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Biomedical subjects

D Margalith

Publications and source records attributed to D Margalith.

At least 19 recordsLinked to original sources
PubMed2003

Gastroscopic removal of an adjustable gastric band after partial intragastric migration.

BACKGROUND: Laparoscopic implantation of an adjustable gastric band is being performed widely. One potential complication is the transgastric migration of the band, that should be extracted. METHODS: The authors report a series of 182 patients, followed prospectively, October 1996 - April 2002, who had undergone insertion of the Swedish adjustable gastric band. All implantations had been completed by laparoscopy alone. RESULTS: There were no deaths. 15 complications were detected, of which 7 were intragastric migrations of the band (3.8%) at an average follow-up of 40 months. 6 were treated successfully by gastroscopy only, with a new cutter device and without complications. CONCLUSION: The endoscopic technique is beneficial even when the intraluminal migration is partial.

Adolescent↗
PubMed2000

The effects of omeprazole on healing and appearance of small gastric and duodenal lesions during dosing with diclofenac in healthy subjects.

BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) are associated with gastrointestinal mucosal damage. Omeprazole prevents the formation, and accelerates the healing, of NSAID-induced ulcers. AIM: To test whether omeprazole accelerates healing of standardized gastroduodenal lesions in the presence of diclofenac. METHODS: In a double-blind, double-dummy, placebo-controlled, crossover study, 12 healthy volunteers received consecutive, 2-week courses of omeprazole (40 mg o.d.) and placebo, in random order, with an intervening, 4-week washout period; diclofenac (50 mg t.d.s.), was given for the second week of each course. Five endoscopies were performed, one at the outset and the others before and after each course of diclofenac. Biopsies were taken from the endoscopically normal mucosa of the corpus, antrum and duodenum and also from any new mucosal lesion that developed after diclofenac. The sites of biopsies taken before each course of diclofenac were evaluated endoscopically after each course to assess the extent of healing according to a predetermined healing score scale. RESULTS: The healing scores observed after administration of placebo/diclofenac (median=0; range 0-6) and after omeprazole/diclofenac (median=0; range 0-6; P=0.17) did not differ. Small gastroduodenal lesions developed de novo in six subjects during placebo/diclofenac and in seven during omeprazole/diclofenac. Focal chemical gastropathy was observed only in close proximity to macroscopic lesions. CONCLUSIONS: In healthy subjects, omeprazole does not accelerate the healing of pre-existing mucosal lesions or prevent the development of small diclofenac-induced mucosal lesions.

Adult↗
PubMed1997

A family with hemiplegic migraine and focal seizures.

Familial hemiplegic migraine is a distinctive form of migraine with autosomal dominant inheritance. The patients undergo attacks of migraine complicated by hemiplegia. Seizures have not been reported as comprising a part of this syndrome. We describe three generations of a family with hemiplegic migraine and focal seizures occurring concurrently with the migrainous attacks. There were five affected family members whose clinical features included unilateral headache and transient hemiplegia. Two family members also had focal seizures during the migrainous attacks. One of the patients was treated with carbamazepine with good results. The only associated neurological finding was ataxia which was found in the oldest patient. The presence of focal seizures during an episode of hemiplegic migraine suggests that the two phenomena of migraine and focal seizures may share the same underlying pathophysiology.

Adolescent↗
PubMed1996

Effects of misoprostol on healing and prevention of biopsy-induced gastroduodenal lesions occurring during the administration of diclofenac to volunteers.

AIM: To determine whether misoprostol promotes the healing of non-steroidal anti-inflammatory drug-induced gastroduodenal lesions in a human experimental model. METHODS: Mucosal damage and healing of mucosal biopsy sites were assessed endoscopically in 10 healthy, Helicobacter pylori-negative volunteers with a normal initial endoscopy: they were enrolled in a double-blind, double-dummy, placebo-controlled cross-over study. They received 2-week courses of misoprostol (200 micrograms b.d.) or placebo; a water-soluble non-steroidal antiinflammatory drug diclofenac 50 mg t.d.s., was given during the second week of each dosage regimen after three endoscopic biopsies had been taken from each of the duodenum, antrum and corpus. RESULTS: The number of unhealed biopsy sites was not different after misoprostol or placebo, although the number of healed biopsy sites was greater in the corpus and duodenum than in the antrum. Misoprostol did not prevent the appearance of diclofenac-induced erosions and petechiae. Epigastric discomfort was related to the intake of diclofenac and was reduced by misoprostol. Bloating and flatulence occurred more frequently with misoprostol alone and with misoprostol plus diclofenac, than with placebo alone or placebo plus diclofenac. CONCLUSION: Misoprostol does not prevent new mucosal lesions induced by diclofenac in healthy volunteers and it does not accelerate the healing of the biopsy sites. Misoprostol decreases the frequency of diclofenac-induced epigastric discomfort, but it increases gas bloating and flatulence.

Adult↗
PubMed1993

Ictal cortical blindness: a case report and review of the literature.

Acute cortical blindness as an ictal phenomenon has seldom been reported in the literature. The authors describe a seven-year-old boy who experienced several episodes of complete visual loss, accompanied by gastro-intestinal symptoms and a sensation of fright, but with preservation of consciousness. These episodes ended abruptly with visual recovery and no postictal phenomena. CT brain scan was normal and interictal EEG showed bi-occipital epileptiform activity. This case fits the definition of true ictal blindness. A literature review of seizure-related blindness is presented.

Blindness↗
PubMed1991

Diclofenac delays healing of gastroduodenal mucosal lesions. Double-blind, placebo-controlled endoscopic study in healthy volunteers.

The effects of the water-soluble and delayed-release formulations of a nonsteroidal antiinflammatory drug, diclofenac, on the healing of gastroduodenal mucosal lesions were compared in a double-blind, double cross-over, placebo-controlled endoscopic study conducted in 14 healthy volunteers. Severe endoscopic lesions (petechiae, erosions, ulcers, and esophageal candidiasis) were found only in the group taking the soluble formulation of diclofenac (P less than 0.05 vs placebo). The endoscopic healing of biopsies at one week was delayed by both preparations in comparison to placebo (P less than 0.05 vs placebo). Neither formulation produced significantly more histological inflammation or minor endoscopic lesions (erythema, red striae) than placebo. Both formulations were equally well tolerated and produced no more symptoms than placebo. This study suggests that soluble diclofenac acts topically to delay gastroduodenal healing and produce gastroduodenal injury; it thus provides a model for future studies of the production, perpetuation, and healing of peptic lesions.

Adult↗
PubMed1989

[Screening for colorectal tumors using fecal occult blood studies].

Guaiac tests such as Hemoccult are widely used but are affected by several factors. Occult blood testing does uncover subclinical colorectal cancer often at early stage, but a favorable effect on survival remains to be proven. The sensitivity for the detection of malignancies is from moderate to good, but it is poor for benign polyps. Predictive value of a positive test for cancer ist about 8-12%. Thus, most of the individuals with a positive test would not need colonic investigations. Recommendations relating to the testing for of occult blood could change rapidly with the new immunologic techniques or with new data on mortality coming from controlled clinical trial now being conducted.

Colorectal Neoplasms↗
PubMed1985

Congenital optic nerve hypoplasia with hypothalamic-pituitary dysplasia. A review of 16 cases.

Sixteen children had congenital optic nerve hypoplasia and hypothalamic-pituitary dysplasia. Investigation disclosed an extremely variable spectrum of neuroendocrinological findings that ranged from deficiency to hypersecretion of trophic hormone. Neuroendocrine abnormalities consisted mainly of trophic hormone deficiencies, the most common being growth hormone deficiency, but trophic hormone hypersecretion, including growth hormone, corticotropin, and prolactin was found as well. The extent of anterior pituitary hormone deficiency was variable. Anti-diuretic hormone deficiency was presented in two patients. Our findings support the concept of hypothalamic defect as the major cause for the pituitary dysfunction in this syndrome. Physicians should be aware of this syndrome as a common cause for growth failure and multiple pituitary hormone deficiencies in visually impaired children, which would facilitate the diagnosis and early institution of therapy for this treatable but potentially serious entity.

Adolescent↗
PubMed1984

Friedreich's ataxia with dysautonomia and labile hypertension.

An Amerindian girl with Friedreich's ataxia presented at the age of 14 years with intermittent bifrontal headaches and abdominal aching, often associated with nausea and recurrent vomiting and an evanescent pink, blotchy rash on the upper trunk. In these attacks she also had hypertension up to 210/160 mm Hg. Renal function studies, including intravenous pyelogram and angiography, were normal. Plasma renin activity (2.5 ng/ml/hr) was also normal. Total body CT scan was negative for phaeochromocytoma, and repeated estimations of 24-hour excretion of urinary VMA were normal or borderline high. Levels of total catecholamines in 24-hour urine were normal twice, but two random specimens during the paroxysmal episodes contained abnormally high levels of norepinephrine and dopamine. Plasma catecholamine concentrations were increased but not as high as with phaeochromocytoma. Blood pressure monitoring demonstrated marked fluctuations with position and temperature. A clonidine suppression test showed a substantial fall of plasma catecholamine levels, consistent with dysautonomia and not with phaeochromocytoma. It is concluded that the patient has dysautonomia of central origin, probably as a manifestation of Friedreich's ataxia. These findings are discussed in relation to the recent demonstration of increased levels of plasma catecholamines in that disease.

Adult↗
PubMed1984

Clinical spectrum of congenital optic nerve hypoplasia: review of 51 patients.

Fifty-one patients with congenital optic nerve hypoplasia (CONH) were reviewed. It was found that the risk of having an affected child is higher in an adolescent mother, and that maternal alcohol or drug abuse may be important factors. Frequently the disorder is associated with other neuropsychiatric handicaps, and with neuro-endocrine abnormalities. The findings suggest that CONH probably is not a homogeneous group of disorders; some may be caused by primary failure of differentiation of the retinal ganglion cells, while others may be the product of an acquired transsynaptic degeneration of optic-nerve fibres.

Abnormalities, Multiple↗
PubMed1984

Renin and the complications of acute myocardial infarction.

To determine whether plasma renin activity in addition to catecholamines could be used as risk indicators, these parameters were measured in 19 patients with acute myocardial infarction. During the course of hospitalization, five patients developed ventricular fibrillation and three, cardiogenic shock. On admission, heart rate, plasma norepinephrine, epinephrine, and renin levels of these eight patients were significantly higher than those of the other patients with uncomplicated course. Peak creatine kinase MB activity was positively related to initial plasma renin activity (r = 0.62, p less than 0.01). Thus, the patients with the highest sympathetic activity following an acute myocardial infarction also had the highest plasma renin levels. They seem particularly prone to develop large infarcts and life-threatening complications.

Acute Disease↗
PubMed1983

Argininosuccinic aciduria. A developmental and biochemical case study.

An infant with argininosuccinic aciduria was detected through the routine newborn screening program for inborn metabolic diseases and has been followed for over 7 years. Treatment consisting of restricted protein intake and arginine base supplementation was initiated at the age of 8 months and was continued intermittently. She maintained normal psychomotor development to the age of 3 years and currently at the age of 7.3 years, she has measured intelligence in the borderline range. She has had mild symptoms of cerebellar ataxia. Her physical growth has been below normal. Biochemical abnormalities are described. Special metabolic investigations and the effects of treatment are discussed.

Amino Acid Metabolism, Inborn Errors↗
PubMed1983

Diagnostic strategy in hyperandrogenic syndrome.

Plasma testosterone (T), androstenedione (A), follicle-stimulating hormone, (FSH), luteinizing hormone (LH), prolactin (PRL), and urinary 17-ketosteroids (17-CS) have been measured in 152 women complaining of acne and/or hirsutism. Mean plasma levels of T, A, LH, PRL, and urinary 17-CS were significantly increased as compared to controls. T and/or A were increased in 59% of the cases. T was higher in women with PRL greater than 16 micrograms/l as compared to women with PRL less than 13 micrograms/l. Hirsutism had markedly decreased in 64% and acne in 84% of patients treated with cyproterone acetate.

Acne Vulgaris↗
PubMed1982

Presence of fungiform papillae in classic dysautonomia.

Lack of fungiform papillae over the surface of the tongue is considered essential for the diagnosis of familial dysautonomia. We describe two cases with dysautonomia in which the diagnosis was delayed because numerous fungiform papillae were easily seen. Only a close inspection of the tongue with an ophthalmologic slit lamp revealed that each papilla was degenerated and atrophic. Lacking a clinical sine qua non or easily available diagnostic laboratory tests, fungiform papillae should be studied in detail to establish not only that their number is sufficient but also that their shape and structure are normal. The simple technique described enables confirmation of the diagnosis in children and newborns in whom familial dysautonomia is suspected.

Diagnostic Errors↗
PubMed1981

Unilateral pupillary dilatation during focal seizures.

Pupillary dilatation was observed in a young boy who had a sudden onset of right focal seizures. Clinical and laboratory investigation revealed the presence of a benign left frontal epileptic focus. Lacking signs of third cranial nerve compression, this transient pupillary abnormality could be caused by the contralateral frontal epileptic focus. Such a focus might inhibit dilatation of the homolateral pupil, thus permitting dilatation of the contralateral pupil only. Unilateral mydriasis as described hereby could also represent a pupillary "Todd's Paralysis" caused by the contralateral frontal epileptic focus.

Adolescent↗
PubMed1980

Posterior fossa subdural hematoma in a normally delivered, full-term newborn.

A large subdural hematoma of the posterior fossa was diagnosed by computerized tomography in a normally delivered, full-term newborn. This potentially treatable condition has been previously diagnosed in only 13 reported cases during the last 40 years. It is conceivable that the routine use of CT scan in newborns who show progressive neurological dysfunction will facilitate the rapid detection and treatment of similar cases.

Brain↗