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Biomedical subjects

A Yarmolovsky

Publications and source records attributed to A Yarmolovsky.

9 recordsLinked to original sources
PubMed2001

Successful use of high dose rate brachytherapy for non-malignant bronchial obstruction.

High dose rate (HDR) endobronchial brachytherapy is a palliative treatment for symptomatic airway obstruction by malignant tumours. We report a novel use of HDR brachytherapy for treating non-malignant bronchial obstruction. The patient had a metal stent placed in a reconstructed airway after a bronchial tear to ensure patency. Granulation tissue formation in and around the stent caused symptomatic occlusion of the airway, necessitating multiple laser applications. A single treatment of HDR brachytherapy (1000 cGy) was delivered following laser therapy. The patient remains well 15 months after treatment with no evidence of recurrent granulation tissue formation on bronchoscopy. HDR brachytherapy is an effective treatment for non-malignant airway obstruction.

Adult↗
PubMed2001

Relationship between pulmonary function and unsupported arm exercise in patients with COPD.

UNLABELLED: In patients with chronic obstructive pulmonary disease (COPD) the limitation on unsupported arm exercise (UAE) is predominantly respiratory muscle function-dependent. It is characterized by neuromechanical dysfunction (thoracoabdominal dyssynchrony) of the inspiratory muscles (diaphragm, accessory), superimposed by lung mechanics dysfunction. The undergoing mechanism is probably multifactorial. To study the relationship of resting pulmonary function and UAE performance in patients with COPD. Twenty-one patients, mean age 63 +/- 7 years, with COPD [forced expiratory volume in the first second (FEV1) 42 +/- 12% of predicted] underwent assessment of resting lung function (inspiratory capacity 57 +/- 17%; functional residual capacity 204 +/- 38% of predicted), maximal inspiratory pressure (67 +/- 14 cmH2O), upper arm circumference (30 +/- 2 cm), and symptom-limited cardiopulmonary UAE assessments. UAE consisted of bilateral anterior arm elevation to shoulder level at a rate of 40 arm strokes.minute-1. A series of stepwise multiple regression models were fitted to the data to predict exercise time from resting pulmonary function indices. RESULTS: Statistically significant correlations (r) were found between exercise time and inspiratory capacity (% of predicted) (r = 0.67, p = 0.0008), maximal inspiratory pressure (cmH2O) (r = 0.47, p = 0.03), upper arm circumference (r = 0.74, p = 0.0001), FEV1 (% of predicted) (r = 0.62, p = 0.0026), oxygen uptake (r = 0.56, p = 0.0085) and functional residual capacity (% of predicted) (r = -0.41, p = 0.06, borderline). Inspiratory capacity (% of predicted), functional residual capacity (% of predicted), upper arm circumference (cm) and FEV1 (% of predicted) explained 77% of the variance in exercise time. Therapeutic strategies that aim to increase inspiratory capacity or decrease functional residual capacity, or increase inspiratory muscle strength and upper arm/torso muscle endurance are likely to alleviate symptoms and improve UAE performance in patients with COPD.

Aged↗
PubMed2000

[High dose endobronchial brachytherapy for malignant airway obstruction: first study of 30 patients].

Brachytherapy is especially suitable for palliative treatment of endobronchial tumors adjacent to internal organs that might be damaged by intensive external beam radiation, but are easily accessed with a flexible bronchoscope. This treatment is mostly palliative. 30 patients underwent such palliative high-dose endobronchial brachytherapy to alleviate malignant airway obstruction. With the aid of a flexible fiberoptic bronchoscope an endobronchial catheter was inserted adjacent to the tumor and treatment delivered using a 192Ir remote afterloader for 5-10 min, in 2 or 3 sessions. There was symptomatic improvement in 26 (86%) and objective improvement in 27 (90%). 1 patient died of hemoptysis.

Aged↗
PubMed2000

Severe amyloidosis with mild multiple myeloma--an unusual course.

Amyloidosis may be primary or myeloma-associated. Skeletal lesions and the percentage of bone marrow plasma cells (<10% in primary, >20% in myeloma) account for the major differences between the two varieties. In the literature there are rare cases of primary amyloidosis presenting without myeloma and followed by development of myelomatous manifestations. Usually, the primary disease (i.e. the myeloma) is advanced, when amyloidosis is diagnosed. We describe a patient who had presented with a severe and progressive systemic amyloidosis and was diagnosed later to have a mild light chain myeloma. Aggressive treatment with melphalan, prednisone and colchicine resulted in a temporary partial remission, followed by a rapid downhill course, and the patient's death. The point of relatively mild myeloma following a rapidly progressive course of advanced amyloidosis is emphasized. Awareness of the possibility of such a combination may lead to early diagnosis, a more aggressive or novel therapeutic approach and, possibly, to a better prognosis.

Amyloidosis↗
PubMed1995

Is it possible to improve the autopsy rate?

To improve the autopsy rate in a department of internal medicine, the method reported by Clayton and Sivak in 1992 was simplified and applied for a 12 month period, from January through December 1993. The basic principle of this method is involvement of the senior resident staff and supervision of the project by the head and deputy head of the department, on a daily basis. A simple form was designed for this purpose and was completed for each case. Results were compared with those between the same months in 1992. An increase in the autopsy rate from 1.8% in 1992 to 26.7% during the trial period in 1993 was noted.

Autopsy↗
PubMed1995

Hemorrhagic pleural effusion as a complication of chronic lymphocytic leukemia.

We report a case of hemorrhagic pleural effusion in a 59-year-old-man with chronic lymphocytic leukemia (CLL). The association between pleural effusion and CLL has been rarely reported and we believe that the pleural effusion probably reflected an advanced and refractory disease in our patient. Early detection of this complication is essential for appropriate therapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

Chorea in polycythemia vera: a rare presentation of hyperviscosity.

A 65-year-old woman developed severe chorea as the presenting symptom of the hyperviscosity syndrome together with polycythemia vera and an ovarian cyst. Whole blood viscosity was 69.5 centipoise at a shear rate of 1.1 s-1 (normal 12.0-22.0 centipoise). After four phlebotomies the chorea subsided completely, and the blood viscosity became normal. Hemoglobin level was stable at normal range and then increased to 18.0 g/dl with recurrence of the faciobuccal dyskinesia that disappeared promptly following the phlebotomies. This case emphasizes that in elderly patients with neurological disorders, such as chorea, polycythemia should be strongly considered as one of the treatable causes.

Aged↗