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Biomedical subjects

M Yaron

Publications and source records attributed to M Yaron.

214 records · Page 12Linked to original sources
PubMedDate not supplied

Female adnexal tumor of probable wolffian origin: a clinicopathological case report and a possible new treatment.

Female adnexal tumors of probable wolffian origin (FATWOs) are rare tumors arising in the broad ligament from the remnants of the mesonephric duct. We report a case of recurrent disease. A 15-year-old girl who presented with a painful pelvic mass underwent a laparotomy with tumor resection. Pathology findings confirmed a FATWO. The tumor recurred within 2 years and was treated with multiple chemotherapy regimens, including a platinum-based drug, and surgery for progressive disease. The tumor was positive for c-kit oncogene (CD 117). Gleevac therapy, a tyrosine kinase inhibitor, was prescribed, and she developed severe persistent lower abdominal pain 2 months later. She underwent a hysterectomy and debulking of retroperitoneal masses. Pathology showed evidence of tumor necrosis, suggesting a possible beneficial effect, and she was recommenced on Gleevac in an effort to prevent recurrences. She is currently asymptomatic, without evidence of disease 10 months after surgery, continuing on Gleevac therapy. FATWOs are very rare tumors. Most cases are benign but have the potential to recur and metastasize. There is limited knowledge about the optimal treatment for this neoplasm. Our patient's favorable response to Gleevac therapy supports the concept of targeted molecular therapy in patients with c-kit-positive FATWO tumors.

Abdominal Pain↗
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Insufficiency fractures in rheumatic patients: misdiagnosis and underlying characteristics.

OBJECTIVE: To report 9 patients with rheumatic diseases referred to our observation due to presumed exacerbation of their rheumatic disease, subsequently diagnosed as stress insufficiency fractures, and to characterize the clinical profile of patients prone to this complication. METHODS: The medical history of the patients was reviewed with special emphasis on their rheumatic disease, its course, duration and management, their menopausal state, location and characteristics of the fracture, its presentation and the initial presumed diagnosis, the delay in diagnosis, imaging diagnostic tests performed and outcome. Three representative case reports are presented. RESULTS: All 9 patients were women, 8 of them aged 50 years old or more, 8 with rheumatoid arthritis and 1 with polymyalgia rheumatica. They were all treated with corticosteroids and had reduction in their bone mass density when evaluated. Three of the patients presented with subcapital fracture of the femur, 4 had fractures of metatarsal bones and 2 had fractures of the distal tibia. In only one patient was a stress fracture initially suspected. Diagnosis was delayed by a mean of 31 days. CONCLUSION: The diagnosis of stress fractures in patients with rheumatic diseases may often be delayed or missed, and thus improperly treated. Increased awareness of this entity is of importance for prompt diagnosis and correct management.

Adult↗
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Restrictive lung disease due to diaphragmatic dysfunction in systemic lupus erythematosus. Two case reports.

Two patients with systemic lupus erythematosus and unexplained dyspnea are described. Both had severe dyspnea and a restrictive lung function pattern without any apparent specific pathology. Both patients initially responded to corticosteroids and/or immunosuppression; one patient, however, relapsed and eventually died. Many factors may contribute to this syndrome, including diaphragmatic dysfunction, splinting of the diaphragm, pleuritis, atelectasis and respiratory muscle dysfunction. This syndrome, which may respond to steroids or immunosuppressive treatment, must be considered in SLE patients with dyspnea lacking a concrete underlying cause.

Adult↗
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Induction of acute synovitis in the rat by human interferon.

Intra-articular injection of human interferon (alpha, beta or gamma) into rat knee joints induced increases in knee diameter, synovial effusion and synovial membrane weight. An inflammatory cell infiltrate was also noted in synovial membranes. Hydrocortisone diminished the inflammatory response when injected together with interferon. Mouse beta interferon did not produce synovitis in rat knees. These results further support the hypothesis that interferon may play a role in the pathogenesis of human arthritis.

Animals↗
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Abdominal fat tissue aspirate in amyloidosis of familial Mediterranean fever.

Abdominal fat tissue aspirates from 20 patients with biopsy-proved amyloidosis were investigated by polarized microscopy after staining with Congo-red. Positive results were obtained in 4 of 5 patients with primary amyloidosis (AL) and in none of 15 with amyloidosis (AA) of Familial Mediterranean Fever (FMF). We suggest that although this technique is simple, safe and effective in other forms of amyloidosis, it cannot be used as a diagnostic tool in FMF patients suffering from amyloidosis.

Abdomen↗
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Stimulation of prostaglandin E production by rat synovium induced by intraarticular injection of measles virus.

Measles virus was injected into the joints of rats. Prostaglandin E in organ cultures of synovial tissue removed from injected joints was evaluated. A 9-fold increase of prostaglandin E concentration was found in cultures of synovial membranes from joints injected with measles virus as compared to controls. Histologic examination revealed inflammation in the synovial membranes of joints injected with virus. We suggest that prostaglandin E may mediate joint inflammation induced by measles virus.

Animals↗
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Oxygen saturation in children living at moderate altitude.

BACKGROUND: Physicians caring for newborns and infants residing at or traveling to moderate altitude have little information available about the normal range for arterial oxygen saturation (SaO2) measured by pulse oximetry. To aid clinicians in making rational decisions about the oxygen status of children at moderate altitude, we measured SaO2 in newborns and infants who came to two family practice offices located at an altitude of 2800 meters (9000 feet) to obtain normal values for both well-child and illness visits. METHODS: SaO2 measured by pulse oximetry was recorded for children younger than 2 years seen consecutively in a family practice clinic for care for any reason. The children all resided at an altitude of 2800 m (9000 ft). RESULTS: The mean SaO2 for healthy awake infants was 91.7 percent, significantly lower than the reported normal ranges for either sea level or Denver. Saturation levels in infants with minor acute illnesses did not differ from saturation levels in healthy infants, while infants with lower respiratory tract infections had significantly lower SaO2 measurements. CONCLUSIONS: SaO2 levels are significantly lower in newborns and infants living at moderate altitude. Measurement of SaO2 at moderate altitude can be helpful in the care of both healthy and ill newborns or infants.

Altitude↗
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Jaccoud's arthropathy and psoriatic arthritis.

A patient with long-standing psoriatic arthritis developed an arthropathy of the hands characterized by subluxations of the metacarpophalangeal joints without erosive changes. This is to the best of our knowledge the first reported case describing Jaccoud's arthropathy associated with psoriatic arthritis.

Arthritis, Psoriatic↗
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Multidisciplinary approach to chronic back pain: prognostic elements of the outcome.

OBJECTIVE: This study presents an evaluation of a multidisciplinary approach to patients with chronic back pain. METHODS: Sixty-seven patients with back pain of more than three months duration participated in a comprehensive 4 week program which included back schooling, psychological intervention, and treatment by acupuncture, chiropractic, the Alexander technique and a pain specialist. At admission to the study, patients were asked to complete a questionnaire concerning their socio-demographic background and disease history. Patients also underwent a psychological evaluation based on a questionnaire and an interview. On the basis of this evaluation, patients were graded on three criteria: (i) predominance of psychological factors; (ii) secondary gain; (iii) personality features. At the end of the treatment, patients were divided into three groups according to their degree of improvement. Patients were evaluated at the end of the four week program and after 6 months of follow up. RESULTS: Significant improvement in the pain rating, pain frequency and analgesic drug consumption was observed in the treatment group, and was maintained for a period of 6 months. Satisfactory outcome was correlated to a moderate predominance of psychological factors, good functioning, a high level of motivation, and family support. Poor outcome was associated with a divorced marital status and unemployment, diffuse complaints, post surgery status, a high predominance of psychological factors, and the presence of secondary gain and personality disorders. CONCLUSION: Patients with chronic back pain seem to benefit from this proposed multidisciplinary approach. The improvement was maintained for a period of 6 months. Outcome was clearly related to psychosocial factors.

Acupuncture Therapy↗
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Transient regional osteoporosis with antiphospholipid antibodies: a report of two cases.

We describe two patients with clinical, radiological and laboratory findings consistent with transient regional osteoporosis. In both cases antinuclear and antiphospholipid antibodies were found with no evidence of any other autoimmune disease. Both patients were smokers. We suggest transient ischemia caused by antiphospholipid antibodies as a possible etiological factor in this rare and poorly understood syndrome, and hypothesize that anticoagulants and abstinence from smoking may play a role in the prevention of recurrence in these patients.

Antibodies, Antinuclear↗
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Sleep disturbances, fibromyalgia and primary Sjögren's syndrome.

OBJECTIVE: To investigate the association and prevalence of sleep disturbances and fibromyalgia (FM) in a group of patients with primary Sjögren's syndrome (pSS). METHODS: Sixty-five patients with pSS were investigated. A 10-point Mini Sleep Questionnaire (MSQ) was completed focusing on sleep complaints. The same questionnaire was also used in three control groups: Group A-67 patients with rheumatoid arthritis. Group B-53 patients with rheumatoid arthritis (RA) and sicca symptoms; Group C-31 patients with osteoarthritis. All patients with pSS were also studied fro the presence of FM. RESULTS: Moderate or severe sleep disturbances were reported by 49 out of 65 pSS patients (75%). This frequency was significantly higher than that reported by patients in the three control groups (p < 0.001). FM was present in 36 out of 65 pSS patients (55%) and was associated with sleep disturbances. FM or sleep disturbances were not associated with any clinical or laboratory parameters. CONCLUSION: Our results suggest that sleep abnormalities and FM in pSS patients are frequent and their etiology might involve other mechanisms besides joint pain or sicca symptomatology.

Aged↗
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Polymyalgia rheumatica in patients with ankylosing spondylitis: a report of 5 cases.

OBJECTIVE: To report the cases of 5 elderly male patients with ankylosing spondylitis (AS) who developed polymyalgia rheumatica (PMR). MATERIALS AND METHODS: The files of 5 patients with AS who developed PMR were retrospectively reviewed. The demographic, clinical, laboratory characteristics and outcome of these patients were summarized. RESULTS: All 5 patients were male, 65-80 years old at the time of their PMR diagnosis. The diagnosis of AS was made simultaneously based on clinical and radiological data; the age at onset of symptoms retrospectively attributable to AS was 20-40 years in three cases, while in the two other patients it could not be determined. The patients presented with typical symptoms of PMR and responded to steroid treatment. HLA B27 was found in three cases, while HLA DR did not show a consistent pattern. CONCLUSIONS: The coexistence of AS and PMR could be more than coincidental. Further screening of both patient populations is needed to assess the true extent of this preliminary observation.

Aged↗