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Biomedical subjects

A R Patel

Publications and source records attributed to A R Patel.

At least 19 recordsLinked to original sources
PubMed1990

The accuracy and precision of the Accutracker ambulatory blood pressure monitor.

Prerequisite to the use of ambulatory blood pressure monitors in epidemiologic research is demonstration of a satisfactory level of accuracy and precision. Previous evaluations of these devices raise a number of methodological concerns which complicate interpretation of their findings. Also, important issues regarding the precision of blood pressure measurements and the identification of factors associated with measurement inaccuracies remain unaddressed. To assess the accuracy and precision of the Accutracker ambulatory blood pressure monitor, we obtained five serial estimates of resting blood pressure on 120 ambulatory subjects in The Johns Hopkins Medical Institutions in 1987. Two Accutrackers and two manual observers independently recorded blood pressure with the order determined at random. The fourth observer in each sequence obtained a replicate measurement. For both systolic and diastolic blood pressures, the mean difference between Accutracker and manual measurements was less than 3 mmHg for each pairwise comparison. Scatter plots and regression analyses demonstrated that both Accutrackers tended to underestimate high systolic and diastolic blood pressures. In bivariate and multivariate analyses, increased age was significantly associated with underestimation of systolic blood pressures by both Accutrackers. With respect to the precision of blood pressure measurement, no significant differences were present among the four observers. In summary, our data suggest that the Accutracker has satisfactory accuracy and precision, but that accuracy is not uniform across patient subgroups.

Adult↗
PubMed1990

Recombinant alpha-interferon therapy in multiple myeloma.

Three patients with multiple myeloma were treated with recombinant alpha-interferon (r IFN-alpha 2b Intron AR) along with combination chemotherapy i.e. melphelan and prednisolone. In one case it was given as an initial therapy, while the other two patients had refractory and relapsing disease respectively. IFN-alpha 2b was given in the dose of 2 x 10(6) Mu/m2 by subcutaneous injection thrice in a week for six months in two patients and for three months in one patient. All three patients experienced improvement in bone pains; partial response with reduction in the paraprotein level was seen in one patient; while there was no radiological, biochemical or haematological improvement in two patients. Side effects noted were flu like syndrome in all three patients and urticaria in one patient. They were treated symptomatically and did not require cessation of interferon therapy.

Adult↗
PubMed1979

Fibrosarcoma of the mediastinum.

Fibrosarcoma is a rare primary malignant tumor of the mediastinum. Three cases are presented with different presenting symptoms and clinical manifestations. Thoracotomy with biopsy of the mass is the only method for arriving at a definitive histologic diagnosis.

Adult↗
PubMed1979

Persistent ST segment elevation in left ventricular aneurysm before and after surgery.

Post-myocardial infarction aneurysms are often accompanied by persistent ST segment elevations. To determine whether or not these ST segments regress following successful surgery for left ventricular aneurysms, serial electrocardiograms were studied in 74 patients and compared to changes of heart size and NYHA Functional Class. The mean postoperative follow-up period was 18.2 months (range 3 to 52 months). The mean precordial sigma ST elevation preoperatively was 5.27 mm. and 4.71 mm. after surgery (P less than 0.025). For the highest ST segment of an individual lead, the mean values were 1.9 mm. before surgery and 1.88 mm. postoperatively (P less than 0.1). Although clinical improvement occurred in 66 (89.2 per cent) by NYHA class and x-ray evidence of improvement was seen in 46 (62.2 per cent), a degree of ST elevation remained in all cases and was less elevated in only 19 (25.7 per cent). After surgery for left ventricular aneurysm, ST segments tend to remain elevated with little apparent relation to reduction of heart size or clinical improvement.

Adult↗
PubMed1979

Giant trichobezoar--an unusual case.

It has been known for several thousand years that concretions of animal and vegetable matter form in the stomachs and intestines of certain animals. These objects are known as bezoars. The finding of such curiosities in man is also recognised but is rare. A short history of bezoars is given and a case of a giant trichobezoar reported. The medical, surgical and psychiatric aspects are discussed.

Adolescent↗
PubMed1978

Mediastinal lymphangioma.

Mediastinal lymphangioma is an uncommon benign tumor accounting for 0.7 to 4.5% of all mediastinal masses. Lymphangiomas consist of dilated cystic lymph spaces lined by single layers of endothelium and do not undergo malignant change. Most mediastinal lymphangiomas are asymptomatic. There are no specific radiological findings. Surgical excision is the treatment of choice and the prognosis is excellent.

Adult↗
PubMed1978

Cyclophosphamide induced nail pigmentation.

Cyclophosphamide therapy may occasionally cuase black pigmentation of the nails. We report five cases with this side effect and review the data on eleven cases in the literature. These changes start in the proximal nail beds and progress distally; on withdrawal of cyclophosphamide, clearing of the nail pigmentation proceeds in a similar fashion. The development of the nail pigmentation does not bear any relation to the primary condition for which cyclophosphamide was prescribed. The dose of the drug before the onset of pigmentation ranged from 1.2 to 12.3 g; the duration of treatment ranged from 10 days to 26 weeks. The mechanism of the nail pigmentation is unknown.

Adolescent↗
PubMed1978

Transient pseudoleukocytosis caused by cryocrystalglobulinemia.

A patient with Sjögren's syndrome and cryoglobulinemia was found to have pseudoleukocytosis when a leukocyte count was performed on an electronic particle counter. This apparent increase in the leukocyte count was found to be caused by spontaneous crystallization of the cryoglobulin. Further studies showed that this phenomenon was transient. Disappearance of the spontaneous crystal formation without a change in the level of cryoglobulin suggests the possibility of an interaction between the cryoglobulin and a plasma component. Factors affecting spontaneous crystallization of cryoglobulins and the laboratory as well as the clinical implications of pseudoleukocytosis are discussed.

Cold Temperature↗
PubMed1977

Acute renal failure after low-dose irradiation. A complication of chronic lymphocytic leukemia.

A middle-aged woman received low-dose irradiation for treatment of chronic lymphocytic leukemia: 1,000 rads to the spleen in four sessions over four days and 400 rads to each abdominal quadrant in eight sessions over eight days. Three days after the last irradiation session, acute hyperuricemic renal failure developed and conservative treatment was begun, with use of hydration, forced diuresis, alkalization, and short-term peritoneal dialysis. Uric acid levels were carefully monitored. Renal function promptly returned to normal.

Acute Kidney Injury↗
PubMed1977

The use of frozen, thawed erythrocytes in blood banking: a report of 28 months' experience in a large transfusion service.

A program of component therapy using largely frozen erythrocytes was initiated at Cook County Hospital in July 1973. Use of the three existing washing systems for routine preparation of frozen erythrocytes has shown that there are differences in the levels of free hemoglobin, hematocrit, and residual glycerol in the washed products. Adenosine triphosphate, 2,3-diphosphoglycerate, and extracellular potassium and sodium were found to be within acceptable limits. Some expired units were cultured and were found to be positive for Staphylococcus and Corynebacterium. The source of contamination has not been determined. Frozen blood, when available, has been given to all patients, regardless of age or clinical condition. The incidence of transfusion reactions has decreased from 0.57% prior to the inception of the component therapy program to 0.11% since that time. Two cases of possible posttransfusion hepatitis occurred in patients who had received non-frozen blood, and in three patients who received non-frozen erythrocytes and/or components as well as frozen blood. Although the goal of the program was the use of frozen erythrocytes exclusively, only 64% use was achieved, as sufficient quantities of blood for freezing were not available at all times.

Blood Banks↗
PubMed1977

Hemophiliac with hemolytic anemia resulting from factor VIII concentrate.

Bilateral herniorrhaphy was successfully performed on a group AB hemophiliac with cirrhosis of the liver. Adequate hemostasis was maintained with infusions of commercial factor VIII concentrates and fresh frozen plasma. An anti-A antibody mediated hemolytic reaction occurred in the postoperative period. Hemolysis subsided after the cessation of commercial factor VIII infusions. The risk of such hemolytic reactions could be eliminated through the use of group-specific cryoprecipitated factor VIII.

ABO Blood-Group System↗