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Biomedical subjects

J Hoff

Publications and source records attributed to J Hoff.

At least 55 records · Page 3Linked to original sources
PubMed1990

Prognostic value of intravenous dipyridamole thallium imaging in patients with diabetes mellitus considered for renal transplantation.

Patients with diabetes and end-stage renal failure are known to have a high risk for cardiac morbidity and mortality associated with renal transplantation. The most efficient method to determine preoperative cardiac risk has not been established. To determine the effectiveness of intravenous dipyridamole thallium imaging in predicting cardiac events, 40 diabetic renal transplant candidates were studied preoperatively in a prospective trial. The study group consisted of 40 patients whose average age was 42 years (range 27 to 64); 34 (85%) were hypertensive and 21 (53%) were cigarette smokers. Cardiac history included chest pain in 6 patients and prior myocardial infarction in 3 patients. Dipyridamole thallium imaging showed reversible defects in 9 patients, fixed defects in 8 patients and normal scans in 23 patients. Dipyridamole thallium imaging was performed using 0.56 mg/kg of dipyridamole infused intravenously over 4 minutes. Cardiac events occurred only in patients with reversible thallium defects, of which there were 6. Of these 6 patients, 3 had cardiac events before transplantation and 3 had them in the early postoperative phase (within 6 weeks of surgery). Of 21 patients who underwent renal transplantation, 3 had cardiac events within 6 weeks of transplantation. The average duration of follow-up was 11 months (range 1 to 21). Thus, dipyridamole thallium imaging is an effective method of identifying renal transplant candidates likely to develop cardiac complications. Routine coronary angiography may not be necessary to screen all renal transplant candidates for coronary artery disease before surgery.

Adult↗
PubMed1990

Introital adenosis associated with the Stevens-Johnson syndrome.

A young woman presented with erosive lesions of the labia minora, which appeared 3 years ago after Stevens-Johnson syndrome. Pathological examination showed 'vulval adenosis'. A similar case has been previously reported. Vaporization by carbon-dioxide laser gave satisfactory results, and after 2 years the patient remains totally cured. We discuss several embryological theories which may explain the mechanism of the vulval adenosis in this patient.

Adult↗
PubMed1987

Hemodynamic effects of esmolol, an ultrashort-acting beta blocker.

The hemodynamic effects of esmolol were evaluated in 12 male patients at rest (mean age, 51 +/- 10 years) undergoing routine cardiac catheterization. Hemodynamic measurements were obtained during baseline (prior to esmolol), at steady state (during an intravenous infusion of esmolol 300 micrograms/kg/min), and at 30 minutes after stopping esmolol (postinfusion). Esmolol produced hemodynamic effects similar to the effects of other beta blockers. Significant reductions in rate-pressure product (mean decrease, 15%), cardiac index (mean decrease, 17%), stroke volume index (mean decrease, 13%), left ventricular stroke work index (mean decrease, 20%), and left ventricular ejection fraction (mean decrease, 18%) were observed. In contrast to other beta blockers, all hemodynamic effects of esmolol had returned to baseline values within 30 minutes after the infusion stopped. One patient exhibited hypotension during the esmolol infusion; this episode resolved without sequelae after discontinuation of esmolol. In summary, the effects of esmolol at rest on hemodynamic parameters and left ventricular function are similar to other beta-adrenergic blocking agents. Due to its ultrashort half-life, esmolol can be administered safely in critically ill patients whose disease status makes treatment with currently available beta blockers risky.

Adrenergic beta-Antagonists↗
PubMed1986

Long-term therapy with disopyramide phosphate: side effects and effectiveness.

In this study, the safety and efficacy of long-term therapy with disopyramide phosphate were evaluated in 40 patients with documented, recurrent, symptomatic tachyarrhythmias. Twenty-one (53%) of the patients had organic heart disease, and nine of these patients had compensated congestive heart failure. The tachyarrhythmias which were treated were paroxysmal supraventricular tachycardia (21 patients), paroxysmal atrial fibrillation (six patients), and paroxysmal ventricular tachycardia (13 patients). In each patient there was evidence, from continuous ECG monitoring or electrophysiologic testing, that disopyramide would be effective therapy, and each patient was able to tolerate disopyramide (no side effects or tolerable side effects) during an initial trial period of 1 to 2 weeks. Dosages of disopyramide were 400 to 1600 mg/day (994 +/- 320 mm/day). During long-term therapy, side effects were reported by 28 (70%) of the patients. The side effects were usually anticholinergic, and were usually a continuation of side effects noted during the initial trial period. None of the patients had idiosyncratic reactions to disopyramide. Most of the patients found side effects to be tolerable; however, in seven patients it was necessary to discontinue disopyramide after 1 to 8 (6 +/- 3) months. Actuarial incidence of intolerable side effects was 21 +/- 7% at 12 months. Nine (22%) of the 40 patients had symptomatic recurrences of tachyarrhythmia after 3 to 32 (15 +/- 9) months of therapy. Actuarial incidence of drug ineffectiveness was 32 +/- 10% at 24 months. Disopyramide was both effective and tolerated in 24 (60%) of the patients, who were followed for 2 to 64 (23 +/- 16) months.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

Living-related kidney donors: a multicenter study of donor education, socioeconomic adjustment, and rehabilitation.

To determine the consequences of living-related kidney donation, a study was conducted of 536 donors whose nephrectomies had been performed at nine geographically dispersed centers during the past 12 years. The data demonstrated that greater than 84.0% of the donors thought they had been adequately informed regarding all aspects of donation, and less than 15.0% reported being pressured in their decision. Only two serious medical complications were directly attributable to the surgery, greater than 92.0% of the donors believed their health had not been adversely affected by donation, and 96.8% reaffirmed their decision regardless of the graft's success or the financial distress they experienced (P greater than .05). However, greater than 14.0% experienced direct pressure, particularly not to donate. Donation also appeared to stress previously troubled marriages, especially among donors without a religious affiliation, who were pressured to donate by their families, or who borrowed from family members (P less than .05). Substantial unreimbursed expenses (greater than or equal to $1,000) were incurred by 43 donors, and 23.2% of all donors reported that donation caused a financial hardship.

Adolescent↗
PubMed1984

[Malignant degeneration in testicular feminization. Apropos of a case].

The authors describe the main therapeutic features found in a case of testicular feminisation that became malignant. Bilateral gonadal ablation should be carried out after puberty for fear of malignancy. When cancer occurs treatment is best decided on the grounds of extension to the lymph nodes and the histological findings in the tumour. Where there is no extension to the lymph nodes, surgery should be carried out on the gonads with radiotherapy to the lymph nodes. If the tumour is not clearly a seminoma the lymph nodes should be removed before radiotherapy is started.

Adult↗
PubMed1983

[Management of a lump in the breast?].

Cancer is the primary concern in a patient with a nodule of the breast. Diagnosis is based on clinical, radiological and pathological data. After the preoperative workup, tumorectomy with intraoperative pathological examination is the first step of the surgical procedure. Resection can be extended to radical mastectomy when malignancy is demonstrated. Additional radio, chemo, hormono or immunotherapy may be given according to tumor staging. In non-malignant disorders, isolated nodules must be distinguished from multiple ones. A single nodule may be either a fibroadenoma, if it is solid, or a cyst accompanying a mastopathy. Multiple nodules rise the difficult problem of the management of Reclus disease. Other nodules are uncommon, such as cystosarcoma phyllodes, gigantic fibroadenoma, scirhus, and tumor of the galactophorus duct.

Breast Neoplasms↗
PubMed1983

[Digestive endometriosis: a diagnostic pitfall not to be ignored].

Seven selected cases illustrate the problems which arise in the diagnosis and management of digestive endometriosis. The site is variable but the rectosigmoid region is most commonly involved. Digestive endometriosis, which is often mistaken for intestinal carcinoma, may have various clinical presentations: latent form discovered during laparotomy, subacute intestinal obstruction, acute abdominal syndrome, or cyclic gynecologic or digestive symptoms. Finally, the therapeutic means of curing these patients and avoiding unnecessary extensive intestinal resection are discussed.

Adult↗
PubMed1983

[Cancer of the endometrium: detection and prophylaxis].

For material reasons, mass screening for cancer of the endometrium is not feasible. The authors therefore attempt to outline the characteristics of those patients who are especially prone to develop an endometrial carcinoma. The sequence of clinical and paraclinical diagnostic procedures is recalled. Special attention is given to prophylaxis; if cancer of the endometrium is hormono-dependent, it follows that such prophylaxis is possible. In order to prevent cancer from developing, a correct balance between estrogens and progestogens must be ensured, particularly in premenopausal women. As for cancer of the cervix, correct screening and prophylaxis should result in significant improvement of the prognosis of endometrial cancer.

Adult↗