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Biomedical subjects

J L Held

Publications and source records attributed to J L Held.

At least 19 recordsLinked to original sources
PubMed1992

Nursing care of patients with esophageal cancer.

Esophageal cancer is an uncommon but aggressive disease with the potential for early metastasis. The majority of patients will present with metastatic disease, and treatment is usually palliative. This affects the physical and psychosocial needs of the patient and family. The nurse plays a crucial role in the care of these individuals and, therefore, needs a current and in-depth understanding of the disease, its treatment, and its nursing management.

Combined Modality Therapy↗
PubMed1991

Disseminated histoplasmosis presenting as an ulcerated verrucous plaque in a human immunodeficiency virus-infected man. Report of a case possibly involving human-to-human transmission of histoplasmosis.

A 46-year-old homosexual man with disseminated histoplasmosis and human immunodeficiency virus (HIV) infection had a histoplasmosis-related ulcerated verrucous plaque above his left upper lip; systemic and cutaneous disease manifestations of histoplasmosis resolved with daily ketoconazole therapy. Disseminated histoplasmosis, with similar cutaneous features, also was present in his HIV-seropositive male sexual partner. The possibility of human-to-human transmission of histoplasmosis between these patients is considered and the skin lesions of systemic fungal infections in HIV-infected patients are reviewed.

Dermatomycoses↗
PubMed1991

Evaluation of the relative contribution of exposure routes in a health risk assessment of dioxin emissions from a municipal waste incinerator.

Polychlorinated dioxins (PCDDs) and furans (PCDFs) are perceived by the public as the most hazardous materials emitted from municipal waste incinerators. These compounds disperse in the atmosphere and deposit on environmental media, where they may bioconcentrate in the food chain, resulting in a number of potential sources for human exposure. We performed a cancer risk assessment of PCDD/PCDF emissions from a municipal waste incinerator to evaluate the relative contribution of various exposure routes. Three scenarios were examined, all of which predicted ingestion of fish to be a significant source of exposure. In the common case, representative of the general population consuming mainly foods from commercial sources, inhalation was predicted to be the source of greatest exposure, followed by ingestion of fish, beef, milk, vegetation, and soil. In addition to fish, milk and beef ingestion contributed significantly to total exposure under the highly-exposed and worst case scenarios. Life-time cancer risk from the emitted PCDD/PCDFs was assessed for each scenario and was estimated as 1.8 x 10(-7) (common case), 2.5 x 10(-6) (highly-exposed case), and 6.7 x 10(-6) (worst case). In view of the conservative assumptions used in the assessment, the relatively low magnitude of these risks suggests that the PCDD/PCDF emissions from this incinerator should not be considered a significant public health concern.

Air Pollutants↗
PubMed1990

Linear porokeratosis: successful treatment with diamond fraise dermabrasion.

A patient with linear porokeratosis was successfully treated with diamond fraise dermabrasion. Follow-up evaluation revealed an excellent cosmetic result with adequate repigmentation, no scarring, and no recurrence of lesions. Long-term follow-up will be necessary to determine whether dermabrasion treatment of linear porokeratosis provides adequate prophylaxis against the subsequent development of malignancy.

Adult↗
PubMed1990

Benign neonatal hemangiomatosis: review and description of a patient with unusually persistent lesions.

Benign neonatal hemangiomatosis (BNH) is a disorder in which multiple cutaneous hemangiomas appear at birth or shortly thereafter; visceral complications are absent. While previously reported cases of BNH emphasize the relatively early spontaneous regression of the cutaneous lesions, we describe a patient in whom new lesions arose and old ones persisted during the first year of life. The features of BNH are contrasted with those of diffuse neonatal hemangiomatosis (DNH), a dermatosis with a more grave prognosis.

Female↗
PubMed1990

Noduloulcerative or "malignant" syphilis occurring in an otherwise healthy woman: report and review of a dramatic dermatosis.

We present the case of an otherwise healthy woman with noduloulcerative ("malignant") syphilis, the first female patient reported with this dermatosis in fifty years. This rare form of secondary syphilis is characterized by noduloulcerative lesions with rupioid crusts that dramatically involve the face while usually sparing the palms and soles. The aggression and destruction of the skin lesions may mimic that of other granulomatous and infiltrative dermatoses. Since the incidence of syphilis is increasing, physicians should be aware of this variant that is so disfiguring it has historically been referred to as lues maligna.

Facial Dermatoses↗
PubMed1990

A review of blepharochalasis and other causes of the lax, wrinkled eyelid.

Cosmetically unappealing lax, wrinkled eyelid skin may result from various processes including connective tissue diseases, natural aging, and blepharochalasis. Since the end-stage eyelid changes due to several different processes are similar, the presence or absence of prior chronic or recurrent eyelid edema is an important differentiating point. We review blepharochalasis and provide a logical approach to its differential diagnosis.

Edema↗
PubMed1990

Vitiligo and pernicious anemia presenting as congestive heart failure.

The skin often provides diagnostic clues to systemic disorders. Vitiligo is an acquired disease characterized by depigmentation of the skin due to destruction of melanocytes. Vitiligo may be an autoimmune disease and is associated with other disorders that may also arise due to autoimmune mechanisms. We present the unusual case of vitiligo associated with pernicious anemia in a patient who presented to the hospital because of hyperdynamic congestive heart failure.

Adult↗
PubMed1990

Coma blisters: report and review.

Coma blisters are self-limited lesions that occur in the setting of coma of various causes, but are most commonly associated with barbiturate overdose. Examination of a skin biopsy specimen demonstrates the characteristic presence of eccrine sweat duct necrosis. Although the exact cause of coma blisters remains unknown, they are not related to underlying infections or rheumatologic disorders, and do not contraindicate the continued therapeutic use of barbiturates.

Adult↗
PubMed1989

Surgical amelioration of Dercum's disease: a report and review.

Dercum's disease, or adiposis dolorosa, is a rare condition characterized by painful lipomas, usually on the extremities of obese postmenopausal women. At present, there are no treatments known to alter the progressive course of this often incapacitating disease. Surgical intervention, while not preventive, is useful in ameliorating local symptoms of pain. We report a characteristic 15-year course of Dercum's disease.

Adiposis Dolorosa↗
PubMed1989

Phytophotodermatitis.

Phytophotodermatitis is a skin eruption resulting from the interaction of the sun's radiant energy and photosensitizing compounds found in various plants. Common offenders are celery, limes and certain oranges, as well as natural grasses. The acute phase of the skin eruption is characterized by edema and erythema. In the chronic phase, hyperpigmentation may develop at the contact site.

Administration, Topical↗
PubMed1989

Basal cell carcinoma of the scalp in a black patient.

Basal cell carcinoma rarely occurs in black persons. When it does occur, it most often involves the sun-exposed areas of the face. Basal cell carcinoma of the scalp often occurs after other predisposing events such as radiation damage, nevus sebaceus, or systemic conditions such as arsenic exposure or immunosuppression. We report the unusual case of a basal cell tumor arising de novo on the scalp of a black patient with none of these predisposing conditions.

Biopsy↗