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R Rabinovici

Publications and source records attributed to R Rabinovici.

69 records · Page 4Linked to original sources
PubMed1990

Acute surgical abdominal disease in chronic schizophrenic patients: a unique clinical problem.

From our experience with chronic schizophrenic patients treated for acute intra-abdominal surgical disease, we present seven examples of this unique clinical condition. In all seven cases the decision to operate was preceded by considerable delay, owing to misleading medical history, patient behavior, and the lack of definitive signs of peritonitis. The intra-operative findings were unexpected, and in all cases the disease had reached an advanced stage. As chronic schizophrenic patients have a distorted perception of pain and seldom demonstrate a clinical picture commensurate with the disease, we advocate that a higher index of suspicion be assigned to these patients than to the average acutely ill patient.

Abdomen, Acute↗
PubMed1990

Protective effect of BN 50739, a new platelet-activating factor antagonist, in endotoxin-treated rabbits.

Platelet-activating factor (PAF) has been demonstrated in the circulation and organs of animals exposed to gram negative endotoxins, whereas PAF antagonists have been shown to exhibit some efficacy in modifying the course of endotoxemia. In this study we evaluated BN 50739, a novel specific PAF antagonist, for its capacity to block PAF or lipopolysaccharide endotoxin (LPS)-mediated effects in rabbits. Pretreatment with BN 50739 (3 and 10 mg/kg i.p.) inhibited PAF (500 pmol/kg i.v.)-induced thrombocytopenia, leukopenia and plasma thromboxane B2 elevation in a dose-dependent manner. The inhibitory effect lasted 3.5 to 4.5 hr. BN 50739 (10 mg/kg) prevented the early phase of LPS (50 micrograms/kg i.v.)-induced thrombocytopenia and thromboxane B2 elevation, and reduced the 24-hr mortality rate from 75 to 22% (P less than .05). Post-treatment with BN 50739 increased the 10-hr survival rate from 33 to 87% (P less than .05); however, it had no effect on the 24-hr mortality. BN 50739 did not affect LPS-induced leukopenia or the elevation in plasma tumor necrosis factor. Our data support possible therapeutic efficacy of PAF antagonists in septic shock despite their inability to prevent the generation of tumor necrosis factor.

Animals↗
PubMed1990

Biological responses to liposome-encapsulated hemoglobin (LEH) are improved by a PAF antagonist.

Liposome-encapsulated hemoglobin (LEH) is an experimental oxygen-carrying blood substitute. Previous studies in our laboratory with hydrogenated soy lecithin-based LEH indicated that while this solution maintained some physicochemical and oxygen-carrying properties of red blood cells, it evoked several transient (30-120 min) untoward biological responses, such as hypertension, tachycardia, thrombocytopenia, hemoconcentration, and elevation of plasma thromboxane B2 (TXB2). Such biochemical, hematological, and hemodynamic derangements are also produced by platelet-activating factor (PAF). The purpose of this study was to test the biological responses to administration of a newly produced synthetic distearoyl phosphatidylcholine-based LEH (s-DSPC-LEH) in the normal conscious rat (n = 6-11) and to examine the role of PAF in these processes. Systemic (IV) administration of S-DSPC-LEH caused transient hypotension (-23 +/- 8 mmHg, P less than 0.05), bradycardia (-24 +/- 11 bpm, P less than 0.05) followed by tachycardia (+62 +/- 21 bpm, P less than 0.05), decreased cardiac index (217 +/- 21 ml/min/kg, P less than 0.01), increased peripheral resistance (0.570 +/- 0.003 mmHg/ml/min/kg, P less than 0.01), transient leukocytosis (+6,870 +/- 1,801/microliters, P less than 0.05), hemoconcentration (+5.2 +/- 0.4%, P less than 0.01), thrombocytopenia (-160 +/- 18 X 10(3)/microliters, P less than 0.01), and increase in plasma TXB2 (45.0 +/- 1.9 pg/100 microliters, P less than 0.01). Separate infusion of the liposome vehicle or free hemoglobin, the two components of s-DSPC-LEH, did not evoke any consistent responses. Administration of the PAF antagonist BN 50739 (10 mg/kg, i.p.) 30 min prior to LEH prevented the hemodynamic changes and hemoconcentration induced by s-DSPC-LEH. These data suggest that hemoglobin/phospholipid interactions might account for the transient side effects of s-DSPC-LEH, possibly through interactions with blood elements and the resultant production of PAF and TXA2. Furthermore, PAF antagonists incorporated into or co-administered with LEH might enhance its biological applications.

Animals↗
PubMed1989

Convulsions induced by aminocaproic acid infusion.

Aminocaproic acid is a widely used antifibrinolytic agent. Serious adverse effects associated with its use are rare, but we report on a patient with liver disease and cirrhosis who experienced a grand mal seizure during the intravenous administration of aminocaproic acid. Clinicians should be alert to the occurrence of this adverse effect in patients with no previous neurological problems.

Aminocaproates↗
PubMed1989

Infusion of small volume of 7.5 per cent sodium chloride in 6.0 per cent dextran 70 for the treatment of uncontrolled hemorrhagic shock.

The effect of a solution of 7.5 per cent sodium chloride in 6.0 percent dextran 70 was studied in a rat model of uncontrolled hemorrhagic shock induced by partial resection of the tail of the rat. Fifty rats were randomly assorted into five groups of ten rats each. In group 1, uncontrolled hemorrhagic shock was induced by sharp resection of 10 per cent of the terminal portion of the tail of the rat. In group 2, uncontrolled hemorrhagic shock was treated with 5 milliliters per kilogram of 0.9 per cent sodium chloride. In group 3, uncontrolled hemorrhagic shock was treated with 5 milliliters per kilogram of 6 per cent dextran 70. In group 4, rats were treated with 5 milliliters per kilogram of 7.5 per cent sodium chloride, and in group 5, 5 milliliters per kilogram of 7.5 per cent sodium chloride in 6.0 per cent dextran 70 were infused. During the first five minutes, bleeding in rats in group 1 was 3.0 +/- 0.4 milliliters and the mean arterial pressure fell from 105 +/- 5 to 73 +/- 7 torr (p less than 0.001). In group 4, bleeding at 15, 30 and 60 minutes was 1.9 +/- 0.3 milliliters (p less than 0.02), 2.0 +/- 0.7 milliliters (p less than 0.04) and 2.4 +/- 1.1 milliliters (p less than 0.02), and in group 5, 2.5 +/- 0.6 milliliters (p less than 0.02), 2.2 +/- 0.6 milliliters (p less than 0.04) and 3.1 +/- 0.8 milliliters (p less than 0.04), respectively, compared with bleeding in group 1. Increased bleeding was followed by a fall in mean arterial pressure in groups 4 and 5 with a 60 per cent mortality rate (p less than 0.01) in both groups and respective, mean survival times of 135 +/- 29 and 144 +/- 26 minutes, which were significantly increased compared with group 1 (p less than 0.01 for both). The intravenous infusion of 6 per cent dextran 70 alone in group 3 resulted in delayed bleeding of 1.23 +/- 0.6 milliliters (p less than 0.04) after 180 minutes. It is concluded that infusions of small volume of 7.5 per cent sodium chloride or 7.5 per cent sodium chloride in 6.0 per cent dextran 70 solutions in rats in a state of uncontrolled hemorrhagic shock led to increased bleeding, decrease in mean arterial pressure and increased mortality.

Animals↗
PubMed1989

Cystic duct carcinoma mimicking empyema of the gallbladder.

An 80-year-old woman underwent cholecystectomy because of a clinical and ultrasonic diagnosis of gallbladder empyema. Primary carcinoma of the cystic duct, which was completely removed, was incidentally found during pathologic examination. Although the prognosis following complete removal of this carcinoma is considered to be good, the patient died of the disease 7 months after the operation.

Adenoma, Bile Duct↗
PubMed1989

Characterization of hemodynamic, hematologic, and biochemical responses to administration of liposome-encapsulated hemoglobin in the conscious, freely moving rat.

To improve the outcome of trauma victims and of patients undergoing high-blood-loss surgical procedures and to avoid the many serious complications of blood transfusion, there is a need for an oxygen-carrying blood substitute. Synthetic erythrocytes composed of liposome-encapsulated hemoglobin (LEH) represent one of the significant research efforts in this direction. The purpose of the present study was to examine some of the cardiovascular, hematologic, and biochemical effects of a recently developed LEH preparation in the conscious rat (n = 7). LEH increased mean arterial pressure (MAP) by +18.7 +/- 4.7 mm Hg (P less than 0.01) and heart rate (HR) by +117 +/- 18 beats/min (P less than 0.05). Platelet count dropped to 40% of basal value (P less than 0.01), while plasma thromboxane B2 (TXB2) increased by +25.1 +/- 5.4 pg/100 microliters (P less than 0.001). There was no effect on plasma 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha). Hemoglobin and hematocrit levels were elevated as well as the white blood cell count [( WBC] lymphocytosis). The platelet and TXB2 responses to LEH showed negative correlation (R = -0.56, P less than 0.01). The injection of the liposome vehicle (LIP) decreased MAP by -16.5 +/- 5.1 mm Hg (P less than 0.01) and platelets, but increased HR, WBC, and TXB2. All observed effects exerted by LEH and LIP were transient, and basal levels obtained 120 min after LEH injection. These data suggest that while LEH maintains some physicochemical properties of red blood cells, its biological properties at the present time indicate potential cardiovascular and hematological liabilities. Furthermore, it seems that the phospholipid bilayer alone or in combination with free Hb might be responsible for the biological effects of LEH.

6-Ketoprostaglandin F1 alpha↗
PubMed1986

Ultrasonographic diagnosis of vesical leakage in a renal transplant recipient.

Technical complications following renal transplantation contribute significantly to graft loss, morbidity, and mortality. Since these patients are immunosuppressed such complications are life-threatening and require early diagnosis and management. Vesical extravasation is a major complication usually evident in the early posttransplant period and occurs more commonly in diabetic patients, and those with multiple prior bladder operations, persistent outflow obstruction, and urinary tract infection. The detection of vesical leakage by real-time ultrasound examination is described.

Adult↗
PubMed1984

Amputation neuroma of common bile duct with obstructive jaundice: a case report.

A 67-year-old woman was hospitalized because of recurrent attacks of epigastric pain, chills, fever, jaundice and pruritus of 6 months' duration. Six years earlier, the patient had undergone cholecystectomy. The present endoscopic retrograde cholangiopancreatography demonstrated a proximal irregular choledochal stricture. Resection of the stricture with end-to-end anastomosis was performed. Histological examination of the surgical specimen revealed an amputation neuroma.

Aged↗
PubMedDate not supplied

Admission patterns of an urban level I trauma center.

Because trauma admission and hospitalization patterns have profound effects on the organization and utilization of urban trauma-care systems, the objective of this study was to identify and analyze these patterns. As an example, admissions to an urban Level I trauma center were reviewed. Retrospective review of all 2029 trauma admissions to a Level I trauma center was conducted from 1993 to 1996. The result was that most trauma patients were young (40% < 30 years of age) and male (74%). Mechanisms of injury were motor vehicle accident (36%), fall (27%), gunshot (17%), stab (7%), assault (6%), and swimming or diving accident (3%). Half of the patients were directly admitted from the scene. Injury Severity Score, length of stay, and mortality were 14.1 +/- 0.3, 10.5 +/- 0.3 days, and 5.1%, respectively. Admissions tended to occur more frequently between 4:00 PM and midnight (46%), between Friday and Sunday (52%), and between July and October (41%). The following patterns were identified: admissions per year decreased (-21%) because of reduced penetrating trauma (-43%, P < .01); pediatric patients (< 15 years) had similar incidence of penetrating trauma as adults (ages 15-45). Length of stay for all mechanisms of injury was not statistically different; most mortalities occurred within the first day (33%, P < .01) or after 6 days (36%, P < .01); early mortality was mainly due to penetrating injury (74%, P < .01), whereas late mortality was related to blunt trauma (92%, P < .01). The conclusion was that admission and demographic patterns were identified, which may be useful in the utilization, modification, and future design of trauma systems.

Adolescent↗
PubMedDate not supplied

Inhibitory effect of new PAF antagonists on PAF-induced rabbit platelet aggregation in vitro and ex vivo.

The effect of BN 50739, a recently developed PAF antagonist, on PAF-induced rabbit platelet aggregation in vitro and ex vivo was investigated. BN 50739 caused a right shift in PAF dose-response curves of platelet aggregation both in vitro and ex vivo. The amplitude of maximum aggregation, however, did not change as the concentration of PAF was increased indicating that BN 50739 is a competitive inhibitor. In vitro, in the presence of 10, 33 and 66 nM of BN 50739, the EC50 of PAF inducing aggregation increased 3.7, 11.1 and 50 times, respectively, and platelet disaggregation was promoted. The IC50 of BN 50739 for 2.5 nM PAF-induced platelet aggregation was 13.8 nM. Under the same condition, the IC50s of BN 50741, BN 50730, BN 50726, SRI 63-441 and BN 52021 were 18.3, 33.1, 63.4, 712 and 24,600 nM, respectively. BN 50739 given i.p. at 1, 3 or 10 mg/kg increased the concentration of PAF inducing 50% maximal platelet-rich plasma aggregation 3.4, 28 and 134 times, respectively. The apparent biological half-life of BN 50739 at 3 and 10 mg/kg i.p. was 2.5 and 5.4 h, respectively. BN 50739 had no effect on arachidonic acid (AA)- or collagen-induced platelet aggregation at concentrations effectively inhibiting PAF-induced platelet aggregation; however, moderate inhibition on AA- and collagen-induced aggregation was observed as the concentration of BN 50739 exceeded 100 nM. The results indicate that BN 50739 is the most potent and competitive PAF antagonist.

Animals↗
PubMedDate not supplied

Nonoperative management of blunt splenic trauma in adults.

Forty-five adult patients with traumatic splenic injuries were treated during a 6-year period between 1980-1986 at Hadassah Hospital. The diagnosis was confirmed by splenic scintigraphy with 99mTc Tin-colloid. Fifteen patients (33%) who were stable on admission or after initial resuscitation were treated non-operatively and selected for this study. Treatment consisted of careful hemodynamic monitoring, strict bed rest, nasogastric suction, and i.v. fluids. In no case was emergency laparotomy necessary for deterioration of clinical condition or late complications. Splenic scans were repeated in 11 of the patients to assess resolution. In six of the patients, minimal residual defects were detected with no further complications. It is concluded that nonoperative treatment of splenic injuries in carefully selected patients is both safe and effective.

Adolescent↗