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Biomedical subjects

R Enat

Publications and source records attributed to R Enat.

At least 55 records · Page 3Linked to original sources
PubMed1984

Bridging hepatic necrosis in acute viral hepatitis.

Bridging hepatic necrosis has, in the past, been found to be of prognostic significance in patients with acute viral hepatitis. In two studies performed on a selected group of patients with acute viral hepatitis, one-third of the patients with bridging hepatic necrosis developed chronic liver disease. These patients differed from the average hepatitis patient in that they were more severely ill and a higher percentage of them had acute viral hepatitis Type B. As all army personnel in Israel who develop jaundice and are suspected of having acute viral hepatitis are hospitalized, regardless of their clinical state, they constitute a group of patients not preselected for severity of illness. Forty-eight soldiers diagnosed clinically and biochemically as having viral hepatitis were hospitalized during a 27-month period. After giving informed consent, 41 of them underwent a liver needle biopsy within a few days of hospitalization. Each histological specimen was coded, and was then examined for bridging hepatic necrosis by three independent observers. Fourteen patients (34%) were found to have bridging hepatic necrosis. Clinically, these patients could not be clearly separated from the group without bridging hepatic necrosis, although hepatomegaly was more frequent among them, and their mean leukocyte count and bilirubin and alkaline phosphatase levels were higher. During a follow-up of more than 1 year, patients in both groups recovered completely. Four patients, two in each group, consented to a second liver needle biopsy, which was found to be normal. We conclude that bridging hepatic necrosis seems to be more common than expected, and does not seem to have the severe prognostic significance attributed to it in the past.

Acute Disease↗
PubMed1983

Hyperglucagonemia--a partial explanation for the increased amylase/creatinine clearance in pancreatitis.

Hyperglucagonemia accompanies several clinical conditions characterized by increased amylase/creatinine clearance. We tested the hypothesis that glucagon may be responsible for this augmented clearance. Therefore, a constant glucagon infusion was given to eight volunteers in order to attain physiological levels comparable to those obtained during acute pancreatitis. The amylase/creatinine clearance increased from 0.84 +/- 0.8% to a mean of 1.30 +/- 1.14% (p less than 0.001). This was, however, less than the clearance of 2.94 +/- 0.23% observed during acute pancreatitis. The rise in amylase clearance during acute pancreatitis is, therefore, only partially explained by the hyperglucagonemia.

Acute Disease↗
PubMed1983

Ethnic differences in the incidence of postnecrotic cirrhosis in Israel: correlation with hepatitis B virus serological markers.

While immigrants from Morocco and Romania make up 7 and 6%, respectively, of the Israeli population, one-third of all postnecrotic cirrhosis patients come from Morocco and another third from Romania. The rate of hepatitis B virus (HBV) infection, as expressed by serum hepatitis B surface antigen, anti-HBs, and anti-HBc, was compared in immigrant patients with postnecrotic cirrhosis and in age and sex matched controls from the same countries. Among 19 Moroccan immigrants with postnecrotic cirrhosis 74% showed evidence of HBV infection. This was not significantly different from the prevalence of HBV infection (64%) in a matched control group of 61 Moroccan individuals. In the 26 Romanian cirrhotics, however, a significantly higher prevalance of HBV infection than in the 60 matched controls was observed (54 and 23%, respectively, p less than 0.01). The difference was detected only when anti-HBc was looked for in addition to hepatitis B surface antigen and anti-HBs. These results indicate that: 1) HBV infection and postnecrotic cirrhosis are associated in Romanian immigrants to Israel. 2) Association between HBV infection and cirrhosis in Moroccan immigrants cannot be shown because of the high infection rate in the control population. 3) Anti-HBc is often the only marker of HBV infection in cirrhotic patients, and should be examined in addition to hepatitis B surface antigen and anti-HBs in order to get meaningful results.

Adult↗
PubMed1982

Pellagra as the presenting manifestation of Crohn's disease.

An 18-yr-old woman hospitalized with classical signs of pellagra was found to have Crohn's disease of the small and large bowel as well as malabsorption of nicotinic acid and iron. The symptoms of pellagra disappeared after intramuscular treatment with nicotinic acid, while the malabsorption was corrected following steroid therapy for the Crohn's disease. Pellagra should thus be added to the list of complications of Crohn's disease that are secondary to malabsorption. Although this complication seems to be very rare, it may be worthwhile to check for nicotinic acid malabsorption in untreated cases of Crohn's disease in order to determine its real prevalence.

Adolescent↗
PubMed1981

Antibiotic-responsive malabsorption: a tropical sprue-like syndrome in countries with temperate climates.

Antibiotic-responsive malabsorption is prevalent in the tropics, but has been seen only sporadically in countries with temperate climates. We describe a 19-year-old Israeli patient who has never left the country and was hospitalized with shigellosis and malabsorption of fat and D-xylose. A short course of ampicillin reversed the malabsorption. The syndrome of antibiotic-responsive malabsorption in countries with temperate climates may well be underdiagnosed and should be looked for more actively.

Adult↗
PubMed1980

Cholestatic jaundice caused by cloxacillin: macrophage inhibition factor test in preventing rechallenge with hepatotoxic drugs.

Severe intrahepatic cholestasis occurred in a patient after taking nitrofurantoin, ampicillin, and cloxacillin. As only nitrofurantoin was known to cause cholestasis she was given cloxacillin again two years later. The cholestasis reappeared at once. A macrophage inhibition factor test confirmed that cloxacillin was the offending drug. Cloxacillin should be added to the growing list of drugs causing cholestasis. Inadvertent rechallenge with hepatototoxic drugs might be prevented by routine use of the macrophage inhibition factor test.

Aged↗
PubMed1980

Subacute bacterial endocarditis.

Two patients in whom various immunological phenomena obscured and delayed the diagnosis of subacute bacterial endocarditis (SBE) are described. Immunological abnormalities usually correlate well with the chronicity and severity of the disease, as is demonstrated here. The mechanisms underlying the various immunological phenomena are discussed. The importance of alertness to the possibility of SBE in cases of disease manifesting itself as an immunological disorder, thus achieving early diagnosis and early antimicrobial treatment, is stressed.

Adult↗
PubMed1980

Cutaneous pigmentation: a probable sign of spontaneous bacterial peritonitis.

A cirrhotic patient with ascites was apparently well managed with diuretics and salt and water restriction for 9 months. A spontaneous bacterial peritonitis (SBP) developed and the patient finally died following septic shock. There were enough findings indicating that SBP in this case had been existing silently for some time. During this period the only apparent manifestation of this complication was a cutaneous pigmentation on the abdomen. It is suggested that pigmentation may be incuded among other presentations of this frequently silent process.

Aged↗
PubMed1980

Monoarthritis with heterophil-negative infectious mononucleosis. Case of an older patient.

A patient aged 57 years with infectious mononucleosis and monoarthritis of the knee joint is described. To our knowledge, this association in elderly patients has not been reported heretofore, nor has the pathogenesis of arthritis in infectious mononucleosis been established. Because of the clinical picture and the synovial fluid findings, we suggest that the main mechanism of this arthritis is viral replication in the synovia.

Antibodies, Viral↗
PubMed1979

Ultrastructural pathology with normal light microscopy of liver in Wilson's disease. A case report.

Light microscopy findings in early Wilson's disease (hepatolenticular degeneration) may be normal even when special cytochemical stains are used. We present a case of Wilson's disease in which light microscopy was negative, while electron microscopy showed the characteristic changes in the hepatocytes. Since low serum ceruloplasmin levels and high urinary copper excretion are not by themselves definite proof of Wilson's disease, and since copper content of the liver is not universally measured, electron microscopy examination of liver tissue appears to be a worthwhile additional tool for the early diagnosis of Wilson's disease.

Adult↗