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Biomedical subjects

M S Shapiro

Publications and source records attributed to M S Shapiro.

At least 109 records · Page 6Linked to original sources
PubMed1971

Myasthenia gravis occurring in twins.

Myasthenia gravis in one member each of two sets of twins is described. A 17 year old girl developed generalized myasthenia gravis at the age of 14 years, while her monozygotic twin sister has remained in good health during a three year period of observation. Another patient was a 19 year old woman with the onset of generalized myasthenia gravis at the age of 11 years, and her dizygotic twin sister has been in good health.Myasthenia gravis has been described in 13 sets of monozygotic twins, seven sets of dizygotic twins, and one set of twins with undetermined zygosity. Both members of twins were affected in five sets of monozygotic twins and one set of twins with undetermined zygosity, and only one twin was affected in the remaining sets of twins. Occurrence of myasthenia gravis in both members of monozygotic twins and in none of dizygotic twins, and frequent familial occurrence of the disease suggest the role of a genetic factor in the pathogenesis of this disease.

Adolescent↗
PubMedDate not supplied

Sarcoidosis masquerading as a parathyroid adenoma.

Two patients presented with a presumptive diagnosis of hyperparathyroidism. Surgically excised "parathyroid glands" were found to be, in fact, large lymph nodes with sarcoid granulomata. In one patient, the preoperative localization of the "parathyroid adenoma" was based on scintigraphy (thallium-technetium subtraction imaging) and sonography procedures. The differential diagnosis of hypercalcemia, and positive scintigraphy-sonography studies, must include sarcoidosis in an isolated cervical lymph nodes.

Adenoma↗
PubMedDate not supplied

Hypothalamic-pituitary function in Cushing's disease.

Hypothalamic pituitary function was evaluated in seven patients with Cushing's disease. In all subjects there was an absence of GH elevation following hypoglycemia. Three patients demonstrated basal hyperprolactinemia. Six had an intact PRL rise following TRH. However, four patients failed to show PRL elevation with insulin hypoglycemia and six were unresponsive to chlorpromazine. Five patients showed impaired TSH response to TRH. Many of the subjects had low basal LH and FSH levels. Attenuated or absent gonadotropin responses to LHRH were noted in three females. One male demonstrated an exaggerated FSH response to LHRH. These results indicate that multiple abnormalities of anterior pituitary hormone secretion characterize Cushing's disease.

Adult↗
PubMedDate not supplied

Changes in acromial morphology with age.

It has not been determined whether acromial morphology is an innate anatomic characteristic or whether it represents a degenerative process with type I acromions changing to type III acromions over time. The purpose of this study was to determine the incidence of the three types of acromial morphology with respect to age. The acromial morphology of 272 patients (176 patients with no signs of mechanical impingement or rotator cuff disease and 96 patients with mechanical impingement) was determined by supraspinatus outlet radiographs. In the entire group of 272 patients there was a significant increase in the incidence of type III acromions and a decrease in the incidence of type I acromions in patients older than 50 years of age (p = 0.046). In 176 patients with no symptoms there was a very significant increase in the number of type III acromions in those patients older than 50 years of age (p = 0.004) with a corresponding decrease in the incidence of type I acromions. The incidence of the three acromial types also varied between patients with and without symptoms of mechanical impingement. The incidence of the three acromial types varies with respect to the age of the patient and whether he or she has symptoms of mechanical impingement. This raises the possibility that type I acromions may progress to type II acromions and then further change into type III acromions over time.

Acromion↗
PubMedDate not supplied

Quality of life assessment in elite collegiate athletes.

The objectives of this study were to establish baseline Medical Outcomes Study Short Form Health Survey (SF-36) data for Division I collegiate athletes and to determine the effects of injury severity and training time. All participating athletes (N = 562) at a major university were evaluated with the SF-36. Regression analysis was performed to identify predictive factors. When the men without injury were compared with a previously established norm group, there was a significant increase in the role emotional score. In the women without injury there were significant increases in mental component summary, physical function, role emotional, mental health, and vitality scores when compared with the norm group. Serious injury was a predictor of lower scores in all domains, whereas minimal injury was predictive of lower physical component summary, role physical, bodily pain, social function, and general health scores. Increased training time was predictive of higher mental component summary, role physical, vitality, and general health scores. Elite collegiate athletes scored differently from previously established age-matched norms, and injury was a strong predictor of lower scores.

Adult↗
PubMedDate not supplied

Ankle sprain prophylaxis: an analysis of the stabilizing effects of braces and tape.

Five cadaveric ankles were used to determine the effects of prophylactic bracing and tape on resisting an inversion moment applied to the ankle. The ankles were tested in neutral flexion and 30 degrees of plantar flexion and with both low- and high-top shoes. Eight different strap-on braces were studied. High-top sneakers significantly increased the passive resistance to inversion afforded by all braces and tape. Many of the braces functioned to resist inversion at a level that was comparable with or exceeded the capability of freshly applied tape. This finding was independent of the type of footwear. Braces that were not as effective as freshly applied tape nevertheless retained the advantage over tape in that they could be easily readjusted and their effectiveness restored, whereas the quality of the support provided with tape deteriorated with usage.

Adult↗
PubMedDate not supplied

Rupture of Lisfranc's ligament in athletes.

Ligamentous injuries to the tarsometatarsal joints are uncommon and usually result from violent trauma to the forefoot. A more subtle tarsometatarsal injury consisting of an isolated diastasis of the first and second tarsometatarsal rays has recently been described. This injury is thought to be caused by a rupture of Lisfranc's ligament. Nine injuries that occurred during athletics are described. History and physical findings are crucial for arousing the clinician's suspicion for this injury, but confirmation can best be obtained by comparison weight-bearing radiographs; the space between the first and second metatarsal bases may be widened 2 to 5 mm. Nonoperative treatment consisting of casting and the use of crutches for 4 to 6 weeks was successful in returning patients back to athletics; however, the time to return to competition averaged 4 months.

Adolescent↗