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Biomedical subjects

Z Stern

Publications and source records attributed to Z Stern.

At least 37 records · Page 2Linked to original sources
PubMed1993

The cost of an extensive burn survival.

A 17-year-old male sustained 95 per cent body surface area burns (87 per cent full thickness skin loss). He was hospitalized in the Department of Plastic Surgery that also treats burns. After 232 days he was discharged home when he was functionally independent. He had 16 surgical procedures for excision of burn eschar and skin grafting; received a total of 128 units of blood; 899 units of fresh frozen plasma and had enteral hyperalimentation for 175 days. About 1000 physician-hours, 3000 nurse-hours, 1000 physiotherapy and occupational therapy-hours and about 250 dietician-hours were needed for his treatment. More than 1850 laboratory tests and 120 X-rays were performed, and more than 600 kg of ointment and creams were used, as well as half a ton of topical antimicrobial solutions. Ten different antibiotics were used for a total of 85 treatment days. Some 8500 m of dressing were applied with more than 6000 pieces of petroleum jelly gauze dressing. Hospitalization costs were found to be US$141,750, only 37.5 per cent of which were salaries. An analysis of these costs is given.

Adolescent↗
PubMed1991

Learning from experience--a revised approach to quality assurance.

This article introduces a model for directing quality assurance activity in hospitals outside of the US. We believe that this model will be more expedient than the systems presently in use. The rationale for this new approach is based on the American experience but proposes an improved organizational and scientific method that has evolved to replace the previously existing ad hoc committees and punitive, post-factum approach. The suggested model includes the establishment of an inter-related network of institutional and departmental committees coupled with the active participation of the hospital director and a specialized unit for quality assurance activities. This approach has the potential for affording major improvements in the implementation of quality assurance in hospitals, outside of the US, which have not been part of the evolutionary process which has taken place in America.

Decision Making, Organizational↗
PubMed1990

Effects of arachidonic acid on hepatic lipids in ethanol-fed rats.

The effects of arachidonic acid supplementation on rats fed ethanol employing an ad libitum schedule have been reported to be different from those observed when rats are fed in more limiting, matched fashion. To reexamine this issue, rats were fed unrestricted amounts of a diet in which 36% of the energy was provided by either ethanol or isocaloric amounts of carbohydrate. In half the animals, 7% of fat consisted of arachidonic acid. Despite earlier reports to the contrary, arachidonic acid had no effect on weight gain and did not attenuate the ethanol-induced fatty liver. Arachidonate supplementation tended to increase hepatic total lipids and triacylglycerols, and to potentiate the ethanol-induced elevation of cholesterol esters. Our present results are consistent with those previously reported using pair-feeding techniques in which dietary intakes are somewhat limited. Thus, regardless of the feeding technique employed, relative arachidonic deficiency cannot be involved to explain the lipid accumulation observed after chronic ethanol consumption.

Animals↗
PubMed1986

Plasma calcium and phosphate levels in an adult noninsulin-dependent diabetic population.

Duplicate or triplicate measurements of fasting plasma glucose, calcium (Ca), phosphate (Pi), and glycosylated hemoglobins were performed on a group of non-insulin dependent diabetic patients and controls at 3-6 month intervals. In the diabetic group (48 males and 44 females), 18 were on diet only, 21 on diet and oral hypoglycemic treatment, and 51 on diet and insulin. These were a total of 217 measurements for each parameter. Results were compared to 416 measurements obtained from sex and age-matched controls. Plasma Ca levels were higher in the diabetic group (2.48 +/- 0.004 vs 2.38 +/- 0.006 mmol/liter) P less than 0.001; plasma Pi levels were similar to those of controls. The difference in plasma Ca was not influenced by age, sex, or mode of treatment. No correlation was found in the three treatment groups between plasma Ca and duration of diabetes nor with patients' weights. The results are consistent with the view that an alteration in calcium homeostasis accompanies the diabetic state.

Adult↗
PubMed1984

Antibodies to cultured rat heart cells in sera of patients with rheumatoid arthritis.

Since heart lesions occur in many patients with rheumatoid arthritis (RA), sera from these patients were tested with an indirect fluorescent technique for antibodies reactive with rat heart cell cultures. Of 27 sera 22 had reactivity with non-muscle (nM) cells and 3 reacted with cultured beating muscle cells (M). Positive sera reactive with nM cells exerted complement-dependent cell cytotoxicity towards M cells. The nM antibodies were found to belong predominantly to the IgG class. They displayed no cross-reactivity with bovine collagen, human and bovine serum proteins, or human and sheep red blood cells. The relationship of these antibodies to the pathogenesis of RA heart lesions remains to be determined.

Adult↗
PubMed1984

Nifedipine plasma concentration in patients treated for angina pectoris.

Nifedipine, a "calcium channel blocker", is increasingly employed in the treatment of angina pectoris. Large interindividual differences have been observed in the effective dosage of the drug. Many of the reported alleged adverse reactions to nifedipine are linked to its primary pharmacologic action - vasodilatation. Therefore in 15 patients with angina pectoris we studied the relation between nifedipine concentration in the plasma and its clinical effects. Although in individual patients an increase in daily dose from 30 to 50 mg was followed by increased plasma levels and cessation of anginal attacks, no "therapeutic plasma range" could be delineated. Similarly, although some patients developed a headache when relatively high levels were measured, these levels still overlapped with those found in asymptomatic patients.

Adult↗
PubMed1981

Relationship between ventricular arrhythmias detected by ambulatory ECG monitoring and subsequent sudden cardiac death.

During the years 1971-1974, ambulatory ECG monitoring (AEM) during everyday activities was done in 888 consecutive subjects. Half of them were patients who suffered from chronic ischemic heart disease (IHD), while in the others no symptoms or signs of this disease were found. Ventricular arrhythmias (VA) were detected in 196 subjects of the former and in 190 of the latter group. The Bureau of Statistics provided information concerning the individuals who died before December 31, 1976, the cause of their death and whether or not the death occurred in hospital or was 'sudden'. We found that during the follow-up period, the rate of sudden cardiac death among the patients with IHD in whom AEM detected VA was higher than in subjects without VA. In the former group, there were 12 sudden cardiac deaths among 196 patients, while in the latter there were only 4 out of 248, a statistically significant difference. Sudden cardiac death was more frequent in individuals without IHD if AEM disclosed VA (4 sudden cardiac deaths among 190 subjects), as compared to individuals without VA (no sudden cardiac deaths among 254 subjects).

Adult↗
PubMed1981

Coexistence of pheochromocytoma and renal artery occlusion in a patient with malignant hypertension.

A patient with malignant hypertension due to the simultaneous occurrence of pheochromocytoma and renal artery occlusion is described. The pheochromocytoma was resected, but hypertension persisted postoperatively and significant renovascular disease was observed. The blood pressure returned to normal after nephrectomy. The possible pathogenetic link between the two conditions is discussed, and a therapeutic approach is suggested.

Adrenal Gland Neoplasms↗
PubMed1980

Electrocardiographic characteristics of neurocirculatory asthenia during everyday activities.

We describe the electrocardiographic changes during everyday activities recorded by ambulatory electrocardiographic monitoring in 67 patients with neurocirculatory asthenia. The findings were compared with the results of ambulatory monitoring in 33 healthy controls. We observed episodes of sinus tachycardia > 120/min unrelated to effort in 60 of the patients, 35 had frequent episodes of pronounced sinus arrhythmia, 16 showed transient ST depression, and six transient ST elevation. All these changes appeared during the patients' routine activities, without any unusual exertion and frequently at rest. Periods of sinus tachycardia and sinus arrhythmia were recorded from the patients during sleep. Cardiac arrhythmias, especially ventricular premature beats, were also much more common in those with neurocirculatory asthenia than in the control subjects. These findings indicate that ambulatory electrocardiographic monitoring provides important information on the electrocardiographic characteristics of patients with neurocirculatory asthenia and helps to establish this diagnosis in obscure cases.

Activities of Daily Living↗
PubMed1980

Glycogenic acanthosis of the esophagus. A benign but confusing endoscopic lesion.

During 160 consecutive fiberoptic endoscopic examinations, glycogenic acanthosis was diagnosed in 24 patients. The endoscopic diagnosis was confirmed histologically in the first 14 patients from whom biopsies were obtained. No correlation with any other disease affecting the gastrointestinal tract was found including reflux esophagitis. This common benign condition must be differentiated from lesions of similar appearance and more important prognostic significance.

Biopsy↗