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Biomedical subjects

L Nall

Publications and source records attributed to L Nall.

At least 19 recordsLinked to original sources
PubMed1995

Sequential endoscopic/laparoscopic management of sickle hemoglobinopathy-associated cholelithiasis and suspected choledocholithiasis.

We reviewed the medical records of 17 patients with sickle hemoglobinopathy-associated cholelithiasis who were candidates for laparoscopic cholecystectomy (LC) between 1991 and 1994. Eight patients with suspected choledocholithiasis (CDL) were identified, all of whom had preoperative endoscopic retrograde cholangiopancreatography (ERCP), which revealed CDL in 3 patients (18%), all of whom had endoscopic ductal clearance. Choledocholithiasis was suspected because of hyperbilirubinemia or serum liver enzyme abnormalities. Incremental hyperbilirubinemia exceeding "baseline" values by > 5 mg/dL was the best predictor of CDL. Subsequent LC was successful with discharge within 2 days of LC in all but one patient, who was converted to open cholecystectomy. This small series suggests that in sickle hemoglobinopathy patients with cholelithiasis (1) CDL is relatively common among patients with an increase above baseline hyperbilirubinemia, (2) bile duct dilatation, alkaline phosphatase, and serum aminotransferase levels are poor predictors of CDL, and (3) sequential endoscopic/laparoscopic management of cholelithiasis and suspected CDL is successful.

Adult↗
PubMed1995

Fatal outcome of jugular vein cannulation.

We describe the case of a woman who had cannulation of the internal jugular vein for the placement of a hemodialysis catheter. The procedure was unsuccessful and resulted in a retropharyngeal hematoma, which in turn caused severe compression on a carotid artery that was already severely narrowed by atherosclerosis. This resulted in massive cerebral hemispheric infarction and death. During the course of hospitalization, ultrasonography, computed tomography, and angiographic studies were done. Cannulation of neck vessels in patients with bleeding diatheses must be done with caution, especially in the presence of severe stenotic disease of the carotid arteries.

Aged↗
PubMed1994

Psoriasis in the tropics. Epidemiologic, genetic, clinical, and therapeutic aspects.

There is a dearth of information on psoriasis in the tropics. Psoriasis occurs more frequently in northern geographic regions than in tropical climates. Its prevalence varies not only within the ethnic groups of a country but from country to country. A review of published studies on the natural history of psoriasis in the tropics is presented in this article.

Africa↗
PubMed1994

Psoriasis and alcoholism.

The association of psoriasis and alcoholism is controversial. Early studies negate a relationship of psoriasis and alcohol intake, whereas more recent studies demonstrate a positive correlation between the two. Results of investigations of familial aggregation, adoption studies, twin concordance, marker gene associations, and biochemical and genetic evidence suggest that alcoholism is a multifactorial disorder with both genetics and environmental factors playing a role. Selected studies on the occurrence of psoriasis and alcoholism are presented.

Alcoholism↗
PubMed1993

Psoriasis and ultraviolet radiation.

Prevention and detection screening programs as a public health service in curtailing the ever-increasing incidence of all forms of skin cancer are reviewed. The effect of solar and artificial ultraviolet radiation on the general population and persons with psoriasis is examined.

Atmosphere↗
PubMed1993

Systemic antifungals.

The administration, effectiveness, action, adverse reactions, and commentary are presented in Table I for a selected number of systemic antifungal agents.

Antifungal Agents↗
PubMed1993

Psoriasis associated with human immunodeficiency virus/acquired immunodeficiency syndrome.

Since the prevalence of psoriasis is between 1.5 to 2 percent, it would be expected to occur by chance in a person infected with HIV who is genetically predisposed to psoriasis. Several studies in the literature on HIV/AIDS-associated psoriasis have reported such percentages of frequency. Although psoriasis is a low priority for a patient with HIV/AIDS who is coping with many other cutaneous conditions and cancers, when treating the HIV/AIDS-infected psoriatic patient, immunosuppressive drugs are contraindicated because of their serious impact on an already immunodeficient person.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Pustular psoriasis.

Pustular psoriasis may appear as localized pustular psoriasis, which runs a chronic course, or, in a more severe state, generalized pustular psoriasis. Precipitating factors influencing both local and generalized forms include various drugs (eg, lithium, hydrochloroquine), irritative topical therapy (eg, coal tar), dental and upper respiratory infections, pregnancy, and solar irradiation. Both adults and children are affected, but infantile and juvenile pustular psoriasis is rare. It is recommended that provoking factors be eliminated as the first line of management. Short-contact anthralin therapy and topical psoralen/ultraviolet A can be used in treating localized pustular psoriasis. Methotrexate, hydroxyurea, etretinate, dapsone, cyclosporin A, as well as systemic corticosteroids may be needed in life-threatening cases.

Adult↗
PubMed1993

Guttate psoriasis.

Prevention and early treatment with appropriate antibiotics administered at the onset of upper respiratory infections in children with psoriasis may be able to block the appearance of acute guttate psoriasis. A careful screening for a focus of infection is also indicated, especially in children.

Child↗
PubMed1993

Erythrodermic (exfoliative) psoriasis.

Erythrodermic (exfoliative) psoriasis represents a manifestation of psoriasis that is difficult to treat and requires the execution of consummate clinical skills. Careful analysis of precipitating factors may prevent recurrences. Systemic as well as topical therapy are essential for a favorable outcome.

Humans↗
PubMed1993

The office visit and the self-help concept in treating the patient with psoriasis: a strategy revisited.

All dermatologists and physicians who care for patients with psoriasis should be aware that their patients may have an insufficient understanding of their disease. Every effort should be made to help patients fully comprehend their condition: to become aware of factors that can improve self-care and environmental events that can exacerbate the disorder. Strategies for self-help instructions can be modified from the highly structured approach in a university setting to the more informal atmosphere of a physician's office using the abundant patient educational resources available today. Improving communication between patient and physician will benefit the patient, by providing knowledge about psoriasis, encouraging the patient to acquire specific skills in dealing with the disease, and instilling a sense of responsibility for the patient's involvement in self-care.

Humans↗
PubMed1993

Psoriasis: a stress-related disease.

Stress is a well-known triggering factor in the appearance or exacerbation of psoriasis. The concept of psychoneuroimmunology in relation to stress is described. As part of the total care of the psoriasis patient, physicians are urged to augment traditional psoriasis treatment regimens with stress-reduction strategies, such as biofeedback, meditation, and self-help approaches.

Adolescent↗
PubMed1992

Genital psoriasis.

Psoriasis of the genitalia occurs in all age groups from infancy to the elderly. Approximately one-quarter to one-half of various epidemiologic studies report that genital psoriasis occurs with a higher frequency in males than in females. Therapeutic modalities for management of psoriasis in this site underscore the need for caution in not irritating the sensitive genital skin. Preventive measures include avoiding tight under- and outer-garments that provoke penile or vulvar psoriasis as well as maintaining cleanliness of the genital area.

Adolescent↗
PubMed1992

Perianal and intergluteal psoriasis.

Psoriasis of the perianal and intergluteal areas can cause pain and discomfort. Individualized therapeutic programs will reduce the morbidity. It is essential that optimal hygienic conditions be maintained in these regions to avoid itching and inflammation.

Anal Canal↗
PubMed1992

Nonpustular palmoplantar psoriasis.

Nonpustular palmoplantar psoriasis can be disabling in causing painful fissuring and scaling. Preventive measures in avoiding friction and irritants can reduce the morbidity of this variant. Lubricants, anthralin, and corticosteroids form the mainstay of therapy in mild and moderate psoriasis of the palms and soles. Topical PUVA therapy and use of cytotoxic agents should be reserved for refractory cases.

Adolescent↗
PubMed1992

Nail psoriasis.

Psoriatic nail involvement is common and accompanies skin lesions on the body surface. The occurrence of nail psoriasis has been reported in up to 50 percent of patients, including children, adults, and the elderly. The characteristics of psoriatic nails are pitting, discoloration, onycholysis, subungual hyperkeratosis, as well as crumbling and grooving of nails and splinter hemorrhages. There is no consistently effective treatment for psoriatic nail involvement; nails are difficult to treat and respond slowly to therapy. Corticosteroids, 5-fluorouracil, systemic agents such as photochemotherapy, oral retinoids, and methotrexate, and nail avulsion are among the therapeutic approaches utilized. We offer suggested measures whereby patients may benefit in the prevention and control of their nail psoriasis.

Humans↗
PubMed1992

Natural history and treatment of scalp psoriasis.

The scalp is a common site of involvement at onset and throughout the course of psoriasis. Worldwide census studies report that approximately half of the psoriasis population are afflicted with psoriasis of the scalp. We describe the frequency, clinical aspects, and treatment of scalp psoriasis in childhood, adulthood, and in the geriatric age groups. Measures of prevention and control are reviewed.

Adolescent↗