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Biomedical subjects

B Sharf

Publications and source records attributed to B Sharf.

At least 19 recordsLinked to original sources
PubMed1998

[Diagnosis of cerebral embolism by transesophageal echocardiography].

Cerebrovascular events have high mortality and morbidity, especially in the elderly. Ischemia is the main cause and 30% of the ischemic events are embolic and of cardiac origin. The clinical picture is not always typical of the type of stroke, but diagnosis of the mechanism of the event determines treatment. Transesophageal echocardiography (TEE) is a sensitive procedure more appropriate for diagnosing emboli of cardiac origin than transthoracic echocardiography (TTE). We therefore compared TEE and TTE in the determination of the source of emboli in 65 patients with ischemic stroke but without significant atherosclerotic changes in their carotid arteries, and compared these findings with those in 50 patients without stroke. 68% of the patients had potential sources of emboli according to TEE, compared to only 15% according to TTE. In the control group only 24% had potential sources of emboli by TEE. The findings were: clots in the left atrium, severe aortic atheroma, patent foramen ovale with paradoxical shunt, spontaneous echocardiography contrast, vegetations and mitral valve prolapse. The study showed that TEE is better than TTE in detecting the etiology of embolic stroke in those with normal carotid arteries, thus determining appropriate management.

Brain Ischemia↗
PubMed1998

High association of anticardiolipin antibodies with psychosis.

BACKGROUND: Lupus anticoagulant (LA) and anticardiolipin antibodies (aCL) are autoantibodies that can be detected in plasma or serum of patients with autoimmune-related diseases. The presence of these autoantibodies has been associated with recurrent arterial and/or venous thromboembolism as well as with recurrent fetal loss and thrombocytopenia. In recent years, other medical conditions such as dementia, chorea, psychosis, migraine, and peripheral neuropathy have been associated with these autoantibodies. An adverse response to neuroleptic treatment was reported to be associated with the presence of autoantibodies, but these patients rarely developed clinical vascular manifestations. METHOD: We conducted a study of 34 unmedicated patients admitted to the hospital with acute psychosis in whom aCL and LA were examined before and after neuroleptic treatment to determine the presence of antibodies relative to the treatment condition. RESULTS: 32% (11/34) of the unmedicated psychotic patients had antiphospholipid antibodies: we detected elevated titers of IgG-aCL isotype in 24% (8/34) of unmedicated patients (p < .02 compared with 20 normal controls, none of whom tested positive), and 9% (3/34) had LA. Twenty-two patients were followed up after medication; 31.8% (7/22) of these patients showed moderate titers of IgG-aCL (p < .28), and 18.2% (4/22) were LA positive. Altogether, antiphospholipid antibodies were detected in 40.9% (9/22) of the medicated patients. CONCLUSION: This study shows the increased incidence of LA and aCL antibodies in neuroleptic-treated psychotic patients and the possible association between psychosis and antiphospholipid antibodies.

Acute Disease↗
PubMed1996

Brain-stem trigeminal and auditory evoked potentials in multiple sclerosis: physiological insights.

Thirty-six patients with multiple sclerosis were evaluated by means of brain-stem trigeminal and auditory evoked potentials. The brain-stem auditory evoked potentials (BAEPs) were abnormal in 26 patients (72.2%). Brain-stem trigeminal evoked potentials (BTEPs) yielded similar results, showing distorted waveforms and/or prolonged latencies in 25 patients (69.4%). As expected, the MRI proved to be the most efficient single test, revealing plaques in 86.4% of the patients evaluated. However, the diagnostic accuracy of MRI was lower than that provided by the combination of the BTEP and BAEP (88.9%). Moreover, in patients having signs of brain-stem involvement, the BTEP, alone and in combination with the BAEP, proved to be more sensitive than the MRI in revealing brain-stem lesions. Correlation between clinical and BTEP findings could be found only in those patients who presented with signs of trigeminal involvement such as trigeminal neuralgia or dysesthesiae. The analysis of the BTEP waveforms showed two distinct types of abnormality-a peripheral type and a central type-suggesting plaques in distinct locations. Both the BTEP and the BAEP demonstrated a correlation with the clinical course of the disease and the condition of the patient at the time of the evaluation. Relapse of the disease was associated with a marked prolongation of the central conduction time in the BTEP and in the BAEP, suggesting the application of such studies to the monitoring of unstable patients in the evaluation of new therapeutic protocols.

Adolescent↗
PubMed1994

[Idiopathic intracranial hypertension and tetracycline].

Idiopathic intracranial hypertension (IIH, pseudotumor cerebri) was diagnosed in 4 patients who had been treated with tetracycline. The main symptom was headache, and in all there was papilledema. Symptoms and signs improved after tetracycline was discontinued and acetazolamide treatment started. When a patient receiving tetracycline develops IIH, the medication should be stopped as it may be the cause of the IIH, as appeared to be the case in our 4 patients.

Acetazolamide↗
PubMed1993

[Psychiatric manifestations in Wilson's disease].

Wilson's disease is an inherited, autosomal recessive disease characterized by progressive hepatic and neurological symptoms. Clinical features usually start between the ages of 10 and 40. Psychiatric disturbances are present in almost all patients. In about a third of them psychiatric symptoms are present early in the disease and in almost 20% they precede hepatic and neurological dysfunction. In these cases the diagnosis of Wilson's disease is often difficult, as a result of which treatment is begun when the illness is already advanced. We report 3 patients with Wilson's disease in whom the psychiatric manifestations preceded neurological symptoms and necessitated admission for psychiatric treatment.

Adult↗
PubMed1993

Tardive dyskinesia in northern Israel: preliminary study.

Tardive dyskinesia (TD) is an iatrogenic syndrome caused by long-term treatment with neuroleptics and is characterized by abnormal involuntary movements in the orofacial region, lingual dyskinesia and in some cases dyskinesia also in the extremities, head and trunk. In the present study we found 20% TD in chronic-neuroleptic-treated patients with a significantly greater prevalence in females (27% of the total population), and a higher frequency in older patients. In males, patients who received electroconvulsive therapy had a significantly lower prevalence of TD. 23 patients had seizures; 7 of these suffered from TD, all of them female.

Adult↗
PubMed1990

Brainstem auditory evoked potential with increased stimulus rate in minor head trauma.

Fifteen Minor Head Trauma patients were investigated by Brainstem Auditory Evoked Potentials at 10/s and 55/s stimulus rate. The results were compared with those of the same patients at a second examination, two months later, as well as with a matched normal control group. Increasing the stimulus rate in MHT patients caused a significant but reversible delay in the central conduction time. No significant difference was found regarding the interpeak latency differences at a 10/s stimulus rate. The present study suggests that the primary lesion in MHT is ischaemic, affecting synaptic efficiency, and not axonal damage. These findings may be informative on the as yet obscure pathophysiological mechanism of minor head trauma.

Audiometry, Evoked Response↗
PubMed1990

Sulpiride in tardive dyskinesia.

The abnormal involuntary movements in tardive dyskinesia can be reduced by the dopamine antagonist drugs, phenothiazines and butyrophenones, but most cause an increase in Parkinsonian signs. Sulpiride, a benzamide derivative, and selective antagonist of D2 receptors had a significantly beneficial effect on most of 15 patients (p less than 0.01). In 12 patients the improvement was marked. The reduction of abnormal movements was observed even with low doses, and it was not necessary to increase the dose of sulpiride above 600 mg daily. There were no significant side effects during the trial nor during an additional three months of treatment.

Adult↗
PubMed1988

Brainstem auditory evoked potentials to different stimulus rates in parkinsonian patients.

Twenty-five Parkinson's disease (PD) patients were studied by brainstem auditory evoked potentials (BAEP) with increased stimulus rate (ISR) and compared to a control age and hearing matched group. A second comparison was made between L-dopa-treated and untreated PD patients. The results of the study suggest that there is subclinical involvement of the auditory brainstem in PD patients, possibly due to the dopamine influence upon the blood vessels. Our results also indicate that dopamine is probably not involved in the synaptic transmission along the auditory pathway of the brainstem.

Aged↗
PubMed1985

Muscle involvement in progressive diaphyseal dysplasia.

Muscle involvement in progressive diaphyseal dysplasia was evaluated in five children, of whom four were members of one family. Age range was 2 to 10 years 9 months, and mean age was 5.5 years. Evaluation included serum enzymes, electromyography, and muscle biopsy examined by light and electron microscopy. Serum enzymes were usually noncontributory. Electromyography revealed "myopathic pattern" in four of the five patients. Muscle biopsy specimens were taken from three of the five children, including two patients from one family, of whom one had normal electromyography, and one sporadic case. Examination of the biopsy specimens by light microscope was generally not useful, whereas electron microscopic examination revealed myopathic and vascular changes consisting of atrophy of isolated muscle fibers, accumulation of endomysial collagen fibrils, and thickening of the perivascular basement membrane. The main contribution of this study is to describe electron microscopic vascular changes in muscles that appear to be similar in familial and sporadic cases of progressive diaphyseal dysplasia.

Aspartate Aminotransferases↗