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Biomedical subjects

M Fisher

Publications and source records attributed to M Fisher.

At least 451 records · Page 25Linked to original sources
PubMed1986

Porphyria cutanea tarda in a patient with acute leukemia.

A 20-year-old woman with acute nonlymphocytic leukemia in remission was treated postremission with intermittent courses of intensive chemotherapy. She required blood and platelet transfusions following therapy, and oral contraceptives were used to suppress her menses while she was thrombocytopenic. One and one-half years after treatment began, she developed blisters on her hands, hypertrichosis, and dark urine. The diagnosis of porphyria cutanea tarda was made. This report discusses the possible precipitating cause(s) and the subsequent treatment of both her porphyria and her leukemia.

Adult↗
PubMed1986

Effects of dietary fish oil supplementation on polymorphonuclear leukocyte inflammatory potential.

Polymorphonuclear leukocytes (PMNLs) are an important contributor to inflammation and are thus a part of the pathophysiology of many human diseases. We assessed the effect of fish oil on PMNL inflammatory potential by measuring chemiluminescence and superoxide production before and after six weeks of daily cod liver oil ingestion by healthy volunteers. Phagocytosing PMNLs demonstrated a 27% decrease in chemiluminescence (P less than 0.05) and a 64% decrease in superoxide production (P less than 0.01), following the cod liver oil supplementation. Analysis of PMNL and platelet fatty acids revealed the appearance of eicosapentaenoic acid and a significant decrease in arachidonic acid in both types of cells.

Dietary Fats↗
PubMed1986

Failure of platelet transfusion to improve human renal allograft survival.

Platelets, expressing only class I antigens on their surface, have been shown to improve renal allograft survival in some experimental models but do not lead to humoral sensitization. In this pilot study, 24 previously untransfused patients were given 3 platelet transfusions at 2-week intervals before renal transplantation. Twelve patients (group 1) received 200 X 10(8) platelets contaminated by 15 X 10(6) leukocytes in each transfusion, and 42% developed cytotoxic antibodies; 12 further patients (group 2) received a purified preparation containing 200 X 10(8) platelets and less than 5 X 10(6) leukocytes, and no cytotoxic antibodies were detected. Using a more sensitive flow cytometry technique, 83% of group 1 but only 17% of group 2 (P less than 0.004) responded to their platelet donors. From each group 9 patients have been transplanted. Four grafts in group 1 and 6 in group 2 have failed, yielding a 1-year graft survival rate of 44%, compared with 69% in blood-transfused patients (P = 0.03). Pure platelet transfusions, using our protocol, do not appear to improve renal allograft survival, and minimal contamination by leukocytes can lead to humoral sensitization.

Blood Transfusion↗
PubMed1986

Standardized incidence ratios of stroke: a worldwide review.

Comparison of stroke incidence in various parts of the world is difficult because differences in diagnostic criteria, medical facilities and age-sex distributions are often not taken into account. We calculated age-sex standardized incidence ratios (SIR) of stroke in 37 regions based on recent reports. The USA (1976) was taken as the standard population. In western countries SIRs varied from 0.8 to 2.1. In China and Japan, SIRs varied from 0.7 to 3.6. While the lowest and highest SIRs differed by a factor of 5, only 6 of the 37 studies yielded a SIR of more than 2.0 or below 0.75. Of these, 4 were from China and Japan. The highest ratios were based on a very intensive door-to-door survey and probably should not be compared to less intensive studies. We conclude that world-wide variation in age-sex adjusted stroke rates is relatively small.

Adult↗
PubMed1986

Unruptured intracranial aneurysm and transient focal cerebral ischemia: a follow-up study.

Transient focal cerebral ischemia may occasionally be due to distal embolization of a clot from an unruptured intracranial aneurysm. Follow-up data in 12 such patients revealed no ischemic strokes, subarachnoid or parenchymal hemorrhages in a mean follow-up period of 6.5 years. The aneurysms ranged in size from 2 to 12 mm in diameter, and only two were larger than 10 mm. Two patients had clip ligation of the aneurysm, five patients were given platelet antiaggregation therapy, one was given oral anticoagulants after aortic valve surgery, and four had no specific therapy. The prognosis for unruptured aneurysms presenting with transient focal ischemia was good, regardless of therapy.

Adult↗
PubMed1986

Cerebral infarct, TIA, and lupus inhibitor.

A lupus inhibitor paradoxically prolongs phospholipid-dependent coagulation assays, but may increase risk of thromboembolism. We studied seven patients with cerebral infarcts and one with TIA who had lupus inhibitor. The average age at onset of cerebral ischemia was 41 years. Three patients had multiple cerebral ischemic events. The activated partial thromboplastin time was longer than that of controls, but usually within normal limits. Other abnormalities included biologic false-positive VDRL, antinuclear antibodies, thrombocytopenia (three patients each), and deep vein thrombosis (two patients).

Adult↗
PubMed1986

Cerebral embolism.

Explore the source record for details and available documents.

Anticoagulants↗
PubMed1986

Postmenopausal tubo-ovarian abscess.

Tubo-ovarian abscess in postmenopausal women is a distinct and rare entity. The disease is usually diagnosed on the operating table and its high rate of postoperative complications and mortality commands special attention. By presenting our experience with four cases of tubo-ovarian abscess in postmenopausal women, we would like to re-emphasize the importance of including this disease in the differential diagnosis of the surgeon and the gynecologist. Early laparotomy is essential to reduce morbidity and mortality.

Abscess↗
PubMed1986

Cerebral infarction in an adult with disseminated varicella.

A 26-year-old patient with disseminated varicella developed a cerebral infarction 11 days into the illness. Cerebral infarction, typically delayed, is primarily reported in association with zoster with only one previous report in primary varicella. The mechanism is speculative and thrombosed vessels with and without vasculitis have been demonstrated. Our patient showed mild evidence of systemic alteration in immune function, suggesting the possibility of vasculitis.

Adult↗
PubMed1986

Subarachnoid hemorrhage at an inner-city hospital.

We evaluated the clinical manifestations, treatment, and outcome of a group of inner-city patients with subarachnoid hemorrhage. Twenty-one patients had surgical therapy and sixteen patients were managed with supportive measures. Patients were graded according to their clinical condition on initial presentation. Those with a favorable outcome tended to be in better condition initially. The surgical mortality was 14% and decreased substantially for the group of patients in optimal clinical condition. Cerebral vasospasm was more frequent with a poor clinical state and was associated with an unfavorable outcome. Inner-city patients with subarachnoid hemorrhage seemed to fare no worse than the general population.

Adolescent↗
PubMed1986

Aspirin, anticoagulants, and hemorrhagic conversion of ischemic infarction: hypothesis and implications.

Anticoagulation may exacerbate possible tendencies for an ischemic infarction to become hemorrhagic. Little is known of any potential added risk of aspirin plus anticoagulation for such hemorrhagic transformation. A patient is reported who sustained a cerebral infarction from carotid artery disease and was treated with aspirin. Anticoagulation was begun and aspirin discontinued when the patient experienced a transient ischemic attack. Despite good control of anticoagulation, the patient sustained a hemorrhage at the site of infarction. The prolonged effects of aspirin combined with anticoagulants may have potentiated the conversion of an ischemic to a hemorrhagic infarction. Caution is advised when using anticoagulation immediately following aspirin therapy in patients with cerebral infarction.

Anticoagulants↗
PubMed1986

The effect of vegetarian diets on plasma lipid and platelet levels.

Vegetarians have an apparent diminished risk for the development of ischemic coronary heart disease. This may be secondary to dietary effects of plasma lipids and lipoproteins, but platelets, which may also play a role, have also been observed to have aberrant functions in vegetarians. We measured plasma lipid and lipoprotein levels, platelet function, platelet fatty acid levels, and platelet active prostaglandins in ten strict vegetarians (vegans), 15 lactovegetarians, and 25 age- and sex-matched omnivorous controls. The most striking observations were a highly significant rise in platelet linoleic acid concentration and a decline in platelet arachidonic acid concentration in both vegetarian subgroups as compared with omnivorous controls. Serum thromboxane and prostacyclin levels as well as results of platelet aggregation studies did not differ among the groups tested. Cholesterol levels were significantly lower in both vegetarian groups as compared with controls, but plasma high- and low-density lipoprotein levels were lower only in the vegan subgroup as compared with omnivores. If diet produces these changes in platelet fatty acid and plasma lipid levels it may contribute to the decreased risk of coronary heart disease and possibly atherosclerosis in vegetarians.

Adult↗
PubMed1985

Tissue plasminogen activator reduces neurological damage after cerebral embolism.

Intravenous administration of tissue plasminogen activator immediately after the injection of numerous small blood clots into the carotid circulation in rabbit embolic stroke model animals caused a significant reduction in neurological damage. In vitro studies indicate that tissue plasminogen activator produced substantial lysis of clots at concentrations comparable to those expected in vivo, suggesting that this may be the mechanism of action of this drug. Drug-induced hemorrhages were not demonstrable. Tissue plasminogen activator may be of value for the immediate treatment of embolic stroke.

Animals↗