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Biomedical subjects

J Pinkhas

Publications and source records attributed to J Pinkhas.

At least 19 recordsLinked to original sources

The state of leukocyte adhesiveness/aggregation in the peripheral blood is more sensitive than the white blood cell count for the detection of acute mental stress.

We determined the state of the leukocyte adhesiveness/aggregation in the peripheral blood by using a simple slide test and found it to be more sensitive than the white blood cell count for the detection of acute mental stress. Included were 71 controls, 64 young athletes examined just before their exercise, 14 volunteers who were examined 10-20 min before engagement in rappelling while an additional group of 20 were examined just before the act as they were facing an abyss from the top of a cliff. The state of leukocyte adhesiveness/aggregation correlated significantly (p less than 0.0005) only with the increasing strain assumed to occur from the first to the fourth group. The state of leukocyte adhesiveness/aggregation was 3.3 x more sensitive than white blood cell count in both rappelling groups and 5 x more sensitive than white blood cell count when evaluated in those examined at the last minute. We concluded that the state of leukocyte adhesiveness/aggregation is a reliable marker of acute mental stress.

Adolescent

Yersinia enterocolitica endocarditis on a prosthetic valve.

Yersinia entercolitica endocarditis has rarely been described before. This is the first report of prosthetic valve Yersinia enterocolitis endocarditis, complicated by infected brain embolization. The patient, however, completely recovered after 6 weeks of combined therapy with ceftriaxone and gentamicin.

Brain Abscess

Erythromycin base-induced rash and liver function disturbances.

OBJECTIVE: To report a case of erythromycin base-induced rash and liver function disturbances. CASE SUMMARY: A patient with erythema nodosum and high antistreptolysin-O titers was treated with erythromycin on the assumption that occult streptococcal infection was the cause of the erythema nodosum. Forty-eight hours after the initiation of therapy the patient developed fever, severe generalized rash, pruritus, and cholestatic and hepatocellular liver function disturbances. Extensive evaluation to determine the cause of liver function disturbances was unrevealing. Marked improvement was noticed within days after cessation of erythromycin. DISCUSSION: Case reports in the literature on the adverse effects of erythromycin and its derivatives were reviewed. The possible immunologic mechanism involved is postulated. CONCLUSIONS: Erythromycin base must be added to the list of erythromycin derivatives that can cause rash and liver function disturbances. The concomitant appearance of fever, rash, jaundice, and liver function disturbances raises the possibility of hypersensitivity as the mechanism for the liver disturbances.

Adult

Lupus anticoagulant: correlation with magnetic resonance imaging of brain lesions.

Brain magnetic resonance imaging (MRI) was performed in 21 patients with systemic lupus erythematosus (SLE) with and without lupus anticoagulant (LAC), one lupus-like patient and 5 patients with primary antiphospholipid antibody syndrome. Thirteen patients had white matter focal brain lesions on MRI, 10 of whom had LAC (p = 0.03). We found no correlation between these lesions and neurologic manifestations, nor any clinical or serologic indices of activity of SLE. Our MRI lesions were similar to those described in multiple sclerosis and may indicate a similar pathologic process.

Adolescent

Hemophagocytosis by small cell lung carcinoma.

A 60-year-old woman with disseminated small cell carcinoma of the lung and hemophagocytosis by the metastatic cells in the bone marrow is presented. It is the first clinicopathologic report on phagocytosis of erythrocytes by lung tumor cells in concordance with a recently described evidence of a macrophage origin of small cell carcinoma of the lung.

Bone Marrow

Corynebacterium CDC group A-4 native valve endocarditis.

A patient with endocarditis caused by Corynebacterium CDC Group A-4 is described. This is the first case in the literature of endocarditis caused by this bacteria, and is unique in that the patient was immune competent and the infection occurred on a native valve. This case illustrates that corynebacteria cannot be considered a contaminant and that the exact pathogen should be identified.

Aged

Detection of aggregated leukocytes in the circulating pool during stress-demargination is not necessarily a result of decreased leukocyte adhesiveness.

Leukocyte endothelial interactions are essential for a normal immune response. It is known that this response is influenced by stress and that the latter induces demargination. We examined the question of whether stress demargination results from a decreased state of leukocyte adhesiveness. Included were various volunteers and patients under different degrees of stress. 66 young athletes before beginning their daily exercises, 67 middle-aged healthy volunteers, 25 patients before ergometry for evaluation of chest pain, 75 patients who were referred to the emergency room with chest pain without ischemia/infarction, 78 patients with ischemia/infarction, 65 patients with minor trauma, 25 with a fracture and 12 with polytrauma. The leukocyte adhesiveness/aggregation (LAA) values were measured with a direct slide test. The respective LAA values were 7.4 +/- 4.7, 6.3 +/- 4.4, 5.8 +/- 3.6, 5.2 +/- 3.5, 10.8 +/- 8.5, 9.1 +/- 5.8, 12.2 +/- 6.6 and 19 +/- 12.6% of aggregated leukocytes. We conclude that an increase in aggregated white blood cells can be detected in the circulating pool during major stress. It is therefore suggested that stress demargination is not necessarily a result of diminished leukocyte adhesiveness.

Adolescent

Urinary retention associated with ipratropium bromide.

A 69-year-old man was hospitalized for exacerbation of chronic obstructive lung disease. Treatment with nebulized ipratropium bromide resulted in urinary retention that resolved once the drug was discontinued. Urinary retention is a rare complication of ipratropium bromide. Because all of the cases described in the literature occur in elderly men with prostate hypertrophy, the drug should be used cautiously in this group of patients.

Administration, Inhalation

Possible role for a plasma factor in the induction and/or maintenance of the state of leukocyte adhesiveness/aggregation in the peripheral blood. A study of mothers and their newborns.

The adhesive property of white blood cells is essential for a normal immune response. We examined the state of leukocyte adhesiveness/aggregation (LAA) in the peripheral blood of 31 mothers and their newborns by means of a direct slide test and found it to differ significantly, the respective per cents of aggregated leukocytes found in the peripheral blood being 15 +/- 6.4 and 5 +/- 3.3 (mean +/- SD). However, the particle concentration of white blood cells in the peripheral blood did not differ significantly (14.2 +/- 4.4 and 13.6 +/- x 10(9) l-1). By incubating a mother's plasma with her newborn's whole blood we could induce a significant (p less than 0.0001) increment in the state of LAA. We conclude that deficiency of a plasma factor that does not cross the placenta is responsible for the low LAA in the newborn's peripheral blood.

Cell Adhesion

Heterotypic leukocyte aggregation in the peripheral blood of patients with leukemia, inflammation and stress.

This study deals with the question of whether the aggregates of leukocytes in the peripheral blood are homo- or heterotypic. One hundred-fifty individuals with leukemia, inflammation, and physical and mental stress, were examined. It was found that the various cell populations of the peripheral blood are represented in the aggregates and that aggregates are generally heterotypic. Normal and malignant leukocytes were noted in aggregates of patients with leukemia, suggesting that adhesive mechanisms are similar for both normal and malignant leukocytes. This was also supported in two animal models, one with leukocytosis of normal cells and the other with leukocytosis of leukemic cells, in which the state of leukocyte adhesiveness/aggregation in the peripheral blood correlated with tissue leukostasis. The possibility exists that "non specific stickers", present in the peripheral blood, promote interactions between the white blood cells, normal and malignant, and between these cells and the endothelium.

Adolescent

Native valve Staphylococcus epidermidis endocarditis: report of seven cases and review of the literature.

This report describes seven patients from three university hospitals whose native valve infective endocarditis was caused by Staphylococcus epidermidis. The literature on endocarditis caused by S. epidermidis is also reviewed and the clinical features of patients with native valve endocarditis due to this organism are compared with those of patients from a general series of infective endocarditis cases. Compared with infective endocarditis caused by other organisms, S. epidermidis endocarditis tends to occur more frequently in male patients. Patients with S. epidermidis endocarditis exhibit fewer embolic complications and skin manifestations. The frequency of congestive heart failure is lower in this group. The relative indolent course and apparent rarity of native valve S. epidermidis endocarditis necessitate a high index of suspicion for early diagnosis.

Aged

Adult T-cell lymphoma in Israeli patients of Iranian origin.

The clinical and laboratory features of four Israeli patients with adult T-cell lymphoma-leukemia (ATL) are presented. In three of them evidence for human T-cell lymphotropic leukemia virus (HTLV-I) infection was obtained. Interestingly, all of the patients immigrated to Israel from the same regions in Iran. Except for lack of skin involvement, the clinical course was typical for ATL as described worldwide. This is the first report of ATL in an Iranian cohort. This observation suggests that Iranian patients with ATL-like illness should be studied for the presence of HTLV-I infection.

Aged

Serum cobalamin and transcobalamin levels in systemic lupus erythematosus.

PURPOSE: The purpose of this study was to assay serum cobalamin levels in patients with systemic lupus erythematosus (SLE) as there are few case reports on the association of pernicious anemia and SLE. PATIENTS AND METHODS: Serum cobalamin levels were assayed in 43 female SLE patients by a radio-dilution assay using purified intrinsic factor. RESULTS: Cobalamin levels were found to be significantly lower in the SLE group compared with a normal control group, eight of whom (18.6%) had serum cobalamin levels equal to or lower than 180 pg/mL (mean: 129.25 +/- 40.05 pg/mL). None of the SLE patients had been found to have pernicious anemia. The transcobalamin II level and unsaturated vitamin B12 binding capacity, but not the cobalamin level, were positively correlated with SLE activity. CONCLUSION: Our results may indicate a subtle cobalamin deficiency in SLE patients without pernicious anemia.

Adolescent

Systemic sclerosis and chronic lymphocytic leukaemia.

The association between the CREST (calcinosis, Raynaud phenomena, oesophageal hypomotility, sclerodactyly and telangiectasia, variant of systemic sclerosis and chronic lymphocytic leukaemia is described in three patients. The present description raises the possibility that the association of chronic lymphocytic leukaemia and systemic sclerosis is non-random.

Aged

The state of leukocyte adhesiveness/aggregation in the peripheral blood of patients with respiratory tract infections.

The state of leukocyte adhesiveness/aggregation (LAA) in the peripheral blood has been employed as a marker of inflammation. In the present study we examined patients with varying intensities of inflammation caused by respiratory tract infections to further investigate the reliability of the state of LAA for the detection and assessment of the severity of disease activity. The study includes 140 controls, 46 patients with upper respiratory tract infection, 30 with bronchitis, 27 with suspicion of pulmonary infiltrate, and 39 with small and 18 with large pulmonary infiltrate. Assessment was based on assuming an increasing severity of inflammation from the 1st to the 6th diagnostic category and by making use of discriminant analysis. It was found that the state of LAA proved to be the best variable to classify the patients into their diagnostic category (F to enter 27), followed by erythrocyte sedimentation rate at the 1st h (F to enter 20.8) and total white blood cell count (F to enter 8.3). These studies were followed by animal experimentation. A highly significant correlation (p = 0.005) was found between the state of LAA in the peripheral blood and the degree of pulmonary leukostasis in a model of endotoxemia in rabbits. These results suggest that the state of LAA is not an epiphenomenon and represents the tendency of the white blood cells to stick to the endothelium which facilitates their migration into the tissues.

Adolescent

Acute coronary events following cisplatin-based chemotherapy.

Six patients with no previous signs or symptoms suggestive of coronary artery disease developed acute coronary ischemia/infarction shortly after cis-diamine-dichloroplatinum II (cisplatin) -based chemotherapy. In two patients this was the sole chemotherapeutic agent used. One patient underwent coronary angiography which disclosed no pathology, but following which, while on a calcium channel blocking agent regimen, he had an uneventful course of chemotherapy with cisplatin. Documentation of cisplatin-related vascular events is important in view of the growing number of patients who undergo cisplatin-based chemotherapy.

Aged