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Biomedical subjects

M J Lanska

Publications and source records attributed to M J Lanska.

36 records · Page 2Linked to original sources
PubMed1988

Syphilitic polyradiculopathy in an HIV-positive man.

We report a case of syphilitic lumbosacral polyradiculopathy in an HIV-positive, 22-year-old bisexual man with a recent history of secondary syphilis treated with intramuscular penicillin. He presented with rapidly progressive pain and weakness, and muscle wasting in the legs. CSF was under increased pressure and showed a marked pleocytosis (1,130 cells/mm3), hypoglycorrhachia (19 mg/dl), and very elevated protein (1,000 mg/dl). Serum and CSF VDRL serologies were positive. In the legs, nerve conduction studies and needle EMG were consistent with an asymmetric lumbosacral polyradiculopathy with active denervation. His clinical state, CSF, and electrophysiologic studies all improved promptly and markedly after intravenous penicillin. This report documents an uncharacteristically aggressive case of neurosyphilis accompanied by marked changes in the CSF in an HIV-positive patient. While the immunologic effects of HIV and syphilis in combination are not yet fully understood, the cellular immunity defect associated with HIV may alter the natural history of syphilis in patients with concomitant infection, producing unusually aggressive forms or atypical presentations of neurosyphilis.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Factors influencing anatomic location of fat tissue in 52,953 women.

Data from a cross-sectional, questionnaire-based study of women was undertaken to determine factors associated with the anatomic distribution of body fat. The women studied were members of TOPS, Inc. (Take Off Pounds Sensibly), a non-profit organization dedicated to weight reduction. Recent evidence suggests that anatomic location of body fat has prognostic significance for some chronic conditions. The simple ratio of waist girth to hip girth can be used to estimate the location of body fat. Using this ratio as an index we found that increased age and higher body weight were significantly associated with greater fat deposition in the waist areas as compared to the hip areas. The effects of age and current obesity level were independent and could not be accounted for on the basis of parity, menopausal status, or obesity history. Furthermore, though obesity history and parity were significantly associated with the waist-hip ratio, they were relatively unimportant, together explaining less than one percent of the observed variation in the ratio. No association could be found between body fat distribution and menopausal status. Our findings do not support previous work which suggested that menopausal status and obesity history were important determinants of body fat location.

Adipose Tissue↗
PubMed1985

A prospective study of body fat distribution and weight loss.

Previous studies have suggested an association between adipose tissue cellularity and body fat distribution, and between adipose tissue cellularity and ability to lose weight. To determine whether there was an association between body fat distribution and ability to lose weight, we prospectively studied 187 severely obese women. The women were all 50 percent or more above ideal body weight, with personal physician documentation of no known major illnesses. Weights were recorded at the beginning and end of a 3-week hospitalization and every 3 months following hospitalization, for up to 2 years. The ratio of waist girth to hip girth (WHR) was used as an index of body fat distribution. A statistical analysis which adjusted for age and weight on admission did not find any association between WHR and weight loss during hospitalization, or at any time up to 2 years after hospital discharge. We conclude that the WHR index of body fat distribution is not a useful prognostic indicator of weight change for severely obese women with refractory obesity.

Adipose Tissue↗
PubMed1984

Effect of rising percentage of female physicians on projections of physician supply.

The Graduate Medical Education National Advisory Committee (GMENAC) in 1980 projected a surplus of 145,000 physicians in the year 2000. Inherent in the GMENAC prediction are several assumptions, including the assumption that the current percentage of female physicians will remain unchanged. However, the number of female physicians is increasing at a rapid rate. Since it has been estimated that female physicians work 40 percent fewer hours during their lifetimes than their male counterparts, the increasing percentage of female physicians will result in a decrease in overall physician productivity as measured by total practice hours. Using an adjustment to the GMENAC model that will take into account the changing male/female ratios of physicians, the estimated physician surplus in the year 2000 is reduced by 41,000 physicians, or approximately 28 percent of the GMENAC-predicted surplus.

Adult↗
PubMed1984

Atrial fibrillation.

Explore the source record for details and available documents.

Alcoholic Intoxication↗
PubMedDate not supplied

Effect of resident turnover on patients' appointment-keeping behavior in a primary care medical clinic.

In this study of 208 patients attending a Primary Care Medical Clinic of a metropolitan teaching hospital, objective measurements were used to assess the effect of discontinuous care as a result of resident turnover on patient appointment-keeping behavior. A change of resident resulted in no significant difference in return visit failure rate, subsequent appointment-keeping rate, or number of patients expressing new problems or requiring chronic therapy plan changes.

Adult↗
PubMedDate not supplied

Presentation, clinical course, and outcome of childhood stroke.

We reviewed the presentations, clinical courses, and outcomes of 42 children with unilateral hemispheric stroke. Infants with strokes identified within the first few days of life usually presented with seizures. These infants had few abnormal neurologic findings as neonates, but hemiparesis became evident as gross motor development proceeded. Infants with strokes identified later in the first year of life usually presented with pathologic early hand preference without a history of an ictus. During subsequent development, the motor deficits in these children became more evident, producing an apparent progression of the neurologic abnormalities. Strokes identified in older children typically presented as sudden hemiparesis, often associated with seizures. The hemiparesis in these children was most severe at the onset, followed by some improvement in strength in all patients. Functional outcome was variable. At last follow-up, all children were ambulatory, some with clinically apparent hemiparesis. Eight of the 42 children (19%) developed recurrent seizures with an onset ranging from 4 months to more than 10 years (median: 26 months) after the stroke.

Adolescent↗
PubMedDate not supplied

Visual "release" hallucinations in juvenile neuronal ceroid-lipofuscinosis.

A child with juvenile neuronal ceroid-lipofuscinosis developed formed and unformed visual hallucinations with the development of blindness. The hallucinations lasted for prolonged periods, were of simple, varied, and novel content and were not associated with any ictal manifestations. The clinical features support a "release" mechanism for the hallucinations.

Adolescent↗
PubMedDate not supplied

Serial MR studies in Menkes disease.

We describe a characteristic combination of findings in a patient with Menkes disease who was serially imaged with magnetic resonance over 2 months. Abnormal intracranial vessels were demonstrated as was the progression of white matter disease.

Brain Diseases, Metabolic↗