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Biomedical subjects

S Bar-Sela

Publications and source records attributed to S Bar-Sela.

35 records · Page 2Linked to original sources

Lead encephalopathy treated by versenate (CA-EDTA).

A patient with generalised epileptic seizures, mental and psychotic signs was diagnosed as suffering from lead encephalopathy. He was a big consumer of home-made arrack, illicit alcohol prepared at home in secrecy, in tools containing copper and lead. Basophilic stippling increased the possibility of lead encephalopathy, which was soon proved. He was successfully treated with low doses of Versenate, a chelating factor, and totally recovered.

Chelating Agents↗

Insect-sting allergy in Israel: immunotherapy with pure venoms.

Demographic, atopic and other clinical characteristics of 25 patients with insect-sting allergy are reported. All patients were skin tested by pure venoms (PVs) or whole body extracts obtained from bees and several vespids. PVs were found to be extremely useful and highly superior to whole body extracts in the diagnosis of insect allergy. Immunotherapy was indicated in 15 patients, 12 of whom completed a 12-wk PV desensitization course. Immunization was associated with minimal side effects and proved to be highly effective against a live-insect challenge.

Adolescent↗

Arterial embolism in thyrotoxicosis with atrial fibrillation.

The incidence of atrial fibrillation (AF) in 142 patients with thryotoxicosis was 21% and that of thromboembolic disease was 8.5%. Male sex, increasing age, and associated rheumatic or hypertensive heart disease were significantly associated with the presence of AF. Thromboembolic episodes occurred in 12 (40%) of the patients with AF and in none of the 112 patients without AF. Cerebral emboli accounted for 53% of the episodes. In view of the grave prognosis of the embolic episodes, patients with thyrotoxicosis should be treated with heparin during attacks of AF and with oral anticoagulants when they have chronic fibrillation.

Atrial Fibrillation↗

Bee venom immunotherapy: clinical and immunologic observations.

In the present study the authors evaluated the usefulness of pure venom (PV) in the diagnosis and prevention of bee allergy in a group of 25 patients. In addition, they followed changes in specific IgE and IgG serum levels during the course of immunotherapy. They found excellent correlation between the clinical history and skin test reactivity to PV. The RAST values correlated well with skin test but were somewhat less specific. They used a rather moderate schedule of desensitization by which a 100 mcg maintenance dose was attained by the 11th week. This schedule resulted in minimal side effects and was extremely effective. None of the live insect challenged patients had major reactions. Successful immunization was not associated by a decrease in specific IgE level. In contrast, most patients exhibited an increase in specific serum IgG levels. An increase in IgG level did not prove to be an absolute indication of successful immunization.

Bee Venoms↗

Hyperglobulinemic purpura in the course of multiple myeloma.

Secondary hyperglobulinemic purpura of Waldenström is characterized by polyclonal gammopathy associated mainly with autoimmune diseases. Its occurrence with multiple myeloma is very rare. We described a patient who developed characteristic lesions of hyperglobulinemic purpura in the course of IgA myeloma. Skin biopsy revealed deposition of IgA in the blood vessels.

Aged↗

Liver abscess at the Hadassah University during years 1967-77.

The charts of 36 patients, 27 males and 9 females, with liver abscess diagnosed at the Hadassah University Hospital between 1967-1977 were reviewed. The patients ranged in age from two months to 80 years and 25 patients (69%) were older than 40 years. The diagnosis was initially suggested by liver scan in 18 patients (50%), and was first made at autopsy in six (17%). The time-lapse between the onset of illness and diagnosis ranged from one day to 13 months, with a bimodal distribution. Large solitary abscesses were diagnosed later than small multiple abscesses. Ten patients (28%) were admitted with fever as the only sign of illness; specific signs and laboratory evidence of liver involvement often occurred late in the course of the disease. In 15 patients (42%), the etiology was regarded as amebic. In patients with pyogenic abscesses, the most commonly isolated organisms belonged to the normal bowel flora and biliary tract disease was present in 62% (13/21) of these patients. The overall mortality rate was 31%. This survey stresses the need for an increased awareness of the subtle presentation of liver abscess.

Adolescent↗

The relationship between bone marrow sideroblasts and iron deficiency in chronically hemodialyzed uremic subjects.

Bone marrow sideroblast counts were found to be persistently depressed to between 0 and 30 per cent in 24 uremic patients with residual renal tissue undergoing chronic dialysis therapy. Marrow sideroblastopenia notwithstanding, sideroblast counts in these subjects correlated well with iron balance, being respectively 6.6 +/- 0.8 (S.E.M.) per cent in iron depleted, and 18.2 +/- 1.7 per cent in iron-repleted individuals (p less than 0.0005). Following bilateral nephrectomy a persistent relative marrow sideroblastosis developed, counts reaching values of 46.5 +/- 3.1 per cent on average. It is suggested that this sideroblastosis is a response to reduced heme synthesis and reflects the iron removal function of ferritin granules within erythroid cells.

Bone Marrow↗

Fulminant cutaneous T-cell lymphoma and Sézary syndrome.

The term cutaneous T-cell lymphoma (CTCL) has recently been coined to describe a group of rare lymphoproliferative T-cell disorders classically beginning in the skin and pursuing a chronic, progressive, and indolent course eventually followed by visceral involvement. This term encompasses the spectrum of the traditional mycosis fungoides and Sézary syndrome. A unique case of CTCL that developed a fulminant course leading to death within a few months following the initial symptoms is presented. The clinical course bears a striking similarity to a group of acute T-cell malignancies, while the cytologic-pathologic findings favor the diagnosis of Sézary syndrome. Regardless of the exact classifications, this entity appears to be a highly malignant T-cell disorder, resistant to chemotherapy.

Adult↗

Amyotrophic lateral sclerosis in a battery-factory worker exposed to cadmium.

A 44-year-old patient died from amyotrophic lateral sclerosis (ALS) after nine years of heavy exposure to cadmium (Cd) in a nickel cadmium (Ni-Cd) battery factory. Two years after starting work he and co-workers had experienced pruritus, loss of smell, nasal congestion, nosebleeds, cough, shortness of breath, severe headaches, bone pain, and proteinuria. Upper back pain and muscle weakness progressed to flaccid paralysis. EMG findings were consistent with motor neuron disease. Cd impairs the blood-brain barrier, reduces levels of brain copper-zinc (Cu-Zn) superoxide dismutase (SOD), and enhances excitoxicity of glutamate via up-regulation of glutamate dehydrogenase and down-regulation of glutamate uptake in glial cells. High levels of methallothionein, a sign of exposure to heavy metals, have been found in brain tissue of deceased ALS patients. The effects of Cd on enzyme systems that mediate neurotoxicity and motor neuron disease suggest a cause effect relationship between Cd and ALS in this worker.

Adult↗

Medical findings in nickel-cadmium battery workers.

Thirty-eight workers from a factory producing nickel-cadmium and other types of batteries came to us for medical evaluation. They included 21 women and 17 men (seniority 2-20 years, age range 31-63 years), and represented a self-selected subset of 700-900 ever-employed and 200+ recently or currently employed workers in the factory. Thirty-four worked on the nickel-cadmium assembly line. Symptoms and signs included: headache in 34; weakness, fatigue and lassitude in 26; dizziness in 16; pruritus and skin eruptions in 37; gingivitis, teeth loss and caries in 34; nasal congestion, nosebleeds and anosmia in 30; cough, phlegm production, wheezing and shortness of breath in 26; "asthma" in 14; bone pain in 18; urinary frequency, beta 2 microglobulinuria and kidney stones in 17; and sterility or multiple abortions (33) in 8 of 21 women. One additional patient had died from an "amyotrophic lateral sclerosis-like syndrome", while CT scans in six workers revealed brain atrophy. One other worker had leukemia, and two had died from cancer (lung and pancreas). Those who had worked for more than 10 years had more symptoms and signs than shorter-term employees, especially neurological illness, bone pain and urinary tract problems, including beta 2 microglobulinuria. Past blood and urinary cadmium levels were in the range of 1.6-8.7 micrograms/dl and 8-306 micrograms/l, respectively. Our findings indicated that: a) health risks for workers were not confined to the nickel-cadmium assembly line or to older workers, b) hazardous exposures still existed and illness appeared in new workers after a clean-up and intervention program, and c) exposures involved increased risks for renal disease and cancers. Finally, there is a need to control exposures and determine health risks in the full cohort of those ever employed, in the workers' children, and in the surrounding environment (air, ground, water) due to the dumping of waste from the plant.

Adult↗

Bone marrow and peripheral blood modifications in C57BL mice administered with cyclophosphamide and levan.

The effects of cyclophosphamide (CY) and levan at low (0.1 mg) and high (10 mg) doses (previously found to inhibit and stimulate, respectively, B16 melanoma growth) were studied. in single and combined administration, on the blood and bone marrow of C57BL mice. Very marked changes in the cellular composition of blood and bone marrow were induced by the various treatments. CY caused a sharp depletion of leukocytes in blood and bone marrow followed by a restoration of granulocytes while lymphocytes remained low. Levan caused a sharp dose-dependent depletion in bone marrow lymphocytes. Blood lymphocytes were not affected, however, by the polysaccharide. With the high levan dose, after a temporary granulocytopenia and monocytopenia, prominent granulocytosis was observed. While CY affected equally the different types of cells, levan decreased the number of lymphocytes and erythroblasts to a greater degree than the number of granulocytes. In the combined CY-levan treatments, the low levan dose generally attenuated the suppressive effect of CY, while the high concentration aggravated it.

Animals↗

A lupus-like syndrome due to lbuprofen hypersensitivity.

A patient with degenerative joint disease with an unusual hypersensitivity reaction to ibuprofen is described. The patient developed transient fever, myalgia polyarthritis and rash following each of 4 exposures to the drug. These manifestations were associated with positive Coombs' and FANA tests.

Antibodies, Antinuclear↗