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Biomedical subjects

A Mega

Publications and source records attributed to A Mega.

13 recordsLinked to original sources
PubMed2001

Bone metabolism and gonad function in male patients undergoing liver transplantation: a two-year longitudinal study.

Osteodystrophy is a major complication of end-stage liver disease, especially in postmenopausal women. Our aim in this study was to evaluate bone metabolism and gonad function in men undergoing orthotopic liver transplantation (OLTx). Twenty-three consecutive men (mean age 48+/-13 years) evaluated for OLTx were studied, assessing the following parameters at baseline and 3, 6, 12 and 24 months after OLTx: lumbar spine (L2-L4) bone mineral density (BMD), parathyroid hormone (PTH), osteocalcin (BGP), 25-hydroxyvitamin D (25OHD), free testosterone (FT) and gonadotropins (FSH, LH). At baseline, 12 patients (52%) had a T-score <-2.5 SD and the mean BMD was 0.806+/-0.11 g/cm2 (range 0.470-1.045 g/cm2). The BMD was lower 3 months after OLTx and significantly higher 12 and 24 months after OLTx. A significant increase in serum BGP was observed at 6, 12 (p<0.05) and 24 months (p<0.005) after OLTx. The mean serum PTH level was 26.6+/-3.1 pg/ml at baseline and increased significantly at 12 and 24 months (to 49.4+/-9.9 and 61.2+/-10.1 pg/ml, respectively; p<0.05). 25OHD serum levels were low at baseline and returned to the normal range after 12 and 24 months (baseline, 8.73+/-1.54 ng/ ml; 12 months, 16.4+/-2.6 ng/ml; 24 months, 17.67+/-3.1 ng/ml; p<0.05). FT was significantly lower at baseline than in a group of 10 healthy controls (5.09+/-10.99. vs 10.3+/-1.1 pg/ml; p<0.0001). After OLTx a significant increase in FT was recorded at 6, (p<0.05) and 24 months (p<0.005). FT was not correlated with BMD, however. After OLTx an increase in FSH and LH was observed (but failed to reach statistical significance) at 3 and 6 months, followed by a slight reduction at 12 and 24 months. Thus a high proportion of men with end-stage liver disease do have osteoporosis. After OLTx, an early recovery of gonad function is observed, followed by an increase in bone mass, which occurs from the sixth month onward.

Adult↗
PubMed1999

Persistent parvovirus B19 related anemia of seven years' duration in an HIV-infected patient: complete remission associated with highly active antiretroviral therapy.

A human immunodeficiency virus (HIV)-infected individual was first diagnosed with red blood cell aplasia due to B19 parvovirus infection in late 1989. Over the subsequent seven-year period, he received a total of 119 units of red blood cells (RBCs) and intravenous immunoglobulin every 2-3 weeks. In 1996 combination antiretroviral treatment with a protease inhibitor was initiated. He received four more units during the following two months and then required no more transfusions for the subsequent 24 months of follow-up. His CD4 count progressively increased and DNA polymerase chain reaction for parvovirus B19 became undetectable. Aggressive antiretroviral treatment may effectively diminish transfusion requirements among HIV-infected individuals with pure RBC aplasia resulting from parvovirus B19 infection.

Adult↗
PubMed1999

Occurrence of both t(1;19) and t(8;14) in a patient with chronic lymphocytic leukemia.

While t(1;19) and t(8;14) have been reported singly in pre-B-ALL and Burkitt's lymphoma, respectively, the occurrence of both translocations simultaneously in the same patient is rare. Indeed, a review of the English literature from 1966 to 1999 revealed no case reports with these findings. We report here an 88-year-old patient who was clinically diagnosed to have chronic lymphocytic leukemia and who carried both translocations in her peripheral blood cells. The patient refused to give consent for a bone marrow sample, the preferred tissue for study. The patient's clinical findings are discussed, although the relationship between the clinical information and cytogenetic findings, if any, is not known. Study of additional cases identical to ours will be helpful in determining the correlation, if any, between the patient's phenotype and the occurrence of the two translocations.

Aged↗
PubMed1998

Paclitaxel and concurrent radiation for locally advanced pancreatic carcinoma.

An effective local-regional therapy is needed for adenocarcinomas of the pancreas. Paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton NJ) may enhance the effect of radiation therapy. Paclitaxel synchronizes cells at G2/M, a relatively radiosensitive phase of the cell cycle. We have shown that response to paclitaxel and concurrent radiation (paclitaxel/RT) was not affected by p53 mutations in non-small cell lung cancer (NSCLC). This suggested that paclitaxel/RT was a rationale treatment approach for other malignancies which frequently harbor p53 mutations such as upper gastrointestinal malignancies. We have completed a phase I study of paclitaxel/RT for locally advanced pancreatic and gastric cancers. The maximum tolerated dose (MTD) of paclitaxel was 50 mg/m2/week for 6 weeks with abdominal radiation. The dose limiting toxicities were abdominal pain within the radiation field, nausea and anorexia. Twenty-five patients with locally advanced pancreatic cancer have now completed treatment at the phase II dose level of paclitaxel 50 mg/m2/week with 50 Gy concurrent RT. Thus far, the only grade 3/4 toxicities have been hypersensitivity reactions in 2 patients, asymptomatic grade 4 neutropenia in 3 patients, and non-neutropenic biliary sepsis in 1 patient. Of the first 22 assessable patients treated at the phase II study, 8 obtained a partial response (PR) for a preliminary response rate of 36%. These findings demonstrate that paclitaxel/RT is well tolerated with substantial activity for locally advanced pancreatic cancer.

Adenocarcinoma↗
PubMed1997

Determinants of case selection at morning report.

OBJECTIVE: To determine why residents present certain cases and not others at morning report (MR) in an institution that permits residents the free choice of cases. DESIGN/PARTICIPANTS: Prospective survey of 10 second- and third-year residents assigned to the medical service. SETTING: A 241-bed teaching hospital with 55 categorical internal medicine residents. MEASUREMENTS AND MAIN RESULTS: Over a 4-week period, there were 194 admissions to the medical service on 18 call days preceding MR. Of these admissions, 30 (15%) were presented at MR. Cases were more likely to be presented if they were considered unusual or rare in presentation or incidence (P = .001), involved significant management issues (p = .001), or were associated with remarkable imaging studies or other visual material (p = .006). Residents were more likely to present cases in which they disagreed with attending physicians on management plans (p = .005). Overall, residents rated few admissions as having notable physical examination findings (29/194) or ethical or cost issues (6/194). Of the seven most common admitting diagnoses, representing 44% of admissions, residents did not present cases involving four of these diagnoses. CONCLUSIONS: Residents presented cases at MR that they felt were unique or rare in presentation or incidence for purposes of discussing management issues. Complete resident freedom in choosing MR cases may narrow the scope of MR and exclude common diagnoses and other issues of import such as medical ethics or economics.

Case Management↗
PubMed1994

Noninvasive measurement of forearm blood flow and oxygen consumption by near-infrared spectroscopy.

We applied near-infrared spectroscopy (NIRS) for the simultaneous measurement of forearm blood flow (FBF) and oxygen consumption (VO2) in the human by inducing a 50-mmHg venous occlusion. Eleven healthy subjects were studied both at rest and after hand exercise during vascular occlusion. FBF was also measured by strain-gauge plethysmography. FBF measured by NIRS was 1.9 +/- 0.8 ml.100 ml-1.min-1 at rest and 8.2 +/- 2.9 ml.100 ml-1.min-1 after hand exercise. These values showed a correlation (r = 0.94) with those obtained by the plethysmography. VO2 values were 4.6 +/- 1.3 microM O2 x 100 ml-1.min-1 at rest and 24.9 +/- 11.2 microM O2 x 100 ml-1.min-1 after hand exercise. The scatter of the FBF and VO2 values showed a good correlation between the two variables (r = 0.93). The results demonstrate that NIRS provides the particular advantage of obtaining the contemporary evaluation of blood flow and VO2, allowing correlation of these two variables by a single maneuver without discomfort for the subject.

Adult↗
PubMed1989

Rostral ventrolateral medulla muscarinic receptor involvement in central ventilatory chemosensitivity.

The muscarinic receptor antagonist atropine (105 mM) dramatically decreased the response to increased CO2 when applied by cotton pledgets to the rostral ventrolateral medulla ventilatory chemosensitive area in anesthetized, paralyzed, vagotomized, glomectomized, and servoventilated cats with integrated phrenic nerve activity used as respiratory center output. Lower dose atropine (4.4 mM) and the M1-muscarinic receptor subtype antagonist pirenzepine (10 mM) also significantly decreased the mean CO2 response slope 48.3 +/- 6.2 and 40.7 +/- 6.0% (SE), respectively, and significantly decreased the maximum response value 26.3 +/- 8.1 and 19.2 +/- 3.2%, respectively, without significant effects on blood pressure or on the phrenic response to carotid sinus nerve stimulation. The M2-muscarinic receptor subtype antagonist AF-DX 116 (10 mM) had no significant effect on phrenic output or blood pressure. Application of carbachol (10 mM) at the rostral area augmented eucapnic phrenic output and the maximum value of the CO2 response but decreased the initial slope, effects blocked by atropine. Carbachol also decreased the response to carotid sinus nerve stimulation, suggesting that the system was saturated by carbachol stimulation. Muscarinic cholinergic receptors accessible to surface application at the rostral ventrolateral medulla antagonized by pirenzepine but not AF-DX 116 appear to be involved in the central chemoreceptor process.

Animals↗