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Biomedical subjects

Y Sidi

Publications and source records attributed to Y Sidi.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Recurrent syncope as a presenting symptom of systemic mastocytosis].

A 48-year-old man presented with recurrent syncope which was preceded by facial edema and difficulty in breathing. Physical examination, laboratory tests, abdominal CT and bone scan were all within normal limits. Bone marrow biopsy was consistent with mastocytosis. Systemic mastocytosis consists of a spectrum of disorders characterized by aberrant proliferation of tissue mast cells, and are mainly related to mast cell mediator release.

Diagnosis, Differential↗
PubMed1998

New aspects of malaria imported from Ethiopia.

We describe a high incidence of Plasmodium vivax malaria among travelers returning from Ethiopia, who all took the recommended prophylaxis. Three groups of 7-11 nonimmune travelers received mefloquine (250 mg weekly), beginning 1-2 weeks prior to departure and continuing for 4 weeks after their return. A fourth group mistakenly took inadequate prophylaxis and is presented for comparison. Vivax malaria occurred at a rate of up to 50% in the first three groups; nearly all patients became ill 3 months after exposure. In the fourth group, primary attacks of both falciparum and vivax malaria occurred within 1 month of return, at an incidence of 50%. The use of mefloquine prevented Plasmodium falciparum infection, but a very high rate of relapses of P. vivax infection occurred. The complexity of prophylaxis for malaria in an area with a high rate of both P. falciparum and P. vivax infections and the urgent need for effective causal prophylaxis are discussed.

Animals↗
PubMed1997

Lactic acidosis and fatal myocardial failure due to clozapine.

OBJECTIVE: To describe a patient with neutropenic fever complicated by hyperglycemia, lactic acidosis, and fatal myocardial failure associated with clozapine therapy. CASE SUMMARY: A 37-year-old Ashkenazic Jewish man was admitted for agranulocytosis and fever, which developed after 11 weeks of clozapine monotherapy for drug-resistant schizophrenia. Complete blood counts and a routine serum chemical analysis had been normal before the treatment was initiated, and remained within normal limits during the first 10 weeks of the treatment. On the day of admission, the patient deteriorated rapidly and developed extreme hyperglycemia, severe lactic acidosis, recurrent cardiac arrest, cardiogenic shock, and coma. He died 36 hours later despite intensive treatment. DISCUSSIONS: Clozapine intake reduced fatal aganulocytosis, associated with hyperglycemia, lactic acidosis, and heart failure. White blood cell count monitoring was insufficient to predict these adverse effects. CONCLUSIONS: Clozapine should be avoided in high-risk patients (e.g., the elderly, women, Ashkenazic Jews).

Acidosis, Lactic↗
PubMed1996

Adenine nucleotide metabolism in primary rat neuronal cultures.

The metabolism of adenine nucleotides (AdRN) has been studied previously in whole brains, brain slices and brain extracts, containing mixed populations of neurons and glia. The availability of primary neuronal cultures enables us to study these pathways in almost pure neuronal preparations. The aim of the present study was to characterize the relative importance of the pathways of AdRN metabolism in the neurons. The metabolic fate of (8-14C) adenine and of AdRN prelabeled with (8-14C)adenine were studied in immature and mature primary rat neuronal cultures. Specific inhibitors were used to clarify the various metabolic fluxes, which were evaluated based on the time-related changes in the distribution of label (the cellular nucleotide content did not change during incubation). The turnover rate of AdRN was found to reflect mainly conversion of label to acid insoluble derivatives (AID) and partly degradation to hypoxanthine. The turnover was faster in the immature neurons. The combined addition of 2'-deoxycoformycin (2'-dCF) and of 5'-amino-5'-deoxyadenosine, inhibiting adenosine metabolism, resulted in both cultures in enhanced loss of label from AdRN, mainly to adenosine and adenine. This finding indicates the activity of the futile cycle AMP-->adenosine-->AMP. In both cultures, in the presence of these inhibitors, the ratio (hypoxanthine + inosine)/(adenine + adenosine) was 1.1, indicating that the fluxes through AMP deamination and AMP dephosphorylation are about equal. Addition of L-alanosine, inhibiting the conversion of IMP to AMP, resulted in both cultures, but especially in the mature neurons, in enhanced loss of label from AdRN to hypoxanthine and inosine. This finding indicates the functioning of the adenine nucleotide cycle (AMP-->IMP-->adenylosuccinic acid-->AMP). Under conditions of enhanced degradation of ATP (induced by iodoacetate and antimycin A), addition of 2'-dCF resulted in the immature cultures in lowering the ratio (hypoxanthine + inosine + IMP)/(adenine + adenosine) to 0.62, indicating a shift in favor of AMP dephosphorylation.

Adenine Nucleotides↗
PubMed1996

Dengue fever among travelers.

PURPOSE: The present paper describes the epidemiology and clinical manifestations of dengue fever in a nonendemic population of travelers. PATIENTS AND METHODS: Clinical manifestations, epidemiologic information, and laboratory findings are described for a series of 18 Israeli travelers who tested serologically positive for dengue. RESULTS: All the patients in the series contracted the disease in Southeast Asia, mostly in Thailand; 30% had to be evacuated due to severe morbidity. The clinical symptoms in travelers somewhat differ from the classical description among endogenous populations. High fever, chills, extreme fatigue, and severe headaches were prevalent. Other symptoms considered to be typical of dengue fever, such as myalgia, arthralgia, rash, biphasic fever, were uncommon. Laboratory findings were marked leukopenia, usually accompanied by lymphopenia, thrombocytopenia, liver function impairment, and hyponatremia. Some hemorrhagic phenomena were manifest despite it being the first exposure, without mortality. CONCLUSIONS: Dengue fever among the nonimmune has a somewhat different manifestation from that reported for the Southeast Asian population. Although it is a significant cause for morbidity and hospitalization, it is underestimated as a factor affecting traveler's health. More efforts should be expended in developing an effective vaccine.

Adult↗
PubMed1996

Acute dystonic reaction to methotrimeprazine in hypoparathyroidism.

OBJECTIVE: To report a case of acute dystonic reaction to methotrimeprazine in a patient with untreated hypoparathyroidism, emphasizing the potential increased sensitivity of hypocalcemic patients to the extrapyramidal adverse effects of antipsychotic drugs. CASE SUMMARY: An 80-year-old man who had untreated hypoparathyroidism and chronic hypocalcemia developed an acute dystonic reaction 20 minutes after ingestion of methotrimeprazine 25 mg. His medical history included an ill-defined psychiatric disorder for which he had been treated with methotrimeprazine several years earlier. The patient denied having any other diseases or taking any other medications. After 4 days, the disorientation, psychomotor restlessness, dystonic grimacing, protrusion of the tongue, and speech difficulties disappeared, despite a remaining low serum calcium concentration. DISCUSSION: A possible mechanism, by which striatal calmodulin-mediated adenylate cyclase activation is inhibited by the combined effects of phenothiazines and hypocalcemia, is discussed. CONCLUSIONS: In this patient, it is not possible to ascertain whether the dystonic reaction was due to hypocalcemia, phenothiazine administration, or both. However, it is suggested that patients with hypocalcemia may be sensitive to the extrapyramidal adverse effects of antipsychotics. In addition, acute unexpected dystonic reactions to a small dose of antipsychotics warrants measurement of the patient's serum calcium concentration.

Aged↗
PubMed1996

Clinical manifestations of temporal arteritis: a report from Israel.

OBJECTIVE: To examine the clinical manifestations of 39 patients with temporal (giant cell) arteritis (GCA), allocated during a 10 year period in the largest medical center in Israel. METHODS: The patients were included in the analysis if they fulfilled the new American College of Rheumatology Classification Criteria for the diagnosis of GCA. Patients were divided into biopsy-proven (30 patients) and biopsy-negative (9 patients) groups, and their clinical manifestations were compared using Student's t test for comparison of continuous variables, and Fisher's exact test for comparison of proportions. RESULTS: The most common presenting symptoms of the patients with TA included headache (87% of the biopsy-proven patients), fever (64%), visual abnormalities (41%), and polymyalgia rheumatica (PMR) or weight loss (20% each). Pulmonary involvement occurred in 5 patients. Ten percent of the biopsy-proven patients presented with occult presentation. Analysis of biopsy-proven and biopsy-negative groups revealed the feasibility of making the diagnosis of temporal arteritis on the basis of simple clinical variables, even without a positive biopsy, as the 2 groups of patients had comparable manifestations. However, the biopsy-proven group was older, included more males and presented significantly more with fever, compared to the biopsy-negative patients. Moreover, although not reaching statistical significance, the biopsy-proven patients tended to have more systemic and extracranial symptoms, including pulmonary manifestations. CONCLUSION: Compared to a previous report from Israel on patients with temporal arteritis, almost 2 decades ago, our data suggest that the incidence of the disease in Israel has increased, whereas the ethnic distribution has not changed.

Age Distribution↗