Search PubMed⌕ Search

Biomedical subjects

L Caplan

Publications and source records attributed to L Caplan.

At least 37 records · Page 2Linked to original sources
PubMed1992

Critical carotid and vertebral arterial occlusive disease and cough syncope.

BACKGROUND AND PURPOSE: Cough syncope typically occurs in patients with known chronic lung disease. The mechanism usually involves a combination of decreased venous return, increased cerebrospinal fluid pressure, and secondary hypocapnia, all resulting in cerebral arterial vasoconstriction. Cough syncope has not in the past been associated with occlusive cerebrovascular disease. CASE DESCRIPTION: We describe a 50-year-old man with a 6-month history of episodes of loss of consciousness during paroxysms of coughing. Physical examination showed asymmetrical upper extremity blood pressures and carotid and subclavian artery bruits. Pulmonary function studies were normal. Ultrasound and angiography showed total occlusion of the left common carotid artery, right internal carotid artery, and right vertebral artery; tight stenosis of the right subclavian artery; and a hypoplastic left vertebral artery. The patient had a left subclavian-to-left common carotid artery bypass and has had no syncope since that time. CONCLUSIONS: To our knowledge, this is the first reported case of cough syncope and severe cerebrovascular disease in which surgery led to amelioration of symptoms. Cerebrovascular occlusive disease may contribute to cough syncope.

Aortography↗
PubMed1991

The effect of excessive add power on the acceptance of progressive addition lenses.

Twenty-nine subjects wearing Varilux Plus (Varilux 2) or Varilux Infinity lenses were drawn from the UAB School of Optometry primary care clinic population. Using a double-masked, randomized cross-over design, subjects wore one pair of progressive addition lenses (PALs) with a normal add and one pair with the add overplussed by 0.50 D. Subjects wore each pair of lenses for 1 week. Twenty-five of the 29 patients preferred the normal add over the overplussed add. In all subjective response categories the normal add was rated higher than the overplussed add.

Adult↗
PubMed1987

Dental chair intracerebral hemorrhage.

A 52-year-old woman had a fatal intracerebral hemorrhage after dental manipulation. Normotensive in the past, the initial blood pressure was high but rapidly returned to normal. Necropsy showed no vascular malformation or evidence of hypertensive vascular disease. Clinical and experimental data show that stimulation of trigeminal fibers can cause important changes in blood pressure and pulse.

Cerebral Hemorrhage↗
PubMed1987

Clinical evaluation of a custom toric hydrogel contact lens.

Eleven astigmatic patients seen in a private practice were fit with the Hydron-T custom toric soft lens. The fitting mechanics are described along with the results which illustrate the potential utilization of this lens in the management of patients with high astigmatic errors.

Adult↗
PubMed1986

Clinical evaluation of two soft lens bifocals.

This paper reviews two approved soft bifocal contact lenses for the U.S. market. The discussion centers around lens specifications, fitting philosophies, and clinical experiences with these lenses during clinical investigations.

Adult↗
PubMed1985

Occlusive disease of the middle cerebral artery.

We studied 20 patients with severe occlusive disease of the mainstem middle cerebral artery (MCA) or its major division branches, and 25 patients with internal carotid artery (ICA) disease. MCA disease patients were more often black, female, younger, and had fewer TIAs than the ICA disease patients. Neurologic signs in patients with MCA disease evolved progressively during days to weeks, whereas ICA disease patients more often had an acute onset of nonprogressive deficits. CT commonly showed restricted subcortical or wedge-shaped infarcts in MCA disease patients. All MCA disease patients had stroke, but 40% of ICA disease patients had no infarction. MCA lesions usually affected the mainstem MCA or its major superior division. Patients with MCA disease seldom had recurrent ischemia in the same vascular territory as the stroke and had a low incidence of subsequent cardiac death.

Adult↗
PubMed1984

Comparing thermal and chemical disinfection systems for the etafilcon A 58% water content contact lens.

Several high water content lenses (greater than or equal to 55%) have been approved for either thermal or chemical disinfection. Thermal disinfection has been reported to be contraindicated for higher water content lenses, yet no studies have been performed to show this with a high water content daily or extended wear lens approved for thermal disinfection. A three-phase clinical study was initiated in which eight previously successful soft contact lens wearers were fitted with etafilcon A lenses. The subjects were placed on an approved thermal disinfection regimen for the lens on the right eye, and on an approved chemical disinfection regimen for the lens on the left eye. Results show that thermal disinfection of the etafilcon A lenses results in lens discoloration and reduced lens performance over a short period of time, as compared to the chemically disinfected lenses which showed no compromise in fit or any discoloration. Possible causes of the poor performance and appearance of the thermally disinfected lenses are discussed.

Adult↗
PubMed1984

Intraluminal clot of the carotid artery detected radiographically.

Nine patients had intraluminal filling defects identifiable as clot within the internal carotid artery at angiography. Thrombus was unilateral in eight, bilateral in one. Eight of the 10 clots were attached to atheromatous plaques. Three patients had serious concurrent illness: pancreatic cancer, rheumatoid arthritis with arteritis, and chronic pulmonary disease with polycythemia. In three patients, the clot was related to severe atherosclerosis. In three other patients, all young, the carotid thrombi remained unexplained though two of these patients had coagulation abnormalities. No patient had a new stroke after surgical or anticoagulant treatment.

Adult↗
PubMed1983

Intracerebral hemorrhage and oral amphetamine.

Four patients suffered intracerebral hemorrhages following the oral or nasal use of amphetamine or related compounds. Two of these patients had abnormal-appearing cerebral blood vessels on angiography. Review of previously reported cases showed that intracerebral hemorrhage may occur in patients using the drug for the first time and for nonrecreational purposes.

Administration, Intranasal↗
PubMed1983

Neuro-ophthalmologic signs in the angiitic form of neurosarcoidosis.

We studied eight patients with CNS sarcoidosis, including two patients with postmortem evidence of sarcoid granulomatous angiitis. Neuro-ophthalmologic findings included perivenular sheathing of retinal veins resembling the dripping of candle wax, vitreous cells, anterior uveitis, optic disk edema or granulomas, and conjunctival granulomas. Perivenous sheathing in the retina and the perivascular meningeal lesions in sarcoid angiitis were identical.

Adult↗
PubMed1981

Transient global amnesia and migraine.

Twelve patients with transient global amnesia (TGA) had prior migraines (six classical and six common). In three patients, classic migrainous phenomena accompanied TGA, and in nine patients severe headache accompanied the amnestic attack. Migrainous vascular dysfunction in the dominant posterior cerebral artery territory could explain TGA: (1) The pathophysiology and transient nature of TGA have led many to postulate posterior circulation vascular disease; migraine is a vascular disorder with a posterior circulation bias. (2) TGA and migraine share common precipitants. (3) Migraine differs from arteriosclerotic ischemia; the repetitive queries of TGA are absent in amnestic stroke. (4) TGA and migraine are usually benign.

Adult↗
PubMed1979

Cerebral embolic disease: a complication of carotid aneurysms.

Thrombus formation in large aneurysms is well recognized. However, thrombi in small aneurysms with subsequent embolization into intracranial vessels is infrequently identified or suspected. A series of cases in which this phenomenon has occurred is documented. Since many of these examples present embolic disease without suspicion of aneurysm, definitive diagnosis can only be accomplished by angiography. The importance of this study should be emphasized since embolic disease is usually assessed only by computed tomography which fails to delineate the embolic source.

Adult↗