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M A Papadakis

Publications and source records attributed to M A Papadakis.

23 records · Page 2Linked to original sources
PubMed1986

Hepatorenal syndrome complicating chronic lymphocytic leukemia.

Hepatorenal syndrome and portal hypertension developed in a 59-year-old man with chronic lymphocytic leukemia. At autopsy, he had portal hypertension from lymphocytic infiltration of the liver with compression of the portal veins, and no other pathologic process in the liver. Histologic examination of the kidney did not reveal a lesion that could account for the observed renal insufficiency. This case report documents the association of a lymphoproliferative disorder with portal hypertension and hepatorenal syndrome.

Humans↗
PubMed1986

Temporal arteritis after normalization of erythrocyte sedimentation rate in polymyalgia rheumatica.

We describe a 72-year-old woman with classic presentation of polymyalgia rheumatica and an elevated erythrocyte sedimentation rate. After treatment with low-dose corticosteroids and normalization of the sedimentation rate, hematocrit, and serum alkaline phosphatase, she developed symptoms and biopsy proved temporal arteritis. In patients with polymyalgia rheumatica and an initially elevated sedimentation rate, normalization of the sedimentation rate with corticosteroid therapy does not exclude the need for temporal artery biopsy if the symptoms warrant it.

Aged↗
PubMed1985

Hyperkalemia complicating digoxin toxicity in a patient with renal failure.

We describe the occurrence of hyperkalemia in a stable hemodialysis patient who developed digoxin toxicity. The patient had been receiving digoxin for 2 years. His maintenance digoxin dose was increased from 0.125 to 0.25 mg three times a week, which resulted in a toxic serum level of 4.9 ng/mL (therapeutic range is 0.8 to 2.0 ng/mL). As a consequence of the digoxin toxicity, he became hyperkalemic (7.8 mEq/L), and this value returned to normal only after the digoxin level was lowered by a combination of oral charcoal and dialysis. This study shows how readily hyperkalemia can occur in an anephric patient manifesting digoxin toxicity. Thus, potentially lethal hyperkalemia can occur in hemodialysis patients who ingest therapeutic quantities of digoxin. Digoxin toxicity should be added to the differential diagnosis of hyperkalemia in patients with renal failure. This can occur despite the absence of a history of massive ingestion of a cardiac glycoside.

Aged↗
PubMedDate not supplied

Prevention training and medical residency.

We developed a questionnaire to assess training and perceived competence in prevention skills during medical residency. We asked residents at a university training program about 20 prevention interventions recommended by the U.S. Preventive Services Task Force. Primary care and categorical medicine residents rated the adequacy of training and the perceived relevance to clinical practice of these interventions as well as basic skill and knowledge areas (such as patient education) on five-point Likert-type scales (1 = very inadequate or very unimportant and 5 = very adequate or very important). Fifty-eight residents (n = 19 primary care and 39 categorical medicine) completed the questionnaire (response rate = 63%). Primary care residents felt significantly (P < .05) more competent than categorical medicine residents in 14 of the 20 prevention interventions. Primary care residents rated the adequacy of training in eight of 10 basic skill and knowledge areas significantly (P < .05) higher than did categorical medicine residents. For both groups of residents, mean relevance scores significantly exceeded mean perceived competence scores in 18 of 20 prevention interventions and in all 10 skill and knowledge areas. Primary care residents felt more competent than categorical medicine residents in performing most prevention interventions. However, residents in both training programs rate the relevance of several basic skill and knowledge areas as higher than their perceived competence, suggesting training underemphasis. Both primary care and categorical medicine training programs could use this instrument to assess the adequacy of their training in these areas.

Clinical Competence↗