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Biomedical subjects

J Grossman

Publications and source records attributed to J Grossman.

139 records · Page 8Linked to original sources

Monozygotic twins discordant for systemic lupus erythematosus.

A pair of monozygotic twins discordant for systemic lupus erythematosus(SLE) were studied and no differences noted in their immune respose to tetanus toxoid, keyhole lympet hemocyanin, DNCB, delayed sensitivity, or antibody titers to viruses. Both were noted to have biologically false positive serology at an early age, but only one twon developed SLE. The clinically unaffected twin underwent castration at an early age, suggesting that ovarian hormones may play an important role in the development of SLE.

Adult↗

Low-molecular-weight heparin for deep vein thrombosis prophylaxis in foot and ankle surgery: a review.

The necessity of prophylaxis for deep vein thrombosis (DVT) in those patients who undergo foot and ankle surgery remains poorly defined. The authors explore and review the low-molecular-weight heparin (LMWH) preparations for use by foot and ankle surgeons. Recent literature has described a low incidence of DVT and pulmonary embolus (PE) following foot and ankle surgery. Nonetheless, it is paramount that foot and ankle surgeons be aware of the potential risk factors and methods of prophylaxis for DVT. Many options are available for prophylaxis. This article presents a review of DVT with particular attention given to distinguishing risk factors, prophylaxis, and LMWH preparations.

Ankle↗

Utilization of autogenous corticocancellous bone graft from the distal tibia for reconstructive surgery of the foot and ankle.

Procurement of corticocancellous autogenous bone graft from any donor site is not without potential complications. Increased postoperative morbidity, fracture at the donor site, an additional surgical procedure, increased operative time, excessive blood loss, hematoma, and increased relative cost are all factors that must be considered, regardless of donor site. The authors have been using the distal tibia as a source of corticocancellous bone since 1988. A review of 16 patients with distal tibial bone grafts at our institution has demonstrated this area to be readily available and effective with limited morbidity. The distal tibial metaphyseal area has been found to be an excellent source of corticocancellous bone for grafting in reconstructive foot and ankle surgery.

Adolescent↗

Lateral ankle instability and the Brostrom-Gould procedure.

Lateral ankle instability can present as either acute or chronic. Proper identification of the etiology is necessary to determine the proper treatment plan. The Brostrom-Gould procedure, when properly used, can provide adequate correction of the unstable ankle. A review of the procedure, its indications, and the results of 44 patients who underwent the procedure will be discussed.

Adult↗

The anticholinergic agent, ipratropium bromide, is useful in the treatment of rhinorrhea associated with perennial allergic rhinitis.

The effects of the new ipratropium bromide nasal spray on rhinorrhea associated with perennial allergic rhinitis were studied in 219 patients over eight weeks in a multicenter, randomized, double-blind trial. The purpose of the study was to determine whether the new spray reduces nasal hypersecretion in allergic patients without causing excessive dryness or other potential cholinergic side effects. The investigators compared two doses of the spray (42 or 84 mcg/nostril t.i.d.) to placebo. Two hundred and nineteen patients were admitted to the study; 176 completed it. Study design included one week of screening to confirm a diagnosis of perennial allergic rhinitis with clinically significant rhinorrhea, one week of single-blind treatment with a placebo consisting of the saline vehicle of the spray, an eight-week double-blind treatment-comparison period, and one week of follow-up without treatment. Both doses of ipratropium bromide nasal spray significantly reduced the hypersecretion associated with PAR, compared with placebo. The two doses of active drug were equally effective. Treatment differences were noticeable during the first week and remained relatively stable during the eight-week treatment period. There was no evidence of nasal rebound after discontinuation of treatment. The incidence of side effects was comparable to placebo. The spray was well-tolerated, and was not associated with any significant adverse events.

Adolescent↗

Beta-blockade during whole-body hyperthermia: a toxicity study in the dog.

A radiant heat device (RHD) for whole-body hyperthermia (WBH) has been safely and effectively used with a dog model. The cardiovascular changes which occur in the dog during WBH--including heart rate, blood pressure, cardiac output, stroke volume and ejection fraction--agree qualitatively and quantitatively with changes observed in previous WBH-RHD studies done in pigs and humans. We elected to study the effect of propanolol in dogs during WBH in order to evaluate this drug's potential use in human cancer patients who are ineligible for WBH because of coronary artery disease. This report details cardiovascular changes which occur with beta-blockade during 42 degrees C WBH in the dog. Our results show that the level of beta-blockade needed to control heart rate during WBH produces acute cardiovascular decompensation.

Animals↗

A modified brace (Prenyl) for scoliosis.

Sixty-six skeletally immature patients with idiopathic scoliosis were treated with a Prenyl brace and their results were analyzed. Fifty-three patients (80%) showed a satisfactory response. The best results were obtained in patients with lumbar curves and thoracolumbar curves less than 40 degrees. Advantages of this brace are simplicity of fabrication and fitting, patient comfort, patient acceptance and relatively low cost. The disadvantages of this brace are that it is less effective in thoracic curves in the upper thoracic spine, double major curves and kyphosis. It probably causes more significant chest restriction than the Milwaukee brace.

Adolescent↗

Pulmonary hypertension in a patient with mixed connective tissue disease: clinical and pathologic findings, and review of literature.

A patient with pulmonary hypertension (PH) complicating mixed connective tissue disease (MCTD) is described. The patient died suddenly after catheterization documenting the pulmonary hypertension. Pathologic examination demonstrated marked medial hypertrophy and intimal proliferation of the pulmonary arterial vessels. Review of the literature revealed few and differing reports concerning the pathology of PH as seen in MCTD. Sudden death in patients with pulmonary hypertension undergoing invasive procedures is not an uncommon occurrence.

Adult↗