PubMed Health⌕ Search

Biomedical subjects

E Bloom

Publications and source records attributed to E Bloom.

At least 19 recordsLinked to original sources
PubMed1992

[Left pancreatectomy with preservation of the spleen without its pedicle. Apropos of 13 cases].

Overwhelming post splenectomy infections in childhood were first described by King and Shumaker in 1952. This septic risk, although a matter of controversy, also exists in adults. Thus, splenic conservation must become a surgical concern in left pancreas resections for benign or traumatic diseases. The authors report their experience with a simplified procedure in which the splenic pedicle is resected "en bloc" with the left pancreas. This technique has been employed in thirteen patients, in whom spleen could be preserved in twelve, without operative mortality and a low morbidity rate.

Adult↗
PubMed1992

[Evolution and treatment of 8 patients with Fournier's perineal-scrotal gangrene].

The authors present eight cases of Fournier's gangrene treated from 1987 to 1989 (3 years). There was no discernable cause for 5 patients (62.5%). Immediate aggressive surgical debridement of all necrotic tissue was performed. Intravenous antibiotics and resuscitation fluid and hyperbaric oxygenation were also administered to all patients. Skin grafting was performed for 4 patients (40%), 3 weeks after surgical debridement. One patient died (12.5%) and 2 subsequently developed an urethral stricture. Etiology, treatment and outcome of Fournier's gangrene are discussed and the results of the study are compared to other studies. This disease is still serious, its pathogenesis is not completely elucidated, but when immediate adequate treatment is performed, the outcome is generally favourable.

Acute Disease↗
PubMed1991

Prevention of gram-positive infections after bone marrow transplantation by systemic vancomycin: a prospective, randomized trial.

Gram-positive bacteria are the most commonly isolated organisms after bone marrow transplantation (BMT) and severe streptococcus septicemia has been reported. In order to evaluate the benefit of a gram-positive prophylaxis after BMT, we conducted a prospective, randomized trial of systemic vancomycin among 60 patients undergoing BMT for hematologic malignancies. Patients were randomized to receive (n = 30) or not receive (n = 30) prophylactic vancomycin 15 mg/kg every 12 hours from day -2 until resolution of neutropenia or until the first episode of fever. All patients were treated in laminar air-flow rooms, received sterile diet, total gut decontamination, and had central venous catheters placed surgically. Vancomycin was found to be highly effective in preventing gram-positive infections that occurred in 11 of 30 patients in the control group versus zero of 30 in the vancomycin group (P less than .002). All gram-positive infections occurring in the control group were symptomatic (nine septicemia and two local infections), and one patient with Streptococcus septicemia died with pneumonia. Thus, gram-positive prophylaxis was found to decrease infection morbidity after BMT. Moreover, the number of days with fever (P less than .001), and empiric antibiotic therapy (P less than .01) was reduced without added toxicity or cost. This study confirmed the high prevalence of gram-positive infections after BMT and emphasized the clinical benefits of an adapted prophylaxis.

Adolescent↗
PubMed1990

[Mesenterico-atrial shunt in Budd-Chiari syndrome with inferior vena cava thrombosis. Report of 2 cases].

Two new cases of Budd-Chiari syndrome associated with thrombosis of the inferior vena cava are reported. The predominant clinical sign was ascites, and the diagnosis was suggested by ultrasound and confirmed by angiography and the imaging techniques. In one case, the etiological assessment revealed an association with an oral contraceptive treatment; the etiological research remained negative in the other case. A mesenterico-atrial shunt was performed in both patients, and its patency was controlled with magnetic resonance imaging: both shunts are functional after 38 and 45 months respectively. On the basis of these two cases, the diagnostic process, the surgical indications and the choice of the techniques are discussed. The mesenterico-atrial shunt described by Cameron and Maddrey in 1978 seems to be an interesting and reliable therapeutic choice for the Budd-Chiari syndrome with thrombosis of the inferior vena cava.

Adult↗
PubMed1989

Kinetics of phagocytosis in trabecular meshwork cells. Flow cytometry and morphometry.

Confluent human trabecular meshwork (HTM) cells from three different donors and at various stages of serial passage were fed fluorescein-labeled polystyrene beads. Phagocytosis was monitored for up to 6 days using flow cytometry, fluorescence microscopy, and morphometric calculations from comprehensive electron microscopic observations at key time points. During the first 4 hr after initiation of phagocytosis, the confluent endothelial monolayer lost its cohesiveness and became segregated into separate cells. During the first 3 days the cells underwent marked and progressive changes in shape and size. After 4 days, some cells detached from the dish, as necrotic debris and degenerative changes appeared. The kinetics of phagocytosis in this stable, confluent monolayer showed that recruitment (the percentage of cells which had ingested at least one bead) proceeded semilogarithmically, with 50% of the cells recruited by 8 hr and 97% by 96 hr. The time course of phagocytosis (ie, the average number of beads phagocytosed per cell) is described by a sigmoidlike curve, reaching half-maximum at 40 hr and maximum (about 500 beads per cell) at 96 hr. The rate of uptake (ie, the first derivative of the average number of beads per cell) reached a peak (nine beads per cell per hr) at 24 hr and then decelerated slowly over the next 5 days. Cytochalasin B treatment, as a control, reduced phagocytosis by approximately 70%. Flow cytometry, when combined with electron microscopy, should provide a useful tool to examine phagocytosis in HTM cells exposed to steroids and other hormones and drugs.

Adult↗
PubMed1988

Plasma cortisol and natural killer cell activity during bereavement.

Natural killer cell (NK) activity, which is important in the defense against tumors and viral infections, is reduced in women undergoing conjugal bereavement. The relationship between NK activity and plasma cortisol was investigated in three groups of subjects: women who were anticipating the death of their husbands, women whose husbands had recently died, and controls. Bereaved women showed reduced NK activity and increased plasma cortisol levels as compared to controls. Anticipatory bereaved women also showed significant reductions in NK activity, but had levels of plasma cortisol comparable to those of controls. The reduction of NK activity during anticipatory and actual bereavement cannot be explained solely on the basis of increased cortisol secretion.

Female↗
PubMed1987

Central obesity and coronary heart disease in men.

The relation between central body fat distribution, determined by measurement of subscapular skinfold thickness (SSF), and the development of definite coronary heart disease (CHD) was examined after 12 years of follow-up in a cohort of 7692 men who participated in the Honolulu Heart Program. The risk of incident coronary events was directly related to SSF. Compared with men in the lowest tertile of SSF, those in the middle tertile experienced a 70% excess of definite CHD. For those in the highest tertile, the excess more than doubled. For a given level of body mass index (BMI), SSF remains a significant and independent predictor of definite CHD, even after adjustment for age, total cholesterol, glucose, triglycerides, hypertensive status, and cigarette smoking. In contrast, the independent effect of BMI was not significant after adjustment for SSF. Thus centrally obese individuals are at increased risk of CHD, independent of BMI.

Body Height↗
PubMed1987

Impaired natural killer cell activity during bereavement.

Natural killer (NK) cell activity, a component of the immune surveillance system, was compared in women whose husbands had recently died with that found in age-matched women who had not experienced recent adverse life events. Bereaved women had significantly lower NK activity than women whose husbands were healthy. In a second study, depressive symptoms and NK activity were measured longitudinally in women before and after the death of their husbands. Our results suggest that depressive symptoms, not merely the death of the spouse, are related to a reduction in NK activity during bereavement.

Bereavement↗
PubMed1986

Does obesity protect hypertensives against cardiovascular diseases?

Recent studies suggest that obesity may protect hypertensives against cardiovascular disease (CVD). This concept was investigated by the Honolulu Heart Program, a prospective epidemiologic study of CVD in a cohort of Japanese-American men aged 45 to 65 years who have been followed up for 12 years. The combined effect of body mass index (BMI), as a measure of obesity, and blood pressure on coronary heart disease and CVD incidence was examined in 7554 men who were free of CVD and cancer at baseline. Rates of coronary heart disease and CVD were higher in the most obese than in the nonobese men for both normotensives and hypertensives. Blood pressure-BMI interaction was not significant for any CVD end point. Hypertension was associated with higher rates of coronary heart disease and CVD at all levels of BMI. This study supports the conclusion that hypertension is associated with an increased risk of CVD in both obese and nonobese men and that the relationship of blood pressure to CVD incidence does not vary with level of BMI. The inclusion of prevalent cases of CVD and the collapsing of continuous data into two categories may explain the results of earlier studies.

Aged↗
PubMed1986

Resection of the rectum with construction of a colonic reservoir and colo-anal anastomosis for carcinoma of the rectum.

Rectal resection with colo-anal anastomosis was performed in 65 patients with carcinoma of the lower rectum. In 20 a pelvic colonic reservoir was constructed while in 45 a direct anastomosis was carried out. There were no postoperative deaths and morbidity was comparable in the two groups. Functional results were determined by clinical examination and manometry. The frequency of bowel movements was inversely related to the maximum tolerated volume (P less than 0.001). During the first year 60 per cent of the patients with a reservoir and 33 per cent of the patients without had one or two stools per day (P less than 0.05). After one year, 86 per cent of the patients with a reservoir and 33 per cent of the patients without had one or two bowel movements per day (P less than 0.01). The maximum tolerated volume was increased by the reservoir (P less than 0.05). The loss of reservoir capacity of the rectum increases frequency of bowel movements in colo-anal anastomosis. The creation of a colonic reservoir improves function by increasing the maximum tolerated volume without any increase in mortality or morbidity.

Adult↗
PubMed1986

Systematic risk factor screening and education: a community-wide approach to prevention of coronary heart disease.

Within a community-wide heart disease prevention effort, it was hypothesized that personalized risk factor screening and education would result in modified health behaviors and reduced risk factor levels for coronary heart disease. Adults from a population sample were randomized to a community-wide screening and education program or were excluded from that program for 1 year. At the end of that year, both groups were measured for risk factor levels and related health behaviors. Those who received the screening and education program had significantly lower risk factor levels and other evidence of health behavior change, including lower blood cholesterol (206.9 vs 211.5 mg/dl), lower diastolic blood pressure (68.7 vs 70.0 mm Hg), lower resting heart rate (71.4 vs 72.7 bpm), and increased selection of low-fat and low-sodium meals in local restaurants. These data suggest that systematic risk factor screening and education may result in lower population risk for coronary heart disease.

Adult↗
PubMed1986

Reproductive history and body mass index in black and white women.

The relationships of timing, spacing, number of births, and demographic variables to body mass index were examined in 844 white and 289 black women. Subjects were interviewed in 1978-1979 as mothers or female guardians of a stratified random sample of all Minneapolis children in grades 1-3. Results indicate that among black and white women, number of births, age at last birth, and years between first and last births were positively associated with body mass index. However, when age, education, and income were included in the regression equation for black women, none of the reproductive variables predicted body mass index. When number of births, age at last birth, and years between first and last birth were included in the same regression for white women, only number of births was independently associated with body mass index.

Adult↗
PubMed1985

Adrenergic and cholinergic receptors in isolated non-pigmented ciliary epithelial cells.

Methods were developed to isolate non-pigmented ciliary epithelium from bovine eyes (BCBE) free from other cell types in the ciliary process. Once background binding due to pigment was minimized, it was possible to assay specific beta adrenergic receptors in these preparations. The BCBE beta adrenergic receptors showed appropriate stereospecificity and an order of binding affinities compatible with a beta 2 adrenergic selectivity. Interestingly, specific high affinity muscarinic cholinergic receptors were detected in both BCBE and primate non-pigmented ciliary epithelium. These muscarinic receptors showed an appropriate affinity and selectivity for agonists and antagonists. Further evaluations of the receptors and responses of non-pigmented ciliary epithelial cells may prove useful in understanding the effects of adrenergic and cholinergic agents on aqueous humor inflow.

Animals↗
PubMed1979

Quantitation of skin bacteria: lethality of the wash solution used to remove bacteria.

A widely used technique for the quantitative removal of bacteria from the skin uses a detergent, Triton X-100 (p, t-octylphenoxynonaethoxyethanol), to remove and suspend the bacteria. We determined the half-life for the survival of five common skin bacteria suspended in the solution. The shortest-lived was Streptococcus pyogenes with a half-life of 0.9 hours. All of the others (Propionibacterium acnes, Staphylococcus epidermidis, Staphylococcus aureus, and Klebsiella pneumoniae) had half-lives of 1.5 hours or longer. K. pneumoniae, the only Gram-negative species tested, had a half-life of more than 30 hours. Thus, a one hour delay in plating and incubation of samples suspended in this detergent solution inhibits quantitation of most species tested.

Bacteria↗
PubMed1978

Quantification of anaerobic diphtheroids on the skin.

The widely used technique for sampling skin bacteria employs a detergent (Triton X-100) in buffer solution to remove and suspend the microorganisms. The fraction of the total population of anaerobes on the forehead removed by scrubbing with this solution was estimated. We calculated that approximately 10% of the resident anaerobes were removed by one minute of scrubbing with the detergent solution and two 1-min washes remove approximately 19.5% of the resident anaerobes (8.8 X 10(5)/CM2).

Acne Vulgaris↗