Search PubMed⌕ Search

Biomedical subjects

S Kaufman

Publications and source records attributed to S Kaufman.

501 records · Page 28Linked to original sources
PubMedDate not supplied

Left coronary artery arising from the non-coronary sinus: a rare congenital coronary anomaly.

Anomalous origin of the left coronary artery is a cause of sudden death in adolescents and young adults. Most commonly, it originates from the right coronary sinus or the pulmonary artery. Origin of the left main coronary artery from the non-coronary sinus of Valsalva is extremely rare. We report a case of a child with anomalous origin of the left main coronary artery from the non-coronary sinus diagnosed during the evaluation of a ventricular arrhythmia.

Child↗
PubMedDate not supplied

Noninvasive prediction of pulmonary artery pressure in patients with isolated ventricular septal defect.

Management of patients with isolated ventricular septal defect (VSD) requires information regarding pulmonary artery pressure (PAP). The purpose of this study was to evaluate the individual predictive value of noninvasive methods for assessment of PAP and to determine if any combination of techniques significantly improved their predictive power. We reviewed the clinical history, electrocardiogram, and echocardiogram of 31 patients (age 1.9 +/- 1. 73 years) who underwent catheterization for isolated VSD. Noninvasive data were compared for patients with mean PAP <20 mmHg (group 1) and those with mean PAP > or =20 (group 2) at catheterization. Fourteen (45%) patients were in group 1 and 17 (55%) in group 2. Doppler estimation of VSD gradient, right ventricular hypertrophy by echocardiogram, interventricular septal orientation, and VSD size had predictive value for elevated mean PAP (p < 0.01). All patients (n = 6) with normal findings in all four variables had normal PAP. All patients (n = 12) with at least three of four abnormal findings had elevated PAP. Six patients in group 1 had at least one variable that incorrectly predicted high PAP, whereas 3 patients with normal findings on three of the four variables nevertheless had elevated PAP. No single noninvasive variable accurately predicted PAP in all cases. However, normal findings for all four significant variables did predict normal PAP and suggest that cardiac catheterization is unnecessary in that setting. However, any other combination of normal and abnormal findings for the four significant variables did not reliably predict PAP and such patients may require catheterization to directly measure PAP.

Blood Pressure↗
PubMedDate not supplied

Impact of positive preoperative surveillance blood cultures from chronic indwelling catheters in cadaveric intestinal transplant recipients.

Recurrent bloodstream infections are a common indication for intestinal transplantation (ITx). Often, clinical symptoms may be absent in the setting of bacteremia, especially in patients with chronic liver disease. This study investigated the incidence and impact of positive blood cultures (BCx) obtained from central venous catheters used for total parenteral nutrition (TPN) in asymptomatic patients immediately prior to cadaveric ITx. Of 13 consecutive patients transplanted between November 2003 and November 2004, 12 underwent preoperative surveillance BCx with four positives (33%). Isolates included Staphylococcus epidermidis (n = 2), methicillin-resistant Staphylococcus aureus, and Citrobacter freundii. All four patients with positive BCx displayed liver dysfunction at the time of transplant (> or = grade 2 fibrosis, total bilirubin >8.0 g/dL), three of whom were inpatients. In contrast, only three of eight nonbacteremic patients showed liver disease of comparable severity. Liver dysfunction and inpatient status at the time of transplant appear to predict positive blood cultures. Postoperative length of stay and time on the ventilator were significantly longer among bacteremic as compared with nonbacteremic patients, but there were no differences in intraoperative blood use, time to total parenteral nutrition independence, or operative time between bacteremic and nonbacteremic patients. Our study showed that occult bacteremia in asymptomatic pre-intestinal transplant patients was not uncommon and may increase postoperative morbidity. Preemptive removal of long-term central venous catheters should be considered prior to ITx.

Cadaver↗
PubMedDate not supplied

The normal pattern of pulmonary venous flow on pulsed Doppler examination of the human fetus.

The pattern of pulmonary venous flow was studied in 52 normal fetuses between 16 weeks gestation and term. A characteristic flow profile was defined. This was similar to that described in the child and adult and different from the pattern of flow in the systemic veins described in the fetus. The velocity of flow increased with gestation and was not influenced by heart rate. The velocity-time integral showed that systolic flow was 2.0 +/- 0.3 times the flow in diastole. Pulsed Doppler echocardiography demonstrates a distinctive pattern of pulmonary venous blood flow that reflects left atrial hemodynamics.

Adult↗
PubMedDate not supplied

Case report. Simultaneous fungal and viral infection of the central nervous system.

A patient with lymphoma developed central nervous system dysfunction and the diagnosis of cryptococcal meningitis was made. Because of discordant clinical and laboratory responses to appropriate treatment, further investigations were performed and the additional diagnosis of progressive multifocal leukoencephalopathy (PML) was established. Computerized axial tomography (CT scanning) proved helpful in pointing toward the latter disorder. Clinical, neuropathological, and microbiologic features are presented. The diagnostic approach to central nervous system illness in patients with impaired immunocompetence should include consideration of simultaneous infection with multiple agents.

Central Nervous System Diseases↗
PubMedDate not supplied

Generation and ethnic identity: a typological analysis.

Data bearing on cognitive acculturation, ethnic behavior, and values were gathered from three generations of Mexican and Japanese Americans. Two dimensions of ethnic behavior were identified and named: Anglo Face and Traditional Orientation. Although subcultures and generations differed in value orientation, the values data did not contribute to the identification of ethnic identity types. Typological analysis using Anglo Face, Traditional Orientation, and Acculturative Balance Scale scores identified six types of ethnic identity, two for each generation. Immigrants differ mainly on whether or not they retain Traditional Orientation; later generations differ mainly on Anglo Face. Although there are large differences between generations in Acculturative Balance, the two types within each generation do not differ.

Acculturation↗
PubMedDate not supplied

[False-positive cultures due to cross contamination in tuberculosis laboratories].

Fifteen episodes of Mycobacterium tuberculosis laboratory cross-contamination suspected between 1996 and 2001 at 6 laboratories in Buenos Aires City and suburbs were investigated by IS6110 RFLP. Thirteen episodes were confirmed. Even though BACTEC 460 produced the highest number of confirmed episodes in a single laboratory, the most extended one occurred while employing conventional culture procedures in solid medium. The double repetitive element-polymerase chain reaction (DRE-PCR) was applied to 8 of these episodes and produced concordant results with those of the RFLP. The DRE-PCR appears to be a valuable tool for the prompt identification of false positive cultures. The timely rectification of defects in laboratory protocols can avert false diagnoses of tuberculosis and unnecessary prolonged treatments.

Aerosols↗
PubMedDate not supplied

[Comparison of methods for the identification of the most common yeasts in the clinical microbiology laboratory].

We evaluated different methods for the routine identification of medically important yeasts. A total of 150 clinical isolates: 25 C. albicans, 25 C. tropicalis, 25 C. glabrata, 25 C. parapsilosis, 8 C. guilliermondii, 11 C. krusei and 31 Cryptococcus neoformans were tested by Yeast Biochemical Card bioMerieux Vitek (YBC), CHROMagar Candida (CHR). The addition of yeast morphology in Corn Meal agar-Tween 80 (AM) to YBC and CHR was also evaluated. The reference methods used were: API 20C, germ tube formation, AM, Christensen urea and Birdseed agar. YBC identified 135 yeasts with an overall accuracy of 90%. Sensitivity (S) and specificity (E) were: 92-98% for C. albicans and C. tropicalis; 84-99% for C. papapsilosis; 100-99% for C. glabrata; 91-100% for C. krusei; 63-98% for C. guilliermondii and 90-99% for Cryptococcus neoformans, respectively. CHR identified correctly 100% for C. albicans, 92% for C. tropicalis and 91% for C. krusei. Both methods combined with AM provided 100% S and E. We found that YBC system was appropriate for identification of yeasts isolated from human sources. CHR was effective and easy to use for identification of C. albicans, C. tropicalis and C. krusei. The routine use of AM with both methods is recommended.

Automation↗
PubMedDate not supplied

Phenylketonuria and its variants.

The hepatic phenylalanine hydroxylase system is complex, consisting of at least two enzymes and two non-protein cofactors. In classical phenylketonuria (PKU) the affect component has been shown to be the enzyme, phenylalanine hydroxylase. Recently, several variant forms of PKU have been identified which are due to deficiencies of two of the other components of the hydroxylase system, dihydropteridine reductase and tetrahydrobiopterin. In these cases, the defects lead to symptoms which are more severe than in PKU. Furthermore, since these two components are also required in the biosynthesis of the neurotransmitters, serotonin, dopamine and norepinephrine, treatment with a phenylalanine-restricted diet is not effective. Thus, it is important to distinguish PKU from one of its variant forms at as early an age as possible to institute alternate therapies. The methods for determining the affected component will be discussed.

Biopterins↗