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Biomedical subjects

J Waxman

Publications and source records attributed to J Waxman.

At least 145 records · Page 8Linked to original sources
PubMed1985

Systemic lupus erythematosus (SLE) induced by quinidine.

Only two definite cases of quinidine-induced systemic lupus erythematosus (SLE) are reported in the English-language literature. We have treated five patients who had an SLE-like syndrome while receiving quinidine. Symptoms, signs, and abnormal laboratory values improved after quinidine therapy was discontinued and prednisone therapy was started. The disease did not return after steroids were withdrawn. These cases indicate that quinidine can indeed cause an SLE-like syndrome.

Aged↗
PubMed1984

Metastatic gestational trophoblastic neoplasm. A study of two cases in unusual clinical settings and review of the literature.

Two cases of metastatic gestational trophoblastic neoplasms (MGTN) diagnosed by mediastinoscopic and gastroscopic biopsies, respectively, are presented. Both patients are young women who presented with hemorrhagic events involving the CNS in one case and the gastrointestinal tract in the other, with histories of recent pregnancies. Both cases belong to the group of high-risk MGTN because of the location of the metastatic lesions (CNS and liver) and because of the delayed onset of chemotherapy. One patient is in clinical remission, 3 years later, and the other succumbed to her disease. A review of the literature suggests that CNS involvement has a better prognosis than liver metastases. The patient diagnosed to have MGTN by a gastroscopic biopsy is the first reported, to the best of out knowledge. The outcome of MGTN, although greatly improved by chemotherapy, is still fatal in numerous cases in the high-risk group. Since an early diagnosis is critical for successful chemotherapy, it is advisable to perform HCG titers in the blood serum of young patients presenting with unexplained hemorrhagic events, especially in those with recent gestations.

Adult↗
PubMed1983

Gonadal function in men treated for acute leukaemia.

Gonadal function was assessed in eight men in remission of leukaemia who had completed treatment eight months to eight years previously. All four men treated for acute myeloid leukaemia had normal sperm counts and motility, compared with only one of the four with acute lymphatic or undifferentiated leukaemia. Hormonal studies indicated that the sterility resulted from gonadal failure rather than pituitary dysfunction after cranial irradiation. These findings are important in the counselling of patients with leukaemia.

Acute Disease↗
PubMed1983

Localized rheumatologic diseases. Common diagnostic challenges.

Rheumatic pain is usually generalized, but in a variety of conditions it may present as localized and often remain so. These conditions include palindromic rheumatism, osteoarthritis, gout or pseudogout, seronegative spondyloarthropathy, septic arthritis, tendinitis and bursitis, radiculopathy and nerve entrapment, nodular growth, and tendon enlargement. When the presenting feature is focal pain in muscles, joints, or fibrous tissue, the differential diagnosis should include these considerations.

Arthritis, Infectious↗
PubMed1983

Acne conglobata responding to buserelin, a gonadotrophin-releasing hormone analogue.

A 65-year-old man who had had acne conglabata since early adult life was treated with buserelin for advanced prostatic cancer. Within 1 month of starting therapy, the inflammatory acne had completely resolved and this coincided with remission of the carcinoma. Gonadotrophin-releasing hormone analogues may be useful in the treatment of resistant acne.

Acne Vulgaris↗
PubMed1982

Membranous nephropathy in rheumatoid arthritis.

We have described a man with classic rheumatoid arthritis who had membranous nephropathy associated with nephrotic syndrome not related to gold or penicillamine therapy. Complete remission of the nephrosis occurred after discontinuation of hydroxychloroquine therapy. Further study is needed to determine the incidence of subclinical membranous nephropathy in patients with rheumatoid arthritis, and the effect of drugs in triggering clinical manifestations of this condition.

Adult↗
PubMed1981

Overdiagnosis of temporal arteritis.

Temporal arteritis is not a common disease, but it is often incorrectly diagnosed in elderly patients with a high ESR and pain in the temporal area. Such an incorrect diagnosis can subject the patient to needless biopsy and the serious side effects of therapy with large doses of prednisone. When temporal arteritis is suspected yet presentation is atypical, careful consideration should be given to ENT and neurologic examination, and even psychiatric evaluation. Temporal artery biopsy should be done on the tender side, with multiple serial sections. A negative biopsy does not rule out temporal arteritis. Therapy should not be deferred until biopsy results are reported. It consists of 40 to 60 mg of prednisone daily for at least four to six weeks with a gradual decrease thereafter.

Aged↗
PubMed1980

Ankylosing spondylitis in women.

Although ankylosing spondylitis (AS) has been considered rare in women, we believe that its incidence is underestimated. In our case studies of 12 women with AS the characteristic clinical features of the disease included onset before the age of 30 (12 patients); night pain and morning stiffness (12 patients); intermittent, migratory joint pain (9 patients); and history of uveitis (2 patients). Spine mobility was decreased in all patients. Sacroiliac (SI) (8 patients) and circumthoracic (5 patients) tenderness were common findings. If these pertinent clues are present, further diagnostic studies are indicated. Histocompatibility testing for the HLA-B27 antigen, which is reported to be present in over 90% of patients with AS, is useful in detecting early and mild forms of the disease. We found the antigen in 10 of 11 patients tested. Radioisotope (RI) scanning can show early inflammation of the SI joints long before changes are evident on standard roentgenograms: In 3 cases, SI films were reported as normal but RI scans revealed abnormal uptake and ratios. Early detection of AS prevents inappropriate treatment of patients and mislabeling them as functional complainers.

Adolescent↗
PubMed1980

Quadriceps myofibrosis. A complication of intramuscular injections.

Cases of fibrofatty replacement of the quadriceps muscles following repeated intramuscular injections into the thighs of infants and young children are being reported with increasing frequency. In such cases, the knee shows progressive painless limitation of flexion, habitual dislocation of the patella, or both. The recommended treatment is surgical release, done early before secondary adaptive changes occur in the soft tissues, cartilage, and bones comprising the joint. Full flexion should be obtained at the time of surgery. In children, the lag in extension that follows extensive release will usually disappear spontaneously.

Child, Preschool↗
PubMed1979

A finite state model for meditation phenomena.

Various reports of brain wave synchrony during Transcendental Meditation have appeared in the literature and have been interpreted as indicating a heightened state of integration of brain function. We suggest that this observed synchrony rather than indicating a greater integration of brain function might be an artifact of parts of the brain acting like a finite state machine. The finite state model is developed, its properties derived and a test for the hypothesis is presented.

Cerebral Cortex↗
PubMed1977

Joint surgery for rheumatoid arthritis.

The state of the art in the surgery of rheumatoid joint disease is discussed with emphasis on guidelines for choosing the patients and the types of procedures available. Strong-willed, strong-boned, strong-muscled, and well-informed patients are the best candidates. Synovectomy is particularly useful in the minimally erosive stages of the disease when the active synovitis is not suppressed by one or more steroid injections or other modalities of therapy. Arthrodeses and arthroplasties are midstage procedures that are now being supplanted by total joint replacement. This is especially true of the knee, but new prostheses for elbows, shoulders, wrists, and ankles are on the horizon.

Ankle Joint↗