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Biomedical subjects

J Halevy

Publications and source records attributed to J Halevy.

At least 37 records · Page 2Linked to original sources
PubMed1988

Severe hypophosphatemia in hospitalized patients.

Severe hypophosphatemia (serum phosphorus less than or equal to 0.48 mmol/L [less than or equal to 1.5 mg/dL]) was found in 120 patients admitted to a major university hospital, during a period of 16 months. Fifty-one patients (42.5%) developed hypophosphatemia postoperatively. Medications known to precipitate hypophosphatemia were a causative factor in 82% of the patients, with glucose administered intravenously, antacids, diuretics, and steroids being the most common agents associated with profound hypophosphatemia. Gram-negative septicemia was observed in 16 patients, and it was the second most common cause of severe hypophosphatemia. The mortality rate was 20% in patients with a serum phosphorus concentration between 0.36 and 0.48 mmol/L (1.1 and 1.5 mg/dL) (group A) and 30% in patients with a serum phosphorus concentration of less than or equal to 0.32 mmol/L (less than or equal to 1.0 mg/dL) (group B). The cause of death and its temporal association with the lowest observed values of phosphorus concentration indicate that severe hypophosphatemia might be a contributory factor to mortality. Our data indicate that severe hypophosphatemia in hospitalized patients is the result of a combination of factors. Surgery, followed by a period of fasting with intravenous administration of glucose, and gram-negative septicemia are the most common causes.

Adult↗
PubMed1988

Life-threatening hypokalemia in hospitalized patients.

Severe life-threatening hypokalemia (serum potassium less than or equal to 2.5 mmol/l) was found in 0.03% of serum biochemical profiles within 13 years in a major university hospital in Israel. Out of 130 patients with hypokalemia of this magnitude, 84 (65%) were females and the mean age was 64 years. A combination of iatrogenic factors, including the administration of intravenous fluids with insufficient or no potassium (K) replacement and the use of K-depleting medications and insulin, was responsible for the hypokalemia in 68% of the patients. Gastrointestinal loss of K was the main cause of severe hypokalemia in 22% of the patients. It is concluded that severe hypokalemia in hospitalized patients is commonly the result of multiple iatrogenic factors and, therefore, can be prevented by frequent monitoring of serum K and appropriate K supplementation.

Adult↗
PubMed1987

Aldosterone increases the maximal turnover rate of the sodium pump.

These experiments were performed to determine whether aldosterone-dependent effects in apical and basolateral membranes could be temporarily dissociated and whether aldosterone increases the maximal capacity, or maximum turnover rate of the sodium pump. Tissue from rat distal colon exposed to the action of high plasma levels of aldosterone for 4 h, 24 h and 7-10 days was compared to control tissue in a modified Ussing chamber, before and after addition of nystatin to the mucosal solution to remove the apical barrier to the cell entry of sodium. The maximum turnover rate of the sodium pump was represented by the equivalent short circuit current, Isc, after the addition of nystatin. After 4 h of aldosterone basal Isc increased 2.6-fold above control (43 +/- 34 microA.cm-2, p less than 0.05) and transepithelial PD, VT, increased 2-fold over control (-7.0 +/- 5.5 mV, lumen negative, p less than 0.05). Administration of aldosterone for 24 h caused further marked increases in Isc (11-fold) and a fall in RT to 50% of control. Similar changes were observed after 7-10 days on low sodium diet, and at all time intervals the changes were completely inhibited by amiloride (10(-4)M). Although aldosterone stimulated Isc within 4 h, there was no further increase in Isc in the presence of nystatin during the same time period compared to the control post-nystatin Isc of 419 +/- 79 microA.cm-2. However, after 24 h aldosterone caused approximately a 40% increase in the maximal turnover rate of the sodium pump, which persisted for 7-10 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Aldosterone↗
PubMed1987

Cholestasis and liver failure with lambda-AL amyloidosis.

Clinically significant liver involvement in systemic amyloidosis, especially with cholestasis, is rare. We report a case of primary amyloidosis with severe intrahepatic cholestasis leading to terminal liver failure. The present case is the first of its kind reported involving Lambda light chains only as the associated paraprotein. Conventional treatment and a therapeutic trial with dimethyl sulphoxide were unsuccessful.

Aged↗
PubMed1986

Role of aldosterone in the regulation of sodium and chloride transport in the distal colon of sodium-depleted rats.

Dietary sodium depletion with elevated aldosterone levels induces electrogenic, amiloride-sensitive sodium absorption and inhibits electroneutral sodium chloride absorption in the rat distal colon. To assess the role of aldosterone in the production of these changes, unidirectional 22Na and 36Cl fluxes were performed under voltage clamp conditions across isolated distal colonic mucosa of rats given continuous aldosterone infusions for up to 12 days. Aldosterone infusion for 7-12 days produced identical changes in both electrogenic sodium absorption and electroneutral sodium chloride absorption compared with dietary sodium-depleted animals. In contrast, aldosterone at 24, 48, and 72 h produced varying changes in ion transport: electrogenic sodium absorption progressively increased, whereas electroneutral sodium chloride absorption was initially augmented but then inhibited. Aldosterone induced active potassium secretion, demonstrated by a reversed short-circuit current after addition of amiloride, in all experimental groups. These results demonstrate that the changes in ion transport observed in sodium-depleted animals are produced by aldosterone, and that aldosterone not only stimulates electrogenic sodium absorption and potassium secretion but in a time-dependent manner both stimulates and inhibits electroneutral sodium chloride absorption.

Aldosterone↗
PubMed1986

Long-term outcome of network therapy.

Hospital utilization by crisis-ridden chronic mentally ill persons living in the community was studied after their participation in a network therapy program, which convenes a social network of relatives and friends to provide continuing emotional and practical support for mentally ill individuals and their families. The study compared the number of psychiatric hospitalizations and total days hospitalized for 20 network therapy participants and 20 nonparticipants before and after referral to the program. In a follow-up period ranging from six months to two years, the number of hospitalizations fell by 74 percent for participants and by 19 percent for nonparticipants. The total number of days hospitalized decreased by 76 percent for participants, compared with a 112 percent increase for nonparticipants. The results suggest that participants benefit from network therapy and that its effect is enduring.

Adolescent↗
PubMed1986

Cloxacillin-induced cholestatic jaundice.

A case of cholestatic jaundice after cloxacillin treatment is presented. Hepatotoxicity due to the drug was confirmed by inadvertent rechallenge and strongly positive tests for macrophage migration inhibitory factor and mast cell degranulation. The recognition of cholestatic hepatotoxicity due to oxacillin derivatives should help to avoid unnecessary invasive procedures in the evaluation of this reversible condition.

Aged↗
PubMed1985

Serum creatine kinase after intramuscular injections.

Serum creatine kinase (CK) activity was measured after intramuscular injections in 44 patients hospitalized for non-cardiac reasons. The drugs injected were: diazepam, dipyrone, metoclopramide, meperidine, pentazocine and procaine penicillin. Only 3 out of 44 patients (7%) demonstrated significant elevation of CK levels following the intramuscular injections. In these 3 patients the elevation was mainly due to a rise of the MM-isoenzyme fraction with MB levels increased in one patient. These findings do not justify the common clinical notion of regarding intramuscular injections as a frequent cause of serum CK elevation. It is concluded that high CK serum values in a patient with chest pain should always be considered with utmost suspicion, disregarding the possible effects of a previous intramuscular injection.

Adult↗
PubMed1985

Significant metabolic acidosis induced by acetazolamide. Not a rare complication.

Blood gas and serum electrolyte levels were measured in 27 elderly patients (mean age +/- SD, 63.3 +/- 13.5 years) who were receiving acetazolamide (250 to 1,000 mg/day) for glaucoma. Eleven glaucomatous patients (mean age, 69.1 +/- 7.4 years) who were not receiving acetazolamide served as a control group. In the acetazolamide-treated group, four patients (14.8%) had mild acidosis (7.29 greater than pH less than or equal to 7.31), ten (37%) had moderate acidosis (7.20 greater than pH less than or equal to 7.29), and one patient (3.7%) had severe acidosis (pH, 7.15). None of the patients in the control group had acidosis. It is concluded that moderate metabolic acidosis of potential clinical significance is common among glaucomatous elderly patients who receive acetazolamide. The exact clinical significance of our observations is yet to be determined.

Acetazolamide↗
PubMed1983

Intrasinusoidal metastatic melanoma of the liver with reactive hepatitis. An immunologic phenomenon?

The macrophage migration inhibition factor (MIF) test toward extracts of choroidal melanoma was repeated four times in a patient with ocular malignant melanoma. In the initial stage, when there was only an ocular finding, the MIF test result was positive. It remained so for a period of two years, even when intrasinusoidal hepatic diffusion developed concomitantly with a nonspecific reactive hepatitis. These histologic findings can be interpreted as evidence of the presence of an immune reaction at a particular moment in the disease process. Several months later, when the patient's condition went into an abrupt decline and showed extensive nodular spread, the results of MIF test were found to have become negative.

Choroid Neoplasms↗
PubMed1982

Macrophage migration inhibitory activity in the sera of patients undergoing peritoneal dialysis for psoriasis.

A study of macrophage migration inhibitory activity (MIA) in serum was carried out in four psoriatic patients with normal renal function who were undergoing peritoneal dialysis (PD) as a method of therapy. Before weekly PD treatment, the MIA was negative in these patients. whereas immediately thereafter it was positive. In two of these patients the appearance of MIA paralleled the clinical improvement observed. The increase in MIA observed after each PD was of short duration, usually being followed by a subsequent decrease prior to the next PD. Seven uremic patients who were similarly studied for the presence of MIA before and after PD did not show this pattern of response. It is suggested that the appearance of MIA in psoriatic patients undergoing PD as a method of therapy reflects the extraction of a "dialysable serum factor", which may be associated with cell-mediated immunity as well as with the clearing of skin lesions observed in these patients.

Adult↗
PubMed1982

Demonstration of net potassium absorption in mammalian colon.

The present in vivo studies were performed in the rat to determine whether the colon was capable of net potassium absorption, as well as secretion, and to further elucidate the process responsible for net potassium movement. Both the proximal and distal lumina of the colon of control, potassium-deficient, and potassium-loaded animals were perfused with solutions containing either 140 or 20 mmol/l sodium. Net potassium secretion was present in both proximal and distal colon of control animals during perfusion with the 140 mmol/l sodium solution. The rate of net potassium secretion was reduced in the potassium-deficient animals. During perfusion with the 20 mmol/l sodium solution, the rate of potassium secretion was also reduced (compared with control perfusion solution) in both the control and potassium-deficient animals. As a result, there was net potassium absorption (0.94 +/- 0.14 mueq.1-1.g dry wt-1) and zero net potassium movement in the distal and proximal segments, respectively, of the potassium-deficient animals perfused with the low-sodium solution. Additional studies were performed to determine whether net potassium secretion was saturable and showed that, during progressive increases in the plasma potassium level, net secretion was constant at plasma potassium levels above 11-13 meq/l. These data, therefore, demonstrate that the mammalian colon regulates intestinal transport of potassium by both absorptive and secretory mechanisms and that a carrier-mediated process probably regulates both transport processes.

Animals↗
PubMed1982

Ethambutol-induced thrombocytopenia.

Extreme thrombocytopenia, purpura, and melena developed in a 71-year-old woman four days after ethambutol administration was started. The macrophage inhibition factor test was positive for ethambutol, and the thrombocytopenia subsided shortly after discontinuation of the drug therapy. The sequence of events in this patient suggests that, although previously unreported, thrombocytopenia should be added to the list of side effects of ethambutol.

Aged↗
PubMed1981

Dialysis therapy for psoriasis. Report of three cases and review of the literature.

Three patients with psoriasis, who were resistant to all modes of accepted therapy, underwent 32 hours of peritoneal dialysis weekly for ten weeks. In two patients, there was a clearing of 80% of the psoriatic lesions after completion of therapy. In one of these patients, there was a recurrence of the lesions two months later, but the other patient is still in relative remission after 12 months. The third patient had clearing of 50% of the lesions, but there was recurrence two months after cessation of treatment. This experience as well as a review of the literature indicates that dialysis may have a positive effect on psoriasis and that the effect obtained is more prominent with peritoneal dialysis than with hemodialysis.

Adult↗