity in the medium of articular chondrocytes was stimulated by IL-1 beta (p < 0.005 compared to unstimulated cells), suggesting that cartilage is a source of serum and SF NAHase activity. CONCLUSION: The serum concentration of the matrix hydrolase, NAHase, is higher in destructive RA than in inflammatory RA.

Adolescent↗
PubMedDate not supplied

[Transient osteoporosis of the hip in pregnancy. Report of three cases (author's transl)].

Three cases of transient osteoporosis of the hip in pregnant women are reported, and compared with 13 similar observations, published in world literature. The disease occurs during second half of pregnancy, revealed byrnotion hip pain, and slight limitation of mobility. On radiography, the femoral head and acetabulum are radiolucent and heterogenous. These modifications may be impressive but careful analysis of X rays rules out coxitis or malignant osteolysis. Major functional disturbance is common but the course of pregnancy and delivery is not impaired. Healing, without sequelae, occurs in a few months. Before delivery, attention should be paid to the fetal risk when prescribing X rays examinations or drug treatment. Pathogeny is unclear; the role of nerve or vein compression by the pregnant womb is discussed.

Adult↗