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Biomedical subjects

A M Freedman

Publications and source records attributed to A M Freedman.

At least 55 records · Page 3Linked to original sources
PubMed1988

Percutaneous transluminal angioplasty: delayed response in neurofibromatosis.

Percutaneous transluminal angioplasty (PTA) was eventually successful in a patient with renal artery stenosis due to neurofibromatosis. Although the immediate postangioplasty appearance showed little improvement, the residual stenosis has completely resolved at 5 months. Delayed response to PTA has been previously documented in other types of vascular disease. Its occurrence in renal artery stenosis due to neurofibromatosis emphasizes the importance of long-term follow-up and may be a factor in the poor short-term results that some have reported for PTA in patients with this condition.

Adult↗
PubMed1987

Unusual forms of malaria transmission. A report of 2 cases.

Malaria is uncommonly acquired without mosquito transmission. Two patients presenting with malaria illustrate this rare phenomenon. The first was a 1-month-old child who had received an exchange blood transfusion for severe haemolytic anaemia due to ABO blood incompatibility. The second was a doctor who had taken blood from the first patient. The occurrence of both transfusion malaria and accidental malaria from the same blood transfusion must be very uncommon.

Exchange Transfusion, Whole Blood↗
PubMed1987

Renal revascularization in patients with a single functioning ischemic kidney.

From 1965 to 1985, 19 patients with a single, ischemic kidney underwent renal revascularization. Thirteen patients had a single kidney and six had a single functioning kidney. The cause of the renal artery lesions was atherosclerosis in 17 patients and fibromuscular dysplasia in two. All but one were hypertensive with a mean diastolic blood pressure of 119 mm Hg and they were taking an average of 2.6 antihypertensive medications. Most had diminished renal function with a mean serum creatinine value of 3.7 mg/dl (range 0.8 to 9.0 mg/dl) and a mean creatinine clearance of 38 ml/min (range 8 to 75 ml/min). Three patients required preoperative hemodialysis. The first two patients treated died postoperatively, but no deaths have occurred since 1970. Follow-up among the survivors averaged 32.9 months. The mean serum creatinine value decreased significantly to 2.2 mg/dl postoperatively (p less than 0.04); the mean diastolic pressure decreased significantly to 86 mm Hg (p less than 0.001). One patient was normotensive preoperatively. Of the 16 patients surviving operation, 14 had improvement of their hypertension, one was cured, and only one did not benefit. No patient's hypertension was worse. The mean number of postoperative antihypertensive medications decreased significantly to 1.5 medications per patient (p less than 0.02). These data suggest that an aggressive surgical approach is warranted in patients with a single ischemic kidney in need of revascularization because of the gratifying response both in control of hypertension and improvement of renal function.

Adult↗
PubMed1986

Recognizing the role of bereavement and reactive depression in modern psychiatry.

In the modern world the recognition, understanding and treatment of bereavement in recent widows, widowers, those who experienced severe medical and surgical trauma, and victims of disasters is essential for all physicians, rescue workers such as the International Red Cross, and the community in general. This paper reviews the consequences of personal encounters with catastrophic events, as well as methods of immediate and long-term management. Similarly, the dynamic manifestations and treatment of psychologic dissonance in the family of victims, the community, and survivors are addressed. Of special interest are the problems of rescue workers, witnesses and reporters involved in disasters.

Adjustment Disorders↗
PubMed1985

Maintenance of psychosocial attitudes in medical students.

Attitudes of medical students towards the psychosocial aspects of illness is of serious concern to medical educators. It is thought that medical students are overwhelmingly disease-oriented and not sufficiently sensitive to the role of the psychological, emotional, sociological and economic factors in the etiology and management of illness. In the present study the ATSIM (Attitudes Towards Social Issues in Medicine) was presented to third year medical students and compared with their responses obtained 2 years previously when they were first year students. The data suggest that third year medical students have positive attitudes towards certain psychosocial issues (the importance of social factors as determinants of health or illness, the role of preventive medicine in maintaining health, the role of physician-patient interactions in patient care). These attitudes were positive during the students' first year and have been maintained during the course of medical school. These finding are contrary to previous studies which indicate a deterioration in attitudes during the course of medical school.

Adult↗
PubMed1985

The evaluation of postoperative function of the adrenal gland.

The cosyntropin (Cortrosyn) stimulation test has been adapted for use in the postoperative period. The normal adrenal gland response to 200 micrograms of cosyntropin given intravenously has been quantified at six, 12, 24, 48 and 72 hours after extensive general surgical procedures. The value of the test in quickly and accurately diagnosing postoperative acute insufficiency of the adrenal gland remains to be established.

Adrenal Gland Diseases↗
PubMed1985

The serum and urinary cortisol response to operative trauma.

Serum and urinary cortisol levels were monitored throughout the perioperative period in eight patients who underwent elective extensive general surgical procedures. Significant elevations of serum cortisol levels occurred four and eight hours after anesthetic induction and were reflected by elevated urinary cortisol production on the day of operation. Cortisol serum levels and urinary production rapidly returned toward normal as all subsequent measurements were insignificantly different from preoperative values. Adrenal gland stimulation resulting from general surgical procedures is intense but short-lived.

Adrenal Glands↗
PubMed1984

Capillary blood flow: videodensitometry in the atherosclerotic patient.

Recently the noninvasive technique of videomicroscopy has demonstrated qualitative morphologic changes in the nutritional skin capillaries in atherosclerotic (ATS) patients. The purpose of this study is to quantitatively examine the ATS microcirculation and effects induced by reconstructive surgery. Capillary blood flow velocity (CBV) of single vessels within the nail fold of the large toe was measured by dual-sensor videodensitometry in 14 ATS patients (age 45 to 80 years) and 11 age-matched controls. In addition to CBV, capillary diameter (CD) and the number of flow-active capillaries (FC) were also measured at constant temperature. Of the 14 patients, eight had measurements repeated 1 week after reconstructive surgery. The measurements were obtained at rest and then periodically after a 45-second period of pedal inflow occlusion. Respective group averages at rest for CBV, CD, and FC for the 14 ATS patients were as follows: 0.16 mm/sec, 10.5 micron, and 6.8 capillaries per field. Corresponding values for the control subjects were 0.10 mm/sec, 8.7 micron, and 5.3 capillaries per field. Combining CBV, CD, and FC into a measurement of volume capillary flow yielded a value of 281 pl/sec/mm2 for the patients and only 85 pl/sec/mm2 for the controls (p less than 0.02). Peak postocclusion CBV significantly increased, whereas FC significantly decreased relative to rest in the control group; however, the only patient group that responded to occlusion-induced ischemia was the postoperative group. In these patients there was a decrease in CBV and an increase in FC relative to rest. These responses are exactly opposite to those in the age-matched controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1981

Cholestyramine as an aid to management of prolonged diarrhoea in the hospital drip-room. Preliminary findings.

Two groups of children with diarrhoea of more than 7 days' duration were studied. While the length of stay in hospital of the two groups was similar, there was a significant improvement in the frequency and consistency of the stools of the children given cholestyramine. This improvement was also noted in children with positive stool cultures. Cholestyramine also plays an important role in reducing the number of children or intravenous therapy at any time.

Child↗
PubMed1981

Effects of an ACTH short chain neuropeptide in man.

The authors studied the effect of an ACTH 4-9 analogue (the shortest behaviorally active fragment of the ACTH neuropeptide) on mood in normal aging volunteers. These mood changes, described as a sense of well-being, energy, and drive, are consistent with an arousal-stimulant mechanism of action of the compound. No effect of the compound was found on attention or memory. Because of its apparent safety and the lack of adverse effects, the authors suggest that this short chain neuropeptide be further explored in older individuals for its mood-elevating and potential antidepressant properties.

Adrenocorticotropic Hormone↗
PubMed1980

Keratotic scabies (Norwegian scabies): case reports and literature review.

Keratotic scabies (KS) (Norwegian scabies) is a rare variant of Sarcoptes scabeii infestation and is characterized by hyperkeratosis and crusting and by the presence of millions of mites in the horny layer of the skin. KS may be associated with underlying diseases, e.g. immune deficiency states and lymphoreticular disorders, or may occur in neglected or normal patients. We review the literature and present reports on 2 Black South African patients affected by KS. One was mentally defective; the other, submitted to extensive investigations, showed no abnormalities. This is, to the best of our knowledge, the first report of KS in South African Blacks.

Adolescent↗