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Biomedical subjects

T Rosenthal

Publications and source records attributed to T Rosenthal.

At least 163 records · Page 9Linked to original sources

Uncommon presentation of pheochromocytoma: case studies.

Twelve patients with pheochromocytoma have shown unusual clinical and laboratory presentation. These include three patients with cardiac manifestations (sick sinus syndrome, obstructive cardiomyopathy and ischemic ECG changes). Two patients with gastrointestinal problems (acute abdomen due to ischemic bowel and constipation). One child with sudden blindness and one, non diabetic patient with polyuria. Laboratory findings included four patients with diabetes mellitus, four patients with hypercalcemia two of them with concomitant hyperreninemia and one patient with hypokalemia. Awareness of the illness leads to the discovery of unusual cases and even a most severely sick patient can make a complete recovery.

Adolescent↗

Undiagnosed tuberculosis in hospitalized patients.

Eighty-two cases of active tuberculosis (TB) were diagnosed only at autopsy in patients hospitalized in the Chaim Sheba Medical Center during a 21-year period (1960 to 1980). Some 75 percent of the patients were over 50 years old and a large number of them suffered from accompanying diseases or drug therapy which suppresses the immune system. Diagnostic measures for the confirmation of tuberculosis (skin tests; cultures of sputum, urine, gastric juice; liver biopsy) were not taken in 75 percent of the cases. In those taken, skin tests were negative in 75 percent of cases, most probably as a sign of anergy. The rest were borderline cases in whom the diagnosis of TB was not accepted affirmatively.

Adolescent↗

Nifedipine as a substitute for converting enzyme inhibitors in the treatment of renovascular hypertension.

Nifedipine long acting tablets were substituted for converting enzyme inhibitors in eight patients with renovascular hypertension. A significant drop in blood pressure was observed. Nifedipine was shown to be as effective (in lowering blood pressure) as a drug that acts directly on the renin angiotensin system. These data offer support for previously reported findings that the action of angiotensin II is calcium mediated.

Adult↗

Enalapril in the treatment of renovascular hypertension.

Enalapril, an angiotensin converting enzyme (ACE) inhibitor, was given to 12 patients with renovascular hypertension: To five of them as a single drug after discontinuing other medications, and to seven patients as a substitute for one of their previous medications. The drug proved effective in controlling hypertension in all patients. Flushing and palpitations occurred in two of them, one of whom also showed a rise in creatinine and mild hyperkalemia. Two patients who had developed side effects while on captopril (renal deterioration in one, and severe rash in the other) tolerated enalapril well. Enalapril effectively reduced the blood pressure in the one patient with bilateral renal artery stenosis without causing renal failure.

Adult↗

Diet and weight loss: their effect on norepinephrine renin and aldosterone levels.

The effect of low calorie diet on blood pressure, catecholamines, plasma renin activity (PRA) and aldosterone was examined in 22 obese subjects (19 hypertensives and 3 borderline hypertensives). A significant decrease in blood pressure (P less than 0.05) was observed in all patients after 10 days on the diet. Twenty subjects showed a significant decrease in norepinephrine (NE) levels (P less than 0.05) and two patients showed an extreme increase in NE level. On reexamination six months later these two patients presented with high NE levels and predict blood pressure levels despite having lost 15 and 18 kg respectively. The study group showed a significant decrease in mean PRA (P less than 0.05). A correlation was observed between changes in NE levels and PRA (r = 0.42, P less than 0.05) and between changes in PRA and aldosterone (r = 0.54, P less than 0.05). The reduction in blood pressure associated with caloric restriction in these obese patients may be a result of reduced sympathetic nervous system activity.

Adult↗

Transient renovascular hypertension in childhood.

Two children aged 18 and 30 months presented with severe renovascular hypertension. Initially, surgical intervention was postponed because of the patients' young age. Adequate control of the hypertension and reversal of its sequelae were achieved with aggressive medical management. At present, both patients, aged 9 and 12 years respectively, have discontinued all medication, have achieved normal growth, are normotensive and have normal renal function.

Antihypertensive Agents↗

Anxious depressions. Clinical, family history, and naturalistic outcome--comparisons with panic and major depressive disorders.

Patients with anxiety and depressive states were divided into 4 groups: those with panic attacks only, those with panic disorder and secondary depression, those with depression and secondary panic attacks, and those with depression only. Clinical and familial differences between the groups are described. Patients with both depression and panic attacks had the poorest outcome, and were most likely to be chronically depressed.

Adult↗

Enhanced response of plasma aldosterone to metoclopramide in essential hypertension.

Aldosterone responses to posture and the dopamine antagonist, metoclopramide, were studied in seven normotensive controls and 12 patients with essential hypertension. Both groups had similar basal supine plasma renin activity and aldosterone levels. Aldosterone levels of the hypertensive patients were greater than those of the controls 10 min after assuming an upright posture but indistinguishable at 120 min. Metoclopramide induced a peak fourfold increase above basal aldosterone levels in the hypertensive group as compared to a peak twofold increase observed in the normotensive controls. Mean 120-min integrated aldosterone response area for the hypertensives (237 +/- 44 10(-10) mol min/l) was greater (P less than 0.05) than that for normotensive subjects (106 +/- 32 10(-10) mol min/l). Simultaneous cortisol, plasma renin activity, and serum potassium levels were unaffected by metoclopramide. It is concluded that dopaminergic modulation of aldosterone secretion may be altered in essential hypertension.

Adult↗

Clinical use of captopril in Takayasu's disease.

Three patients with Takayasu's disease (TD), initially observed with hypertension and/or congestive heart failure, were treated with captopril, an orally active inhibitor of converting enzyme. As arteritis in this disease is diffuse and extensive, surgical correction of renovascular hypertension is often delayed or impossible. Our experience enables us to recommend captopril for conservative treatment in TD.

Adult↗

Long acting nifedipine in the treatment of severe hypertension.

The medication of patients receiving hydralazine, captopril and minoxidil was replaced by a new galenical form, long-acting nifedipine. An additional decrease in blood pressure was observed in most of the patients. Renal function was maintained in all of them. Adverse reactions may be reduced by the use of long-acting nifedipine, which would permit a reduction in the dosage of captopril and minoxidil.

Adult↗

A comparative study of infective endocarditis.

A survey of hospitalizations at the Chaim Sheba Medical Center, covering two nonconsecutive decades (1951-60 and 1970-79), included 213 patients (228 episodes) with infective endocarditis. The increase in the age of patients and in the frequency of atherosclerotic heart disease, as well as the introduction of techniques such as heart catheterization and open-heart surgery, are responsible for the differences in clinical course, microbiology and therapy. Despite the changed pattern, rheumatic heart disease remained the principal underlying disease in both periods and Streptococcus viridans remained the most common pathogen. Not a single case of drug addiction appeared in our material, despite its increasing frequency in Israel.

Adolescent↗