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Biomedical subjects

M Vaisman

Publications and source records attributed to M Vaisman.

24 records · Page 2Linked to original sources
PubMed1991

Computed tomography and ultrasonography of the adrenal glands in paracoccidioidomycosis. Comparison with cortisol and aldosterone responses to ACTH stimulation.

Fifteen patients with proven disseminated paracoccidioidomycosis (PCM) had computed tomography (CT) and ultrasonography (US) performed to evaluate the form, shape, density and size of their adrenal glands. Plasma and urinary cortisol were determined and adrenal reserve assessed by measuring the cortisol and aldosterone responses to synthetic ACTH. The adrenal CT showed unilateral lesions in two cases and bilateral in another four. The US study showed more frequent alterations, unilateral in seven and bilateral in three subjects. Combining both methods increased the sensitivity to 85% of the cases. All patients had normal plasma cortisol concentrations and normal or increased urinary cortisol excretion. Plasma aldosterone concentration was also normal except in one patient with hypokalemia. Seven patients showed diminished cortisol responses, five had subnormal aldosterone responses and in five plasma aldosterone concentration increased more than normally after stimulation by ACTH. There was an incidence of limited adrenal reserve in 53% of the patients on ACTH stimulation. No correlation was evident between the disorders in adrenal steroid responses to ACTH and changes in morphology revealed by CT and/or US.

Adrenal Glands↗
PubMed1979

Treatment of symptomatic retinal breaks.

Forty-three patients with symptomatic retinal breaks were treated with photocoagulation and a comparable group of 43 patients were treated with cryopexy. All patients had either a vitreous hemorrhage, or photopsia and floaters. Most of the breaks were of the horseshoe type. Of the patient eyes, 14% (six patients) in both groups developed new retinal tears without detachment during the long term postoperative observation. The new breaks were treated with the method used for the original breaks, and no scleral surgery was necessary. The incidence of retinal detachment was 7% in patients treated with photocoagulation and 11.6% in patients with cryocoagulation, but two cases that developed retinal detachment arising from new tears years after the initial procedure were included.

Cryosurgery↗
PubMedDate not supplied

[Thyroid function tests in viral chronic hepatitis].

BACKGROUND: One hundred and twenty five patients with virus B or C chronic active hepatitis and postnecrotic cirrhosis and different degrees of liver dysfunction were studied. AIM: 1) To determine a thyroid hormonal profile; 2) to evaluate the prognostic value of these tests in relation to the progression of the disease and mortality; 3) compare these findings with Child-Pugh classification. PATIENTS AND METHODS: The patients were divided in four groups: a) 31 with chronic active hepatitis; b) 41 with postnecrotic cirrhosis Child A; c) 35 with postnecrotic cirrhosis Child B and d) 18 with postnecrotic cirrhosis Child C. The protocol comprised serum measurements of albumin and bilirrubin, estimates of prothrombin time and clinical evaluation of ascites and encephalopathy, measurement of total serum triiodothyronine, thyroxine, thyroid-stimulating hormone, free thyroxine, reverse triiosothyronine, calculated rT3/T3 index (IrT3) and thyrotropin-releasing hormone test. RESULTS: Total serum triiodothyromnine showed the most significant difference among the groups, gradually lower as the disease became more advanced (CAH: 149.2 +/- 42.3 ng/dL; PNC-A: 137.4 +/- 37.2 ng/dL; PNC-B: 88.0 +/- 28.4 ng/dL and PNC-C: 41.8 +/- 21.9 ng/dL). Low levels of T4 (4.5 +/- 2.0 micrograms/dL) and FT4 (0.7 +/- 0.4 ng/dL) and elevated levels of thyroid-stimulating hormone (7.2 +/- 11.5 microIU/mL), reverse triiosothyronine (60.8 +/- 52.1 ng/dL) and calculated rT3/T3 index (2.2 +/- 2.6) were more frequent in patients with postnecrotic cirrhosis Child C. Thyrotropin-releasing hormone test was normal in the majority of the patients. CONCLUSION: The present study shows a positive relationship between the low serum levels of T3 and elevated serum levels of rT3 and IrT3/T3 with the degree of hepatic dysfunction according to the Child-Pugh classification.

Hepatitis B, Chronic↗
PubMedDate not supplied

Acromegaly and non-Hodgkin's lymphoma.

OBJECTIVE: To present the fourth case report of development of a non-Hodgkin's lymphoma in a patient with active acromegaly. METHODS: We describe the clinical, laboratory, and imaging findings in a patient with untreated acromegaly in whom a large cell non-Hodgkin's lymphoma developed. RESULTS: Acromegaly is associated with several comorbid conditions. Among these is a higher incidence of several types of visceral malignant lesions, especially carcinoma of the colon. Growth hormone stimulates the hepatic production of somatomedins, such as insulin-like growth factors, which are known promoters of human growth and have also been implicated in tumorigenesis. In recent years, several cases of lymphoproliferative diseases have also been noted in patients with acromegaly. These conditions include multiple myeloma, lymphoma, and leukemia; three previous cases of non-Hodgkin's lymphoma have been described. In our patient, a 57-year-old man with acromegaly, magnetic resonance imaging of the pituitary gland disclosed a large intrasellar mass. Large cell non-Hodgkin's lymphoma was diagnosed. Six months of chemotherapy yielded complete remission. CONCLUSION: An additional case of non-Hodgkin's lymphoma in a patient with acromegaly supports the accumulating evidence of an increased risk for development of cancer in such patients.

Journal Article↗
PubMedDate not supplied

Orbital lymphoma misdiagnosed as Graves' ophthalmopathy.

OBJECTIVE: To describe a case of bilateral orbital lymphoma mistakenly diagnosed as Graves' ophthalmopathy. METHODS: We present a case report, with laboratory data and photographic documentation, and discuss the differential diagnosis in patients with orbital masses. RESULTS: A 65-year-old man with bilateral exophthalmos and substantial weight loss was referred to the Endocrine Clinic for evaluation of possible Graves' disease. A 6-cm mass was detected in the left axilla. Biopsy of this mass revealed the histopathologic diagnosis of anaplastic B-cell lymphoma. Treatment with intrathecally administered methotrexate and orally administered dexamethasone promptly resulted in decreased proptosis. CONCLUSION: The most frequent cause of bilateral proptosis is Graves' ophthalmopathy, and when it is associated with weight loss in an elderly patient, the initial diagnostic consideration is thyrotoxic Graves' disease. This case should remind physicians that bilateral orbital lymphoma, although uncommon, may mimic Graves' ophthalmopathy.

Aged↗