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Biomedical subjects

Raymond Farah

Publications and source records attributed to Raymond Farah.

14 recordsLinked to original sources
PubMed2006

Bacterial meningitis associated with infliximab.

We report an episode of bacterial meningitis in a 45 year-old woman, who was treated with infliximab for Wegener's granulomatosis. This patient presented with the classic clinical presentation of acute meningitis: the triad of fever, neck stiffness, and an altered mental state that appeared 6 months after the infliximab initiation. A computed tomographic (CT) scan of the head showed cerebral edema and Streptococcus pneumoniae was isolated from blood and CSF cultures. Prompt diagnosis and early treatment improved the outcome of this patient.

Anti-Inflammatory Agents↗
PubMed2006

Severe hypercalcemia as a presenting sign of systemic lupus erythematosus.

The association of hypercalcemia and systemic lupus erythematosus is quite uncommon, with only three cases having been reported in the literature. We present a case in which this association is highlighted and demonstrate the presumed mechanism of high calcium level and the usefulness of early diagnosis and aggressive treatment.

Journal Article↗
PubMed2006

Pyloric stenosis as a presenting symptom of Crohn's disease.

We report a rare case of pyloric stenosis as a presenting symptom of Crohn's disease. Clinical improvement and long-term relief of pyloric obstruction were obtained following a short course treatment of corticostroids and total parenteral nutrition. In contrast to most of the cases described previously in the literature, surgical treatment was not required.

Adrenal Cortex Hormones↗
PubMed2006

[Levels of fibrinogen compared to crp in plasma as new marker in diagnosis of pulmonary edema of non septic origin].

INTRODUCTION: Community-acquired pneumonia, that requires hospitalization, is a severe illness with high mortality rates, especially in cases of delay of appropriate treatment. At times, the correct diagnosis of the disease is difficult due to equivocal clinical picture or chest film, accompanying diseases that could mask or simulate the pneumonia. THE AIMS OF OUR STUDY WERE: 1. follow-up levels of fibrinogen throughout hospitalization in the group of patients admitted to the hospital due to pneumonia and pulmonary edema of non-infectious origin; 2. an estimation opportunity using them as possible new markers for diagnosis of pneumonia and for following response to treatment. METHODS: Three groups of patients were studied: a group of 15 patients admitted due to pneumonia, a group of 15 patients admitted due to pulmonary edema, and a control group 15 healthy subjects. The blood samples for white blood cells count, erythrocyte sedimentation rates, levels of fibrinogen, C-reactive protein, albumin, were taken for each patient on admission, 48 and 72 hours following admission and on discharge day. The received dates were compared using Student t-test. RESULTS: The levels of fibrinogen were higher on admission, in the patients with pneumonia, maximally after 48 and 72 hours (P<0.001) in comparison to the control group. In pulmonary edema the fibrinogen levels were also high but less than those with pneumonia (P=0.0044), with gradual declining throughout hospitalization period (P> 0.027 for both groups in discharge day). The comparison of fibrinogen levels between groups of patients with pneumonia and pulmonary edema reveal statistically significant results at time of admission, after 48 and 72 hours but not on discharge day. CONCLUSION: Fibrinogens can be used as reliable markers for primary diagnosing of pneumonia or differential diagnosis from pulmonary edema, on admission and until 72 hours but not for patient follow-up throughout hospitalization period. Additional studies are needed for discovering other new markers for patient follow-up throughout hospitalization period.

Biomarkers↗
PubMed2006

[The significance of troponin T in hemodialysis patients].

INTRODUCTION: Troponin T and I are located in the myocardium. Monitoring blood Troponin levels is advantageous in evaluating unstable angina over measuring CPK-MB, previously serving as a "golden standard" for urgent evaluation of myocardial infarct. AIM: To measure blood troponin T levels in hemodialysis patients without severe cardiovascular events, following its distribution according to various risk factors. METHODS: Sera were collected from 68 hemodialysis (HD) patients before starting dialysis sessions and compared to 10 age- and gender-matched healthy volunteers (NC). Troponin T levels were measured using Troponin T STAT Elecsys-Roche kits. RESULTS: Blood Troponin T levels were significantly higher in HD patients compared to NC (0.126 +/- 0.016 vs. 0.005 +/- 0 ng/dL, respectively; P=0.026). HD patients with ischemic heart disease (IHD) showed significantly higher levels of Troponin T, compared to HD patients without IHD (0.17+/-0.036 vs. 0.081 +/- 0.015 ng/dL, respectively; P=0.012). Diabetic (DM) HD patients showed higher levels of Troponin T, compared to non-DM HD patients (0.168+/-0.034 vs. 0.068+/-0.012 ng/dL, respectively; P= 0.002). CONCLUSION: Troponin T may efficiently serve as a diagnostic, monitoring and prognostic parameter in HD patients.

Biomarkers↗
PubMed2006

[Severe hypercapnia in asthmatic attack].

This is an unusual case, of an adult man who was hospitalized with a severe asthmatic attack and severe hypercapnia, refractory to intensive medical treatment, which responded to pressure mechanical ventilation. We advise to consider this mode of treatment in similar cases.

Asthma↗
PubMed2006

[The effect of calcium channel blocker lercanidipine on lowgrade inflammation parameters in essential hypertension patients].

INTRODUCTION: Oxidative stress (OS), inflammation and insulin resistance are among the mechanisms that have been recently implicated in pathogenesis of essential hypertension (EH). Peripheral polymorphonuclear leukocytes (PMNLs) are primed in EH patients, releasing uncontrolled superoxide anion contributing to OS and chronic low-grade inflammation in these patients. PMNL priming correlates with insulin resistance and with PMNL intracellular calcium ([Ca2+]i). Recent studies have attributed additional anti-oxidative characteristics to the anti-hypertensive drug Lercanidipine (Vasodip), a third generation calcium-channel blocker. AIM: To evaluate possible novel effects of two months of Lercanidipine treatment on systemic and PMNL-related inflammation and on insulin resistance in EH patients. METHODS: Fifteen non-smoking EH patients with untreated mild to moderate high blood pressure (BP) and age- and gender-matched healthy controls (HC) were included in the study. Low-grade inflammation was expressed by PMNL counts and apoptosis, by plasma fibrinogen, CRP and albumin (as a negative acute phase reactant) levels. Fasting serum insulin levels served as a marker of insulin resistance. RESULTS: Inflammation parameters and insulin levels were higher in EH compared to HC. PMNL counts, fibrinogen and insulin levels positively correlated with mean arterial blood pressure values. Two months of Lercanidipine treatment showed a significant decrease in BP, PMNL counts and apoptosis, CRP and serum insulin levels and a significant increase in serum albumin levels. CONCLUSION: The authors imply that the low-grade systemic inflammation and insulin resistance detected in EH patients may be attenuated by the use of Lercanidipine, adding new unknown anti-inflammatory properties to this calcium channel blocker.

Adult↗
PubMed2005

A rare lung manifestation with rapidly progressive glomerulonephritis (RPGN).

In this unusual case, we report the history of a patient who was hospitalized with pulmonary manifestations presenting as broncholitis obliterance organizing pneumonia (BOOP) associated with ANCA-negative pauci-immune glomerulonephritis. Other known causes for the occurrence of BOOP were excluded. Immediate diagnosis and treatment with a combination of steroids and cytotoxic therapy resulted in a complete remission and prevented eventual dialysis.

Journal Article↗
PubMed2005

Low-grade renal collecting duct carcinoma. A case report with histochemical, immunohistochemical, and ultrastructural study.

We report a rare tumor called low-grade renal collecting duct carcinoma. Grossly, the tumor consisted of multiple cysts and solid white nodules, measuring 10 cm in diameter and occupying most of the renal parenchyma. Histologically, the tumor was characterized by well-differentiated tubules lined by eosinophilic cells without papillary projections, abundant predominantly extracellular mucin, minimal cellular atypia, no desmoplasia, and rare mitoses. This tumor occurs in collecting ducts and the tumor cells were positive for epithelial membrane antigen, high-molecular-weight keratin, CD15, and mitochondrial antibody and negative for CD10. Few cells stained weakly positive for ulex europaeus. Ultrastructural study showed a large number of mitochondria according to the eosinophilic cells seen in light microscopy.

Aged↗
PubMed2002

A link between polymorphonuclear leukocyte intracellular calcium, plasma insulin, and essential hypertension.

BACKGROUND: Intracellular ionized calcium ([Ca2+]i) is a key mediator in the activation and oxidant production by peripheral polymorphonuclear leukocytes (PMN). Primed PMN contribute to oxidative stress (OS) and inflammation in essential hypertension (EH). Elevated [Ca2+]i has been described in insulin-resistant states and in various cell types in EH but not in EH PMN. The aim of this study was to evaluate the levels of [Ca2+]i in peripheral EH PMN in relation to plasma insulin levels and blood pressure (BP). METHODS: The PMN were separated from blood of 20 nonsmoking, nonobese untreated EH patients, age range 20 to 60 years and from 20 age- and gender-matched healthy individuals (NC). Plasma glucose and insulin levels 2 h after a 75-g oral glucose load, reflected insulin resistance. PMN [Ca2+]i was measured by flow cytometry in isolated cells stained with Fluo-3. RESULTS: The EH PMNs showed significantly increased [Ca2+]i compared to NC PMN. Eighty percent of EH patients showed significantly higher plasma insulin levels after glucose load. Linear regression analysis showed significant correlation between 1) PMN [Ca2+]i and mean arterial pressure (MAP) (r = 0.5, P < .006); 2) PMN [Ca2+]i and fasting plasma insulin (r = 0.7, P < .005); and 3) fasting plasma insulin and MAP (r = 0.4, P < .04). CONCLUSIONS: This study adds PMN to previously described cells exhibiting elevated [Ca2+]i, contributing to OS and inflammation. The correlation of individual BP with both PMN [Ca2+]i and plasma insulin levels, together with the fact that elevated [Ca2+]i mediates PMN priming, suggest that elevated [Ca2+]i and insulin are involved in the pathogenesis of hypertension-induced vascular injury in EH.

Adult↗
PubMedDate not supplied

Fatal acute sodium phosphate enemas intoxication.

We describe a patient who died as a result of severe hypocalcaemia and hyperphosphatemia after treatment with a sodium-phosphate enema. Physicians should be aware of the risk when using these enemas, even in normal doses, especially in elderly patients without signs of renal failure, as in our patient.

Acute Disease↗