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Biomedical subjects

C Shapiro

Publications and source records attributed to C Shapiro.

At least 55 records · Page 3Linked to original sources
PubMed1988

Obstructing plasmacytoma of the duodenum: first manifestation of relapsed multiple myeloma.

A patient with an obstructing, annular duodenal neoplasm is described. Percutaneous fine needle aspiration biopsy, and biopsy performed through an endoscope, confirmed that the lesion was an extramedullary plasmacytoma. The patient had been in clinical remission from multiple myeloma for the preceeding 13 months. Radiation therapy resulted in cessation of symptoms including gastrointestinal blood loss. After 5 months, recurrent obstructive symptoms and melena led to surgical extirpation of the tumor, with relief of all symptoms.

Aged↗
PubMed1986

Muir-Torre syndrome.

The patient with sebaceous skin tumors and visceral malignancies, Muir-Torre syndrome, is presented. The documentation of tumors in 8 of 13 members in her kindred supports the concept that this syndrome represents a cancer-disposing phenotype.

Adenocarcinoma↗
PubMed1986

Ciprofloxacin in the treatment of Pseudomonas infection in cystic fibrosis patients.

Ten patients with cystic fibrosis received 19 therapeutic courses of ciprofloxacin at a dose of 750 mg orally twice daily. The length of therapy ranged from two to five weeks except for one patient who was treated for six weeks. The mean peak serum concentration of ciprofloxacin was 3.41 mg/l and the mean trough level was 1.11 mg/l. For comparison nine patients were treated with the combination of azlocillin at a dose of 350 mg/kg/day in four divided doses and tobramycin at an initial dose of 9 mg/kg/day in three divided doses. All patients were infected with Pseudomonas aeruginosa except for one patient in whom P. cepacia grew in the sputum cultures; the MICs of ciprofloxacin ranged from 0.05 to 1.56 mg/l. The results obtained with these two therapeutic regimens were comparable. The patient treated for P. cepacia infection developed resistance to ciprofloxacin (MIC greater than 6.24 mg/l) during the course of treatment. Ciprofloxacin appears to be an alternative treatment to the use of an aminoglycoside and a penicillin in cystic fibrosis patients.

Adolescent↗
PubMed1985

A case-control study of BCG and childhood tuberculosis in Cali, Colombia.

We conducted a case-control study to evaluate the effectiveness of BCG vaccination in preventing childhood tuberculosis (TB) in Cali, Colombia. We ascertained 178 cases aged 0 to 14 years from the respiratory clinics with cough or fever for at least three weeks and a positive chest X-ray for TB, as well as 320 controls who were from the same households but had no symptoms and negative X-rays. Using matched set multiple logistic regression analysis, we found the age- and sex-adjusted relative risk (RR) of TB among vaccinees compared with non-vaccinees to be 0.84 with 95% confidence limits (CL) from 0.43 to 1.62. There was, however, a significantly lowered relative risk of TB with increasing time since vaccination (RR = 0.83 per year since time of vaccination with 95% CL from 0.74 to 0.94.)

Adolescent↗
PubMed1985

Androgens, behaviour and nocturnal erection in hypogonadal men: the effects of varying the replacement dose.

The behavioural effects of varying the replacement dose of the oral androgen testosterone undecanoate (TU, Restandol) were investigated in eight hypogonadal men. Each man was withdrawn from his previous androgen replacement regimen and after a period of no treatment was administered four doses of TU (40, 80, 120 and 160 mg/d) in four successive one-month treatment periods using a double-blind design. Throughout the study each man recorded his sexual interest, behaviour and mood state using a daily diary form. In addition, four hypogonadal subjects had sleep erections and sleep quality assessed in the laboratory during a state of androgen withdrawal and again after a minimum of 5 months of androgen treatment. A dose response relationship was demonstrated for frequency of sexual thoughts, arousal accompanying sexual thoughts and well-being. Sleep erections improved significantly during testosterone administration. In men, sexual interest and sleep erections are androgen-dependent.

Adult↗
PubMed1984

Effects of loprazolam and of triazolam on sleep and overnight urinary cortisol.

Nine poor sleepers of mean age 61 years were studied while they took loprazolam 0.5 mg, loprazolam 1 mg and triazolam 0.5 mg for 3-week periods. Loprazolam 1 mg and triazolam 0.5 mg increased sleep duration, but there was some tolerance to both, particularly triazolam, by the 3rd week. Withdrawal of either drug led to sleep significantly shorter than baseline. This rebound effect was significant greater than withdrawing triazolam. After withdrawing loprazolam 1 mg, the rebound was maximal on the 3rd night and after withdrawing triazolam it was maximal and severe on the 1st night. In the third week of use neither drug was associated with late-night wakefulness. Total overnight urinary cortisol was lower during drug intake and there were significant withdrawal rebounds to above baseline levels, immediately so after triazolam.

Aged↗
PubMed1983

Suction lipectomy--a review of 200 patients over a six-year period and a study of the technique in cadavers.

Suction lipectomy is designed to reduce subcutaneous fat. It is strictly a procedure for the removal of localized fat and body contouring in selected patients and is not a substitute for weight reduction. The technique and the complications associated with the procedure were reviewed in more than 200 patients. Suction lipectomy was performed on fresh cadavers to study the nature of the fibrous tissue and to better understand why the procedure has proved safe.

Adipose Tissue↗
PubMed1983

Cor pulmonale in asthma.

The development of right ventricular failure due to pulmonary hypertension is a common complication of severe chronic bronchitis and emphysema (Renzetti et al. 1976) but is rare in bronchial asthma (Clark 1977). We report a 20-year-old extrinsic asthmatic with persistent hypoxaemia and carbon dioxide retention, secondary polycythaemia and cor pulmonale and describe his further investigation.

Adult↗
PubMed1981

Disseminated Trichosporon beigelii (cutaneum).

Two cases of invasive Trichosporon beigelii (syn. cutaneum) infection are reported and are compared with the eight other previous reports. All affected patients were either immunosuppressed or had recently undergone a surgical procedure. The diagnosis had been delayed and the prognosis was poor. Only two patients recovered after vigorous antimycotic therapy and concomitant remission of their leukemia. A biopsy of the skin lesion, as illustrated in one of our patients, may prove to be useful in the early diagnosis.

Aged↗
PubMed1981

Intracavitary bleomycin for the control of malignant effusions.

The results of treatment with intracavitary bleomycin are reported in twenty patients with a malignant pleural effusion and five patients with malignant ascites. The control rate was 17/20 (85%) patients with malignant pleural effusions and 3/5 (60%) patients with malignant ascites. Toxicities were minimal with fever being the most common side effect in four patients (16%. Bleomycin is an effective and nontoxic sclerosing agent.

Adult↗
PubMed1981

Cisplatin nephrotoxicity in rats: defect in papillary hypertonicity.

We examined the effects of cisplatin (5 mg/kg BW) on renal function in rats. Three days after administration of cisplatin whole kidney clearance of inulin fell and 24-h urine volume increased. Maximal urine osmolality and papillary solute content were reduced. Superficial nephron glomerular filtration rate measured along the proximal tubule, where no leak of inulin could be demonstrated, was reduced in cisplatin-treated animals. Differences between superficial nephron glomerular filtration rate determined in proximal and distal tubules were greater in cisplatin-treated rats than in control rats. Neither a change in fluid or sodium movement along superficial nephrons nor a reduced early distal tubule transepithelial sodium gradient explain the polyuria. Urea was reabsorbed from, not added to, the loop fluid in cisplatin-treated animals. Morphologic changes were evident in the S3 segment of the proximal tubule in cisplatin-treated animals but the glomeruli were normal. Polyuria occurred despite diminished glomerular filtration rate in cisplatin nephrotoxicity. The diminished concentration of salt and urea in the papilla as a result of abnormal function of the collecting duct or pars recta portion of the proximal tubule contributed to the defect in concentrating ability.

Acute Kidney Injury↗
PubMed1980

Mesothelial cells in pleural fluid: TB or not TB?

Eighty-five samples of pleural fluid obtained from 76 patients with biopsy-proven tuberculous pleurisy were examined cytologically. Numerous reactive mesothelial cells were present in only 1,2% of specimens examined. In contrast, 65,3% of pleural fluid aspirates obtained from a control group of patients in congestive cardiac failure contained marked mesothelial exfoliation. The suggestion that the presence of numerous, often highly reactive mesothelial cells in a pleural aspirate makes the diagnosis of tuberculosis unlikely is confirmed.

Cell Count↗
PubMed1979

Interns' attitudes towards aspects of their medical education.

During December 1977, the last month of the internship year, students who had obtained the M.B. B.Ch. degree at the University of the Witwatersrand at the end of 1976 completed questionnaires to reveal their attitudes towards aspects of their undergraduate education. Sixty-seven per cent of the class responded. The interns thought that their undergraduate education had prepared them ore adequately for manual tasks than for dealing with emotional aspects of patient care, especially a dying patient. More anxiety was aroused when managing a dying patient and his relatives than when performing diagnostic procedures. The health care function of allied professionals was not fully appreciated, and as a result their services were not fully used.

Attitude of Health Personnel↗