Propylthiouracil-induced agranulocytosis in four patients previously treated with the drug.
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Aged↗
Biomedical subjects
A Shiran
Publications and source records attributed to A Shiran.
The mammalian genome contains a high proportion of processed pseudogenes corresponding to ribosomal protein L19.
The mammalian genome contains multiple copies of ribosomal protein (rp) L19-related sequences. Screening of mouse and rat genomic libraries with cloned rpL19 cDNA yielded seventeen independent lambda Charon 4A recombinant phages containing twelve and five genes for mouse and rat rpL19, respectively. Structural analysis indicated that all of these rpL19 genes contain the entire coding sequence (approx. 700 bp) but lack introns. The nucleotide sequence of a mouse gene (rpL19-17), exhibiting the highest homology with the mouse rpL19 cDNA, revealed genetic lesions which would preclude the translation of an intact protein, from a putative transcript. Based on these features we propose that these clones represent processed genes of which most, if not all, are pseudogenes.
Animals↗
Diffuse hemangiomatosis of the spleen: splenic hemangiomatosis presenting with giant splenomegaly, anemia, and thrombocytopenia.
In an elderly patient with oligosymptomatic giant splenomegaly, clinical and laboratory data were nondiagnostic, while nonhomogeneous splenic enlargement was the only finding detected by imaging procedures. Splenectomy was performed and diffuse hemangiomatosis of predominantly capillary-type found. The failure of imaging techniques to even hint at the nature of the underlying disorder is comprehensible in view of the organ being essentially replaced in toto by the abnormal vascular channels. Diffuse splenic hemangiomatosis, a rare condition, may cause hypersplenism, and its diagnosis may be elusive because of misleading patterns on imaging.
Anemia↗
Determinants of improvement in exercise capacity in patients undergoing cardiac rehabilitation.
In order to identify patients who benefit most from a cardiac rehabilitation program, we studied retrospectively all patients who completed a 3-month comprehensive cardiac rehabilitation program during a 2-year period. Questionnaires regarding physical exercise habits were sent to 122 patients and returned by 117 (96%) of them (53 post-acute myocardial infarction, 50 post-coronary artery bypass surgery, 14 post-infarction and surgery, 2 post-angioplasty). Exercise capacity (subset of 66 patients) improved by 19% after rehabilitation (7.8 +/- 3.1 to 9.3 +/- 2.7 METs, p < 0.0001). Univariate and multivariate analysis identified initial exercise capacity as the only independent variable predicting improvement in exercise performance (inverse relationship) (r2 = 0.24, p < 0.0001). The improvement was not related to age, sex, left ventricular function or time from cardiac event to rehabilitation. Patients recovering from both infarction and coronary artery bypass surgery showed a greater improvement (delta exercise capacity 2.8 +/- 1.4 METs) than patients after myocardial infarction alone (delta exercise capacity 0.8 +/- 2 METs, p < 0.02). Improvement was sustained for up to 2 years after completion of the program.
Adult↗
Exercise testing in patients with chest pain and normal coronary arteries: improving test specificity by use of a simple logistic model.
Despite an exercise electrocardiogram (ECG) positive for ischemia by established criteria, many patients referred for coronary angiography to evaluate chest pain are found to have angiographically normal coronary arteries (NCA). Exercise ECG were analyzed from 27 patients with chest pain and angiographically NCA and 28 patients with chest pain and coronary artery disease (CAD) using univariate and multivariate logistic regression analysis. We derived the following logistic model for the logit probability of CAD: 3 + SEX x 4 - METs x 0.7 + STDV5 x 0.8, where SEX = 0 for female and SEX = 1 for male, METs = maximal estimated work load (metabolic equivalents) and STDV5 = horizontal or downsloping ST depression (mm) in V5. A logit probability > or = 0 identified CAD with a sensitivity of 79% and a specificity of 89%. The model correctly identified 28/36 (78%) patients with CAD, and 7/10 (70%) patients with NCA (correct diagnosis 76%; p < 0.02) in a separate random group of 46 unselected patients with positive exercise tests undergoing diagnostic coronary angiography.
Adult↗