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Biomedical subjects

R Bloom

Publications and source records attributed to R Bloom.

At least 19 recordsLinked to original sources
PubMed2001

Emergency laparotomy in patients on continuous ambulatory peritoneal dialysis.

Peritonitis is the most common complication of chronic ambulatory peritoneal dialysis (CAPD). It is often a diagnostic challenge to differentiate those patients with CAPD-associated infections from those who have unrelated gastrointestinal pathology as the cause of peritonitis and would benefit from surgical exploration. A retrospective chart review was performed on all patients at a single institution who were on CAPD between the years 1990 and 1998 and who underwent laparotomy for peritonitis. Six patients underwent laparotomy. Four were male and two were female; ages ranged from 34 to 80 years. Perforated appendicitis was the cause of peritonitis in three patients, perforated diverticulitis was present in two, and one was without any suppurative intra-abdominal process. In each case CT scan of the abdomen was nondiagnostic. There was a delay in diagnosis of 10 days (range 3-21 days) and an operative mortality of 16 per cent.

Adult↗
PubMed1998

Descending cervical mediastinitis.

Descending cervical mediastinitis is an uncommonly reported presentation of infection originating in the head or neck and descending into the mediastinum, which is fraught with impressive morbidity and mortality rates of 30% to 40% or more. We present the INOVA-Fairfax-Alexandria Hospital experience with descending cervical mediastinitis, January 1, 1986, to April 1, 1997; in addition we review the English-language medical and surgical literature with regard to this entity. Computed tomography and magnetic resonance imaging serve to aid both diagnosis and management. The application of broad-spectrum antibiotics should initially be empiric, with an eye to coverage of mixed aerobic and anaerobic infections. Definitive treatment mandates early and aggressive surgical intervention. All affected tissue planes, cervical and mediastinal, must be widely debrided, often leaving them open for frequent packing and irrigation. The treating physician must remain always alert to the further extension of infection, which, if it occurs, must be further debrided and drained. Tracheostomy serves a dual role of further opening cervical fascial planes and securing an often compromised airway.

Abscess↗
PubMed1996

Intramedullary plasmacytoma in an unusual location in a renal transplant patient.

Transplant patients have increased risk for developing neoplasia. This is due to the use of more potent and long-term immunosuppression. We report a case of a 46-year-old man with a cadaver renal transplant who developed an intramedullary plasmacytoma in an unusual location. The patient had a total right elbow replacement and received 4 weeks of local radiotherapy. The pain completely resolved and the low-dose immunosuppression was continued.

Bone Neoplasms↗
PubMed1989

Endocapsular triple procedure--a new triple procedure technique.

The triple procedure (penetrating keratoplasty, cataract extraction, and intraocular lens implantation) performed using endocapsular cataract extraction and posterior chamber intraocular lens implantation offers advantages over the extracapsular technique. The most significant advantage is easier, assured placement of the posterior chamber intraocular lens entirely in the bag. Another advantage is less chance of injury to the endothelial cells. This paper describes a technique using endocapsular cataract extraction in the triple procedure.

Cataract Extraction↗
PubMed1989

Delivery of albuterol and ipratropium bromide from two nebulizer systems in chronic stable asthma. Efficacy and pulmonary deposition.

Bronchodilator responses to both nebulized albuterol (salbutamol) and ipratropium bromide and aerosol delivery to the tracheobronchial tree have been assessed in eight patients with chronic stable asthma (mean baseline FEV1, 50 percent; reversibility greater than 20 percent). Two commercially available nebulizer systems were used, namely, a Turret nebulizer operated at a compressed gas flow rate of 12 L/min (droplet MMD, 3.3 mu) and an Inspiron nebulizer driven at 6 L/min (MMD, 7.7 mu). Albuterol was given as doses of 250 micrograms, 250 micrograms, 500 micrograms, and 1,000 micrograms (cumulative dose, 2 mg) and ipratropium bromide as doses of 50 micrograms, 50 micrograms, 100 micrograms, and 200 micrograms (cumulative dose, 400 micrograms) at intervals of 35 minutes. For albuterol, bronchodilatation was significantly (p less than 0.05) greater at all dosage levels with the Turret. For ipratropium, bronchodilatation was similar for both nebulizers. Measurements of aerosol deposition using 99mTc-labelled pentetic acid (diethylenetriamine pentaacetic acid; DTPA) showed that 9.1 +/- 1.1 percent and 2.7 +/- 0.2 percent of the dose reached the lungs during nebulization to dryness for Turret and Inspiron, respectively (p less than 0.01); distribution within the lungs was similar for the two aerosols. Selection of nebulizer apparatus can influence delivery of aerosol and subsequent bronchodilator response to albuterol in patients with chronic stable asthma but is less important for aerosol delivery of ipratropium bromide in these patients.

Adult↗
PubMed1989

[Migration of monocytes and granulocytes in co-culture with endothelial cells].

The interaction of leucocytes and endothelial cells was analyzed in a co-culture system using time-lapse video microscopy. Isolated granulocytes or monocytes/macrophages were added to confluent endothelial cell cultures. The migratory behavior of the blood cells was subsequently analyzed using video direct visualization and morphometry. Using this technology the active migration of blood cells through the confluent endothelial layer in both directions could be shown. While granulocytes migrated several times through the endothelium in both directions, monocytes migrated from the top of the endothelial layer underneath the endothelial cells and remained there. The migratory speed of granulocytes was with 1166 microns/h about twice as fast as the speed of monocytes with 608 microns/h. The differentiation between the migratory speed of granulocytes on top or underneath the endothelial cells revealed a marked acceleration underneath the endothelial cells with a speed of 1519 microns/h compared to 671 microns/h on top of the endothelium. These results led to speculation that special extracellular matrix components produced by the endothelial cells activate the migratory behavior of blood cells.

Cell Movement↗
PubMed1989

Solitary nonparasitic cyst of the liver: a rare cause of abdominal distension.

Solitary nonparasitic liver cysts are clinically rare, and fewer than 900 patients have been documented over the years. A case is described of a female patient with a large solitary cyst containing 7 L of fluid, which was treated successfully by unroofing. The literature relating to the clinical features, incidence, pathogenesis, histopathology, diagnostic imaging, and surgical management of such cysts is reviewed.

Abdomen↗
PubMed1987

Therapeutic efficacy and pharmacokinetic properties of ciprofloxacin in intra-abdominal abscesses caused by Bacteroides fragilis and Escherichia coli.

Experimental intra-abdominal abscesses were produced in mice by intraperitoneal injections of Bacteroides fragilis and Escherichia coli. The therapeutic efficacy of ciprofloxacin was investigated in this mixed intra-abdominal abscess model and was compared with that of rifampicin. Treatment with ciprofloxacin at 0.2 to 20 mg/kg or rifampicin at 20 mg/kg prevented all mice from death, as compared to the 60% mortality rate observed in the vehicle-treated controls. Rifampicin concentrations at 10 and 20 mg/kg were effective in preventing abscess formation and eradicated bacterial abscess. Ciprofloxacin at all the levels tested neither reduced the incidence of abscess nor eradicated Bact. fragilis from abscesses. However, ciprofloxacin at levels of 20, 10, 5, and 1 mg/kg reduced significantly the number of E. coli cells in the abscess. The peak serum level of ciprofloxacin at the oral dose of 20 mg/kg was 0.43 mg/l which was well above the MIC values for E. coli but not for Bact. fragilis.

Abscess↗
PubMed1986

HB Chicago or alpha (2)136 (H19) Leu----Met beta 2 and a -G gamma-G gamma-globin gene arrangement in a black family.

Hb Chicago is a newly discovered hemoglobin variant which was present in a Black newborn baby and her father. The leucine residue at alpha 136, which normally participates in the contact with the heme group, is replaced by a methionine residue. The two heterozygotes were clinically well with normal hematological data. Isolation of the alpha X and alpha A chains by reverse phase high performance liquid chromatography and hydrolysis of these chains with dilute formic acid at 110 degrees C for 24 hours, followed by separation of the resulting peptides by reverse phase high performance liquid chromatography, greatly facilitated the final identification of the abnormality. The baby and both parents had a -G gamma-G gamma-globin gene arrangement on one chromosome (normal: -G gamma-A gamma-) which explains the high G gamma values in the Hb F of these three persons.

Amino Acid Sequence↗
PubMed1986

Osteoarthritis of the hand and osteoporosis.

The relationship between osteoarthritis and osteoporosis of the hand was examined in a random sample of the Jewish population in Jerusalem. It was found that osteoporosis and osteoarthritis of the hand showed differing prevalences, only rarely coexisted, and that there was neither a positive nor a negative correlation between them (p greater than 0.05). This would strengthen the contention that these are two independent and unrelated disease processes.

Aged↗
PubMed1983

The normal width of the adult hip joint: the relationship to age, sex, and obesity.

The articular cartilage thickness of the weight-bearing segment of the hip joint, in standard pelvic radiography, of 240 male and female subjects between the ages of 45-84 years was measured in a random sample of a Jerusalem population. The average value was approximately 4.0 mm and no sex or age difference was found. There was no correlation either between joint width and body build as estimated by the weight to height ratio. It is thus concluded that a narrow joint space should not be expected either in elderly or obese subjects other than as a concomitant finding of arthritic change.

Age Factors↗