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Biomedical subjects

S J Peitzman

Publications and source records attributed to S J Peitzman.

17 recordsLinked to original sources
PubMed1989

From dropsy to Bright's disease to end-stage renal disease.

Clinical concepts--labels placed on categories of sickness--are essential to both the physician's and the patient's understanding of a disease. The changing use of labels in renal medicine reflected how physicians and others thought about kidney disease, each new label suggesting increasing complexity in the encounter of renal patient and physician. While dropsy referred to symptoms easily perceived by the patient as well as the physician, Bright's disease focused mainly on microscopic pathology invisible to the patient. Most removed from palpable symptoms is end-stage renal disease, a diagnosis often uncovered by autoanalyzer, defined by the need for dialysis, and formally bestowed by government. This process of definition and redefinition demands the attention of scholars because it reveals much about the evolution of medical thought and practice.

Edema↗
PubMed1989

Postprandial blood pressure decrease in well elderly persons.

To learn if postprandial reduction in blood pressure occurs in active, very well elderly persons, we identified 16 such subjects over the age of 75 years, free of cardiovascular disease, taking no drug affecting blood pressure control. Each underwent measurement of seated and standing blood pressure and heart rate before and after a standard breakfast and before and after a volume of water (control). Eight young persons underwent the measurements before and after the meal. The elderly but not the young showed a significant fall in systolic and diastolic pressures after the meal, with heart rate increases in some subjects clearly inadequate for the decline in systemic pressure. No symptoms were seen. But postprandial decrease in blood pressure may in some less robust elderly persons be a factor in syncope and falls. This change may also confuse the monitoring of antihypertensive treatment in older outpatients.

Aged↗
PubMed1986

Nephrology in the United States from Osler to the artificial kidney.

Modern knowledge of renal physiology, kidney disease, and the body fluids in American medicine was established largely by Donald D. Van Slyke, Thomas Addis, John P. Peters, Homer W. Smith, and Alfred Newton Richards. Only two of these men were physicians, and through this group future nephrology was shaped by a dominant interest in metabolic problems and pathophysiology. Acute renal failure emerged as a new syndrome during World War II and fostered interest in hemodialysis and renal biopsy. Dialysis, when applied to chronic renal failure, eventually spawned an army of renal clinicians; and biopsy provided a specialist's nosology of what had once enjoyed the unity of "Bright's disease." A society and subspecialty board came late to nephrology and have been directed largely by renal academicians of the metabolic tradition. Nephrology is in the 1980s a bipartite subspecialty, its senior leaders still cherishing the metabolic-physiologic tradition, and a growing army of dialysis practitioners mostly looking after patients with chronic and acute renal failure.

Acute Kidney Injury↗
PubMed1985

Moonshine drinking among hypertensive veterans in Philadelphia.

Nearly two thirds of 200 male hypertensive veterans surveyed in Philadelphia admitted to past ingestion of illicit alcoholic beverages (moonshine), many drinking it recently, and in the North. They were more likely to be black and have gout than those denying moonshine use. But we did not detect unequivocally high bodily lead burden in a small subsample.

Black or African American↗
PubMed1979

Ticrynafen and probenecid in hyperuricemic, hypertensive men.

In a double-blind crossover study of ticrynafen (TCN) and probenecid (PBC), 9 hypertensive, hyperuricemic men completed 12-wk courses of each drug. With a TCN dose of 125 mg daily, the fall in serum uric acid was prompt, dramatic, and lasting; it was equal to that after PBC, 500 or 1,000 mg daily. There was a small but significant early weight loss (diuresis) after TCN but no antihypertensive effect. Twelve days after resuming TCN for a proposed additional extension study 1 patient suffered acute, reversible bilateral ureteral obstruction, probably caused by sudden urinary uric acid precipitation.

Blood Pressure↗
PubMed1977

Spontaneous hypoglycemia in end-stage renal failure.

Five men with end-stage renal failure had spontaneous hypoglycemia during lengthy hospitalizations. Four were cachectic, and all five had weight loss and poor caloric intake. Malnutrition were seen also in some of the ten previous case reports of hypoglycemia in renal failure. Impaired renal gluconeogenesis may allow hypoglycemia in such patients.

Adult↗
PubMed1976

Charcot arthropathy secondary to amyloid neuropathy.

Neuropathic (Charcot) ankle joints developed in a 50-year-old patient with end-stage renal disease from primary, nonfamilial amyloidosis. Sensory neuropathy in the legs had been noted three years before the onset of uremia and had porgressed. Sural nerve, but not synovial biopsy specimen, showed amyloid in and around arteriolar walls by light and electron microscopy. Since Charcot joints are only rarely associated with amyloid neuropathy, it is possible that uremic neuritis, or prolonged survival by dialysis, contributed to progression of the neuropathy, allowing subsequent joint degeneration.

Amyloidosis↗