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Biomedical subjects

M Licht

Publications and source records attributed to M Licht.

8 recordsLinked to original sources
PubMed2001

Does pre-dialysis care management reap rewards for patients, renal staff, and payers.

This article describes one renal disease management organization's experience in implementing a pre-dialysis care management program to improve outcomes in patients who develop end-stage renal disease (ESRD). Optimal Renal Care, a national renal disease management company, has implemented care management programs for 600+ ESRD patients and 600+ pre-ESRD patients in Oregon (1998) and Hawaii (1999). This article describes our Oregon pre-ESRD program's start-up experience.

Disease Management↗
PubMed1999

Giant splenic hemangioma: confirmation of diagnosis with labeled erythrocyte scintigraphy

PURPOSE: To assess the use of a Tc-99m erythrocyte-labeled SPECT scan to characterize a giant splenic hemangioma. METHODS: A patient clinically mistaken to have a myelodysplastic disorder underwent a contrast-enhanced CT followed by a Tc-99m erythrocyte-labeled SPECT scan. RESULTS: CT showed a heterogeneous vascular lesion arising in the spleen. Percutaneous biopsy was nondiagnostic. A Tc-99m erythrocyte-labeled SPECT study revealed findings consistent with a giant splenic hemangioma, which was subsequently confirmed at surgery. CONCLUSION: A Tc-99m erythrocyte-labeled SPECT scan may be very useful in confirming the diagnosis of a large or giant splenic hemangioma.

Journal Article↗
PubMed1994

Complications of nephron sparing surgery for renal tumors.

The technical results of 259 nephron sparing operations for renal cell carcinoma or renal oncocytoma were reviewed. Local or renal related complications occurred after 78 procedures (30.1%). The incidence of complications was less for operations performed after 1988 (22% versus 37%, p = 0.009) and for incidentally detected versus suspected tumors (p = 0.009). The most common complications were urinary fistula formation (45 operations) and acute renal failure (33). Significant predisposing factors for urinary fistula formation included central tumor location (p = 0.001), tumor size greater than 4 cm. (p = 0.001), the need for major reconstruction of the collecting system (p = 0.001) and ex vivo surgery (p = 0.001). Only 1 urinary fistula required open operative repair, while the remainder resolved either spontaneously (30) or with endoscopic management (14). Significant predisposing factors for acute renal failure included a solitary kidney (p = 0.001), tumor size greater than 7 cm. (p = 0.008), greater than 50% parenchymal excision (p = 0.001), greater than 60 minutes of ischemia time (p = 0.035) and ex vivo surgery (p = 0.001). Acute renal failure resolved in 28 patients, of whom 9 required temporary dialysis, while 5 required permanent dialysis. Overall, 8 complications (3.1%) required repeat open surgery for treatment while all other complications resolved with noninterventive or endourological management. Surgical complications contributed to an adverse clinical outcome in only 7 patients (2.9%). Nephron sparing surgery can be performed safely with preservation of renal function in most patients with renal tumors.

Acute Kidney Injury↗
PubMedDate not supplied

Population Structure of Anopheles gambiae in Africa.

The population structure of Anopheles gambiae in Africa was studied using 11 microsatellite loci in 16 samples from 10 countries. All loci are located outside polymorphic inversions. Heterogeneity among loci was detected and two putative outlier loci were removed from analyses aimed at capturing genome-wide patterns. Two main divisions of the gene pool were separated by high differentiation (F(ST) > 0.1). The northwestern (NW) division included populations from Senegal, Ghana, Nigeria, Cameroon, Gabon, Democratic Republic of Congo (DRC), and western Kenya. The southeastern (SE) division included populations from eastern Kenya, Tanzania, Malawi, and Zambia. Inhospitable environments for A. gambiae along the Rift Valley partly separate these divisions. Reduced genetic diversity in the SE division and results of an analysis based on private alleles support the hypothesis that a recent bottleneck, followed by colonization from the NW populations shaped this structure. In the NW division, populations possessing the M rDNA genotype appeared to form a monophyletic clade. Although genetic distance increased with geographic distance, discontinuities were suggested between certain sets of populations. The absence of heterozygotes between sympatric M and S populations in the DRC and the high differentiation in locus 678 (F(ST)>0.28) contrasted with low differentiation in all other loci (-0.02<F(ST)<0.09) and with the persistence of departures from Hardy-Weinberg expectations within each form in the DRC. Neither recent reproductive isolation alone nor selection alone can explain these results, a situation that is compatible with incipient speciation. Because it is possible that the molecular forms play different roles in malaria transmission, future studies should treat them separately.

Africa South of the Sahara↗