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Biomedical subjects

S Meyers

Publications and source records attributed to S Meyers.

At least 73 records · Page 4Linked to original sources
PubMed1989

Liquid crystal thermography: quantitative studies of abnormalities in carpal tunnel syndrome.

We performed liquid crystal thermography (LCT) in 38 normal hands and in 23 hands with carpal tunnel syndrome (CTS) documented by nerve conduction studies (NCS). Two of the authors unaware of the clinical situation read the 2 palmar thermograms taken at a 5-minute interval. They determined the absolute temperatures of the tip of digit 1 (D1), D2, D3, D4, D5, and of the thenar and hypothenar eminences. We calculated the temperature differences (absolute values throughout) between any 2 of these 7 sites, and computed the median index (MI = [D1 - D2] + [D1 - D3] + [D2 - D3]). Comparison of the control and CTS groups revealed greater temperature differences in CTS between D1 - D3, D1 - D4, D3 - D5, D4 - D5, and MI. There was a marked overlap between the 2 groups. Comparison of individual CTS hands with controls revealed definite thermographic abnormalities in 0 of 9 hands with mild NCS abnormalities, and in 7 of 14 hands with marked NCS abnormalities. These findings indicate that the sensitivity of LCT in CTS is low compared with NCS, and previous favorable reports concerning thermography in CTS may have been due to lack of control series or absence of quantitation.

Adult↗
PubMed1989

The ileum is the major site of absorption of vitamin B12 analogues.

Non-cobalamin vitamin B12 analogues constitute a significant percentage of total corrinoids in human serum. The source and means of absorption of analogues and their significance are largely unknown. We studied the sites of production and absorption of B12 analogues by measuring serum vitamin B12 and analogues in 93 patients with various gastrointestinal diseases: pernicious anemia (PA), ileal resections, ileitis, Crohn's colitis, ulcerative colitis, and irritable bowel syndrome (IBS). Patients with PA had normal analogue levels that were unchanged or that rose during cessation of B12 administration. Patients with IBS, Crohn's colitis, ulcerative colitis, and total colectomies had B12 analogues in the normal range. Patients with diseased or resected ileums had low B12 and analogues. These data suggest that serum B12 analogues are absorbed in the ileum by a mechanism independent of intrinsic factor, and that colonic bacteria and endogenous metabolism of vitamin B12 do not contribute significantly to their level.

Anemia, Pernicious↗
PubMed1988

Factors determining programmed stimulation responses and long-term arrhythmic outcome in survivors of ventricular fibrillation with ischemic heart disease.

The clinical and angiographic features of 38 patients with ischemic heart disease and nonacute infarction pre-hospital ventricular fibrillation (VF) were examined as a function of their drug-free programmed electrical stimulation (PES) responses. Twenty-two patients (58%) had inducible ventricular tachycardia (VT) at drug-free PES (group I) and 16 patients (42%) did not (group II). Group I had more patients with: (1) remote infarction (22 of 22 vs 2 of 16; p less than 0.01; (2) history of congestive failure (16 of 22 vs 0 of 16; p less than 0.01); (3) prior cardiac arrest (11 of 22 vs 0 of 16; p less than 0.01); (4) left ventricular (LV) ejection fraction less than 40% (19 of 22 vs 1 of 16; p less than 0.01); and (5) akinetic or dyskinetic LV wall motion (22 of 22 vs 2 of 16; p less than 0.001). Group II had more patients with: (1) LV segments at "ischemic jeopardy" (16 of 16 vs 14 of 22; p less than 0.01) and (2) factors suggestive of ischemia at the onset of VF (13 of 16 vs 1 of 22; p less than 0.001). Inducible VT (IVT) was suppressed in 16 of the 20 group I patients surviving hospitalization while four were discharged with persistence of IVT despite therapy. At 27 +/- 15 months, all four with persistent IVT had a recurrence of their arrhythmia. In the 16 group II patients, therapy was limited to antiischemic measures: coronary bypass in 12, propranolol in 3, and angioplasty in one. At 38 +/- 9 months, no group II patient has had a recurrence of his arrhythmia.(ABSTRACT TRUNCATED AT 250 WORDS)

Angina Pectoris↗
PubMed1988

Colchicine therapy of the renal amyloidosis of ulcerative colitis.

Two patients with severe proteinuria, due to renal amyloidosis complicating chronic ulcerative colitis, improved remarkably with colchicine therapy. One patient with an initial daily urine protein excretion of 13.70 g had a reduction within 2 mo to 6.50 g and to 0.37 g after 9 yr. The other patient's daily urine protein excretion was 9.00 g. This was reduced to 5.10 g/day within 3 mo and was 0.53 g/day by 8 mo. Renal function remained stable or improved during the period of therapy. Colchicine resulted in rapid and prolonged benefit for these patients, despite their amyloid-induced nephrotic syndrome.

Adult↗
PubMed1988

The metabolic impact of active ulcerative colitis. Energy expenditure and nitrogen balance.

Resting energy expenditure and nitrogen balance were measured shortly after admission and shortly before discharge or colectomy in eight adult males hospitalized for active ulcerative colitis. The measured resting energy expenditure was 19% higher than that predicted by the Harris-Benedict formula (p less than 0.01). Fecal and urinary nitrogen losses were 2.1 +/- 1.5 g/day and 13.6 +/- 3.8 g/day, respectively. During the early hospitalization period, daily intakes of calories (1,826 +/- 1,050 kcal) and protein (1.5 +/- 0.4 g/kg) were not sufficient to maintain energy (-548 +/- 964 kcal/day) and nitrogen (-1.5 +/- 3.9 g/day) balances. Energy expenditure and nitrogen losses at the end of the study were similar to the values obtained on admission, but because of a voluntary increase in caloric (by 42%) and protein (by 37%) intake during the hospitalization both energy balance (+434 +/- 409 kcal/day) and nitrogen balance (+4.6 +/- 6.5 g/day) (p less than 0.05) improved. These results suggest that, although the metabolic impact of active ulcerative colitis is mild, it does result in negative energy and nitrogen balances. Dietary intake can be voluntarily increased during hospitalization to improve energy and nitrogen equilibrium.

Adult↗
PubMed1988

Fecal alpha 1-antitrypsin as a measure of Crohn's disease activity. The effect of therapy and anatomical extent of disease.

Random fecal alpha 1-antitrypsin levels, determined in 35 patients with Crohn's disease, showed a strong correlation with clinical activity (Spearman r = 0.44, p = 0.01). In 85% of the patients, both clinical and fecal measurements of Crohn's disease activity agreed (kappa = 0.368, p = 0.011). Similar agreement occurred in those with colitis (kappa = 0.385, p = 0.035) or ileitis (binomial, p less than 0.001) and those with (binomial, p = 0.006) or without (kappa = 0.492, p = 0.01) prior surgery. There was a reduction in the mean clinical score and fecal levels among all patient groups after treatment. There was good agreement between both disease activity measurements after medical therapy. However, even after apparent surgical "cure," fecal protein levels generally remained at values consistent with diffuse occult intestinal disease. When surgical removal of all diseased bowel was not possible, fecal measurements again appeared superior to clinical assessment in reflecting the residual disease. A good correlation existed between the anatomical extent of disease and fecal levels (r = 0.606, p = 0.028), in contrast to the relationship between extent and clinical score (r = 0.14, p = 0.64). Random fecal alpha 1-antitrypsin determinations provide a measure of the intestinal activity and extent of Crohn's disease. They may be useful in monitoring the response to therapy and the presence of residual disease after surgery.

Adult↗
PubMed1988

Fulminant herpes simplex hepatitis in a patient with ulcerative colitis.

A 16 year old girl with ulcerative colitis developed hepatitis with a high fever, leukopenia and a marked rise in serum transaminases without jaundice. There were no skin, oral, or genital lesions. Liver biopsy was precluded by abnormalities in coagulation. Postmortem examination of the liver by light and electron microscopy, culture, immunoperoxidase and immunofluorescent staining confirmed the diagnosis of hepatitis due to type 1 herpes simplex virus. Despite the rarity, this viral aetiology should be included in the differential diagnosis of all patients with severe hepatitis. The absence of mucocutaneous lesions should not exclude the diagnosis, especially when other clinical features are compatible.

Adolescent↗
PubMed1988

Olsalazine in the treatment of ulcerative colitis among patients intolerant of sulphasalazine: a prospective, randomized, placebo-controlled, double-blind, dose-ranging clinical trial.

Sixty-six outpatients with active ulcerative colitis who were intolerant of sulphasalazine were treated in a double-blind randomized trial with placebo or olsalazine in daily doses of 0.75, 1.5, or 3 g. Overall, 35% of patients receiving olsalazine improved clinically, compared to 16% of patients receiving placebo. Statistically significant or nearly significant improvement was demonstrated in colitis activity by the end compared to the beginning of the study within the combined olsalazine group and within patient groups receiving olsalazine at daily doses of 1.5 g and 3 g. There were no differences between the treatment and placebo groups for any of the reported adverse effects or laboratory variables. The data suggest that olsalazine is effective for the treatment of ulcerative colitis and is well tolerated among patients intolerant to sulphasalazine.

Administration, Oral↗
PubMed1987

Pancreatitis coincident with Crohn's ileocolitis. Report of a case and review of the literature.

A young woman who developed acute pancreatitis coincident with Crohn's disease is presented. The pancreatitis was documented by pancreatic hyperamylasemia, elevated urine amylase activity, abdominal sonogram, computed tomography, and laparotomy. A cause-and-effect relationship has not been established, however; no etiology other than the Crohn's disease, which was confined to the ileum and colon, could be identified. Surgical removal of the severely involved ileum led to the resolution of the pancreatitis. A possible relationship between acute pancreatitis and Crohn's disease is proposed, although potential pathophysiologic mechanisms are unknown. The diagnosis of pancreatic involvement in such cases may make an important contribution to therapy.

Acute Disease↗
PubMed1987

Olsalazine sodium in the treatment of ulcerative colitis among patients intolerant of sulfasalazine. A prospective, randomized, placebo-controlled, double-blind, dose-ranging clinical trial.

Sixty-six outpatients with active ulcerative colitis who were intolerant of sulfasalazine were treated in a double-blind randomized trial. They received placebo or olsalazine sodium in daily doses of 0.75, 1.5, or 3 g. Overall, 35% of patients receiving olsalazine improved clinically, compared to 16% of patients receiving placebo. When the colitis activity at study entry was compared with that observed at the completion of the study period, statistically significant or nearly significant improvement was demonstrated within the combined olsalazine group (p = 0.01) and within patient groups receiving olsalazine at daily doses of 1.5 g (p = 0.04) and 3 g (p = 0.055). A dose-response relationship was suggested because 16%, 29%, 27%, and 50% of patients improved in the placebo and 0.75-, 1.5-, and 3-g olsalazine groups, respectively, (p = 0.04). A similar pattern of improvement was seen when sigmoidoscopic criteria were used, although a dose-response relationship was not demonstrated. There were no differences between the treatment and placebo groups for any of the adverse effects or laboratory variables reported at baseline or during the trial period. Four patients were withdrawn because of adverse reactions: 2 developed a skin rash while receiving olsalazine and 2 had diarrhea, one while on olsalazine and the other while on placebo. The data suggest that olsalazine is effective for the treatment of ulcerative colitis and is well tolerated among patients intolerant to sulfasalazine.

Adolescent↗
PubMed1987

Predicting the outcome of corticoid therapy for acute ulcerative colitis. Results of a prospective, randomized, double-blind clinical trial.

We looked for factors predicting the therapeutic outcome in 66 patients with severe ulcerative colitis treated with intravenous hydrocortisone or corticotropin (ACTH) for 10 days. Patients were randomized before therapy within strata defined by whether they had received oral corticosteroids continuously before the study (group A, 35 patients) or not (group B, 31 patients). Comparisons were made between groups receiving what we considered optimal corticoid therapy, hydrocortisone for group A and ACTH for group B. Overall, therapeutic success was achieved in 28 (42%), with a median time of 7.5 days. Favorable factors measured on admission to the study were those suggesting less severe colitis activity: absence of fulminant disease, limited disease extent, a shorter duration of the present attack, fewer stools, a lower erythrocyte sedimentation rate (ESR), and a higher hemoglobin. Factors compatible with more severe colitis including fulminant activity, more extensive disease, a shorter total disease duration, bloody stools, and fewer bowel movements, favored an early response among those patients who were to achieve a remission. Prolonging therapy beyond 10 days by switching to the alternate corticoid drug did not improve the remission rate. Achieving remission during the initial therapy period, especially when it occurred early, was the most important predictive factor for a favorable clinical course during the following year. Prolonging therapy did not improve the 1-year remission rate. In fact, a higher proportion of patients who continued to require therapy underwent colectomy than those who received one treatment course.

Acute Disease↗
PubMed1987

Colorectal cancer in regional ileitis.

Six patients, with overt Crohn's disease of the small bowel developed colorectal cancer. Three distinct clinical patterns were observed. Three patients had advanced rectal adenocarcinoma and a relatively long duration of Crohn's disease, two patients had an early adenocarcinoma and a short antecedent history, and a sixth patient had advanced cloacogenic cancer of the anorectum. The prognosis for a patient with carcinoma in association with regional enteritis was poor when there was advanced disease at the time of diagnosis. The late diagnosis of the cancer may have been the result of three erroneous assumptions. First, scepticism as to the association of Crohn's disease and cancer despite the evidence to the contrary; second, misinterpretation of the intestinal symptoms of the carcinoma as those of the underlying inflammatory bowel disease; and third, confusing the clinical picture of colorectal cancer with that of benign perianal disease with stricture formation. Increased awareness of the association of cancer and Crohn's disease, particularly the development of cancer in apparently normal bowel, and careful evaluation of all new symptoms should improve the prognosis of this potentially lethal complication of inflammatory bowel disease.

Adenocarcinoma↗