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Biomedical subjects

R Segal

Publications and source records attributed to R Segal.

At least 145 records · Page 8Linked to original sources
PubMed1989

Pityriasis rotunda in a Caucasian woman from the Mediterranean area.

Pityriasis rotunda (PR) has been known to affect, almost exclusively, Japanese and South African Bantu, often in association with various systemic diseases. However, the occurrence of PR in Caucasian patients is extremely rare, and has been previously described in only three reports. We hereby report a case of an apparently healthy Caucasian woman from Israel having clinical and histological features characteristic of PR. Pityriasis rotunda (PR) is a rare disorder of keratinization characterized by strikingly well demarcated, perfectly round scaly brownish patches of variable number and diameter located mainly on the trunk and extremities. The exact place of this disorder within the nosology of the cutaneous dermatoses is not yet fully established. However, most authors regard it as a special circumscribed form of acquired ichthyosis with a histological resemblance to ichthyosis vulgaris. For more than half a century following the first description of this disorder in 1906 cases reported were almost exclusively from the Far East, particularly from Japan, or in South African Negroids, with a few cases of West Indian Negroids, usually in association with various debilitating diseases. The first report of a Caucasian patient appeared in the literature in 1966 and since then there have been only two additional reports of PR in Caucasian patients.

Adult↗
PubMed1989

The anticariogenic activity of glycyrrhizin: preliminary clinical trials.

A clinical trial to test the compound glycyrrhizin, the sweet component of licorice, was conducted on 21 dental students. A split-mouth technique of glycyrrhizin application was used. Subjects were instructed to discontinue all oral hygiene procedures, but no dietary modifications were imposed. After 3 days a highly significant reduction in plaque was detected in the upper central incisors on the experimental sides compared with the control sides of students' mouths. Comparing all teeth, less plaque was found on experimental sides than on control sides of the mouths. This difference demonstrated a tendency towards statistical significance. After 4 days the quantitative differences between the two halves of the mouths (less plaque on experimental sides) were greater than after 3 days. This pilot study might indicate the potential of glycyrrhizin in controlling dental plaque.

Adult↗
PubMed1989

Short term effects of low dose methotrexate on the acute phase reaction in patients with rheumatoid arthritis.

Sequential daily measurements of erythrocyte sedimentation rate (ESR) and serum C-reactive protein (CRP) were performed for one week after an I.V. injection of 7.5-13 mg methotrexate (MTX) in 18 patients with rheumatoid arthritis. Early decreases of ESR and CRP were observed. Serum CRP was more sensitive than ESR, displaying more pronounced falls from baseline to both the minimal and to the 7th day levels. Patients receiving their first dose of MTX (n = 9) exhibited a more prominent reduction of CRP levels in comparison to veteran MTX users (n = 9). The prompt response of acute phase reactants to MTX may correspond to the relatively rapid clinical effect of the drug in RA. It may also support an antiinflammatory mechanism of action of low dose MTX.

Acute-Phase Reaction↗
PubMed1989

Intervertebral disc space infection and osteomyelitis due to Hemophilus species: report of two cases and review.

Vertebral osteomyelitis and intervertebral disk space infections in adults are most often caused by Staphylococcus aureus or Escherichia coli. Despite an increasing number of cases caused by other gram-negative bacteria, documented spinal infections with Hemophilus species remain exceedingly rare. All prior cases have involved the lumbar spine between the L2 and L4 levels. None has required surgical decompression or stabilization. We report two adult patients with intervertebral disk space infections and osteomyelitis outside the lumbar region. One patient, who had a Hemophilus influenzae infection of the T9-T10 disk space, was successfully treated with intravenous antibiotics and external bracing. Another patient, who had a Hemophilus aphrophilus infection that destroyed the C5-C6 disk space and adjacent vertebral bodies, required surgical debridement and stabilization in addition to antibiotic therapy and halovest immobilization. Neither patient had a significant underlying illness or extra-spinal source of infection. The clinical features and spinal levels affected in these two patients have expanded our knowledge of the spectrum of disease caused by Hemophilus species.

Adult↗
PubMed1989

Folic acid deficiency, megaloblastic anemia and peripheral polyneuropathy due to oral contraceptives.

A 34-year-old woman developed megaloblastic anemia and peripheral polyneuropathy following the use of oral contraceptives for 4 years. Low levels of folic acid and vitamin B12 were found. Both the complete recovery after therapy with the vitamins, and the absence of other causes of vitamin B12 and folate deficiency, suggest that the vitamin deficiencies were caused by the oral contraceptives and resulted in the rare combination of megaloblastic anemia and polyneuropathy. The poor response to vitamin B12 alone, and the development of anemia and polyneuropathy 4 months after cessation of vitamin B12 therapy suggest that folate deficiency was the primary problem.

Adult↗
PubMed1989

Factors influencing pharmacists' selection of their first practice setting.

Factors that influenced the choice of initial practice setting among pharmacists who had completed the majority of their experiential training in a hospital setting were determined. A questionnaire was mailed to all eligible pharmacists who successfully completed the Ohio pharmacist licensure examination in June or September 1987. Respondents were asked to (1) provide demographic data, (2) rate the importance of 23 factors that a pharmacist might consider when choosing a practice site, and (3) rate the desirability of a pharmacist position in their major hospital internship site, as well as positions they had considered in other hospitals and in community pharmacies. The predictive accuracy of four decision-making models--the weighted compensatory choice model, the unweighted compensatory choice model, the lexicographic model, and the conjunctive model--also was determined. Of 105 pharmacists surveyed, 53 returned usable questionnaires. Twenty-five had chosen to practice in hospital settings, and 28 had chosen community settings. The factor "is personally rewarding" was mentioned most often by hospital and community pharmacists as the factor that was most important when choosing their first position. The lexicographic model, which postulates that a pharmacist will choose the practice site with the highest performance rating for the most important factor, was the most accurate predictor of respondents' initial practice sites. Pharmacists' perception of how practice sites would rate in terms of the single job-related factor most important to them was the best predictor of whether they chose hospital or community practice initially and whether they chose to work in the hospital in which they served their internship, another hospital, or a community pharmacy.

Attitude of Health Personnel↗
PubMed1989

National survey of critical-care pharmaceutical services.

The results of a national survey of critical-care pharmaceutical services are reported. A questionnaire was mailed on March 8, 1988, to 1500 of the 6800 U.S. hospitals with more than 100 beds. The questionnaire was divided into four sections: (1) critical-care pharmaceutical services; (2) critical-care clinical pharmacy activity; (3) critical-care pharmacy standards; and (4) general information on the hospital, including pharmaceutical services provided to patients who are not critically ill. A total of 613 usable questionnaires were returned, for a response rate of 41%. Respondents from 124 hospitals reported having a critical-care satellite pharmacy. Critical-care beds served by satellite pharmacies were more likely to have unit dose drug distribution services than were critical-care beds not served by satellite pharmacies. The level of clinical and educational services provided to critical-care patients was significantly lower for intensive-care unit (ICU) pharmacists practicing in satellite pharmacies than it was for ICU pharmacists not associated with satellite pharmacies. There were no differences between satellite and nonsatellite ICU pharmacists in either the percentage of a typical day spent providing clinical services to critical-care patients or the percentage of critical-care patients receiving those services. Respondents expected their hospitals to add 301 full-time-equivalent critical-care pharmacists to their staffs during the next two years, for a 39% increase. Respondents strongly favored establishing 24-hour unit dose drug distribution and i.v. admixture services, providing inservice education to nurses and physicians, and providing written pharmacokinetic consultations.(ABSTRACT TRUNCATED AT 250 WORDS)

Critical Care↗
PubMed1989

Polypeptide growth factors and the kidney.

Various polypeptide growth factors can act on different cell types in an autocrine, paracrine or endocrine manner. These bio-active peptides regulate molecular and cellular events that culminate in DNA synthesis and cell division. While, one or more polypeptides might be implicated as playing a predominant biological role in the kidney, in a given in vitro or in vivo situation, a network and cascade of events determines the final pattern of cell growth and response to injury. Elucidation of these molecular events and mechanisms of action of growth factors in the kidney is of fundamental importance to our understanding of both the normal development and disease states of the kidney.

Animals↗
PubMed1989

Criteria for staff pharmacist selection in Ohio.

Criteria that pharmacy managers think are currently being used and criteria that they think should be used in the selection of staff pharmacists were identified. A questionnaire was mailed to pharmacy directors in 232 Ohio hospitals. Respondents were asked to indicate how frequently they think that pharmacy managers consider each of 63 criteria when choosing a staff pharmacist and whether each criterion should be considered in an ideal selection process. Respondents also assessed the effect that each of 17 of these criteria would have on their own hiring decisions, all other factors being equal. A total of 116 usable questionnaires were returned, for a 50% response rate. Respondents indicated that they believed that many managers consider the following when choosing a staff pharmacist: licensure status, salary requirements, date of availability, interest in the position, ability to relocate, willingness to work unexpected hours, appearance, honesty, friendliness, police record, previous illicit drug use, previous absenteeism record, and the reason for leaving the last job. Respondents also thought that the equal employment opportunity traits, with the exceptions of handicaps and the applicant's age, were considered by few or some managers. However, 17% of the respondents indicated that they would discriminate in favor of a married applicant, 14% indicated that they would discriminate against an applicant born outside of the United States, 22% indicated that they would discriminate against an applicant whose age was in the fifties, and 24% indicated that they would discriminate against an applicant with a handicap that could reasonably be accommodated.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude of Health Personnel↗
PubMed1989

Direct coronal high resolution computed tomography of the temporomandibular joints in patients with rheumatoid arthritis.

Direct coronal high resolution computed tomography (CT) examination of the temporomandibular joints (TMJ) was performed in 40 patients with rheumatoid arthritis (RA). The patients were divided into 3 groups. Group 1 included patients with juvenile rheumatoid arthritis (JRA). Four patients of this group had disability of the TMJ associated with overgrowth of one of the mandibular condyles. This phenomenon has not yet been reported. Group 2 consisted of 10 patients with RA with clinically asymptomatic TMJ, 4 of whom had mild erosions of the condylar head seen on CT, consistent with RA. The majority of patients in Group 3, with clinically symptomatic TMJ showed CT changes of various degrees, which are discussed in this paper. Mild bone changes, not demonstrated by conventional procedures, were clearly seen by CT. Coronal view of the CT examination had advantages over other projections.

Adolescent↗
PubMed1988

Accelerated nodulosis and vasculitis during methotrexate therapy for rheumatoid arthritis.

Three women with classic rheumatoid arthritis, who were receiving weekly doses of methotrexate (MTX), developed accelerated subcutaneous nodulosis, despite good response to the drug. In 2 of the patients, the onset of nodulosis occurred within 3 months and 5 months, respectively, after starting MTX; in the third patient, it was observed only after 4 years of MTX therapy. In all 3 patients, the onset was unusually abrupt, with extensive distribution and remarkable nodule size. Additional manifestations of cutaneous vasculitis in 2 of the patients and Raynaud's phenomenon in the third appeared concomitantly with the nodulosis. Physicians prescribing MTX therapy for patients with rheumatoid arthritis should be aware of these potential complications.

Aged↗
PubMed1988

Mycetoma of the forearm due to Actinomadura madurae.

A case of mycetoma, with abscess-like lesions which appeared on the right forearm of a 43-year-old male, is briefly reported. A few whitish granules were detected in the oily-like discharge, the same as in the histologic examination. No bone involvement was discovered in X-ray examination. Actinomadura was identified in the culture. A daily dose of 4 g bactrin brought significant improvement to the patients continuing the treatment.

Adult↗
PubMed1988

In vitro T-cell functions specific to an anti-DNA idiotype and serological markers in patients with systemic lupus erythematosus (SLE).

The human monoclonal autoantibody 16/6 is a common anti-DNA idiotype found to have clinical relevance in patients with systemic lupus erythematosus (SLE). Therefore the ability of peripheral blood T cells of SLE patients and healthy controls to proliferate and to produce helper T-cell factors following stimulation with this idiotype was tested. It was found that T cells of 75% of healthy donors proliferated to the 16/6 idiotype, whereas only 22% of SLE patients responded to this idiotype by proliferation. On the other hand, the capability to produce T-cell helper factors specific to the 16/6 idiotype was found in a higher percentage of SLE patients (48%) as compared to healthy controls (31%). The low frequency of proliferative responses in SLE patients might be due either to the chronic exposure to the 16/6 idiotype or to the production of antiidiotype antibodies against the 16/6 idiotype, which interfere with the response to the latter stimulator.

Adolescent↗
PubMed1988

Methotrexate in rheumatoid arthritis: a prospective study in Israeli patients with immunogenetic correlations.

In a prospective open study 44 Israeli patients with rheumatoid arthritis were treated with weekly low dose methotrexate (MTX) for up to 36 months. Nine patients withdrew from the study: six because of side effects and three due to inefficacy. One patient died of septicaemia following septic arthritis. Significant improvement, graded by Ritchie articular index, grip strength, physician's global assessment, erythrocyte sedimentation rate (ESR), and platelet counts, was noticed in response to treatment. Seronegative patients had a better clinical response. Transient gastrointestinal symptoms were common and correlated with increases of serum aspartate transaminase (AST). HLA-DR1 and DR7 were significantly associated with increased serum AST concentrations.

Aged↗
PubMed1988

15-year survey of tinea faciei in the adult.

In a series of 100 adults with tinea faciei various dermatologic manifestations were mimicked, viz.: discoid lupus erythematosus in 52 patients, lymphocytic infiltration in 15, seborrheic dermatitis in 11, rosacea in 8, contacts dermatitis in 7, polymorphous light eruption in 4 and granuloma faciale in 3. Trichophyton rubrum was isolated in 78% of the respective cases, other isolated organisms being Microsporum canis (13 cases), Trichophyton violaceum in 6, Trichophyton mentagrophytes (asteroides) in 2 and Epidermophyton floccosum in 1 case. In 85% of these patients the nails were also involved by the same agent found in the lesions of the face. On the basis of these observations it is recommended that all adult patients with tinea faciei should undergo a comprehensive mycological investigation to find the primary focus, which may be an infected nail.

Adult↗