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Biomedical subjects

G Mintz

Publications and source records attributed to G Mintz.

At least 19 recordsLinked to original sources
PubMed1991

Enhanced left ventricular diastolic function in hyperthyroidism: noninvasive assessment and response to treatment.

Hyperthyroidism is associated with a marked effect on the cardiovascular system. Despite enhanced resting ventricular systolic performance, thyrotoxicosis has been implicated as a primary cause of cardiomegaly, congestive heart failure, and decreased exercise tolerance. To further assess potential alterations in ventricular function we have noninvasively studied diastolic performance in nine newly diagnosed and untreated hyperthyroid patients. Parameters including diastolic flow velocities, isovolumic relaxation time (IVRT), and the rate of diastolic flow deceleration were compared to those of an age- and sex-matched control population, and then repeat determinations were made after beta-adrenergic blockade and again when the patients were chemically and clinically euthyroid. Before treatment the IVRT was 33.0 ms, which was significantly (P less than 0.005) shorter than the control value (57.9 ms) and in combination with other measures of diastolic function indicated enhanced left ventricular relaxation. beta-Adrenergic blockade slowed the resting heart rate from 97 to 80 beats/min (P less than 0.005) and partially normalized the rate of diastolic deceleration, but had no effect on the IVRT (33.8 ms). When patients were euthyroid, the IVRT was 51.7 ms, and other measures of diastolic performance were the same as those in controls. The current data assessing resting diastolic function in hyperthyroidism are similar to those previously reported for systolic function. Our findings of enhanced cardiac diastolic performance do not support the hypothesis that thyrotoxicosis is associated with compromised left ventricular function and suggest the possibility that the cardiac symptoms that accompany hyperthyroidism may be due to noncardiac mechanisms.

Adult↗
PubMed1991

Testicular function in active ankylosing spondylitis. Therapeutic response to human chorionic gonadotrophin.

Testicular function was studied in 22 patients with ankylosing spondylitis (AS) with serum measurements of hormone levels, seminal fluid analysis and testicular reserve test. Results were correlated with disease activity. The abnormal findings were elevated luteinizing hormone (LH), inversion of estradiol/testosterone ratio (E2:T) and diminished testicular reserve for testosterone (T) and slightly increased for estradiol (E2). Nine patients with severe active AS received biweekly 2,500 IU of human chorionic gonadotrophin injections with a resulting increase in E2 serum levels. When the values of E2 reached 40 pg/ml or higher, there was a decrease of the sedimentation rate (p less than 0.05) and a reversal to normal of the E2:T ratio. This was accompanied by an improvement in AS at the 10th week that lasted up to 9 weeks after discontinuation of treatment. Our findings suggest a possible role of sex hormones in the physiopathogenesis of AS and offers a possible therapeutic alternative.

20-alpha-Dihydroprogesterone↗
PubMed1990

Ovarian function studies in active ankylosing spondylitis in women. Clinical response to estrogen therapy.

Ovarian function was studied in 17 women with active ankylosing spondylitis (AS). Levels of FSH, LH, prolactin and androstenedione were normal in menstruating patients and FSH and LH were elevated in menopausal patients. In menstruating patients with active AS the estradiol levels were lower than in patients with inactive AS and significantly (p less than 0.05) lower than controls. Progesterone levels in menstruating patients were lower (P = NS) than controls. In menopausal patients estrogen levels were lower than their controls (P = NS). There was a significant (p less than 0.05) inverse correlation between the sedimentation rate and the estrogen level. Seven patients accepted oral estrogen therapy (average duration 4 months) and peripheral arthritis subsided within one month, all variables of clinical activity of AS improved and at the end of the study all patients were in functional class I.

Adult↗
PubMed1989

Dermatomyositis.

Pregnancy in DM/PM is infrequent probably because of the late age of onset of the disease. When pregnancy occurs in patients with long-standing remissions of childhood onset DM/PM the risk of exacerbation is 40 per cent and the prognosis for the fetus is reasonably good. If pregnancy starts in patients already diagnosed and under steroid treatment of DM/PM, the frequency of exacerbations is low (16 per cent) and the outcome of pregnancy is not as good, with only 50 per cent at-term babies and 37.5 per cent fetal loss. When DM/PM has its onset during pregnancy the fetal mortality reaches 62 per cent. No maternal deaths have been reported. The response to steroid therapy for active DM/PM during pregnancy seems to be good with two patients recovering their muscle strength very rapidly after delivery. There are no placental abnormalities that could explain the increased fetal loss. The newborns have no stigmata of the maternal disease. Pregnancy in DM/PM should be considered a high-risk pregnancy and managed accordingly; adequate prednisone therapy for the maternal disease, frequent monitoring of the growth and development of the fetus, careful search for signs of fetal distress and interruption of pregnancy as needed with the care of a neonatologist at the time of delivery. The mechanisms of the reciprocal interaction between DM/PM and pregnancy are unknown.

Abortion, Spontaneous↗
PubMed1989

Systemic lupus erythematosus.

Pregnancy occurring in patients with diagnosed and controlled SLE will be associated with a flare of disease in 60 per cent of cases, which is not significantly different from flares in nonpregnant patients. Signs and symptoms of active SLE should be carefully evaluated and treated with steroids according to severity and organ systems involved. When pregnancy occurs with inactive kidney disease there is a 10 per cent rate of reactivation and SLE kidney disease may appear for the first time during pregnancy in 6.8 per cent of patients. These rates are similar in the control group. There will be a significantly increased abortion rate which cannot be improved with maternal treatment. There will also be a high prematurity rate and an increased number of newborns with intrauterine malnutrition that are associated with active maternal disease. The following points are important when caring for a pregnant SLE patient: 1. Maintain maternal disease inactive throughout gestation. 2. Monitor growth and development of fetus. 3. Monitor for fetal distress. 4. Interrupt pregnancy when fetal distress is diagnosed. 5. A neonatal intensive care unit should be available at the time of delivery. The short-term prognosis is good with no maternal mortality and there is no long-term deleterious influence of pregnancy on the evolution of SLE.

Abortion, Spontaneous↗
PubMed1988

The radiology of cardiac valve prostheses.

The radiographic findings associated with the complications of valve implantation are presented. Complementary roles of echocardiography and cine fluoroscopy in the recognition of complications associated with this procedure are emphasized. Identification of prosthetic valves and the knowledge of the modes of action of the various types of valves are stressed.

Bioprosthesis↗
PubMed1986

Prospective study of pregnancy in systemic lupus erythematosus. Results of a multidisciplinary approach.

Our prospective study attempted to better define the reciprocal relation between pregnancy and systemic lupus erythematosus (SLE), to reduce maternal morbidity/mortality, and fetal loss. Our protocol included all the pregnancies in our total of patients with SLE between the years 1974-1983. There were 102 pregnancies in 75 patients during this period; SLE was exacerbated in 59.7% that started with inactive disease, most with mild episodes. Hematologic manifestations and renal disease, however, required moderate or high doses of steroids. There were no maternal deaths. There were 49% premature newborns in the entire group and this increased to 59% in mothers with active SLE; 23% of newborns were small for gestational age in the entire group and the rate increased to 65% in mothers with active SLE. There was a 16% spontaneous abortion rate with no difference between mothers with active or inactive disease, 5 stillbirths and one neonatal death, with a total fetal loss of 22% (compared with 6.7% in the control group p less than 0.001). There were 32 cesarean sections with live outcomes and 14 newborn infants with a weight below 1.5 kg survived. Our study shows that in patients with SLE planned rheumatologic care of the mother, with special obstetrical and perinatal attention, may reduce the high maternal and fetal morbidity/mortality.

Abortion, Spontaneous↗
PubMed1985

Diagnosis and primary management of laryngeal trauma.

Four cases of laryngeal trauma are presented and the literature is reviewed. Diagnostic techniques and controversial primary treatment of airway obstruction are discussed. Recommendations include the use of indirect laryngoscopy on initial examination and the performance of a tracheostomy in cases of airway obstruction, in lieu of endotracheal intubation. The cases illustrate these points and demonstrate the variability in time intervals between injury and onset of symptoms.

Adult↗
PubMed1985

Cardiovascular manifestations in systemic lupus erythematosus. Prospective study of 100 patients.

One hundred consecutive female patients with active systemic lupus erythematosus (SLE) were studied from the cardiovascular point of view by means of non invasive methods. Seventy percent of the cases presented some type of cardiovascular anomaly. Seventy four percent of the resting electrocardiograms were abnormal as well as 72% of the M mode echocardiograms and 55% of the cardiac X ray series. The most frequent observed complications were: pericarditis and or pericardial effusion (39%), arterial hypertension (22%), ischemic heart disease (16%), myocarditis (14%), congestive heart failure (10%), pulmonary hypertension (9%), valvular heart disease (9%), pleural effusion (7%) and cerebro vascular accident (3%). We analyzed each one of these complications and found of special interest the high incidence of ischemic heart disease which is more frequent than has been hitherto reported. Ischemic heart disease was observed in two types of patients: a) Those with long term steroid therapy. In these, the mechanism seems to be an atherosclerotic disease probably induced by the chronic use of steroids. The management of these cases do not differ from other types of coronary heart disease due to atherosclerosis. b) Those with frank episodes of vasculitis in whom the basic mechanism is an inflammatory process of the coronary arteries and its treatment is fundamentally that of the vasculitis. We consider necessary to study routinely all patients with SLE through non invasive cardiological methods.

Adolescent↗
PubMed1984

Polymyositis/dermatomyositis and pregnancy.

Eighteen women with polymyositis/dermatomyositis (PM/DM) were studied to determine the possible influences of pregnancy on the disease and the influence of the disease on pregnancy. Before the onset of PM/DM there were 77 pregnancies: 7 (9%) ended in abortion, 2 (2.5%) in perinatal deaths, with a total fetal loss of 11.5%. There were 3 (3.8%) premature newborns that survived. These figures are equivalent to those of the general population. There were 10 pregnancies in 7 patients coinciding with PM/DM, 1 of them with twins; 3 (30%) ended in abortion, 3 (25%) in perinatal deaths, with a total fetal loss of 55%, and 5 (50%) pregnancies ended prematurely. Four of the 7 women had onset of PM/DM during pregnancy, and 3 others with previously inactive disease had an exacerbation during pregnancy. There were no maternal deaths, nor was there any correlation between activity of PM/DM and fetal loss. These results together with those previously reported suggest that pregnancy in PM/DM should be considered high-risk for both the mother and the baby.

Abortion, Spontaneous↗
PubMed1984

Renal vein thrombosis and inferior vena cava thrombosis in systemic lupus erythematosus. Frequency and risk factors.

Phlebography of the inferior vena cava with selective study of the renal veins was performed in 43 patients with systemic lupus erythematosus (SLE). Inferior vena cava thrombosis (IVCT) or renal vein thrombosis (RVT) was found in 3 of 11 patients (27%) with nephrotic syndrome, in 8 of 13 (61.5%) with previous thrombophlebitis, and in 3 of 4 (75%) with suggestive acute clinical picture. In contrast, none of the 20 control patients with SLE had IVCT or RVT. These results show that SLE patients with thrombophlebitis have a very high risk of developing IVCT or RVT; patients with nephrotic syndrome have a smaller risk. Neither IVCT nor RVT was found in SLE patients without antecedent thrombophlebitis or nephrotic syndrome.

Female↗
PubMed1984

Contraception with progestagens in systemic lupus erythematosus.

To test the efficacy and tolerance of progestagens as contraceptives in systemic lupus erythematosus (SLE), 200 mg IM norethisterone enanthate was administered to 10 patients, 0.03 mg/day oral levonorgestrel to 15 patients and they were compared with 18 control patients. There were 4 episodes of active SLE in 48 patient-months on norethisterone enantate and 6 episodes in 122 patient-months on levonorgestrel as compared with 9 episodes of active disease in 298 control patient-months (p = ns). There were no pregnancies and intermenstrual bleeding led to discontinuation of medication in 30% of patients. Progestagens may be an alternative contraceptive method in SLE.

Adult↗
PubMed1984

HLA-B27 and ankylosing spondylitis in the Mexican Mestizo population.

Two previous surveys of ankylosing spondylitis (AS) in Mexican Mestizos found HLA-B27 frequencies of 68.6% and 78% and a relative risk (RR) of 37.05 and 120.88, respectively. We examined an additional group of Mexican Mestizos with AS and found an HLA-B27 frequency of 80.77% and a RR of 99.24. Our results are statistically comparable to the previous studies, and they suggest that the Mexican Mestizo is similar to the Spaniard in regards to AS and HLA-B27 association.

Female↗