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Biomedical subjects

S Sukenik

Publications and source records attributed to S Sukenik.

At least 19 recordsLinked to original sources

[Inappropriate antidiuretic hormone secretion in T-cell non-Hodgkin's lymphoma].

A 45-year-old woman was hospitalized for an acute confusional state which was preceded by behavioral changes of a few weeks duration. The diagnosis of the syndrome of inappropriate antidiuretic hormone secretion as a presenting symptom of non-Hodgkin's T-cell lymphoma (needle biopsy) was made. In spite of intensive chemotherapy, and although hyponatremia did not recur, the clinical course was stormy, her condition deteriorated rapidly, and she died 3 months later.

Female

[Calcific periarthritis in patients with endstage renal disease on chronic dialysis].

2 patients with end-stage renal disease undergoing dialysis developed calcific periarthritis. A 25-year-old man on hemodialysis developed arthritis of 2 right metacarpophalangeal joints and a 65-year-old man on chronic ambulatory peritoneal dialysis suffered from pain and tenderness in the left buttock. Treatment with nonsteroidal antiinflammatory drugs in the first case and periarticular injection of methylprednisolone (Depomedrol) in the second were successful.

Adult

[Anaphylactic shock after traumatic rupture of a splenic echinococcal cyst].

Anaphylactic shock as a result of trauma is very rare. We describe a 20-year-old Druze soldier who presented with anaphylactic shock due to rupture of a splenic echinococcal cyst induced by blunt trauma to the left chest wall and upper abdomen. The main clinical manifestations, which developed within minutes of the trauma, were high fever, pruritus, edema of the lips and eyelids, dyspnea, stridor and rhinorrhea. Eosinophilia was not present on admission but appeared 4 days later. Surgery revealed an intact echinococcal cyst in the left lobe of the liver and another in the spleen. The splenic cyst was torn, filled with blood and its contents had spread throughout the splenic tissue, but without peritoneal spillage. Recovery was complete after splenectomy and resection of the hepatic hydatid cyst.

Abdominal Injuries

Mud pack therapy in rheumatoid arthritis.

Twenty-eight patients with classical or definite rheumatoid arthritis were randomly divided into two groups of fourteen patients each. All patients were treated once a day with mud packs derived from the Dead Sea heated to 40 degrees C and applied over the four extremities, neck and back for 20 minutes. Group 1 was treated with the true mud packs and Group 2 with washed out and less concentrated mud packs. The study was double blind and of two weeks duration. All patients were evaluated by one rheumatologist both before treatment and two weeks later at the end of the treatment period. Follow-up evaluations were made one and three months after conclusion of the treatment. The clinical indices evaluated included duration of morning stiffness, hand-grip strength, activities of daily living, patient's own assessment of disease activity, number of active joints and the Ritchie index. A statistically significant improvement (p less than 0.01 or p less than 0.05) was observed in Group 1 only in most of the clinical indices, lasting between 1 to 3 months.

Arthritis, Rheumatoid

Polyarthritis associated with hydatid disease (echinococcosis) of the liver.

A 36-year-old male developed asymmetric polyarthritis during the course of hydatid disease of the liver. Excision of the hydatid cyst was accompanied by full remission of the arthritis without recurrence during the 7-year follow-up period. This sequence of clinical events suggests an eventual cause and effect relationship. A "reactive" immune mechanism, triggered by a parasite located at a distant site, appears to be responsible for this type of arthritis.

Adult

A multidimensional autoantibody analysis specifying systemic lupus erythematosus patients with neuropsychiatric symptomatology.

Utilizing a newly perfected multiple-response permutation procedure, we analyzed the autoantibody titer of systemic lupus erythematosus (SLE) patients during active and convalescent periods of disease, SLE patients without neurological involvement, and three other comparison groups (patients with active tuberculosis, patients with multiple sclerosis, and healthy normal controls). The multidimensional analysis we used distinguished those SLE patients with neurological involvement from the other SLE patients. Differences were noted by a univariate analysis measuring antibodies to single- and double-stranded DNA, poly (G), Sm, RNP, Ro, La, and gangliosides. Elevated concentrations of the common anti-DNA idiotype 16/6 were also noted among SLE patients with neuropsychiatric illness. This report stresses that increased disease activity in SLE patients with neuropsychiatric phenomena is reflected by their autoantibody profile.

Antibodies, Antinuclear

[Heat stroke associated with massive hepatic necrosis].

Heat stroke in a 21-year-old soldier was complicated by acute renal failure with rhabdomyolysis, hypophosphatemia, hypocalcemia, sinus bradycardia and massive liver necrosis. Treatment included general supportive measures, forced alkaline diuresis and IV fresh frozen plasma and cryoprecipitate and was followed by complete recovery.

Acute Kidney Injury

[Sulfasalazine in rheumatoid arthritis].

Sulfasalazine (SLZ) is now a second-line treatment in rheumatoid arthritis (RA), as well as in psoriatic arthritis and ankylosing spondylitis. 54 patients with active RA were treated with enteric coated SLZ (2 g daily) in a 24-week open study. Clinical and laboratory parameters of disease activity were monitored initially and thereafter at 2-week intervals for the first 2 months, and then at 4-week intervals until the end of the 24-week study. There was significant clinical improvement at the end, as shown by scores for joint pain (Ritchie), grip strength and morning stiffness (p less than 0.0001, less than 0.0001 and less than 0.01, respectively, by paired t test). Clinical improvement was accompanied by significant decrease in erythrocyte sedimentation rate and increase in hemoglobin (p less than 0.002 and less than 0.016, respectively). There was improvement in some cases as early as 3 weeks after starting therapy. The drop-out rate was significant: 19/54 (35%), most (13) due to side-effects, mainly gastrointestinal; none of the side-effects were serious. Our results, similar to those of other studies, indicate that despite the high rate of side effects, SLZ is an effective, second-line drug for RA.

Arthritis, Rheumatoid

An unusual case of factitious arthritis.

Factitious arthritis is an unusual manifestation of a factitious illness. We report a case of factitious arthritis after the self insertion of needles and fragments of metallic paper clips into the knee joint area. The case illustrates an unusual presentation of Munchausen's syndrome.

Adult

Jaccoud's-type arthropathy: an association with sarcoidosis.

We describe a patient with sarcoidosis involving the lungs, muscles and tendons of the forearms who developed Jaccoud's-type arthropathy of the hands. This is the first reported case to the best of our knowledge of sarcoidosis associated with this type of arthropathy.

Female