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Biomedical subjects

J E Naschitz

Publications and source records attributed to J E Naschitz.

At least 109 records · Page 6Linked to original sources
PubMed1987

Compensated cardiogenic shock: a subset with damage limited to liver and kidneys. The possible salutary effect of low-dose dopamine.

A variant of compensated cardiogenic shock occurring in patients with chronic congestive heart failure following an episode of pulmonary edema, and in the absence of hypotension, is described. The clinical picture is characterized by combined renal and hepatic injury and a severe, often fatal, course and is distinct from other subsets of cardiogenic shock. When the splanchnic vasodilator dopamine was added to the patients' management, the outcome was uniformly favorable. This variant of compensated cardiogenic shock requires early diagnosis and treatment. The apparently beneficial effect of low-dose dopamine needs further evaluation.

Aged↗
PubMed1987

Intermittent claudication associated with cancer--case studies.

Cancer was diagnosed in 15 patients among 300 consecutive patients with intermittent claudication. The cancer-associated claudication is characterized by a more accelerated course of claudication, more often requires vascular surgery, and moreover, the lasting relief of claudication depends upon the efficiency of cancer therapy. It is the authors' impression that cancer-associated claudication is predetermined by atherosclerosis and aggravated by cancer through the chronic hypercoagulability state secondary to neoplasm. The clinical picture is characterized by rapid progression, with the frequent necessity of vascular surgery for limb salvage and a higher incidence of graft occlusion. Awareness of this possibility of hidden malignancy may be related to the clinical picture of hemodynamic deterioration of the underlying arterial insufficiency. A high index of suspicion leads to earlier diagnosis of neoplasm. Effective oncologic therapy will often bring the symptomatic relief of ischemic symptoms in the lower extremities. This report indicates that associated neoplasm has a more vicious course of the underlying arterial insufficiency and intermittent claudication.

Adenocarcinoma↗
PubMed1987

Massive hepatic steatosis complicating adult celiac disease: report of a case and review of the literature.

Hepatomegaly, chronic diarrhea, and weight loss in a middle-aged woman were found to be due to massive hepatic steatosis and adult celiac disease. After she was on a gluten-free diet for 1 yr, improvement in clinical, laboratory, and pathological parameters was witnessed. Massive hepatic steatosis complicating adult celiac disease is an uncommon occurrence, differing from other, more frequently encountered hepatopathies in this disease, insofar as pathogenetic and prognostic aspects are concerned.

Adult↗
PubMed1986

Spontaneous colosplenic fistula complicating immunoblastic lymphoma.

Immunoblastic lymphoma of the colon, complicated by colosplenic fistulization, is reported. It is suggested that ulceration and extensive coagulative necrosis of a bulky large cell lymphoma in the absence of a desmoplastic reaction are the prerequisites for fistula formation.

Aged↗
PubMed1986

Intrathoracic amyloid lymphadenopathy.

2 patients with intrathoracic lymph node enlargement as their presenting symptom, were found to have amyloid lymphadenopathy. Both also had peripheral involved lymph nodes. The demonstration of amyloid deposits in the peripheral lymph nodes did not suffice to deduce that the intrathoracic nodes were of the same nature. A biopsy of the intrathoracic nodes was needed for final diagnosis. An additional 11 cases of intrathoracic amyloid lymphadenopathy from the literature are reviewed.

Aged↗
PubMed1985

Unilateral chest wall edema in carcinomatous pleurisy.

21 patients with protracted unilateral pleural effusion were studied with respect to the etiology of their pleurisy. 13 presented with unilateral chest wall edema (UCE). These were classified as group A patients. 8 group B patients suffered from unilateral pleural effusion without UCE. A malignant cause of the effusion was established in 8 out of the 13 patients in group A, and in 2 patients from group B. Empyema was present in 4 additional patients, all of them belonging to group A. The diagnosis of purulent pleural effusion could be made promptly by microscopic examination of the pleural fluid. If excluding the empyema patients, the presence of UCE was significantly associated (p less than 0.025) with a malignant etiology of the pleural effusion. It seems that careful examination of the chest wall skin texture can be a simple and useful method in the initial evaluation of patients with pleurisy.

Adult↗
PubMed1985

Nuclear magnetic resonance imaging of liver hemangiomas.

Nine patients with cavernous hemangioma of the liver were examined by nuclear magnetic resonance imaging (MRI) with a 0.5 T superconductive magnet. Spin-echo technique was used with varying time to echo (TE) and repetition times (TR). Results were compared with 99mTc red blood cell (RBC) scintigraphy, computed tomography (CT), echography, and arteriography. Four illustrated cases are reported. It was possible to establish a pattern for MRI characteristics of cavernous hemangiomas; rounded or smooth lobulated shape, marked increase in T1 and T2 values as compared with normal liver values. It is concluded that, although more experience is necessary to compare the specificity with that of ultrasound and CT, MRI proved to be very sensitive for the diagnosis of liver hemangioma, especially in the case of small ones which may be missed by 99mTc-labeled RBC scintigraphy.

Adolescent↗
PubMed1985

Occult infection in the facial area presenting as fever of unknown origin.

Dental infections, otitis media or sinusitis may present as fever of unknown origin (FUO), lacking local symptoms and signs. Physicians are often unaware of this possibility, since current textbooks and major articles do not mention occult facial infections among the causes of FUO. Patients with FUO typically undergo a laborious series of uncomfortable, time-consuming, expensive and often unnecessary investigations in the search for the cause of pyrexia. We report five such patients from a community hospital, representing 14% of cases in a series of patients with FUO. In most of these patients local signs were absent, laboratory investigations were noncontributory, and antibiotic treatment was ineffective. Surgical drainage of pus collections was followed a few days later by defervescence. We suggest that occult infections in the facial area should be considered among the common causes of FUO, and careful dental examination, otoscopy and X-rays of the teeth and sinuses should be included early in the investigation of these patients.

Adult↗
PubMed1984

Isolated amyloid lymphadenopathy.

An elderly patient presented with supradiaphragmatic lymphadenopathy due to massive amyloid deposits. No other organ was involved. The urine contained minute amounts of monoclonal light chains. This isolated amyloid lymphadenopathy with monoclonal gammopathy is of obscure nature and pathogenesis.

Aged↗
PubMed1984

Delayed initial QRS forces of intraventricular pacing: unreliability of the scalar ECG in their diagnosis.

Delta waves, similar to those observed in the Wolff-Parkinson-White syndrome, are currently observed in the ECG tracings of patients with endocardial pacing. With the aid of standard ECG and vectorcardiography (VCG), we studied the initial QRS forces during right endocardial pacing in 20 patients. More details were obtained by VCG concerning the amplitude duration, electrical axis and shape of the delta waves of paced ventricular beats, than by ECG. It is remarkable that delayed initial QRS forces, diagnosed by VCG analysis, were present in only 9 of 20 patients with delta waves in their ECG. In other patients, the slurring or thickening at the onset of the R waves in the ECG resulted from the perpendicular direction of the initial QRS vectors to the lead axis, or from multiple changes in the direction of the early, nondelayed QRS vectors. The superiority of VCG in the study of the initial QRS forces, particularly in the diagnosis of delayed initial QRS forces, is discussed.

Cardiac Pacing, Artificial↗