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Biomedical subjects

V J Hirsch

Publications and source records attributed to V J Hirsch.

11 recordsLinked to original sources
PubMed1993

Resection of a solid and papillary epithelial neoplasm of the pancreas following treatment with cis-platinum and 5-fluorouracil: a case report.

A 15-year-old female was found at laparotomy to have an unresectable 15 cm solid and papillary epithelial neoplasm of the pancreas invading the superior mesenteric vein. The tumor regressed when treated with cis-platinum and 5-fluorouracil for 6 months leaving a 3.5 cm mass which was resected at reoperation. Response to chemotherapy has not been previously documented for this tumor histology and may contribute to the management of this locally invasive tumor.

Adolescent↗
PubMed1987

Medical management of arrest disorders of labor: a current overview.

In order to evaluate the risks specifically related to arrest disorders of labor, obstetric management and perinatal outcome were studied in 5399 births selected to exclude risks clearly not caused by abnormal labor. Management was primarily medical--among patients with arrest disorders, the cesarean rate was 13% and the midforceps rate was 4%, and among those having cesarean or midforceps delivery, 96% received prior oxytocin stimulation. Perinatal outcome was assessed by the parameters of mortality, low Apgar scores, admission to the nursery intensive care unit, and neurological abnormality. With medical management, arrest disorders were not associated with an increased risk of the adverse perinatal outcome evaluated in this study. It appears possible to reduce operative rates for arrest disorders of labor safely by more extensive use of medical management.

Apgar Score↗
PubMed1981

Paroxysmal nocturnal hemoglobinuria. Termination in acute myelomonocytic leukemia and reappearance after leukemic remission.

In a 71-year-old man, acute myelomonocytic leukemia developed six years after a diagnosis of paroxysmal nocturnal hemoglobinuria (PNH) had been established. The classic features of PNH disappeared with the onset of the leukemia. Chemotherapy resulted in complete leukemic remission, during which time intravascular hemolysis and a positive acidified serum (Ham's) test recurred; both findings again disappeared when the leukemia recurred. To our knowledge, this is the eighth reported case of PNH terminating in acute leukemia but is the first in which reappearance of PNH has been documented with leukemic remission. The alternating pattern of the two disorders suggests that the PNH clone survivors in the bone marrow when leukemia supervenes.

Aged↗
PubMed1978

Clinical estimation of gestational age: rules for avoiding preterm delivery.

Reliable knowledge of the duration of pregnancy prior to birth is often of crucial importance in making obstetric care decisions. Laboratory methods for estimating fetal maturity have received considerable attention, but the usefulness of historical information has only rarely been addressed. In order to examine the value of clinical estimators of fetal gestational age (GA) in 690 pregnancies, the correlations of menstrual history (LMP), first unamplified audible fetal heart tones (FFH), and quickening (Q), with GA, based on the modified Dubowitz examination at birth, were examined. Evaluation of each of the data sets used alone reveals that in order to be 90% certain that an infant will be mature at delivery (greater than or equal to 38 weeks), a reliable LMP must have been noted for 42 weeks prior to birth, the FFH heard for 21 weeks, and Q felt for 25 weeks. These findings suggest that carefully obtained historical and physical examination information remains a cornerstone of appropriate obstetric care.

Delivery, Obstetric↗