Flank pain as a presentation of pulmonary embolism.
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Abdominal Pain↗
Biomedical subjects
N Kaminski
Publications and source records attributed to N Kaminski.
Regression of Kaposi's sarcoma after intravenous immunoglobulin treatment for polymyositis.
The authors report on the case of a patient with polymyositis who was given immunosuppressive therapy and then developed Kaposi's sarcoma. Subsequently, the polymyositis was treated with high dose intravenous immunoglobulin, and the Kaposi's sarcoma regressed abruptly. The association between these two diseases and the beneficial effect of intravenous immunoglobulin on Kaposi's sarcoma are discussed.
Humans↗
Acute bacterial diarrhoea in the emergency room: therapeutic implications of stool culture results.
Empiric treatment with ciprofloxacin and norfloxacin has been recommended recently for patients with acute diarrhoeal disease. In a retrospective 6-month study period the results of stool cultures from 209 patients with acute diarrhoea admitted to the emergency room were analysed. Seventy-eight cultures (37%) were positive for one or more bacteria. Shigella was the most commonly isolated pathogen (68%). Shigella sonnei comprised 72% and Shigella flexneri 19% of all the bacterial isolates. While no antimicrobial resistance to ciprofloxacin was found for both Shigella species, only 36 and 26% of the Shigella isolates were sensitive to ampicillin and trimethoprim-sulfamethoxazole (TMP-SMZ), respectively. These findings point out to the emergence of drug resistance to commonly used antimicrobial drugs. Shigella's high sensitivity to the newer quinolones should make this the treatment of choice for the very sick patient, although physicians should be cautioned to the fact that indiscriminate use of this drug could result in the emergence of resistance similar to that noted with ampicillin and TMP-SMZ.
Acute Disease↗
Primary tumours of the duodenum.
Six primary duodenal tumours were diagnosed in our 300 bed institute during a period of 10 years. Two patients had benign tumours (leiomyoma and carcinoid) and four had malignant tumours (adenocarcinoma). The most common manifestation was severe iron deficiency anemia. Diagnosis was usually delayed (with a mean time of 7.7 months from initial complaints), endoscopy being the most common and useful diagnostic tool. A curative procedure was performed in two patients. Patients with unexplained chronic iron deficiency anaemia should undergo thorough gastrointestinal evaluation, including the small intestine, as a curable disease may be found to be the source of the complaint.
Adenocarcinoma↗
Effects of perfusion pressure and renal flow upon albumin excretion in isolated perfused kidneys.
To explore the effects of renal hemodynamics upon urinary albumin excretion, sequential changes in perfusion pressure and/or flow were performed in isolated perfused rat kidneys. Elevation of perfusion pressure from 90 to 130 mm Hg increased renal flow from 48.9 +/- 1.1 to 54.3 +/- 1.4 ml/min and glomerular filtration rate (GFR) from 0.37 +/- 0.03 to 0.81 +/- 0.06 ml/min (p less than 0.001). Despite more than a doubling in GFR, albumin excretion remained unchanged (from 252 +/- 53 to 167 +/- 36 micrograms/min, p not significant), resulting in a decreased fractional clearance of albumin (theta) from 0.009 +/- 0.002 to 0.004 +/- 0.005 ml/min (p less than 0.01). To dissociate the effects of flow from those of pressure, angiotensin II was infused to decrease renal flow from 49.9 +/- 0.6 to 38.7 +/- 0.6 ml/min (p less than 0.001), while keeping perfusion pressure constant at 96 +/- 1 mm Hg. Although GFR was essentially unchanged (from 0.59 +/- 0.02 to 0.65 +/- 0.05 ml/min, p not significant), albumin excretion increased from 68 +/- 8 to 151 +/- 21 micrograms/min (p less than 0.001) and theta rose from 0.002 +/- 0.000 to 0.005 +/- 0.001 (p less than 0.02). Whole kidney hemodynamics acutely affect renal excretion of albumin in isolated kidneys.
Albuminuria↗
Metabolic abnormality induced by streptomycin.
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Adult↗
Dopamine increases renal medullary blood flow without improving regional hypoxia.
The effects of dopamine (10 micrograms/kg/min i.v.) upon intrarenal microcirculation, total, superficial cortical and outer medullary blood flows and outer medullary pO2 were continuously determined in anesthetized rats with ultrasonic and laser-Doppler probes and oxygen microelectrodes. While total and cortical flows were unaffected, outer medullary flow increased by 35 +/- 5% (mean +/- SE, p < 0.01). Outer medullary pO2 was not significantly altered (from 16 +/- 4 to 18 +/- 4 mm Hg). In volume-expanded rats total and cortical flows rose as well. In rats pretreated with indomethacin, with or without N omega-nitro-L-arginine methyl ester HCl, dopamine restored renal microcirculation and ameliorated outer medullary hypoxia.
Animals↗