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Biomedical subjects

L Blum

Publications and source records attributed to L Blum.

At least 37 records · Page 2Linked to original sources
PubMed2000

Telangiectasia macularis eruptiva perstans and multiple myeloma.

The association of mast cell diseases and some hematologic malignancies, usually myeloproliferative disorders, myelodysplastic syndromes, and acute leukemia is well recognized. We report the case of a patient with telangiectasia macularis eruptiva perstans, a rare form of cutaneous mastocytosis, and multiple myeloma, an association that has been described only twice in the literature. Parallel improvement of both conditions was observed under chemotherapy regimens for multiple myeloma. Pathogenesis remains unclear, although the abnormalities in the c-kit pathway may play a role in the proliferation of cells from both lineages.

Aged↗
PubMed2000

Density fluctuations and entropy

A functional for the entropy that is asymptotically correct both in the high- and low-density limits is proposed. The new form is S=S((id))+S((ln))+S((r))+S((c)), where the term S((c)) depends on the p-body density fluctuations alpha(p) and has the form S((c))/k= ln 2-1+ summation operator(infinity)(p=2) (ln 2)(p)/p! alpha(p)-[exp(alpha(2)-1)-alpha(2)]+Sinsertion mark. Sinsertion mark renormalizes the ring approximation S((r)). This result is obtained by analyzing the functional dependence of the most general expression of the entropy. Two main results for S((c)) are proved: (i) In the thermodynamic limit it is only a functional of the one-body distribution function and (ii) by summing to infinite order the leading contributions in the density a numerical expression for the entropy [Eq. (33)] with a renormalized ring approximation is obtained. The relation of these results to the incompressible approximation for the entropy is discussed and preliminary numerical results on hard spheres are presented.

Journal Article↗
PubMed2000

Rational dosages of nutrients have a prolonged effect on learning disabilities.

CONTEXT: Reports that administration of nutrients has increased the academic performance of learning-disabled children exist in the literature. OBJECTIVE: To document the effects of nutrients on learning-disabled children in a controlled study. DESIGN: A randomized, double-blind, placebo-controlled crossover trial, which followed 1 year of open-label nutrients. Children who improved in the open-label trial were eligible to enter the controlled phase of the study. SETTING: Subjects were enrolled from the general community through advertisements. PATIENTS OR OTHER PARTICIPANTS: Twenty children met the criteria for being learning disabled. INTERVENTION: Each child was tried out on some (but not necessarily all) of the B vitamins and minerals used in this study. These were administered semi-blinded for the first year; double-blinded in crossover rotations during the second year; and open-label in the ensuing years. MAIN OUTCOME MEASURES: At various time points, school-certified psychologists administered psychoeducational tests. School report cards were evaluated at baseline and for all subsequent periods. RESULTS: Twenty learning-disabled children entered the study, but 1 dropped out because of nausea. The remaining 19 children showed significant academic and behavioral improvements within a few weeks or months of open-label treatment with nutrient supplements. Some children gained 3 to 5 years in reading comprehension within the first year of treatment; and all children in special education classes became mainstreamed, and their grades rose significantly. Twelve of the children completed the 1-year double-blind phase, after which approximately half of the children chose to remain on the nutrients for at least 2 additional years. For those who discontinued, it took at least 1 year to begin to see the first indications of decline in academic performance, and another year for their grades to drop significantly. In contrast, for children who remained on nutrients, the gains continued the upward trend; at the end of year 4, the difference in scores between the 2 groups had reached statistical significance (P < .01). CONCLUSION: The overall results of this study tentatively support the concept that learning disabilities may in some cases be a nutrient-responsive disorder.

Adolescent↗
PubMed1999

Composite low grade B-cell lymphomas with two immunophenotypically distinct cell populations are true biclonal lymphomas. A molecular analysis using laser capture microdissection.

Low grade B-cell lymphomas comprise several well defined, clinically and immunophenotypically distinct disease entities. Composite lymphomas showing phenotypic characteristics of more than one of these tumor subtypes in the same site are rare, and both common and separate clonal origins of the two tumor parts have been reported for cases studied by molecular methods. We describe the detailed immunohistochemical and molecular findings in three cases with features of composite low grade B-cell non-Hodgkin's lymphoma (B-NHL). All three neoplasms contained morphologically distinct but interwoven compartments of different cell types, which exhibited discordant expression of several markers, including CD5, CD10, CD43, and cyclin D1. According to their morphology and phenotypes, they were classified as mantle cell lymphoma and follicular lymphoma (Case 1), follicular lymphoma and small lymphocytic lymphoma (Case 2), and mantle cell lymphoma and chronic lymphocytic leukemia/small lymphocytic lymphoma (Case 3). PCR analysis of DNA obtained from whole tissue sections failed to reveal evidence for biclonality in any of the cases. We therefore isolated cell populations with different antigen expression patterns by laser capture microdissection and analyzed them by polymerase chain reaction amplification and sequencing of clonal immunoglobulin heavy chain gene rearrangements and oncogene rearrangements. Sequence analysis revealed unrelated clonal rearrangements in each of the two tumor parts in all three cases, suggesting distinct clonal origins. In addition, Case 1 showed a bcl-2 rearrangement present only in the follicular lymphoma part. Our findings suggest that low grade B-NHL with two distinct morphological and immunophenotypic patterns in the same anatomical site are frequently biclonal. This is in keeping with current classification schemes, which recognize subtypes of low grade B-NHL as separate disease entities. Furthermore, our analysis demonstrates the power of laser capture microdissection in revealing molecular microheterogeneity in complex neoplasms.

Aged↗
PubMed1999

Left atrial myxomas presenting with right hand weakness.

A 63-year-old man with multiple left atrial myxomas presenting with right hand weakness is described. Two-dimensional echocardiography obtained during the evaluation for his stroke showed a large left atrial mass. At surgery, two separate left atrial myxomas were excised. Pathology confirmed the diagnosis. Although left atrial myxomas are uncommon, they should be included in the differential diagnosis of stroke, especially in patients who present without cardiovascular or cerebrovascular risk factors. The absence of cardiac symptoms and signs does not rule out a cardiac myxoma.

Central Nervous System Diseases↗
PubMed1998

Clinical and biological impact of antiretroviral therapy with protease inhibitors on HIV-related Kaposi's sarcoma.

OBJECTIVE: To evaluate the clinical and biological impact of protease inhibitors on HIV-associated Kaposi's sarcoma. DESIGN AND SETTING: A cohort of 10 patients included prospectively from April 1996 to June 1997 were studied in one institutional centre after initiation of protease inhibitors. PATIENTS AND METHODS: All patients but one (stable disease) had progressive Kaposi's sarcoma. Three out of 10 patients had stopped specific chemotherapy for Kaposi's sarcoma for more than 4 weeks, three were still under chemotherapy, and four had never received specific treatment of Kaposi's sarcoma. Plasma HIV viral load, human herpesvirus (HHV)-8 viraemia in peripheral blood mononuclear cells (PBMC), and CD4 cell count were sequentially assessed from the beginning of therapy. For six patients, a semiquantitative evaluation of HHV-8 viral load in the Kaposi's sarcoma lesions was performed during treatment using polymerase chain reaction. RESULTS: After initiation of HIV triple therapy with protease inhibitors, we observed six complete responses, two partial responses, and two patients with progressive disease. All patients had undetectable plasma HIV viral load within 2 months of treatment. Undetectable HHV-8 viraemia in PBMC occurred in seven out of eight patients with partial or complete response and in none of the progressive patients. A decrease or negation of HHV-8 viral load in Kaposi's sarcoma lesions was observed in two complete responders. CONCLUSION: Our results suggest that antiviral therapy with protease inhibitors are clinically efficient in HIV-associated Kaposi's sarcoma and that there exists a correlation between clinical response and negation of HHV-8 viraemia.

AIDS-Related Opportunistic Infections↗
PubMed1997

Exacerbations of clinical symptoms in human immunodeficiency virus type 1-infected patients with multicentric Castleman's disease are associated with a high increase in Kaposi's sarcoma herpesvirus DNA load in peripheral blood mononuclear cells.

The epidemiologic link between multicentric Castleman's disease (MCD) and Kaposi's sarcoma (KS) and the high frequency of KS herpesvirus (KSHV) detection in both diseases raise the question of a role of this new virus in the pathogenesis of MCD. To explore this hypothesis, the KSHV DNA load was investigated in peripheral blood mononuclear cells of 3 human immunodeficiency virus (HIV)-infected patients with MCD at different points during the clinical course. Clinical parameters, such as fever and the presence of lymphadenopathy, were systematically assessed. Hemogram and C-reactive protein level determinations were performed as standard procedures. KSHV DNA load was investigated by means of semiquantitative polymerase chain reaction assay using peripheral blood mononuclear cells of the patients. A correlation between the variation in clinical and biologic parameters related to MCD and KSHV DNA load was found, suggesting a close relationship between KSHV and MCD in HIV-1-infected patients.

Castleman Disease↗
PubMed1997

Promotion of folate for the prevention of neural tube defects: knowledge and use of periconceptional folic acid supplements in Western Australia, 1992 to 1995.

To assess changes in knowledge and use of folic acid supplements in relation to a statewide health promotion project for the prevention of neural tube defects, we surveyed general practitioners, pharmacists, women of child-bearing age and pregnant women in Western Australia. We also collected data on wholesale sales of folic acid supplements. By the end of the project, 56.5 per cent of general practitioner respondents knew that the recommended dose of folic acid was 0.5 mg and 70 per cent offered folic acid supplements to women planning pregnancy, 82.5 per cent of responding pharmacists knew the recommended dose, and 87.5 per cent reported an increase in sales of 0.5 mg folic acid. Wholesale sales of 0.5 mg folic acid increased markedly in Western Australia compared with other states. From shopping centre surveys of women of child-bearing age we estimated that their knowledge of the association between folate and spina bifida increased from 8.2 per cent before the project to 67.5 per cent 2.5 years later, and doctors were a major source of information for women. In a 1995 survey of a sample of pregnant women, 43.1 per cent with planned pregnancies had taken folic acid supplements periconceptionally, compared with 19.1 per cent in a similar survey in 1993.

Adult↗
PubMed1997

Early ritonavir-induced maculopapular eruption.

We report 2 cases of maculopapular eruption and fever in patients infected with human immunodeficiency virus (HIV) on the 2nd day of first administration of ritonavir, a protease inhibitor. In the 1st patient, clinical improvement occurred despite continuation of therapy, and in the 2nd the treatment was stopped with remission and rechallenge resulting in recurrence. Ritonavir should be added to the list of drugs that can induce adverse cutaneous reactions in HIV patients.

Adult↗
PubMed1996

[Cutaneous pathology of misery].

Cutaneous disease is the most common health problem found in the homeless, in out patient clinics as well as in hospitals. They are related to life style characteristics. Fungal, bacterial infections, scabies and pediculosis are mainly observed. Other frequently observed skin diseases are caused by physical violence and trauma, drug abuse and nutritional deficiency In addition to limited access to health care, homeless patients tend to neglect their skin until problems become serious and disabling. The patient's condition will worsen without hospitalisation.

France↗
PubMed1996

Adolescent health in Russia: a view from Moscow and St. Petersburg.

PURPOSE: The purpose of this study was to report on the current state of adolescent health in Russia. METHODS: By means of site visits, literature review, discussions with Russian colleagues, and a scientific meeting in Moscow, data were collected on health status of youth, the organization of health services, and professional training. RESULTS: Youth over the age of 14 are served in the adult health care system. Youth clinics are just now emerging. Substance abuse is a major issue; AIDS is rare. Rates of sexual intercourse parallel many western European countries; however, contraception is expensive by Russian standards and often not used. Those with behavioral, physical, and intellectual impairments tend to be educated in special settings and managed by psychiatrists. CONCLUSION: The Russian health care system is undergoing radical transformation. The traditional Soviet system, with its heavy reliance on medical interventions and prolonged inpatient hospitalizations, is threatened by a lack of resources. Privatization of health care poses additional threats, as do the social transformations that are occurring. These changes create a very uncertain future for the health and well-being of youth in Russia.

Acquired Immunodeficiency Syndrome↗