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Biomedical subjects

N Hurwitz

Publications and source records attributed to N Hurwitz.

At least 37 records · Page 2Linked to original sources

Pulmonary alveolar proteinosis associated with recurrence of Hodgkin's disease in the lung.

We report the case of a 36-year-old woman who presented with the clinical and histological features of pulmonary alveolar proteinosis (PAP) 13 years after the diagnosis of Hodgkin's disease. The PAP preceded the recurrence of Hodgkin's disease in the lung by a few weeks. To the best of our knowledge this patient is the first documented case of recurrent Hodgkin's disease in the lung associated with pulmonary alveolar proteinosis.

Adult↗

Clinical and pathological features of non-Hodgkin's lymphoma of the tonsil. Review of the literature and report of 10 cases.

Ten patients with tonsillar lymphomas diagnosed and treated in our hematology unit from 1979 to 1986 are reported. The heterogeneous histology at presentation, the aggressiveness of the histologic types during relapse, and the relatively low incidence of gastrointestinal tract involvement are discussed. A review of the literature is presented. In view of the better survival rate obtained with chemotherapy or combined chemo- and radiotherapy, we confirm that lymphomas of the tonsil should be aggressively treated, regardless of the staging. Among our 10 cases, 2 are of special interest since they progressed into highly malignant disorders: B-acute lymphoblastic leukemia and Burkitt's lymphoma.

Adult↗

Enhanced urinary trypsin inhibitory activity in gentamicin-induced nephrotoxicity in rats.

We delineated in rats, the relationship between trypsin inhibitory activity in the urine and the nephrotoxic effects of gentamicin, eg, proteinuria and deterioration of glomerular filtration rate (GFR), measured by creatinine clearance. Gentamicin, 70 mg/kg per day, was injected intraperitoneally for 6-10 successive days. Serum and urine gentamicin levels were determined by a microbiological test. Trypsin inhibitory activity was assayed by the casein digestion method. The results showed a steady increase in urinary trypsin inhibitory activity starting from the fourth injection day. The increased levels of urinary trypsin inhibitory activity were associated with increased levels of urinary gentamicin excretion (r = 0.36, p less than 0.02, n = 50 after the fourth injection day), and were significantly higher than in control groups (p less than 0.001). The urinary trypsin inhibitory activity was inversely correlated with the GFR (r = -0.45, p less than 0.01, after the second injection day). The serum trypsin inhibitory activity remained unchanged throughout the study period in all groups. These data suggest that increased urinary trypsin inhibitory activity may be involved in the pathogenesis of gentamicin-induced nephrotoxicity.

Animals↗

Immunological challenge with virus initiates leukotriene C4 production in the heart and induces cardiomyolysis in guinea pigs.

Cardiac myolysis was observed in guinea pigs sensitized with vesicular stomatitis virus (VSV), following challenge with this antigen. The phenomenon developed within 1 h of challenge, appearing as islands in the myocardium. The speed and focal nature of the damage point to obstruction of blood flow as a cause of the myolysis. The myolysis was not a toxic effect of the virus itself, but probably a consequence of cardiac anaphylaxis. It occurred only after challenge, and was abolished in 71% of the animals by pretreatment with a mixture of the lipoxygenase-cyclooxygenase inhibitor, BW755C and H1 histamine receptor antagonist, diphenhydramine. Treatment with BW755C alone before challenge prevented myolysis from developing in 46% of the animals. Challenge in vitro with VSV to the perfused, spontaneously beating, sensitized isolated guinea pig heart increased sulfidopeptide-leukotriene (LTC4, LTD4, LTE4) production from undetectable levels (0.5 ng LTD4-equivalent/heart/15' to 13 ng LTD4-equivalent/heart/15'. At the same time, there were derangements in cardiac rate, contractility and coronary outflow typical of cardiac anaphylaxis. The reduction in coronary outflow rate during cardiac anaphylaxis is due largely to the powerful vasoconstrictor effect of LT, as well as perhaps platelet-activating-factor. Thus it is speculated that there is a causal relationship between LT release, vasoconstriction, ischemia and myolysis in the heart, following VSV challenge to sensitized guinea pigs.

Anaphylaxis↗

Kaposi's sarcoma in two lymphoma patients with hepatitis B and other infections.

Kaposi's sarcoma developed in two lymphoma patients previously treated by chemotherapy and chemoirradiation. The histologic picture in the two cases showed a non-Hodgkin's lymphoma with multifocal epithelioid histiocytic reaction. Both patients had Hepatitis-B surface antigen and other infections due to herpes and streptococcus. The European Jewish origin of the two patients, the previous chemotherapy, and their infective state tend to support more the hypothesis of predisposing factors in the occurrence of Kaposi's sarcoma than a coincidental association.

Aged↗

Candidemia and sternal Candida albicans osteomyelitis in a patient with chronic lymphatic leukemia.

Sternal osteomyelitis caused by Candida albicans without previous surgery or trauma occurred in a patient with chronic lymphatic leukemia and recurrent skin cancer. The osteomyelitic process healed without antifungal treatment. Three weeks later, following a radical neck dissection, candidemia, without recurrence of the osteomyelitis, was diagnosed and treated successfully with intravenous amphotericin B and 5-fluorocytosin. The presentation of Candida osteomyelitis as a manifestation of disseminated candidiasis in immunocompromised hosts is discussed and the relevant literature is briefly reviewed.

Bone Marrow↗

Progressive cutaneous herpes simplex infection in acute myeloblastic leukemia. Successful treatment with interferon and cytarabine.

A patient had acute myeloblastic leukemia and extensive progressive cutaneous herpes simplex virus infection. Complete and rapid healing of skin lesions with remission of the leukemia occurred during 15 days of therapy with human leukocyte interferon and minimal doses of cytarabine hydrochloride. Pharmacokinetic studies showed that the patient had a defective antiviral interferon response, which was effectively corrected by treatment with interferon alpha. This may help to explain the dramatic response of both conditions to therapy.

Acute Disease↗

Prenatal diagnosis of severe congenital malformations associated with elevated amniotic fluid alpha-feto protein.

Two cases of severely malformed infants with abnormal fetal images on B-scan sonography and markedly elevated amniotic fluid AFP are presented. There was no evidence of neural tube anomalies. The importance of an amniocentesis and AFP in pregnancies with an abnormal fetal image on B-scan sonography is emphasized, taking into consideration that most pregnancies with elevated fluid AFP have serious fetal anomalies.

Abnormalities, Multiple↗

Intensive hospital monitoring of adverse reactions to drugs.

A total of 1,268 patients admitted to hospital wards were kept under surveillance by one observer throughout their stay in hospital. All drugs given to them and the occurrence of adverse reactions were recorded.Drug reactions were found in 10.2% of the 1,160 patients who received drug therapy. Most reactions were due to known pharmacological actions of the drugs. Though only four reactions were of life-threatening seriousness, 80% of the 129 reactions observed were of moderate severity. Digitalis preparations, bronchodilator drugs, and ampicillin had the highest reaction rates. It is suggested that larger surveys of adverse reactions in relation to drug usage would make a useful contribution to the problem.

Adolescent↗

Predisposing factors in adverse reactions to drugs.

Predisposing factors were sought in 118 patients who developed adverse drug reactions in hospital. Significantly more patients of 60 years and over, and more women than men, developed adverse drug reactions. Patients with reactions had more drugs before the development of the reaction than patients who did not develop reactions. A previous adverse drug reaction and a history of allergic disease were significant factors, while a history of jaundice or the presence of diabetes mellitus and renal disease was not.

Adolescent↗

Admissions to hospital due to drugs.

In a survey of adverse drug reactions in wards of two Belfast hospitals for 52 weeks in 1965-6, 2.9% of 1,268 patients seen were admitted to hospital because of adverse reactions to drugs taken for therapeutic reasons and 2.1% were admitted because of self-poisoning. Patients admitted because of adverse drug reactions were older than those admitted because of self-poisoning and stayed in hospital longer. Among the drugs which caused the adverse reactions were digitalis preparations, antibiotics, corticosteroids, anticoagulants, analgesics, and tranquillizers. Hypersensitivity and side-effect types of reactions were the most common. Barbiturates were the most frequently used drugs in suicidal attempts.

Adrenal Cortex Hormones↗