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Biomedical subjects

J G Schwartz

Publications and source records attributed to J G Schwartz.

At least 19 recordsLinked to original sources
PubMed1992

Toxicity of a family from vacuumed mercury.

A family of four developed toxic blood levels of mercury after the mother vacuumed a spilled jar of liquid mercury from a closet in their apartment. The youngest son developed severe thrombocytopenia which was initially diagnosed as idiopathic thrombocytopenic purpura secondary to viral illness. A possible association between acute mercury toxicity and idiopathic thrombocytopenic purpura has not been previously reported. Chelation therapy with penicillamine for the older child was administered soon after toxic blood mercury levels were known by the physician. Because thrombocytopenia has been reported to occur in up to 5% of patients receiving penicillamine therapy, the younger child was treated with dimercaptosuccinic acid. The mother was also treated with dimercaptosuccinic acid. The father received dimercaprol therapy. The toxic effects and rationale for now outdated therapeutic uses of mercury are discussed.

Adult↗
PubMed1992

Occult metastatic mesothelioma--diagnosis by fine-needle aspiration. A case report.

Fine-needle aspiration biopsy of an enlarged right axillary lymph node was performed on a 33-year-old woman with Ebstein's cardiac anomaly. Microscopic examination of the cytologic material revealed large discohesive cells with abundant pale cytoplasm, "ruffled" cytoplasmic borders, and prominent central nucleoli. Immunocytochemical analysis of the aspirate confirmed the mesothelial origin of these cells and prompted the diagnosis of metastatic mesothelioma. Autopsy examination revealed a large pericardial mesothelioma with metastases to mediastinal and axillary lymph nodes. This case report demonstrates the usefulness of fine-needle aspiration biopsy in the diagnosis of metastatic mesothelioma.

Adult↗
PubMed1992

Use of a more physiologic oral glucose solution during testing for gestational diabetes mellitus.

A lower osmolar oral glucose solution (50 g glucose in 450 mL fluid, 0.62 mol/L) was administered in addition to the standard hyperosmolar oral glucose solution (100 g glucose in 300 mL fluid, 1.85 mol/L) for oral glucose tolerance testing 1 week apart to 102 pregnant women. The standard oral glucose solution creates delayed gastric emptying and is associated with frequent nausea and vomiting. Results using the modified, lower osmolar glucose solution, when compared to the standard hyperosmolar glucose solution showed (1) statistically equivalent glucose excursion values 30 minutes after ingestion, (2) statistically significant decreased plasma glucose values greater than or equal to 60 minutes, (3) no statistically significant difference in insulin excursion values 30 minutes after ingestion, (4) equal area under the curve for glucose at 30 minutes using either solution, and (5) a markedly decreased incidence of nausea and vomiting. These data suggest that the modified, lower osmolar glucose solution empties rapidly from the stomach and allows the glucose to be absorbed and enter the peripheral circulation in an expeditious manner.

Administration, Oral↗
PubMed1992

Rapid gastric emptying of an oral glucose solution in type 2 diabetic patients.

Gastric emptying of a liquid glucose meal was measured with scintigraphic techniques in nine recently diagnosed Type 2 diabetic patients and nine sex- and age-matched nondiabetic control subjects. Seven of the nine Type 2 diabetic patients were receiving oral hypoglycemic therapy which was discontinued the evening prior to the study. The other two diabetic patients were taking no medication. The average gastric half-emptying time was 33.6 min (s.e.m. = 3.2) for the diabetic patients and 64.6 min (s.e.m. = 4.2) for the nondiabetic controls (p = 0.0005). These measurements indicate rapid gastric emptying in Type 2 diabetic patients which may contribute to worsening of glucose control in these patients.

Administration, Oral↗
PubMed1991

Eye injuries with metal missiles presenting to an emergency center: a three year study.

The authors retrospectively evaluated 33 eye injuries due to metal missiles in 31 patients presenting to our emergency center over the last 3 years. Injuries occurred most frequently when the patients were grinding metal or working on their cars. The type of metal involved in the injury often dictates the type of ophthalmic reaction that will occur. A discussion of intraocular metallic foreign bodies with an emphasis on electroretinograms and metal analysis is presented.

Adolescent↗
PubMed1991

Accuracy of common drug screen tests.

Forty consecutive urine specimens, obtained from patients seen in the emergency center, positive for either cocaine and/or marijuana, were analyzed using five methods of analysis. A new latex agglutination inhibition assay, Abuscreen OnTrak, (Roche Diagnostic Systems, Nutley, NJ), was compared with four other drug abuse assays: mass spectrometry, (Hewlett-Packard Co, Richardson, TX); an automated homogeneous enzyme immunoassay technique, ETS System, (Syva Co, Palo Alto, CA); a manual enzyme multiplied immunoassay technique; EMIT-st, (Syva); and a fluorescence polarization immunoassay, TDx, (Abbott Laboratories, Chicago, IL). For statistical purposes, mass spectrometry was the reference point for the presence or absence of a specific substance. All instrument sensitivities, with the exception of mass spectrometry, were set with the same "cut off" point of 100 micrograms/L for marijuana and 300 micrograms/L for cocaine and its metabolites. Efficiency in the detection of cocaine and its metabolites was 95% by all methods. Efficiency for the detection of marijuana and its metabolites ranged from 70% (Roche's OnTrak) to 90% (Syva's ETS). Simple to use, assays of minimal cost are presently available for rapid, accurate drug of abuse screening.

Evaluation Studies as Topic↗
PubMed1991

Linear gastric emptying of hyperosmolar glucose solutions.

We performed a total of 12 gastric emptying studies on 6 normal subjects with a hyperosmolar (1.85 mol/l) 400-kcal glucose solution commonly used for diagnosing diabetes and a more dilute (0.62 mol/l) 200-kcal glucose solution. The gastric half-emptying time was greatly prolonged with both glucose solutions; 107 min for the (1.85 mol/l) 400-kcal glucose solution compared to 66 min for the more dilute (0.62 mol/l) 200-kcal glucose solution. Although the 200-kcal glucose solution contained one-half the amount of glucose (50 g) compared to the 400-kcal solution (100 g), the blood glucose values obtained during a 2-hr period were only slightly lower with the former solution. This study demonstrates significantly delayed gastric emptying of glucose solutions in normal subjects and a linear pattern of gastric emptying formerly associated only with solid meals.

Administration, Oral↗
PubMed1990

Revision of the oral glucose tolerance test: a pilot study.

Nausea and vomiting have been recurrent problems with the oral glucose tolerance tests (OGTT) used to diagnose diabetes. We believe the nausea is associated with delayed gastric emptying caused by the high osmolarity of the glucose solution. In our pilot study, both the "standard" 100-g glucose OGTT and our new modified (lower osmolar) glucose solution were evaluated. Considerably delayed gastric emptying (along with severe nausea) was consistently noted with the standard OGTT. No nausea and a much more rapid gastric emptying time were recorded when the modified glucose solution was administered. We were able to diagnose diabetes (by using Wilkerson's point system) when our modified OGTT was administered to type 2 diabetics. We plan to develop a more physiological, more reproducible, and better tolerated OGTT to diagnose diabetes more accurately in the general population.

Adult↗
PubMed1990

Hospital-based toxicology: patterns of use and abuse.

We examined 949 consecutive toxicology requests to determine (a) the identity and relative frequency of the most commonly detected drugs in our hospital population; (b) degree of concordance between clinical impression and laboratory analysis; (c) influence of age and sex upon the numbers and results of toxicologic analyses; (d) temporal pattern of our annual toxicology case-load; (e) temporal and sexual distribution of various common drugs; (f) drugs most often found together; and (g) frequency with which inappropriate toxicology request were received. Laboratory analysis agreed with clinical impression in only 17.4% of cases. Age and sex correlated with the detection of specific drugs. But for benzodiazepines, no consistent temporal pattern was present regarding either type or number of drugs detected. Certain days of the week demonstrated a statistically significant effect upon the number of toxicology requests received, while seasons, holidays, and lunar phases had no influence. Inappropriate requests comprised 9% of the total annual toxicology caseload.

Adolescent↗
PubMed1989

Serum creatine kinase isoenzyme BB is a poor index to the size of various brain lesions.

We divided patients with brain lesions into three groups: (a) patients with primary or metastatic brain cancer, (b) brain infarctions, and (c) brain contusion(s). We analyzed each patient's sera for creatine kinase isoenzyme BB (CK-BB), using a monoclonal antibody kit (Impres-BB; International Immunoassay Laboratories). Computerized axial tomography (CAT) scans were performed on each patient. The size of the various lesions was measured from the CAT scan and recorded in milliliters. Total CK, CK-BB, and their ratios were compared with the volume of damaged brain tissue. We found no correlation between any of the variables and the various brain lesions. We attribute this lack of correlation to an intact blood-brain barrier, the rapid elimination or inactivation of CK-BB, or some combination of these factors.

Brain Concussion↗
PubMed1989

Clinical and analytical evaluation of different methods for measurement of creatine kinase isoenzyme MB.

We evaluated the clinical and analytical performance of the new immunochemiluminometric assay (ICMA; Ciba Corning) for measurement of creatine kinase isoenzyme MB (CK-MB), and compared it with three other methods: immunoradiometric assay (IRMA; International Immunoassay Labs); immunoinhibition assay (Seradyn); and an immunoinhibition/column method (Du Pont). Intra-test precision for all kits was good. We evaluated 32 patients' samples by all four methodologies. Only one of the four methods (aca, Du Pont) showed evidence of linearity. Efficiency in the diagnosis of myocardial injury in our study ranged from 53% (Seradyn) to 96% (Du Pont). We evaluated serial specimens from 20 separate patients by the IRMA and the ICMA to determine whether myocardial injury could be diagnosed earlier by the ICMA. In patients with acute myocardial infarction, the ICMA displayed positive values earlier and longer than the IRMA, suggesting that the ICMA is suited for screening for myocardial damage in hospitalized patients.

Adult↗
PubMed1988

Primary lymphocutaneous Nocardia brasiliensis infection: three case reports and a review of the literature.

The occurrence of human nocardiosis is increasing in both immunocompetent as well as immunosuppressed patients. We report three rare cases of primary lymphocutaneous Nocardia brasiliensis infection. The mode of inoculation in each case was that of a puncture wound that occurred 1-3 wk prior to the development of the clinically apparent infections. The original clinical diagnosis was erroneous in each case. A review of 16 previously reported cases is presented as well as a discussion of appropriate medical therapy.

Adult↗
PubMed1988

A commercial enzyme immunoassay method (EMIT) compared with liquid chromatography and bioassay methods for measurement of chloramphenicol.

A new enzyme immunoassay method (EMIT; Syva Co.) was compared with conventional high-performance liquid chromatography (HPLC) and agar-diffusion bioassay methods for measurement of chloramphenicol in human serum. Forty-nine serum samples were assayed by each of the three methods. Excellent correlation was observed between values by EMIT and by the two conventional methods (r = 0.986 and 0.961). Precision was acceptable (CV less than 5%) with EMIT. Assay of samples containing chloramphenicol glucuronide and chloramphenicol succinate demonstrated that EMIT recognizes only the biologically active (base) form of the drug. The capability to test serum samples as small as 0.2 mL, adaptation to widely available instrumentation, and provision of rapid results are principal advantages of the EMIT method for routine chloramphenicol measurements.

Biological Assay↗
PubMed1988

LSD intoxication.

Explore the source record for details and available documents.

Diagnosis, Differential↗
PubMed1988

Fine-needle aspiration biopsy of mycosis fungoides presenting as an ulcerating breast mass.

A patient with previously diagnosed Hodgkin's disease presented with ulcerating lesions on her scalp and breast. Fine-needle aspiration of the breast lesion revealed convoluted cells consistent with mycosis fungoides. Review of the patient's previously obtained lymph node biopsy specimens revealed a diagnosis of mycosis fungoides rather than Hodgkin's disease. Better communication between hospitals, pathologists, and clinicians may have prevented the erroneous original diagnosis of Hodgkin's disease in this patient.

Adult↗