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Biomedical subjects

J E Naschitz

Publications and source records attributed to J E Naschitz.

At least 91 records · Page 5Linked to original sources
PubMed1990

Colonic diverticulitis-related exuberant granulomatous reaction in a patient with sarcoidosis.

A patient with long-standing sarcoidosis underwent partial colectomy for diverticular disease. Whereas sarcoid granulomas were rare in the otherwise normal colonic mucosa, an unusually large number of granulomas were scattered within the chronically inflamed peridiverticular tissues. It is suggested that in the framework of the sarcoidotic background, activated macrophages, being nonspecifically attracted to areas of inflammation, elicit an exuberant sarcoid granulomatous response. Our observation represents a previously undescribed variant of the "homing" phenomenon in sarcoidosis, unrelated insults inducing formation of granulomas in overabundance.

Chronic Disease↗
PubMed1990

Treatment with cimetidine of atypical fasciitis panniculitis syndrome.

Three patients presented with septal fasciitis and panniculitis, associated with clinical and laboratory features which precluded straight-forward classification into eosinophilic fasciitis, localised scleroderma, or lupus erythematosus profundus. Treatment with cimetidine caused the remission of cutaneous manifestations and the extracutaneous abnormalities, such as nailfold capillary disturbances and the presence of antithyroid antibodies, improved. It is concluded that features of eosinophilic fasciitis or localised scleroderma and certain additional atypical elements should be categorised as atypical fasciitis-panniculitis syndrome.

Adult↗
PubMed1990

Cardiogenic hepatorenal syndrome.

A variant of hepatorenal syndrome occurring in patients with chronic congestive heart failure following an episode of cardiogenic pulmonary edema, and in the absence of hypotension, is described. This was observed in 13 patients during an eleven-year period. The clinical picture is characterized by hepatic injury and functional renal impairment. Increase of serum glutamic oxaloacetic transaminase levels as high as 2100 IU; prolongation of prothrombin time; elevation of serum bilirubin, creatinine, blood urea nitrogen, and potassium levels; decrease in urinary sodium excretion; and a normal urinary sediment are the salient laboratory abnormalities of this entity. Treated with conventional medication, the patients' course was fatal in 4 cases. When the splanchnic vasodilator dopamine was added to the patients' management, 5 of 9 patients recovered. Cardiogenic hepatorenal syndrome is a severe but potentially reversible complication of heart failure. The apparently beneficial effect of low-dose dopamine needs further evaluation.

Biopsy, Needle↗
PubMed1990

Diffuse hemangiomatosis of the spleen: splenic hemangiomatosis presenting with giant splenomegaly, anemia, and thrombocytopenia.

In an elderly patient with oligosymptomatic giant splenomegaly, clinical and laboratory data were nondiagnostic, while nonhomogeneous splenic enlargement was the only finding detected by imaging procedures. Splenectomy was performed and diffuse hemangiomatosis of predominantly capillary-type found. The failure of imaging techniques to even hint at the nature of the underlying disorder is comprehensible in view of the organ being essentially replaced in toto by the abnormal vascular channels. Diffuse splenic hemangiomatosis, a rare condition, may cause hypersplenism, and its diagnosis may be elusive because of misleading patterns on imaging.

Anemia↗
PubMed1990

[BCG-induced axillary lymph-adenitis in the adult].

Axillary lymphadenopathy is very common, with a wide and well-known differential diagnosis. We present for the first time in the contemporary English medical literature the case of a 50-year-old woman with unilateral axillary lymph node enlargement due to BCG injection 2 months earlier. The difficulty in diagnosis is because BCG inoculation is rare in adults, and the latent period is long, up to 8 months. This was the cause of initial misdiagnosis. We conclude that unilateral axillary lymphadenopathy in adults travelling to third-world countries, should raise the question of BCG-induced lymphadenopathy.

Axilla↗
PubMed1990

Overt gastrointestinal bleeding in the course of chronic low-dose aspirin administration for secondary prevention of arterial occlusive disease.

We describe 13 patients who developed erosive gastritis with overt gastrointestinal bleeding while receiving 75-250 mg nonbuffered aspirin per day for the secondary prevention of cardiac or cerebrovascular events. The bleeding occurred despite good initial tolerance to aspirin for several months or years. All patients were elderly and had severe atherosclerotic cardiovascular disease. Our data suggest that, contrary to common belief, very low doses of nonbuffered aspirin are attendant with clinically apparent gastrointestinal complications.

Aged↗
PubMed1989

Clinical significance of paraneoplastic syndrome.

The prevalence, clinical presentations, and diagnostic significance of the paraneoplastic syndrome (PNS) in the setting of a department of internal medicine in a community hospital was studied. During a 7-year period (1979-1985) a total of 167 patients among 11,000 hospitalized patients were diagnosed as having a malignant neoplasia previously unknown. From this group we selected all cases who presented with one or more of the known clinical PNSs. Forty-two cases, i.e., 25% fulfilled the selection criteria. Their prevalence in our population was higher than usually found in the literature. Sixteen different categories of PNS were observed. They occurred 55 times, since more than one PNS was present in 9 cases. No significant correlation was observed between any type of PNS and any particular class of malignant neoplasia. At the time of initial evaluation, PNSs were associated with stage I malignancy in 15 cases, with stages II and III in 8 and 3 cases, respectively, and with stage IV in 22 cases. PNSs were the leading symptom or sign in 56% of the patients. In these patients the PNS determined the direction of work-up in the search for a malignant tumor. However, PNSs were essential for suspecting cancer in stage I of the disease in 6 cases only, i.e., 14%. We stress that awareness of the clinical implications of these syndromes may permit an earlier diagnosis of malignancy.

Aged↗
PubMed1989

Colitis and pericarditis in a patient with eosinophilic fasciitis. A contribution to the multisystem nature of eosinophilic fasciitis.

A case of eosinophilic fasciitis (EF), associated with monoclonal gammopathy, thyroglobulin antibodies, pericarditis and colitis, is described. The occurrence of EF in the framework of a multisystem disease is the outstanding feature, contrasting with the absence of visceral involvement or solitary organ involvement in the large majority of cases. The unusual histologic features of the colitis and beneficial effect of cimetidine on EF are discussed.

Aged↗
PubMed1989

Recurrent massive alveolar hemorrhage, crescentic glomerulonephritis, and necrotizing vasculitis in a patient with rheumatoid arthritis.

A middle-aged man presented with recurrent alveolar hemorrhage, rheumatoid arthritis, and crescentic immune complex-mediated glomerulonephritis. Nail bed hemorrhages and necrotizing vasculitis were documented concomitantly with the clinical picture of Goodpasture's syndrome. Perusal of the literature disclosed two additional similar cases. It is suggested that Goodpasture's syndrome may evolve in the framework of rheumatoid vasculitis. While immunosuppressive therapy resulted in short-term remission, two of the three patients involved developed late-stage renal failure.

Anti-Glomerular Basement Membrane Disease↗
PubMed1988

Intermittent claudication: predictors and outcome.

The authors reviewed 460 patients with intermittent claudication. With primarily conservative management, these patients were followed for an average of 4.1 years (one to ten years). The mean age was 71.7 years, ranging from thirty-six to eighty-four years; 55.9% were males. The subsequent follow-up study revealed that the status of 44.1% of the patients with underlying arterial insufficiency deteriorated. Eventually, they underwent vascular surgery for limb-threatening ischemia. From this study, the analysis of the parameters could predict the clinical outcome of intermittent claudication at the time of initial and follow-up evaluation. During initial evaluation, when the ankle brachial index (ABI) was higher than 0.7 or when follow-up evaluation did not show a decrease of ABI by 0.15, the chance of favorable outcome was increased by 2.4 and 1.6 times respectively. When the ABI was less than 0.5 at the initial evaluation and decreased 0.15 or more during follow-up studies, the risk of requiring vascular surgery for limb salvage increased by 3.8 and 1.9 times, respectively. The onset of major vascular events in other areas appeared to influence the time of significant deterioration in the lower limb arterial disease, indicating multifactorial and systemic contribution in the natural history of intermittent claudication. In this homogeneous patient population with arterial insufficiency referred to the vascular surgeon, conservative management with strong supervision for smoking cessation, exercise, diet control, body weight reduction, and medical regimen can modify the natural course of intermittent claudication and associated vascular problems.

Adult↗