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Biomedical subjects

J Fidel

Publications and source records attributed to J Fidel.

At least 19 recordsLinked to original sources
PubMed2002

Radiotherapy of pituitary tumours in five cats.

Five cats tentatively diagnosed with pituitary adenoma (four cases) or pituitary carcinoma (one case), based on computed tomography (CT) or magnetic resonance imaging, were treated with radiotherapy. Electrons were applied in four cats and electrons and photons in the fifth. Ten to 12 fractions of 3.5 to 4.0 Gy each were delivered on a Monday/Wednesday/Friday schedule. The mean total dose applied was 39 Gy. No severe acute side effects to treatment were seen. Follow-up CT examination was performed in four cats; the mass had disappeared in one cat and remained stable or slightly decreased in size in the other three. The survival times were 5.5, 8.0, 15.0, 18.0 and 20.5 months, with two cats dying of causes unrelated to the tumour. Based on these cases, radiotherapy appears to be a valuable treatment option for feline pituitary tumours.

Adenoma↗
PubMed1999

Adjuvant therapy for melanoma in dogs: results of randomized clinical trials using surgery, liposome-encapsulated muramyl tripeptide, and granulocyte macrophage colony-stimulating factor.

Spontaneous canine oral melanoma (COM) is a highly metastatic cancer, resistant to chemotherapy, and can serve as a model for cancer immunotherapy. Liposome-encapsulated muramyl tripeptide-phosphatidylethanolamine (L-MTP-PE) can activate the tumoricidal activity of the monocyte-macrophage system following i.v. injection. The objective of these studies was to evaluate the therapeutic effectiveness of L-MTP-PE administered alone and combined with recombinant canine granulocyte macrophage colony-stimulating factor (rcGM-CSF) in dogs undergoing surgery for oral melanoma. Ninety-eight dogs with histologically confirmed, clinically staged, oral melanoma were entered into two randomized, double-blind, surgical adjuvant trials. In trial 1, 50 dogs were stratified based on clinical stage and randomized to once a week L-MTP-PE or lipid equivalent (control). When all of the clinical stages were combined, no difference in disease-free survival or in survival time (ST) were detected. However, within stage I, dogs receiving L-MTP-PE had a significant increase in ST compared with control, with 80% of the dogs treated with L-MTP-PE still alive at >2 years. Within each stage II and stage III, there was no difference detected between the treatment groups. In trial 2, 48 dogs were stratified on the basis of clinical stage and extent of surgery (simple resection or radical excision), treated with L-MTP-PE two times a week, and randomized to rcGM-CSF or saline (placebo) given s.c. daily for 9 weeks. Within each stage and when all of the stages were combined, there was no difference between the treatment groups. In both studies, stage I COM is associated with a better prognosis. No effect on survival was observed with regard to tumor location in the oral cavity, sex, type/extent of surgery, or age. In a subset of dogs tested, pulmonary alveolar macrophage cytotoxicity was enhanced with combined rcGM-CSF and L-MTP-PE but not in dogs treated with L-MTP-PE alone. The present study indicates that after surgery, L-MTP-PE administered alone or combined with rcGM-CSF showed no significant antitumor activity in treating advanced stage COM. In early stage COM, L-MTP-PE was shown to result in a prolongation of ST. Furthermore, this study provides additional rationale for the use of the dog model for human malignant melanoma.

Acetylmuramyl-Alanyl-Isoglutamine↗
PubMed1995

Reproducibility of angiotensin converting enzyme inhibitor induced cough: a double-blind randomised study.

1. The reproducibility of angiotensin converting enzyme inhibitor induced cough was examined in a double-blind cross over study in patients previously shown to have exhibited this side effect. 2. Ninety-seven patients who had experienced angiotensin converting enzyme inhibitor cough within the last 2 years were challenged with enalapril 20 mg daily for 4 weeks to establish eligibility. Eighty-eight of 97 (91%) patients experienced a repeat of their cough symptoms. Sixty-four patients entered the double-blind part of the study where they were treated with enalapril 20 mg and a renin inhibitor for up to 4 weeks in random order. These periods were separated by a minimum 4 week placebo wash out. 3. Of 59 evaluable patients who received enalapril a second time, 37 (62.7%) experienced cough again. Of 62 patients on the renin inhibitor 16 (25.8%) experienced cough, however as it was not equi-efficacious to enalapril no valid comparison could be made. 4. Angiotensin converting enzyme inhibitor cough is not reproducible within patients, as other factors are involved in the aetiology. Objective testing with blinded assessment together with symptom reporting, would give a more accurate measure of the incidence, and mechanism of this side effect.

Adult↗
PubMed1994

Cervicomedullary tumors in children: a distinct subset of brainstem gliomas.

We reviewed the clinical course of 17 children who underwent surgical resection of an intra-axial cervicomedullary tumor between 1980 and 1992. The clinical symptoms, which reflected medullary dysfunction in nine children and cervical cord deficits in eight, were present for a mean of 2.1 years before diagnosis (range, 2 months to 7.5 years), and for at least 1 year in 80% of the patients. Neurodiagnostic imaging (MRI in 14, CT in 3) showed the tumor epicenter in the medulla in 11 and in the upper cervical cord in six. Surgery was performed for newly diagnosed tumor in 11 children, and for progressive disease in six who had received prior radiotherapy. The surgical resection was gross total in two and partial (60 to 95%) in fifteen. Fifteen patients had low-grade glial tumors (10 astrocytomas, four gangliogliomas, and one mixed glioma), and two had anaplastic gangliogliomas. Four-year progression-free and total survival rates after surgery for patients who had surgery as initial therapy were 70 and 100%; for those who had surgery at the time of progression, these were 41 and 62%. Postsurgical neurologic complications occurred in five children. Four of these children had received prior radiotherapy. Two of them already had severe preoperative deficits and three had moderate deficits that worsened after surgery. Twelve patients with mild deficits were unchanged or improved postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗
PubMed1993

Comparison of verapamil and captopril in elderly hypertensive subjects: results of a randomized, double-blind, crossover study.

The effectiveness and tolerability of captopril and verapamil SR were compared in a double-blind, crossover study in 23 elderly hypertensives [15 males and 8 females, aged (mean +/- SEM) 68 +/- 1 years]. After 2 weeks of placebo run-in, patients were randomized to a starting dose of captopril, 12.5 mg b.i.d. or verapamil SR, 120 mg q.d. plus matched placebo of the opposite drug. Medication was titrated up over 6 weeks to a maximum dose of 75 mg of captopril or 360 mg of verapamil SR to achieve a sitting diastolic blood pressure of < 90 mm Hg. After 2 weeks of placebo washout, captopril and verapamil were crossed over. In the 20 patients who completed the study, the dose at the end of the respective treatment periods averaged 63 +/- 4 mg of captopril and 270 +/- 21 mg of verapamil SR. Blood pressure at the end of the run-in and washout placebo periods were comparable: 164 +/- 4/97 +/- 1 and 163 +/- 4/98 +/- 2 mm Hg, respectively. However, the blood pressure was significantly lower after verapamil, i.e., 147 +/- 4/86 +/- 2 mm Hg, than after captopril, i.e., 155 +/- 4/90 +/- 1 mm Hg (p < 0.05, ANOVA). There was no significant change in heart rate and laboratory parameters and no orthostatic hypotension. Captopril-treated patients reported a positive change in well being compared with placebo, although there was no overall difference between the drugs in any of the ten quality of life measurements. Three patients discontinued treatment, two because of constipation (verapamil) and one due to lack of efficacy (captopril).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

Improved kidney function with cilazapril in hypertensive type II diabetics with chronic renal failure.

The purpose of this study was to determine efficacy and safety of the angiotensin converting enzyme inhibitor, cilazapril, in the treatment of hypertensive diabetics with renal insufficiency. Fifteen type II diabetics with hypertension and chronic renal insufficiency aged (mean +/- SD) 64 +/- 7 years were studied in a regional clinic and university hospital hypertension unit. The blood pressure was measured biweekly. Urinary collections were done after 2 weeks of placebo and 8 weeks of cilazapril treatment. The blood pressure decreased from 176 +/- 15/105 +/- 9 to 164 +/- 11/95 +/- 9 mm Hg and serum creatinine from 197 +/- 69 to 179 +/- 73 mumol/L. The creatinine clearance rose from 41.6 +/- 11.4 to 47.4 +/- 14.9 ml/min, while protein excretion decreased from 0.8 +/- 1.3 to 0.5 +/- 0.8 g/24 h (p less than 0.05). The blood pressure change was inversely correlated with the creatinine clearance change (r = -0.5, n = 15, p less than 0.05). In these high-risk patients, 8 weeks of cilazapril treatment improved both blood pressure control and renal function but renal function improved most in the patients whose blood pressure changed the least.

Aged↗
PubMed1989

A new, short family function assessment questionnaire for use in family medical practice in Israel: construction, validation and preliminary application.

This report describes the compilation and initial steps in the field testing of a new questionnaire intended for Israeli family physicians wishing to rapidly assess the general level of family functioning of their patients as part of everyday routine history taking in practice. The questionnaire was shown to have reasonable reliability and validity in a nonrepresentative sample of 140 married Israeli adults in three different family medicine practices. The questionnaire yielded a sum score ranging from 0 to 20. Preliminary estimates, based on a comparison of the sum score of each patient's questionnaire with the doctor's assessment of the family's functioning, suggest that patients of families with poor function score 11 or less, with satisfactory function 12 to 17, and with good function more than 17. These ranges require further refinement and standardization by testing the questionnaire among other groups of the Israeli population.

Adult↗
PubMed1985

Captopril as a replacement for multiple therapy in hypertension: a controlled study.

A controlled study was conducted in hypertensive patients to investigate whether captopril can be substituted for the various other antihypertensive drugs (not including diuretics) to reduce side effects and improve the quality of life. Captopril in a twice daily dose of 25-50 mg, was substituted and titrated in 54 patients. Fifty-two patients, matched by age and sex, comprised the control group, and were treated with a variety of agents. During a follow-up of 9 months, 44 of the patients receiving captopril (81%) achieved the goal of supine blood pressure less than 90 mmHg. Captopril was discontinued in two patients due to side effects. Mild proteinuria was observed in two patients. A significant reduction in scores or rates of side effects (numbness, blurred vision, insomnia, vivid dreams, cold extremities, sleepiness, sexual dysfunction and fatigue) and improvement in quality of life (general feeling, mood and concentration) was observed in the study group compared with the control group. Captopril alone in a twice daily dose of 25-50 mg, or in co-treatment with thiazide, provided sustained blood pressure control with minimal side effects and improvement in quality of life compared with the treatment of hypertension with beta-blockers, vasodilators or methyldopa.

Aged↗
PubMed1980

Genetic studies on Cochin Jews in Israel: 1. Population data, blood groups, isoenzymes, and HLA determinants.

The period in which Jews were first associated with Cochin and the Malabar coast was by tradition, after the destruction of the First Temple (586 BCE). Yet, the earliest evidence of Jewish settlements is from the tenth century CE. The largest group of Cochin Jews are the "Black Jews," of whom about 4,000 live in Israel. A high frequency of consanguineous marriages prevailed among Cochin Jews. Their mean height and weight were low when they came to Israel in 1954; an increase in both was observed 20 years later. Some of the allele frequencies of blood groups, isoenzymes, and HLA antigens were similar to those in other Jewish communities. In the high O, M, cde, and HLA-A28 and the low cDE allele frequencies Cochin Jews resembled Yemenite Jews. A few allele frequencies, the high Fya, AK2 and the low Jka and Hp1, were similar to those observed in indigenous southern Indian populations. In most HLA antigen and haplotype frequencies the Cochin Jews showed a distribution similar to that observed in other Jews and Caucasoids. No comparable HLA data on southern Indian populations were available. The results indicate that Cochin Jews have similarities with Jews, in particular Yemenite Jews, and with the indigenous populations of southern India.

Anthropometry↗
PubMed1980

Genetic studies on Cochin Jews in Israel: 2. Gm and Inv data--polymorphism for Gm3 and for Gm1,17,21 without Gm(26).

Serum samples from 223 Jews from Cochin, India were tested for Gm(1,2,3,5,6,13,14,17,21,26) and for Inv(1). Certain samples were also tested for Gm(15) and Gm(16). The Cochin Jews are polymorphic for: 1) Gm3, a haplotype that does not lead to the formation of gamma 3, as was shown by tests of the serum of a homozygote, and 2) Gm1,17,21, a haplotype lacking Gm(26), which is ordinarily present in this haplotype. The Gm data indicate considerable admixture with southern Indians. There is no evidence for African admixture, such as has been found for all other Jewish populations studied thus far. The Inv data are similar to those for other Jewish populations.

Female↗
PubMed1979

Diabetes, blood lipids, lipoproteins, and change of environment: restudy of the "new immigrant Yemenites" in Israel.

Restudy of 306 "new immigrant Yemenite" Jews, an ethnic group in which, upon their arrival in Israel, no diabetes was detected, revealed, 25 yr after their immigration, an increased incidence of diabetes and higher plasma and lipoprotein-lipid levels. The prevalence of diabetes (defined as "glucose intolerance") rose to 11.8% (13.2% males and 9.7% females). Obesity in females resulted in increased prevalence of diabetes in all age groups, while in males it affected the older age group only. The male/female diabetic ratio was affected by weight status--in the underweight, diabetes was more prevalent in males, in the overweight, the rate of diabetes in females equaled that of males. In nondiabetics (those with normal glucose tolerance), neither the glucose tolerance nor the insulin response deteriorated with aging. Most diabetics had a delayed insulin response. However, about 50% of nondiabetics and diabetics had insulin response peak at 60 min and similar insulin levels. It appears that in newly discovered adult-onset diabetics in this population there is no shortage of insulin, but rather shortage of insulin action. In nondiabetics, the levels of plasma cholesterol and triglycerides (TG) were higher than levels upon their arrival. In diabetics, the plasma TG, cholesterol, and LDL-cholesterol levels were higher when compared to those of nondiabetics, especially in the group of overweight males. Hyperlipoproteinemia was diagnosed in 27.7% of diabetics and 11.0% of nondiabetics. In diabetics, the HDL/LDL cholesterol ratio was found to be reduced, significantly so in overweight diabetics.

Adult↗
PubMed1979

Chronic bronchitis and bronchial asthma in a rural community in Israel: relation to socioenvironmental factors.

Prevalence rates of chronic bronchitis and asthma in a rural community in Israel in 1976 were 2.5 and 2.1%, respectively. The relationships with age, sex, country of origin, marital status, number of children, household crowding, education, occupation and cigarette-smoking habits were studied. A number of significant univariate associations were found. A multiple regression analysis showed a significant independent association between chronic bronchitis and age. Age alone accounted for 4.6% of the variance in chronic bronchitis. Five other variables were significantly associated with chronic bronchitis. Together, these accounted for an additional 1.3% of the variance in chronic bronchitis. The multivariate analysis showed that only one variable--the number of children--had an independent relationship with asthma. It accounted for 0.8% of the variance. All the variables together accounted for 1.3% of the variance observed in bronchial asthma.

Adult↗
PubMed1979

Hypertension and ischemic heart disease in a rural family practice in Israel.

Prevalence rates of hypertension and ischemic heart disease in a rural community in Israel in 1976 were 9.3% and 2.3%, respectively. The rates were related to age, sex, country of origin, education, occupation, marital status, household crowding, and smoking habits. A multiple regression analysis of all variables showed a significantly positive association between the prevalence of hypertension and age, number of children, Cochin or Moroccan origin, and divorce or widowhood. A negative association was found with agricultural work. The prevalence rate of ischemic heart disease correlated positively with age, Cochin origin, and divorce or widowhood. A stepwise linear regression analysis revealed that these variables accounted for 11.3% and 2.8% of the total variance observed, in hypertension and ischemic heart disease respectively.

Adult↗
PubMed1977

Analysis of the work of nurse-practitioners in family practice and its effect on the physicians' activities.

A three-year study on the inclusion of nurse-practitioners (18 months basic training) in family medicine is presented. The nurses were entitled to screen patients and to treat minor ailments. Patient-nurse contact rates were 6.1, 7.1, and 4.2 per year in 1971, 1972, and 1973, respectively. The increased responsibility given the nurses resulted in a decrease in patient-physician contacts from 4.0 in 1970 to 2.0, 2.1, and 1.3 in 1971, 1972, and 1973, respectively. This permitted the physicians to spend more time with each patient, to look for disease in the community, to participate actively in the work of the department of medicine in the regional hospital, and to engage actively in research. As a result, numerous surveys have been performed and a great amount of important medical and epidemiological information has been accumulated. More than one third of all patients handled by nurses suffered from respiratory infections; these were followed by musculoskeletal disorders and skin infections. Diagnosis and treatment accounted for 50 to 53 percent of the nurses' activities. Consequently, the medical and social status of the nurses rose markedly and patients seems to rely increasingly on their judgment.

Acute Disease↗