PubMed Health⌕ Search

Biomedical subjects

Y Adler

Publications and source records attributed to Y Adler.

At least 73 records · Page 4Linked to original sources
PubMed1995

The presence of antiphospholipid antibodies in acute myocardial infarction.

This study was undertaken to determine if there is an association between increased titers of five different antiphospholipid antibodies (aPLA) in young patients' sera and the occurrence of acute myocardial infarction (AMI). Antibodies to anticardiolipin (aCL), anti-phosphatidylserine (aPS), antiphosphatidylinositol (aPI), anti-phosphatidylcholine (aPC), and anti-phosphatidylethanol amine (aPEA) were measured in 214 patients (102 patients, 102 healthy controls and 10 patients with antiphospholipid syndrome). These antibodies were measured twice (within 4h of onset of acute myocardial ischemic chest pain and 3 months after the myocardial infarction) by enzyme linked immunosorbent assay (ELISA). Elevated titers of four different aPLA were detected in 6.9% of all patients with AMI on hospitalization. Titers of aPLA in AMI were elevated in the younger age group < 50 years old (P < 0.001) and in men only (not statistically significant). No correlation was found between the presence of aPLA and cardiovascular risk factors (smoking, hypertension, diabetes mellitus and hyper-cholesterolemia). Three of the seven patients with increased titers of aPLA did not have any other cardiovascular risk factors. The titers of aPLA were within normal range 3 months after AMI. Evidence of significantly elevated titers of different aPLA at the early stage of AMI suggests that these autoantibodies are present before the AMI and are not secondary to them. The disappearance of the elevated aPLA 3 months after AMI may be due to an absorption effect or possibly a cyclic phenomenon similarly found in other autoimmune diseases. aPLA may be an additional risk factor for AMI, and should especially be considered in a patient of the younger age group without apparent cardiovascular risk factors.

Adult↗
PubMed1994

[Relief of recurrent pericarditis by colchicine].

The incidence of recurrence of pericarditis is about 15-32%. The most common causes include trauma, myocardial infarction, and pericardiectomy. The optimal treatment to prevent recurrence has not been fully established. Possible modalities include nonsteroid anti-inflammatory drugs, corticosteroids, azathioprine, and pericardiectomy. We describe a 19-year-old man with osteogenic sarcoma who developed recurrent pericarditis despite treatment with prednisone and pericardiocentesis. Colchicine was administered in an effort to prevent further bouts of pericarditis. During the acute phase he was treated with a combination of prednisone, 60 mg/day, and colchicine, 1 mg/day. The dose of prednisone was then lowered to 5 mg/day. There was a recurrence when he stopped taking colchicine due to abdominal discomfort. On renewal of treatment there were no further attacks during a follow-up of 16 months. We confirm the results of a previous trial which showed that colchicine may be beneficial in preventing the recurrence of pericarditis. However, these results need corroboration by a large double-blind study.

Adult↗
PubMed1994

Isotypic distribution of anti-pyruvate dehydrogenase antibodies in patients with primary biliary cirrhosis and their family members.

IgG subclasses of anti-pyruvate dehydrogenase (PDH) antibodies were determined in 72 patients with primary biliary cirrhosis. All isotypes were detected, but IgG3, IgG1, and IgG2 predominated independently or in association. An average of 33.3 +/- 19.1% of the anti-PDH IgG was IgG1 (mean optical density, 0.863 +/- 0.783, vs 0.053 +/- 0.038 in the normal controls), 25.0 +/- 17.8 IgG2 (0.652 +/- 0.656 vs 0.062 +/- 0.030), 39.5 +/- 23.4% IgG3 (1.140 +/- 0.917 vs 0.010 +/- 0.023), and 2.4 +/- 7.4% IgG4 (0.060 +/- 0.182 vs 0.012 +/- 0.007). Anti-PDH IgG were restricted to IgG1 in the family members of patients (0.180 +/- 0.403).

Adolescent↗
PubMed1994

Anti-endothelial cell antibodies: a need for standardization.

Twenty years have passed since the original description of the anti-endothelial cell antibodies (AECA). It is widely acknowledged that the presence of circulating autoantibodies against endothelial cells surface antigens, found in a number of patients with connective tissue disease and vasculitis, is one of the driving mechanisms for the observed vascular injury and might be an important factor in initiating the pathogenesis of vascular abnormalities. AECA data regarding the prevalence, technical problems, presence with other autoantibodies, antigen distribution and immune endothelial cell injury associated with these autoantibodies, requires standardization for determining the precise pathophysiologic and immunologic role of anti-endothelial cell antibodies.

Autoantibodies↗
PubMed1993

[Gemfibrozil-induced myopathy].

A 61-year-old woman with hyperlipidemia was treated with gemfibrozil. She also had insulin-treated diabetes mellitus and chronic renal failure and was admitted because of severe chest pain. The ST segment was depressed and creatine kinase levels were elevated. The original diagnosis was acute myocardial infarction. In the presence of increasing chest pain, the onset of limb muscle tenderness, and increasing levels of creatine kinase, the diagnosis of myopathy secondary to gemfibrozil therapy was made and the drug was discontinued. All symptoms then subsided and creatine kinase levels returned to normal. Myopathy is a well-known complication of blood lipid-lowering drugs, especially in patients with renal failure.

Diabetes Complications↗
PubMed1993

[Acute pancreatitis after open-heart surgery].

A 53-year-old man after open-heart surgery was referred with complaints of abdominal pain, fever and nausea. Laboratory results and imaging tests suggested acute pancreatitis. We draw attention to this frequent complication of open-heart surgery, which is not sufficiently emphasized in clinical practice. The diagnosis is frequently difficult, due to the nonspecific presentation of the disease in the context of hyperamylasemia secondary to open-heart surgery. It is therefore very important to check amylase and lipase levels. The disease has high morbidity and mortality, hence the importance of early diagnosis and treatment.

Acute Disease↗
PubMed1986

Need for urgent medical care in a Jerusalem neighborhood: a population-based study.

We conducted a population-based survey of an urban community in Jerusalem to estimate the incidence of urgent and emergency medical events and to characterize the response of the populace to various medical episodes. We found deficiencies in the ability of the population to identify an urgent event, resulting in long delays in seeking professional care, as well as inappropriate choice of source of care, in a substantial proportion of subjects. These deficiencies can and should be corrected by inexpensive educational programs.

Adolescent↗
PubMed1984

Emergency department utilization during a doctors' strike.

Emergency department (ED) patient volume at Jerusalem's Shaare Zedek Hospital was 33% higher during the 1983 doctors' strike as compared with the same period in 1982. Excess visits were recorded for both sexes (P less than 0.0001), but there were many more excess visits by females than males. The largest increase in visits by adults (60-70%) was in persons aged 40-64 years (P less than 0.02), and there was also a large and unexplained increase in ED visits by girls under age 6 (P less than 0.0003). In contrast to excess ED visits, which were higher during the strike for both sexes, excess hospital admissions via the ED were recorded only among females (P = 0.007). The number of ED visits during the strike was increased on all three hospital work shifts (P less than 0.0001), with the greatest number of excess visits occurring between 7 AM and 3 PM.

Adolescent↗
PubMedDate not supplied

Mitral annulus calcification with a mobile component as a possible source of embolism.

Mitral annulus calcification has been associated with embolic events, but the precise pathophysiology has not been elucidated. The authors describe four patients who experienced embolic events whose transesophageal echocardiograms showed a mitral annulus calcification, with a mobile component that exhibited the same echogenicity as the calcification. Three patients had no other conditions known to be associated with embolism. On follow-up transesophageal echocardiography, the mobile component of the mitral annulus calcification had disappeared in three patients. These findings support the hypothesis that mitral annulus calcification not only is associated with but also is possibly a direct cause of embolic events in some patients.

Aged↗
PubMedDate not supplied

Therapy for recurrent acute pericarditis: a rheumatological solution?

OBJECTIVE: To assess the efficacy of a multidrug protocol in recurrent acute pericarditis. We tried also to assess the specific role of colchicine. METHODS: We studied 58 patients (34 males) in the largest monocentric observational study. All patients received prolonged courses of non-steroidal anti-inflammatory drugs; generally we do not start a corticosteroid in recurrent acute pericarditis, but if a steroid had already been started, we planned a very slow tapering; if necessary azathioprine, hydroxychloroquine, and other immunosuppressive drugs were used; 44 patients (27 males, 61.4%) were treated also with colchicine and 14 patients (7 males, 50%) were not given this drug. RESULTS: After starting our protocol recurrences dropped from 0.48 to 0.03 attacks/patient/month (p < 0.00001) within 12 months and remained at the same level till the end of the follow-up (mean 8.1 years) in the whole cohort. In the 44 patients treated with colchicine recurrences dropped from 0.54 to 0.03 attacks/patient/month (p < 0.00001) within 12 months, and in 14 patients not given colchicine recurrences decreased from 0.31 to 0.06 attacks/patient/month (p = 0.002). In patients treated with colchicine the decrease was significantly higher (0.51) than in patients not taking this drug (0.25) (p = 0.006). Colchicine was discontinued by 16.3% of patients because of side effects. CONCLUSION: A multidrug protocol including non-steroidal anti-inflammatory drugs at high dosage, slow tapering of corticosteroid, colchicine, reassurance and close clinical monitoring is very effective in recurrent pericarditis; this improvement is more dramatic in colchicine treated patients, but also patients who do not tolerate it can achieve good control of the disease.

Acute Disease↗
PubMedDate not supplied

Impaired binding capacity of asialyl and agalactosyl IgG to Fc gamma receptors.

OBJECTIVE: Autoimmunity in rheumatoid arthritis has been associated with deficient glycosylation of serum and synovial IgG which could potentially be mediated through the binding of the Fc portion of the molecule to its cognate receptor. METHODS: Normal IgG1 and IgG3 were affinity-purified, and sialic acid and galactose were clipped off using neuraminidase and beta-galactosidase, respectively. The binding of these sugar-depleted IgG to the Fc gamma receptors (Fc gamma R)IIIb on polymorphonuclear leukocytes (PMN) was assessed by flow cytometry. RESULTS: The binding of both asialyl and agactosyl IgG1 and IgG3 to PMN was significantly lower than that of the native IgG1 and IgG3. CONCLUSION: These data indicate that agalactosyl and, to a lesser degree, asialyl IgG, do not bind as efficiently as native IgG to Fc gamma R. Such a reduction in the perspective of the heterogeneity of the PMN Fc gamma RIIIb.

Arthritis, Rheumatoid↗