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Biomedical subjects

M D Aronson

Publications and source records attributed to M D Aronson.

At least 37 records · Page 2Linked to original sources
PubMed1984

Neuroleptic malignant syndrome. Patient with unique clinical and physiologic features.

Lethargy, marked muscle weakness and rigidity, a maximal temperature of 40 degrees C, and a maximal creatine kinase value of 17,240 IU/liter developed in a 36-year-old woman following treatment with several neuroleptics. Initial treatment with dantrolene was unsuccessful. The patient's condition improved gradually over a 10-day period with no specific therapy. Muscle biopsy revealed a contracture pattern diagnostic of malignant hyperthermia susceptibility, as well as abnormal sensitivity to fluphenazine. This report may be the first description of a patient with neuroleptic malignant syndrome in whom muscle biopsy response similar to that seen in malignant hyperthermia occurred and documents that dantrolene is not uniformly successful therapy for this syndrome.

Adult↗
PubMed1984

Hypokalemia-induced psychosis in a chronic schizophrenic patient.

An association is documented between hypokalemia and an acute psychotic decompensation in a patient with chronic schizophrenia. The patient's symptom picture and other aspects of the clinical presentation alone were not sufficient to differentiate between hypokalemic psychosis and an exacerbation of schizophrenia. A restricted focus on a history of psychosis, ignoring the possibility of organic factors, can be misleading and dangerous to the patient.

Acute Disease↗
PubMed1983

Serologic evidence of chlamydial and mycoplasmal pharyngitis in adults.

In a study of 763 adult patients we found serologic evidence of infection (a fourfold increase in antibodies) with Chlamydia trachomatis in 20.5 percent of the patients and with Mycoplasma pneumoniae in 10.6 percent, but with group A streptococcus (by culture) in only 9.1 percent. Pharyngitis, the most common problem for which patients seek medical care in the United States, may be caused by nonviral, potentially treatable organisms more often than had been suspected.

Adult↗
PubMed1982

Association between cigarette smoking and acute respiratory tract illness in young adults.

The association of cigarette smoking with the occurrence and severity of an acute respiratory tract illness (ARTI) was studied. Clinical data were obtained prospectively on 867 men and women with an ARTI and on a control group of 289 women. Three hundred seven (57%) of the 534 women in the ARTI group were smokers, compared with 97 (34%) of the 289 women in the control group, a highly significant difference. Of the 867 men and women with ARTIs, 506 were smokers. Smokers had a statistically significant greater likelihood of having a lower respiratory tract illness (57% v 45%), a longer duration of cough (8.9 v 6.8 days), and a greater frequency of abnormal auscultatory findings (31% v 20%) than did the 361 nonsmokers. Cigarette smoking may thus contribute to the substantial morbidity and lost productivity resulting from ARTI.

Acute Disease↗
PubMed1982

Heterophil antibody in adults with sore throat: frequency and clinical presentation.

We studied the prevalence and the clinical and laboratory findings of infectious mononucleosis in ambulatory adult patients with the presenting symptom of sore throat. Extensive clinical data, heterophil antibody test, and differential leukocyte count were obtained prospectively for 709 patients, aged 16 to 73 years, seen in four primary care settings. Heterophil tests were positive in 15 of 709 patients (2%); four of the 15 had greater than 10% atypical lymphocytes. No heterophil-negative patient had greater than 10% atypical lymphocytes. Heterophil-positive patients had mild disease; none was older than 40 years. Of 70 symptoms and signs evaluated, four were found significantly more often (p less than 0.005 for each) in the heterophil-positive patients: palatine petechiae, posterior auricular adenopathy, marked axillary adenopathy, and inguinal adenopathy. If any of these four easily shown physical findings was present, the likelihood of the patient having heterophil antibody was considerably increased; if absent, the probability of infectious mononucleosis was so low that not ordering a heterophil test or differential leukocyte count would have been efficient and safe.

Adolescent↗
PubMed1981

Chlamydia trachomatis infection in adults with community-acquired pneumonia.

We studied 52 adult patients admitted to the hospital over a 11-month period with symptoms suggesting pulmonary infection. Twenty-nine had pneumonia and none were receiving immunosuppressive drug therapy. We found definite serological evidence of recent chlamydial infection in 21% (4/19) of patients with pneumonia of unclear etiology, and in 0% (0/33) of patients with other pulmonary conditions. An additional three patients with pneumonia had suggestive serological evidence of recent chlamydial infection. None of the seven patients had culture evidence of bacterial infection, or serological evidence of mycoplasmal, viral, or Legionella infection; none had physical examination findings suggesting intercurrent chlamydial infection of the eye or genitourinary tract. Chlamydia trachomatis may have been a cause of community-acquired pneumonia in some of these patients.

Adult↗
PubMed1981

Should young adults with a positive tuberculin test take isoniazid?

We used decision analysis to determine the benefits and risks of preventive therapy with isoniazid for young adults whose only risk factor for the development of active tuberculosis was a positive tuberculin skin test. We assumed that the risk of developing active tuberculosis over the next 20 years ranged from 0.56% to 1.30% for such persons; that isoniazid can reduce this risk by 30% to 70%; and that the risk of developing isoniazid-related hepatitis ranged from 0.3% to 1.1%. Among 100 000 such persons, treatment with isoniazid could prevent from 168 to 910 cases of tuberculosis over 20 years. However, from 300 to 1100 cases of isoniazid-related hepatitis would occur in the year of treatment. The benefits of preventive therapy in this group do not appear clearly to outweigh the risks. We disagree with the recommendation of the American Thoracic Society and the Centers for Disease Control that all such patients take isoniazid.

Adolescent↗
PubMed1980

Enteroviruses in Vermont, 1969-1978: an important cause of illness throughout the year.

Enteroviruses continue to play an important role in both epidemic and sporadic febrile diseases. Of the clinical specimens submitted for diagnosis during a 10-year period (1969-1978) at the Medical Center of Vermont Hospital, Burlington, a wide variety of diseases were associated with the isolation of enteroviruses. Among these diseases were aseptic meningitis, hand-foot-and-mouth disease, diarrhea, pleurodynia, myocarditis, herpangia, and fevers. In 1972 a single enterovirus serotype, coxsackievirus B5, WAS SOLELY RESPONSIBLE FOR EPIDEMIC DISEASE. During the other nine years of the study, a variety of enteroviruses were isolated during epidemics. Although epidemics were always seen during the summer and early fall, enteroviruses which may cause sporadic disease were isolated in each of the 12 months. An awareness by both practicing physicians and health officers not only of the epidemic potential of enteroviruses in summer and fall but also throughout the year will aid in the diagnosis and therapy of these illnesses.

Adolescent↗
PubMed1976

Vidarabine therapy for severe herpesvirus infections. An unusual syndrome of chronic varicella and transient immunologic deficiency.

Six patients with severe herpesvirus infections were successfully treated with vidarabine. One patient had a previously undescribed syndrome of chronic cutaneous varicella infection of eight months' duration, associated with transient but complete duppression of lymphocyte response to conconavalin A. Other diagnoses were severe varicella pneumonia, progressive cytomegalovirus pneumonia associated with acute lymphocytic leukemia, herpes simplex encephalitis, severe zoster associated with stage IV lymphoma, and disseminated herpes simplex in a patient receiving high doses of steroids. All patients showed cessation of new lesions or abrupt clinical improvement between days 2 and 4 after initiation of therapy, and all were cured of their clinical infection. Dramatic improvement in all of our patients and the minimal toxicity observed make vidarabine suitable for use in severe herpesvirus infections.

Adolescent↗
PubMed1976

A case of bilateral Escherichia coli endogenous endophthalmitis.

The first reported case of bilateral endogenous endophthalmitis is presented and discussed with reference to pertinent literature. Diagnostic and therapeutic recommendations for suspected gram-negative endophthalmitis are presented and include: immediate paracentesis of the eye for gram stain and culture, systemic therapy with an antibiotic such as gentamicin and either subconjunctival, subtenon or intraocular injection of antibiotics. Despite these measures vision may be lost, and, as in this case, enucleation necessary.

Anti-Bacterial Agents↗
PubMed1975

Coxsackievirus B5 infections in acute oliguric renal failure.

Six patients with acute oliguric renal failure were studied for detection of acute viral or mycoplasma infection. Precipitating causes, such as streptococcal infection, use of nephrotoxic drugs, etc., were ruled out. Tests for neurtralization and complement fixation antibodies, in which 19 viral and mycoplasma agents were used as antigens, demonstrated a recent coxsachievirus B5 infection in five of six patients. Rises in titer to other antigens tested were not noted. A group of control patients showed no significant rises in titer of antibody to coxsackievirus B5. These studies strongly suggest that an association exists between coxsackievirus B5 infections and acute oliguric renal failure. Whether this association is etiologic is not known.

Acute Kidney Injury↗