PubMed Health⌕ Search

Biomedical subjects

S Perlmutter

Publications and source records attributed to S Perlmutter.

33 records · Page 2Linked to original sources
PubMed1987

Diltiazem treatment for the management of ischaemia in patients with poor left ventricular function: safety of long term administration.

The tendency of oral diltiazem (a calcium entry blocking agent and a negative inotrope) to induce or exacerbate congestive heart failure when used for the long term management of myocardial ischaemia in patients with poor left ventricular function has not been investigated before. Twenty two patients (aged 42-73 years) with pretreatment left ventricular ejection fraction ranging from 0.11 to 0.39 were given open label oral diltiazem (120-360 mg/24 h (mean 254 mg)) for two weeks to 16 months (mean 7.5 months, median 6.2 months). There was a weight change of greater than 3 lb (1.35 kg) in nine patients--five gained weight and four lost it. Diltiazem treatment did not alter the mean (SD) cardiothoracic ratio on chest x ray (0.47 (0.06) before vs 0.48 (0.05) after) or the left ventricular ejection fraction at rest (0.28 (0.09) before vs 0.26 (0.08) after). Diltiazem was discontinued in one patient because of symptoms indicative of worsening congestive heart failure. No patient required admission to hospital for treatment of symptoms resulting from further left ventricular decompensation. Diltiazem was discontinued in six other patients for other reasons. Long term administration of oral diltiazem was not regularly associated with a deterioration in clinical, radiographic, or radionuclide ventriculographic estimates of left ventricular function, even in patients with poor baseline left ventricular systolic performance.

Adult↗
PubMed1986

Repigmentation of the gingiva following surgical injury.

Oral melanin pigmentation is not uncommon in some races and ethnic groups. Repigmentation of depigmented oral mucosa has been described after chemical, thermal, surgical, pharmacologic or idiopathic factors. Information on the repigmentation of oral tissues after surgical procedures is extremely limited. The communication reports on gingival repigmentation over a 7 to 8 year period following removal of gingival tissues. Pigmented keratinized gingiva was removed in two Jewish Yemanite adult males, who had moderate or heavily pigmented gingiva. After surgery, the exposed lamina propria was covered by periodontal pack for 7 to 10 days. The tissues were then observed periodically for signs of repigmentation. Healing was uneventful and the surgically treated areas in both patients remained depigmented over the first 2 years. After 32 months, some pigmentation was found in one of the patients, and with the exception of two limited sites, the area was completely repigmented after 7 years. The surgically treated area in the second patient remained depigmented over an 8-year follow-up period. These observations agree with previous reports that describe gingival pigmentation as spontaneous and suggest that further controlled experimental studies be undertaken to explore the biologic basis for repigmentation.

Adult↗
PubMed1980

Epignathus with placental hydrops.

A stillborn male infant with massive epignathus showed placental enlargement, hydramnios, and hydrops. These changes are thought to be due to cardiac decompensation from circulation of the large vascular tumor mass. Y bodies present in the tumor suggest a mitotic origin for epignathi from host cells.

Edema↗
PubMed1980

Laryngeal radiation after hemilaryngectomy.

Laryngeal radiation was administered to 30 patients after hemilaryngectomy for true vocal cord carcinoma at Washington University Medical Center during the years 1957-1976. Twelve patients were irradiated at the time of gross recurrence and 5/12 (42%) of these patients had recurrence of their disease after radiation. Eighteen patients were irradiated immediately after hemilaryngectomy because positive margins were seen in the hemilaryngectomy specimen and 5/18 (28%) of these had recurrence. All but 1 recurrence occurred within 13 months following radiation. Total laryngectomy salvaged an additional 3 patients for ultimate cancer control in 23/30 (77%). This high dose laryngeal irradiation was well tolerated. A major complication occurred in 1 patient (3%) and consisted of permanent laryngeal edema necessitating tracheostomy but permitting useful speech. Mild complications occurred in 5 patients.

Carcinoma, Squamous Cell↗
PubMed1977

Splenic uptake of 99mTc-diphosphonate in sickle cell disease associated with increased splenic density on computerized transaxial tomography.

Splenic uptake of 99mTc-diphosphonate was found on the bone scan of a patient with sickle cell disease. No splenic activity was demonstrated on 99mTc-sulfur colloid liver-spleen scans and no evidence of splenic calcification was seen on plain abdominal radiographs. A computerized transaxial tomographic scan, however, did demonstrate a small spleen denser than other abdominal organs. The splenic accumulation of 99mTc-diphosphonate and the increased density on computerized transaxial tomography could be attributed to microscopic splenic calcifications and/or iron deposits in the spleen.

Adolescent↗
PubMedDate not supplied

Unenhanced helical CT using increased pitch for suspected renal colic: an effective technique for radiation dose reduction?

PURPOSE: To determine the accuracy and utility of unenhanced helical CT for suspected renal colic, using a pitch of either 2.5 or 3.0. METHODS: 59 consecutive patients underwent unenhanced helical CT. 5 mm contiguous images were obtained at a kVP of 120 and an mA of 260. Thirty-four patients were imaged at a pitch of 2.5, and 25 patients were imaged at a pitch of 3.0. Two radiologists, an attending (reader 1), and a second-year resident (reader 2), independently and retrospectively reviewed the CT images, blinded to the clinical outcome. The presence or absence of a ureteral stone was recorded and image quality was graded. A third radiologist determined accuracy for each reader. Average entrance exposure was estimated using a CT phantom at a variety of pitches. RESULTS: Overall sensitivity, specificity, and accuracy for reader 1 were 91, 96, and 93%. For reader 2, they were 86, 93, and 90%. There was no significant difference in accuracy using a pitch of 3.0 compared with 2.5 for either reader. Readers 1 and 2 rated image quality at 2.5 pitch as excellent for 88 and 76% of scans, respectively; at 3.0 pitch the scans were rated by both readers as excellent for 40% and acceptable for 60%. Average entrance exposures were estimated at 461, 553. and 913 mR at pitches of 3.0, 2.5, and 1.5. CONCLUSION: Increasing the pitch on unenhanced helical CT for suspected renal colic to 2.5 or 3.0 appears to be an effective method of reducing radiation dose. Although accuracy of the technique did not significantly change using a pitch of 3.0 in one group of patients, compared with a pitch of 2.5 in another group of patients, image quality did decrease.

Adult↗
PubMedDate not supplied

In vivo tetracycline labeling of experimentally induced reparative dentin in human teeth.

Tetracycline hydrocholoride was administered to label reparative dentin in teeth indicated for extraction. Deep cavities or pulp capping performed on the teeth one of four months before extraction served as a stimulus for new dentin formation. Examination of undemineralized sections under ultraviolet light revealed fluorescent bands in the reparative dentin of most teeth. The technique can be safely used in studies of the effects of clinical procedures on the dentin and pulp of human teeth.

Administration, Oral↗
PubMedDate not supplied

Tube feeding-related diarrhea in acutely Ill patients.

Acutely ill patients received tube feeding for an average of 15.8 days and, on average, 35% of those days were spent in the intensive care unit (ICU). Patients were prospectively assigned either a fiber-free formula (FFF-OSMOLITE HN, Ross; n = 50) or a fiber-supplemented (soy polysaccharide 14.4 g/L) formula (FSF = JEVITY, Ross; n = 50). Diarrhea was defined as three or more loose or watery stools per day and occurred in 30% of all patients. Diarrhea developed in 29 (41%) of the 71 patients who received antibiotics during, or within 2 weeks prior to, the feeding period, whereas only 1 (3%) of the 29 patients not receiving antibiotics developed diarrhea (p less than 0.005); and this patient developed diarrhea on the day of death. Among the 30 patients with diarrhea, stool Clostridium difficile (CD) toxin was positive in 15 (50%), negative in 11 (37%), and was not measured in four. The mean serum albumin was significantly lower in patients with diarrhea (2.43) than in those without diarrhea (2.75) (p = 0.043). There were no significant differences in age, sex, diagnoses, number of feeding days, and percent ICU days between patients with and without diarrhea. While not statistically significant, patients who received FSF were observed to have a lower incidence of diarrhea, a lower percentage of diarrhea days per total feeding days, and a lower frequency of positive CD toxin assays than patients who received FFF. In this patient population, antibiotic usage was the factor most strongly associated with diarrhea during tube feedings.

Acute Disease↗