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Biomedical subjects

L Kramer

Publications and source records attributed to L Kramer.

197 records · Page 11Linked to original sources
PubMedDate not supplied

Weil disease: importance of imaging findings for early diagnosis.

Weil disease is a rare and severe outcome of infection with leptospires. We report the radiographic appearance of this disease in a patient with hepatic, renal, and pulmonary involvement. Imaging findings added significantly to an early correct diagnosis and, thus, to immediate and successful therapy in this critically ill patient.

Adult↗
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Effect of prostaglandin E1 on extravascular lung water in patients with severe heart failure.

Prostaglandin E ( 1 ) (PGE ( 1 ) ) is a naturally occurring paracrine hormone that is used pharmacologically for treatment of peripheral occlusive arterial disease and to maintain ductus-arteriosus patency in neonates with congenital heart disease until the primary condition is operable. PGE ( 1 ) treatment also has been associated with reduction in pulmonary arterial pressure and increase in cardiac output in patients with left ventricular failure. In contrast, in isolated cases, patients with heart failure reportedly have developed pulmonary edema while receiving PGE ( 1 ). Therefore, to better define the effect of PGE ( 1 ) in heart failure, this double-blind study investigated the effect of PGE ( 1 ) on extravascular lung water in intensive-care patients with severe heart failure (New York Heart Association [NYHA] classes III and IV) and slightly above-normal extravascular lung water. Intravenous infusion of 60 microg PGE ( 1 ) (Prostavasin; Schwarz Pharma, Monheim, Germany) over a period of 2 hours caused no significant change in lung water relative to the baseline values (9.8 +/- 4.3 mL/kg before the infusion, 9.3 +/- 3.2 mL/kg after 1 hour, and 9.4 +/- 3.5 mL/kg after 2 hours) or to values observed in placebo-treated patients (6.5 +/- 3.3 mL/kg before the infusion, 7.1 +/- 2.7 mL/kg after 1 hour, and 7.0 +/- 3.2 mL/kg after 2 hours). Thus, administration of PGE ( 1 ) is unlikely to cause or worsen pulmonary edema in patients with severe heart failure (NYHA classes III and IV).

Adult↗
PubMedDate not supplied

Parental responses to sibling conflict: the effects of development and parent gender.

Mothers' and fathers' responses to their children's spontaneous sibling conflicts were observed using a wireless microphone system. Eighty-eight two-child, two-parent families participated in three home observations. Secondborn children were 3 to 5 years of age and firstborn children were 2 to 4 years older. Associations between parents' enactment of three categories of conflict management strategies (passive nonintervention, child-centered management, and parental control) and sibling interaction quality varied according to children's ages, gender of the monitoring parent, and type of strategy used. Passive nonintervention was highly associated with the occurrence of subsequent conflict. Younger sibling dyads, in particular, behaved more antagonistically when their parents did not intervene. In contrast, older sibling dyads were less involved and less close when their mothers intervened in any way. Results suggest that relatively younger sibling dyads may benefit more than older dyads from parental intervention.

Age Factors↗
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Dead bird surveillance as an early warning system for West Nile virus.

As part of West Nile (WN) virus surveillance in New York State in 2000, 71,332 ill or dead birds were reported; 17,571 (24.6%) of these were American Crows. Of 3,976 dead birds tested, 1,263 (31.8%) were positive for WN virus. Viral activity was first confirmed in 60 of the state's 62 counties with WN virus-positive dead birds. Pathologic findings compatible with WN virus were seen in 1,576 birds (39.6% of those tested), of which 832 (52.8%) were positive for WN virus. Dead crow reports preceded confirmation of viral activity by several months, and WN virus-positive birds were found >3 months before the onset of human cases. Dead bird surveillance appears to be valuable for early detection of WN virus and for guiding public education and mosquito control efforts.

Animals↗
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Dead crow densities and human cases of West Nile virus, New York State, 2000.

In 2000, Staten Island, New York, reported 10 human West Nile virus cases and high densities of dead crows. Surrounding counties with <2 human cases had moderate dead crow densities, and upstate counties with no human cases had low dead crow densities. Monitoring such densities may be helpful because this factor may be determined without the delays associated with specimen collection and testing.

Animals↗
PubMedDate not supplied

West Nile virus infection in mosquitoes, birds, horses, and humans, Staten Island, New York, 2000.

West Nile (WN) virus transmission in the United States during 2000 was most intense on Staten Island, New York, where 10 neurologic illnesses among humans and 2 among horses occurred. WN virus was isolated from Aedes vexans, Culex pipiens, Cx. salinarius, Ochlerotatus triseriatus, and Psorophora ferox, and WN viral RNA was detected in Anopheles punctipennis. An elevated weekly minimum infection rate (MIR) for Cx. pipiens and increased dead bird density were present for 2 weeks before the first human illness occurred. Increasing mosquito MIRs and dead bird densities in an area may be indicators of an increasing risk for human infections. A transmission model is proposed involving Cx. pipiens and Cx. restuans as the primary enzootic and epizootic vectors among birds, Cx. salinarius as the primary bridge vector for humans, and Aedes/Ochlerotatus spp. as bridge vectors for equine infection.

Animals↗
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Primary cardiac rhabdomyosarcoma in a cat.

A seven-year-old domestic shorthair (DSH) cat was presented with anorexia and dyspnea. Pleural-pericardial effusion was detected with thoracic radiographs and echocardiography. Echocardiography demonstrated a large, soft-tissue mass in the right ventricular wall, protruding both into the pericardial space and into the right ventricle. Postmortem examination findings included a large mass in the right ventricular wall and multiple smaller masses on the external surface of the left ventricle and on the internal surface of the pericardium. Results of the histopathological and immunohistochemical examinations of the masses were consistent with rhabdomyosarcoma. This is the first reported case of primary cardiac rhabdomyosarcoma in the cat.

Animals↗
PubMedDate not supplied

Hope for the children: a community-based approach to supporting families who adopt children with special needs.

This study explored the need for and use of support by preadoptive families of children with special needs in the Hope for the Children program. The families live in a community alongside other foster and adoptive parents, senior citizen volunteers, tutors, therapists, mentors, and family advocates, and receive extensive community supports. Descriptive results from the study provide a basis for recommendations about the use of coordinated service delivery systems to promote adoption success.

Adoption↗
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Necrotizing typhlocolitis associated with a spirochete in rheas (Rhea americana).

Necrotizing typhlocolitis was diagnosed in 13 juvenile common rheas (Rhea americana) from three separate of geographically isolated Ohio flocks, with mortality ranging from 25% to 80%. At postmortem examination, a diphtheritic membrane covered ulcerated cecal mucosa. Histologically, cecal sections showed necrosis and granulomatous-to-suppurative inflammation that extended into the submucosa and often surrounded large eosinophilic colonies of bacteria. Warthin-Starry staining showed these colonies to be composed of entangled spirochetes that invaded the submucosa and frequently were present transmurally. Similar organisms were identified by Warthin-Starry staining in the cecum of a juvenile rhea from a fourth flock that histologically had mild lymphocytic typhlitis. Scanning and transmission electron microscopy demonstrated the presence of a spirochete in the ceca. Anaerobic culture yielded a gram-negative, beta-hemolytic spirochete. Coccidia, histomonads, and Salmonella spp. were consistently absent.

Animals↗
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Raeder syndrome: MR appearance.

A 40-year-old woman presented with symptoms compatible with Raeder syndrome. MR demonstrated narrowing of the left cavernous carotid artery. The high cervical portion of the left internal carotid artery was not identified. Angiography confirmed the narrowing of the cavernous carotid artery and showed marked and irregular stenosis of the distal cervical internal carotid artery. Involvement of the left sympathetic plexus and of ipsilateral cavernous sinus arteries is believed to have been the cause of the Raeder syndrome in this patient.

Adult↗
PubMedDate not supplied

Effects of aluminum hydroxide on fluoride and calcium metabolism.

In order to determine whether and to what extent aluminum affects the absorption of fluoride in man, a study of the effect of aluminum hydroxide on fluoride metabolism was carried out under strictly controlled dietary conditions. Relatively small amounts of aluminum hydroxide were used: 30 ml given three times daily, containing a total of 1.8 gm aluminum. Fluoride and calcium balances were determined in control studies and during the intake of aluminum hydroxide. The fluoride intake of approximately 4 mg/day was due to the fluoride content of the diet and the drinking water. A study was also carried out in patients with osteoporosis who received a high fluoride intake of approximately 50 mg/day of sodium fluoride therapeutically for osteoporosis. The intake of aluminum hydroxide was associated with a significant increase of the fecal fluoride and with a significant decrease of the net absorption of fluoride, by an average of 57%, irrespective of the intake of fluoride. The-plasma fluoride levels decreased by 41%. The fluoride balances were either negative or less positive. Relatively small amounts of aluminum hydroxide resulted in phosphorus depletion, in an increase of the urinary calcium, and in negative calcium balances.

Adult↗
PubMedDate not supplied

Amoxapine overdose in a young man: a transient mitochondrial abnormality?

Amoxapine is a second-generation tricyclic antidepressant structurally related to the neuroleptic loxapine. It was previously marketed as an alternative to traditional tricyclic antidepressants because of alleged shorter onset of action and fewer cardiotoxic effects. However, various adverse reactions, including cardiac dysrhythmias, renal failure, coma, seizures, and neuroleptic malignant syndrome, were reported during therapy or after acute overdose. A 14-year-old boy ingested 1900 mg of amoxapine and developed seizures, hypertension, hyperpyrexia, altered mental status, myoglobinuria, renal failure, and transient magnetic resonance imaging (MRI) changes suggestive of hypertensive encephalopathy and neuroleptic malignant syndrome. Since mitochondrial disorders can cause multisystem failure, including encephalopathy, renal tubular dysfunction, and myopathy, a transient, toxic disorder of mitochondrial function was considered as the basis for the patient's clinical and MRI changes.

Adolescent↗