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Biomedical subjects

M Ravid

Publications and source records attributed to M Ravid.

At least 109 records · Page 6Linked to original sources

Portal hypertension as an early manifestation of carcinoma of the pancreas.

Massive hematemesis followed by 48 hours the onset of obstructive jaundice in a previously asymptomatic 38-year-old male patient. Splenomegaly was the only abnormal physical finding. Esophagoscopy visualized bleeding varices. The liver scan was normal. Dilated intra- and extrahepatic bile ducts and a possible retroperitoneal mass were demonstrated by ultrasonography. Laparotomy disclosed the presence of a carcinoma of the head and body of the pancreas that obstructed the common bile duct and the portal vein. This case report should draw attention to the vast spectrum of rare presentations of pancreas carcinoma.

Adult↗

Therapy of digoxin intoxication in dogs by specific hemoperfusion through agarose polyacrolein microsphere beads-antidigoxin antibodies.

The usefulness of a new biocompatible, specific immunosorbent, Agarose-Polyacrolein Microsphere Beads--Antidigoxin antibodies (APAMB-AD) for hemoperfusive removal of digoxin in digoxin intoxicated dogs is described. The sorbent contains antidigoxin antibodies covalently bound to polyacrolein microspheres, 0.2 micron in diameter. Thousands of microspheres are matrix-encapsulated in cross-linked agarose to form beads 500 to 800 micron in diameter. The sorbent removes digoxin specifically, leaving other components of the blood intact, in contrast to the nonspecific sorbents (charcoal and ion exchange resins) currently in use. Digoxin-intoxicated dogs looked ill, vomited, and their ECGs showed malignant arrhythmias which were reversed during the first hour of hemoperfusion. By 2 hours of hemoperfusion, the ECG tracings returned to the preintoxication state. Up to 27% of the total body digoxin burden was removed. The sorbent is biocompatible. Neither the formed elements nor a battery of the routinely assayed soluble components of the blood or complement (C'4) were altered significantly during the hemoperfusion trials. The dogs tolerated the hemoperfusion well and all survived the intoxication. Nonhemoperfused dogs or dogs whose blood was hemoperfused through beads lacking antidigoxin did not survive the digoxin intoxication.

Acrolein↗

Importance of early radiologic diagnosis of congenital anomalies of the spine.

Manifest or occult spinal dysraphism in the absence of neurological symptoms is likely to remain undetected. Therefore, accurate and early diagnosis of such underlying anomalies is of prime importance for early surgical intervention in order to avoid late irreparable damage. During a period of just over 1 year, 17 such cases of spinal congenital anomalies were diagnosed by myelography with metrizamide and computed tomography-myelography. There were 16 cases of tethered cord, six with myelomeningocele, two with diastematomyelia, two with a split spinal cord, three with a lipoma, and the remaining three with vertebral anomalies. Scoliosis was present in 60%, weakness of both legs in 45%, and asymmetry of the feet in 25%. Some of these patients were initially brought to the orthopedic department for corrective surgery before undergoing a complete neurological evaluation; thus the radiologist was acting as the link between patient and neurosurgeon. Clinical experience has shown that surgical treatment can be successful and can thereby obviate further progression of neurological symptoms.

Adolescent↗

Treatment of diabetic perforating ulcers (mal perforant) with local dimethylsulfoxide.

Perforating foot ulcers constitute a major problem in diabetics with peripheral neuropathy for which no specific therapy is available. Twenty patients with chronic, resistant mal perforant were treated by local application of dimethylsulfoxide (DMSO) solution. Complete healing of the ulcers was achieved in 14 patients following 4-15 weeks of daily treatment. Partial resolution was observed in another four patients, and in the remaining two there was no effect. A control group, equal in number, was treated conventionally. Complete healing of the ulcers took place in only two patients. The therapeutic effect of DMSO most probably results from an increase in tissue oxygen saturation via a combined mechanism of local vasodilatation, decreased thrombocyte aggregation, and increased oxygen diffusion. Local DMSO is effective, simple, devoid of systemic side effects, and inexpensive. It should be employed for diabetic foot ulcers prior to the consideration of surgical measures.

Aged↗

Favorable response to aggressive chemotherapy in a patient with primary plasma cell leukemia.

Primary plasma cell leukemia was diagnosed in a previously healthy 58-year-old man. The unusual presentation with concomitant multiple osteolytic lesions and hepatosplenomegaly, the favorable response to aggressive chemotherapy with COAP, and the relatively long survival of 22 months prompted this report. This and several other cases recently reported should encourage an aggressive therapeutic approach to this disease.

Antineoplastic Combined Chemotherapy Protocols↗

Analgesic effect of ceruletide compared with pentazocine in biliary and renal colic: a prospective, controlled, double-blind study.

The analgesic effect of ceruletide in biliary and renal colic was evaluated by a randomized, double-blind study in 82 patients. Ceruletide was compared with pentazocine, a well-established analgetic agent. Rapid and effective analgesia was obtained by intramuscular injection of ceruletide 0.5 micrograms/kg in 56 patients with biliary colic. The analgesic effect of ceruletide compared well with pentazocine 0.5 mg/kg im, and was associated with remarkably fewer side effects. In 26 patients with renal colic, ceruletide was significantly inferior to pentazocine. These data support the recommendation of ceruletide as a first-choice analgetic agent for biliary colic.

Adult↗

Ascorbic acid-induced regression of amyloidosis in experimental animals.

Ascorbic acid was found to accelerate amyloid degradation in an experimental animal model. Based on experiments in vitro which demonstrated the ability of ascorbic acid to restore the amyloid-degrading activity of amyloidotic human serum, the effect of orally administered ascorbic acid was tested in casein-induced murine amyloidosis. Histopathological examination of splenic tissue of mice killed at different times after the termination of the amyloidogenic stimulus showed a markedly decreased amyloid deposition in ascorbic acid-treated animals as compared to the controls. The effect of ascorbic acid was to a certain degree dose-dependent. Colchicine blocked amyloid synthesis when administered during amyloid induction. In animals which were given the drug during the post-induction period it had no effect. The amyloid-degrading activity of mouse serum was reduced in amyloidotic mice. Administration of ascorbic acid partially restored the amyloid-degrading activity of these animals.

Amyloidosis↗

The relative antihypertensive potency of propranolol, oxprenolol, atenolol, and metoprolol given once daily. A double-blind, crossover, placebo-controlled study in ambulatory patients.

The antihypertensive effect of four beta-blocking agents given once daily was compared with that of placebo in a prospective, crossover, double-blind study of 150 patients. The preparations tested were slow-release propranolol hydrochloride, 160 mg, atenolol, 100 mg, slow-release oxprenolol hydrochloride, 160 mg, and metoprolol, 200 mg. Propranolol and atenolol produced a significant decline in lying, standing, and postexercise blood pressure and pulse rate values. The effects of oxprenolol and metoprolol were not significantly different from that of placebo.

Adult↗

Recurrent agranulocytosis induced by two different antithyroid agents.

A 45-year-old woman with thyrotoxicosis developed agranulocytosis after treatment with propylthiouracil. When the thyrotoxicosis recurred, accompanied by a severe psychotic reaction, administration of antithyroid medication was recommenced. The patient was given methimazole instead of propylthiouracil but, 10 weeks later, agranulocytosis again occurred. This is, to the best of our knowledge, the first report of a case in which agranulocytosis followed treatment with both propylthiouracil and methimazole in the same patient.

Agranulocytosis↗

The protective effect of dimethyl sulfoxide in experimental ischemia of the intestine.

Experiments with two models of intestinal ischemia were performed in order to examine the protective effect of dimethyl sulfoxide (DMSO). Segmental ischemia of the small intestine for 150 minutes caused necrosis of the affected bowel in 90% of the animals. Intravenous administration of DMSO or impregnation of the peritoneum with this substance prevented the development of gangrene in 28 of 29 rats. 30 or 60 minutes of complete ischemia of the small intestine, produced by clamping of the superior mesenteric artery, resulted in partial or complete necrosis of bowel segments with a high incidence of perforation and peritonitis and a high mortality rate within the first 24 hours. Intravenous DMSO, given upon declamping of the artery, effectively protected the bowel from the ischemic damage. There were no deaths among DMSO-treated animals and at 24 h there was no evidence of ischemic damage to the intestine. Though the exact mechanism of action of DMSO is unknown, the results of these and other experiments may warrant clinical trials especially in cases of mesenteric thrombosis.

Animals↗

Dimethyl sulfoxide in acute ischemia of the kidney.

Renal ischemia was produced in rats by clamping of the renal artery for 1 h. Upon termination of the ischemic period a 20% solution of DMSO (5 g kg-1 b.w.) was given intravenously to 33 rats. Eighteen control animals received normal saline. All DMSO-treated animals survived while all control animals died within the subsequent seven days. At 24 h following the experiment, the mean blood urea of the control rats was 254 mg/100 ml and the mean plasma creatinine 7.2 mg/100 ml. By contrast, the DMSO-treated rats had a mean blood urea of 69 mg/100 ml and plasma creatinine of 1.6 mg/100 ml. In 17 animals the kidney was perfused with DMSO prior to the closure of the renal artery. All these rats survived the procedure and showed near normal kidney function at 24 h. The renal artery was clamped for 60 min in ten dogs. Five dogs received DMSO (3 g kg-1 b.w.) and the other five received an equivalent dose of normal saline. Three weeks later a contralateral nephrectomy was performed. Renal function was normal in the DMSO-treated dogs. One control dog died of uremia, in the remaining four a transient renal failure was observed. These experiments in two different animals highlight the protective effect of DMSO on the ischemic kidney when the drug is administered after the ischemic period.

Acute Kidney Injury↗