Biomedical subjects

S A Weitzman

Publications and source records attributed to S A Weitzman.

99 records · Page 6Linked to original sources

PubMed1977

Long-term unmaintained remissions after agressive multidisciplinary treatment of advanced non-seminomatous testicular germ cell tumors.

Five patients with disseminated non-seminomatous testicular germ cell tumors are described. These patients have been clinically free of disease for 25 to more than 99 months and may be cured, since the interval after last treatment ranges from 13 to more than 76 months. Two patients, including 1 with pure choriocarcinoma, represent chemotherapeutic successes. In 3 patients the advantages of an individualized, multidisciplinary approach with surgery, radiotherapy and chemotherapy are shown. The benefits of continued aggressive treatment using residual therapeutic modalities despite prior failure with other therapy are documented.

Adult↗

PubMed1977

High dose cyclophosphamide as an adjunct to radiotherapy for advanced seminoma.

Two patients with far-advanced seminoma of the testis were given single intravenous injections of high dose (1.5 and 2.0 gm. per m.) cyclophosphamide. Both patients experienced prompt, dramatic objective regressions without severe toxicity. Definitive radiotherapy, deemed technically unfeasible before cyclophosphamide administration, was administered subsequently. Long-term complete remissions (more than 16 and 28 months) have been attained in both patients. High dose cyclophosphamide may prove useful in selected patients with disseminated seminoma.

Adult↗

PubMed1975

Bronchiectasis and homozygous alpha1-antitrypsin deficiency.

A 34-year-old woman with homozygous a1-antitrypsin deficiency suffered from progressive, generalized cystic bronchiectasis. Although bronchiectasis was reported in the original monograph on the enzyme inhibitor deficiency, it has received minimal attention since then. Alpha1-antitrypsin levels should be measured in patients with severe bronchiectasis.

Adult↗

PubMedDate not supplied

Molecular typing for investigating an outbreak of Candida krusei.

Invasive infections due to Candida krusei are often observed in immunocompromised patients who have received prior therapy with fluconazole, although infection has also occurred in patients in the absence of this antifungal agent. From August 25 through September 19, 1995, we identified four patients with C. krusei fungemia on our hematology/oncology unit. Molecular typing of all the isolates was performed by restriction endonuclease analysis of genomic DNA using HinfI. A total of 7 patients found to be colonized or infected with C. krusei were matched with 14 controls. There was no difference between the cases and controls with respect to underlying disease, duration of hospitalization, or neutropenia. The numbers of days of hyperalimentation, corticosteroids, and antibiotics were similar between both groups. The mean number of antibiotics was greater in the cases versus controls (5.0 versus 2.5; p = .003). There was no difference with respect to total dose or duration of fluconazole administration. Molecular typing of the isolates revealed that four had identical DNA banding patterns, plus another two that differed by one band and were considered related. Three historical strains were unrelated. In conclusion, this report demonstrates that molecular typing can be used to define clonality and, thereby, support increased infection control practices to eliminate such outbreaks when evidence of clonal spread is present.

Amphotericin B↗

PubMedDate not supplied

A slide test for detecting neutrophil-associated complement components.

Complement components deposited on neutrophils were detected by a new test that uses staphylococcal protein A and antisera against complement. Serum from three of 51 patients thought to have immune neutropenia deposited complement but not IgG on their own and normal neutrophils. Some cases of immune neutropenia may be caused primarily by complement-mediated neutrophil destruction.

Adult↗

PubMedDate not supplied

Antibody response of patients with Hodgkin's disease to protein and polysaccharide antigens.

We examined the antibody response of patients with Hodgkin's disease to a variety of vaccines to formulate guidelines for immunization. During and after treatment for Hodgkin's disease, both pre- and postimmunization levels of antibody to Streptococcus pneumoniae, Hemophilus influenzae type b, and tetanus toxoid antigens were significantly lower in patients than in controls. Impairments in the antibody response were most severe in intensively treated patients and improved as the interval between treatment and immunization increased. The primary, but not the secondary, antibody responses to the hemagglutinins of the influenza virus A/Victoria/75 and A/New Jersey/76 also were impaired in treated patients. Before treatment antibody responses to pneumococcal vaccine was normal regardless of the stage of disease unless treatment began within 10 days of immunization. Levels of antibody decreased during therapy in proportion to the intensity of treatment but remained higher than levels in comparably treated patients who were not immunized at diagnosis. We recommend that patients with Hodgkin's disease receive pneumococcal vaccine at diagnosis at least 10 days before initiation of treatment. Patients who are treated before immunization may be immunized several months after treatment, although the response of heavily treated individuals to vaccination may be marginal. More studies are needed to determine whether reimmunization of patients initially immunize at diagnosis is safe and effective.

Adolescent↗

PubMedDate not supplied

Phytic acid, an iron chelator, attenuates pulmonary inflammation and fibrosis in rats after intratracheal instillation of asbestos.

Reactive oxygen species, especially iron-catalyzed hydroxyl radicals (.OH) are implicated in the pathogenesis of asbestos-induced pulmonary toxicity. We previously demonstrated that phytic acid, an iron chelator, reduces amosite asbestos-induced .OH generation, DNA strand break formation, and injury to cultured pulmonary epithelial cells (268[1995, Am. J. Physiol.(Lung Cell. Mol. Physiol.) 12:L471-480]). To determine whether phytic acid diminishes pulmonary inflammation and fibrosis in rats after a single intratracheal (it) instillation of amosite asbestos, Sprague-Dawley rats were given either saline (1 ml), amosite asbestos (5 mg; 1 ml saline), or amosite treated with phytic acid (500 microM) for 24 hr and then instilled. At various times after asbestos exposure, the rats were euthanized and the lungs were lavaged and examined histologically. A fibrosis score was determined from trichrome-stained specimens. As compared to controls, asbestos elicited a significant pulmonary inflammatory response, as evidence by an increase (approximately 2-fold) in bronchoalveolar lavage (BAL) cell counts at 1 wk and the percentage of BAL neutrophils (PMNs) and giant cells at 2 wk (0.1 vs 6.5% and 1.3 vs 6.1%, respectively; p < 0.05). Asbestos significantly increased the fibrosis score at 2 wk (0 +/- 0 vs 5 +/- 1; p < 0.05). The inflammatory and fibrotic changes were, as expected, observed in the respiratory bronchioles and terminal alveolar duct bifurcations. The increased percentage of BAl PMNs and giant cells persisted at 4 wk, as did the fibrotic changes. Compared to asbestos alone, phytic acid-treated asbestos elicited significantly less BAL PMNs (6.5 vs 1.0%; p < 0.05) and giant cells (6.1 vs 0.2%; p < 0.05) and caused significantly less fibrosis (5 vs 0.8; p < 0.05) 2 wk after exposure. We conclude that asbestos causes pulmonary inflammation and fibrosis in rats after it instillation and that phytic acid reduces these effects. These data support the role of iron-catalyzed free radicals in causing pulmonary toxicity from asbestos in vivo.

Animals↗

PubMedDate not supplied

AIDS and hospice.

Which AIDS patients should be admitted to hospice programs? Many health care professionals feel that any anti-viral drug or treatment directed against the opportunistic infections characteristic of AIDS to be incompatible with hospice philosophy. Others argue that inclusion of AIDS patients blurs the distinction between hospice and community service programs. We argue that achieving consensus on this issue is best served by focusing on the defining characteristic of hospice programs--the care of the dying. Consensus is not served by dwelling on the specific palliative or supportive measures used to achieve the hospice goal. We suggest a framework by which AIDS patients may be accommodated in existing hospice programs while maintaining hospice program integrity. It is further suggested that these may be used for the consideration of any patient for hospice care.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Metastatic islet cell carcinoma: a potentially treatable cause of "carcinoma of unknown origin.".

A 55-year-old woman presented with diplopia secondary to an orbital mass. Physical examination showed a large ovarian mass. Further evaluation revealed these lesions to be metastases from a nonfunctioning pancreatic islet cell carcinoma, the first such case reported. Since these tumors can be responsive to chemotherapy, it is important to consider islet cell cancers in patients presenting with "metastatic carcinoma of unknown origin.

Adenoma, Islet Cell↗