Biomedical subjects

Mordechai R Kramer

Publications and source records attributed to Mordechai R Kramer.

57 records · Page 4Linked to original sources

PubMed2002

The effect of donor age on survival after lung transplantation.

BACKGROUND: Historically, donor age above 55 years has been considered to be a relative contraindication for organ transplantation. The shortage of organs for transplantation has led to the expansion of the donor pool by accepling older donors. OBJECTIVES: To compare the 1 year follow-up in patients after lung transplantation from older donors (> 50 years old) and in patients after transplantation from younger donors (< or = 50 years). METHODS: The study group comprised all adult patients who underwent lung transplantation at the Rabin Medical Center between May 1997 and August 2001. Donors were classified into two groups according to their age: < or = 50 years (n = 20) and > 50 years (n = 9). Survival, number and total days of hospitalization, development of bronchiolitis obliterans syndrome, and pulmonary function tests, were examined 1 year after transplantation. RESULTS: We performed 29 lung transplantations in our center during the observed period. Donor age had no statistically significant impact on 1 year survival after lung transplantation. There was no statistically significant effect on lung function parameters, the incidence of hospitalization or the incidence of bronchiolitis obliterans between both donor age groups at 1 year after transplantation. CONCLUSIONS: Donor age did not influence survival or important secondary end-points 1 year after lung transplantation By liberalizing donor criteria of age up to 65 years, we can expand the donor pool, while assessing other possible mechanisms to increase donor availability.

Adult↗

PubMedDate not supplied

Pleural effusion with splenic rupture as manifestations of recurrence of sarcoidosis following prolonged remission.

A 55-year-old man presented with a 3-week history of dry cough and left pleuritic chest pain with a new exudative pleural effusion. Sixteen years earlier, he was diagnosed with sarcoidosis presenting with hilar lymphadenopathy, erythema nodosum, mildly disturbed liver function tests and noncaseating granulomata on liver biopsy, with no evidence of pulmonary parenchymal disease. He was treated with prednisone and in recent years maintained at a low daily dose, until it was eventually discontinued two years prior to his present illness. There was no evidence of infection or malignancy, and the fluid resolved following treatment with naproxen. Three weeks later the patient presented with sudden onset of dyspnea and left chest pain. After starting intravenous heparin for suspected pulmonary emboli, the patient developed hemodynamic instability which was accompanied by abdominal tenderness and decreasing hematocrit. Splenic rupture was diagnosed, and the patient underwent splenectomy. Pathology specimens revealed a hemorrhagic infarct with subcapsular hematoma, and numerous noncaseating granulomata within the splenic tissue. This patient had recurrent sarcoidosis with two rare manifestations of the disease, 2 years after withdrawing low dose prednisone, given for a prolonged time. The possibility of reemergence of the disease in organs other than the organs involved in the initial presentation should always be considered in sarcoidosis.

Humans↗

PubMedDate not supplied

The role of routine culture for tuberculosis during bronchoscopy examination of lung masses.

BACKGROUND: Many centers routinely culture bronchoscopy samples for mycobacteria even when tuberculosis (TB) is not strongly suspected. The value of this practice has hardly been investigated. OBJECTIVE: The aim of this retrospective study was to assess the utility of routine culture of bronchoscopy samples of lung masses for mycobacteria in a region where TB is not endemic. PATIENTS AND METHODS: The study group consisted of 168 patients who underwent bronchoscopy for investigation of lung masses in a major tertiary-care, university-affiliated facility in central Israel. The findings on acid-fast bacillus staining and culture were reviewed, and data on demographic characteristics were collected from the files. RESULTS: There were 97 men (58%) and 71 women with a mean age of 62 +/- 25 years. One culture (0.6%) grew Mycobacterium tuberculosis. There were no cases of positive acid-fast bacillus smear or positive nontuberculous mycobacteria culture. Sixty USD (5.45%) would be saved per patient without clinical suspicion of TB. CONCLUSIONS: These findings highlight the need to formulate new guidelines for the performance of mycobacterial cultures of bronchoscopy specimens in areas with a low prevalence of TB.

Aged↗