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Biomedical subjects

H Mendelsohn

Publications and source records attributed to H Mendelsohn.

11 recordsLinked to original sources
PubMed2004

Fluocinolone acetonide topical oil for scalp psoriasis.

Numerous preparations that are available for the treatment of psoriasis of the scalp contain high potency steroids, such as betamethasone dipropionate lotion or clobetasol propionate solution. Of special interest is a currently marketed oil preparation that contains the steroid fluocinolone acetonide (0.01%), classified as low potency (Class 6) steroid. Because the combination of emollients in the vehicle base are present to aid in softening the stratum corneum and allow penetration of the steroid component into the lower skin layer, it was thought this preparation would be an efficient treatment for psoriasis of the scalp. This study was designed to demonstrate the efficacy, tolerance and safety of fluocinolone acetonide 0.01% in oil, compared to its vehicle, for the treatment of scalp psoriasis. This was a randomized, double-blind, vehicle-controlled multi-center study in patients with moderate to severe scalp psoriasis. At the completion of the treatment period (21 days) all signs of psoriasis had improved in both treatment groups, the improvements in the FA group being significantly greater compared to those in the vehicle-treated group. The results of the physician global assessments of improvement in the signs of psoriasis from baseline confirmed the findings. Significantly more patients in the FA group had a good or better improvement from baseline compared to the number in the vehicle-treated group. The results of this study conclusively show that FA in an oil base that aids in the softening of the skin and allows penetration of the steroid into the stratum corneum, is an effective treatment for psoriasis of the scalp. This study also showed that the vehicle alone causes an improvement in the signs of psoriasis, but that the addition of 0.1% of the low potency steroid, fluocinolone acetonide, leads to a significantly better improvement.

Administration, Topical↗
PubMed1992

[Masturbation in infancy simulating convulsive disorder].

We describe a 7-month-old girl referred for evaluation of a convulsive disorder. The tentative diagnosis of epilepsy was based on what were apparently paroxysmal events which occurred many times during a day. A cousin had suffered from infantile spasms and is mentally retarded. The episodic "attacks" in our patient consisted of sudden rhythmic body movements, crossing of thighs, altered awareness, glassy stare and profuse sweating. While the attacks subsided spontaneously, they could easily be aborted by changing the infant to a sitting position or by picking it up and holding it, when it would revert to completely normal behavior. A detailed history and personal observation of the "attacks" made it clear that they were really physical manifestations of masturbation. The diagnosis of epilepsy was therefore discarded. Awareness of masturbation in infants is essential for establishing the correct diagnosis, and spares infants and families many superfluous investigations and the anxiety associated with a diagnosis of convulsive disorder in children.

Diagnosis, Differential↗
PubMed1989

[Inborn errors of metabolism: lessons from a clinical case].

Dramatic advances in recent years in the diagnosis and treatment of inborn errors of metabolism (IEM) make it imperative for the physician to be both aware of their occurrence and acquainted with their clinical presentations. Many may present with symptoms and signs common to sick infants, such as refusal to feed, vomiting and convulsions. Failure to include IEM in the differential diagnosis may have grave consequences, because only prompt recognition and appropriate treatment of a metabolic crisis can help prevent irreversible brain damage or death. We describe a 3-week-old female infant, eventually diagnosed as having an IEM (3-hydroxy-3-methyl-glutaric aciduria), who was admitted to various hospitals and died during her last admission. We focused on the clinical and laboratory findings of each of the first 2 admissions which might have provided clues to the true nature of the illness had the clinicians been aware of the possibility of IEM. Patients with IEM are generally managed in specialized centers; however, the responsibility for initial recognition and immediate treatment of a metabolic emergency lies with the primary physician. The purpose of our case presentation and the discussion of the lessons derived from it, is to prompt the clinician to an awareness and understanding of a subject that used to be considered reserved for specialists. In fact, all that is needed is clinical alertness and the performance of certain well-focused, simple laboratory tests for IEM.

Amino Acid Metabolism, Inborn Errors↗
PubMed1983

Primary sclerosing cholangitis associated with immunodeficiency.

An infant, first admitted at the age of 5 months with diarrhea (which was adequately treated with formula), was readmitted at the age of 1 year with poor weight gain, steatorrhea, and hepatomegaly. Liver function test results were compatible with cholestatic jaundice, and hepatobiliary scintigraphy visualized dilated bile ducts and evidence of hepatocellular disease. Exploratory laparotomy, liver biopsy, and cholangiography disclosed pathologic and roentgenographic findings of primary sclerosing cholangitis (PSC). The patient proved to be immunodeficient, pointing to the possible pathogenetic role of immunodeficiency in causing PSC in some patients. It is important to look for the disease in immunodeficient children and in patients with ulcerative colitis, and to consider PSC in the differential diagnosis of cholestatic jaundice.

Bile Ducts↗
PubMed1976

Thymectomy for myasthenia gravis.

A group of 71 patients with myasthenia gravis is reviewed. All were initially managed medically, and 18 underwent thymectomy. Twenty-three responded poorly to drug treatment, and seven died from respiratory failure. In contrast, thymectomy was beneficial in 16 of the 18 who were subjected to operation. Seven patients had significant postoperative respiratory complications, and nine required a tracheostomy. Thymectomy appears to be effective and safe and to be indicated in young patients with early disease, and in patients who do not respond to drug treatment. The transcervical approach to thymectomy was satisfactory on two occasions.

Adolescent↗
PubMed1975

Open thoracotomy for pneumothorax in cystic fibrosis.

The results of open thoractomy and pleurectomy or pleural abrasion for 17 episodes of pneumothorax in patients with cystic fibrosis were compared with the results of observation, closed thoracostomy, and closed thoracostomy with sclerosing agents. Open thoracotomy had the advantage of insuring prompt resolution of the pneumothorax. A small incision minimized postoperative morbidity. The average hospital stay was 15 days after open thoracotomy and 19 days after closed thoracostomy, with or without sclerosing agents. Complications of all treatments were infrequent. A limited symptomatic recurrence was observed in 2 of 17 pneumothoraces successfully treated with open thoracotomy. Recurrence also occurred in 1 of 8 treated with observation, 3 of 9 treated with closed thoracostomy, and 1 of 14 treated with closed thoracostomy and sclerosing agents. A loss of vital capacity was usually noted 4 to 18 months after resolution, regardless of treatment. Forty per cent of patients in both operative and nonoperative groups survived 3 years. In our experience, open thoracotomy can be used safely for treatment of unresolved or recurrent pneumothorax and warrants further evaluation as a primary therapy for pneumothorax in patients with cystic fibrosis.

Cystic Fibrosis↗