PubMed Health⌕ Search

Biomedical subjects

D Zahger

Publications and source records attributed to D Zahger.

13 recordsLinked to original sources
PubMed1991

Limitations of the captopril test in the diagnosis of renovascular hypertension.

The captopril test has been suggested as a sensitive and specific noninvasive tool for the diagnosis of renovascular hypertension. We applied the test to 72 consecutive hypertensive patients in whom renal artery stenosis was suspected. The test was positive in seven cases (9.7%), of whom four were true positive and three false positive. The captopril test has value in screening for renovascular hypertension, but its limitations should be recognized. False positive results are not uncommon and false negative results have been reported under certain circumstances. Nevertheless, when properly applied to appropriate patients, the test can enhance the diagnosis of renal artery stenosis.

Adolescent↗
PubMed1990

Partial resistance to anticoagulation after streptokinase treatment for acute myocardial infarction.

This study examines the response of 3 different groups of patients to anticoagulants: 50 patients previously treated with streptokinase for acute myocardial infarction (AMI) (group 1), 24 patients with AMI who had received anticoagulants without prior thrombolysis (group 2) and 11 subjects who received anticoagulants for noncoronary indications (group 3). No significant differences were detected between groups 2 and 3; therefore, they were combined for analysis. After streptokinase, patients required 37,755 +/- 1,516 (mean +/- standard error of the mean) U of heparin per day to achieve the desired activated partial thromboplastin time (APTT). The dosage was 30,294 +/- 1,089 U/day in patients without antecedent thrombolysis (p less than 0.001). Group 1 patients required 5 +/- 0.4 days until adequate anticoagulation was achieved, compared with 3 +/- 0.2 days in the control group (p = 0.01). Despite higher heparin requirements, group 1 patients had a lower APTT value than the other subjects (87 +/- 5 vs 101 +/- 6 seconds, p = 0.08). Group 1 patients required 5 +/- 0.3 days to reach anticoagulation with warfarin versus 4 +/- 0.2 days in groups 2 + 3 (p = 0.05). Comparison of groups 1 and 2 yielded similar, although smaller, differences. Patients treated with streptokinase for AMI seem to be partially resistant to anticoagulation, which may increase the risk of reocclusion.

Anticoagulants↗
PubMed1990

Systemic embolization following thrombolytic therapy for acute myocardial infarction.

We describe a patient with acute inferior myocardial infarction who developed a "saddle" aortic embolus during streptokinase infusion. Three months previously, this patient had sustained an anterior infarction, and an apical aneurysm was found. This patient's embolus had most probably originated from a left ventricular mural thrombus that had been dislodged by streptokinase. As fibrinolytic treatment is gaining wide acceptance, physicians should be aware of this rare, but possible, complication.

Aged↗
PubMed1989

[An outbreak of hepatitis B associated with acupuncture].

2 clusters of between 5 and 11 cases of hepatitis B virus infection were associated with acupuncture by a physician late in 1986. The source of the infection is believed to have been an Ethiopian immigrant, a known HBsAg carrier. While he was being operated on a nurse cut her finger on a scalpel blade. During the prodromal period of hepatitis which followed, she was treated by acupuncture. The acupuncture needles were supposedly sterilized by dry heat for 80 minutes at 200 degrees. However, there were apparently breaks in technique which were responsible for the spread of the infection to at least 4 other women, ranging in age from 26 to 80 years. We stress the need for strict enforcement of correct sterilization procedures whenever needles are used to pierce skin. This should be performed only by licensed practitioners of officially recognized occupations, some of which are not as yet covered by our national health regulations.

Acupuncture Therapy↗
PubMed1989

Cholestatic liver injury after prolonged exposure to methyldopa.

We describe a 75-year-old patient who presented with severe cholestatic liver disease. He had been receiving methyldopa, 250 mg daily, for 6 years. An extensive evaluation failed to reveal extrahepatic obstruction or serologic evidence of viral hepatitis. A liver biopsy disclosed marked cholestasis, without hepatitis, and was compatible with a rare form of methyldopa-induced liver injury. Cessation of drug treatment was followed by a slow but complete recovery. Cholestasis is a rare manifestation of methyldopa hepatotoxicity. Although methyldopa-associated liver injury usually appears after about 4 weeks of treatment, a history of a much longer exposure does not exclude this entity.

Aged↗
PubMed1989

Evidence of prolonged myocardial dysfunction in heat stroke.

Heat stroke is a life-threatening syndrome of multi-organ dysfunction caused by elevated body temperature. It may result from failure of the thermoregulatory mechanisms or from inadequate heat dissipation and affects members of several risk groups. A number of authors reported cardiac involvement in heat stroke, but heart failure rarely has been documented. We report the cases of two heat stroke victims, one of whom developed pulmonary edema and the other, peripheral edema. In both, RVG demonstrated dilatation and diffuse hypokinesis of the right ventricle, which persisted for several weeks. We conclude that the heart may be involved in heat stroke and that heart failure is a potential complication of the syndrome that can have a prolonged subclinical course. Fluid replacement in heat stroke should be done under careful observation, which may be facilitated by noninvasive assessment of cardiac function.

Adolescent↗
PubMed1988

An acupuncture-associated outbreak of hepatitis B in Jerusalem.

Two clusters of between five and eleven cases of hepatitis B associated with acupuncture treatment by a physician occurred in Jerusalem in late 1986. The origin of the outbreak is believed to have been an Ethiopian immigrant surgical patient, a known HBsAg carrier, who infected an operating room nurse during a surgical procedure. This is the first recorded instance of transmission of HBV from an Ethiopian immigrant to the local Israeli population. We reiterate the need for the enforcement of correct sterilization techniques in all skin-piercing settings, a step which in many countries will require the licensing of a variety of occupations not presently covered by health regulations.

Acupuncture Therapy↗
PubMedDate not supplied

Acute septal myocardial infarction diagnosed by endomyocardial biopsy in a heart transplant recipient.

We describe an unusual case of acute septal myocardial infarction in a heart transplant recipient. The clinical presentation was most suggestive of acute rejection; the correct diagnosis was first made by endomyocardial biopsy and was then verified by coronary angiography. Acute myocardial infarction should be included in the differential diagnosis of acute rejection after heart transplantation and included among the possible diagnoses made by endomyocardial biopsy in these patients.

Biopsy↗