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Dyachenko P, Ziv M, Rozenman D. Epidemiological and clinical manifestations of patients hospitalized with brown recluse spider bite. J Eur Acad Dermatol Venereol 2006; 20:1121-5. [PMID: 16987269 DOI: 10.1111/j.1468-3083.2006.01749.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Necrotic arachnidism represents a common health problem and standard treatments are usually safe and effective. OBJECTIVE The aim of this study was to review documented Loxosceles species spider envenomations and identify the natural history of affected patients. METHODS A retrospective single-centre study included 52 patients with necrotic arachnidism hospitalized in the dermatology department between 1997 and 2004. We examined the relationship between the epidemiological, clinical and laboratory parameters and degree of lesion severity, length of hospitalization and time to complete healing. RESULTS The bites occurred predominantly in rural areas, 67% between April and August. Only 35% of the patients sought medical care within 24 h post bite. Most bites were of the extremities (67%). Time to complete healing ranged from 14 days to more than 8 weeks (mean, 4.8 weeks). A marked relationship was found between age, comorbidities, lesion severity and time to complete healing (P < 0.01). Duration of hospitalization was significantly longer in patients with severe thigh lesions (P < 0.02). CONCLUSIONS Loxosceles species spider bites frequently induce necrotic, slowly healing ulcers on the fatty areas of the body. Early, appropriate systemic therapy may provide clinical benefit.
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Dodiuk-Gad R, Ziv M, Loven D, Schafer J, Shani-Adir A, Dyachenko P, Rozenman D. Sister Mary Joseph's nodule as a presenting sign of internal malignancy. Skinmed 2006; 5:256-8. [PMID: 16957443 DOI: 10.1111/j.1540-9740.2006.04826.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
CASE 1: A 64-year-old, otherwise healthy woman was referred to the surgery clinic for a presumed umbilical hernia. On physical examination, a cutaneous nodule was noted on the umbilical region and the patient was referred to the dermatology clinic. The patient was reexamined and an erythematous nodule was observed in the umbilicus measuring 2.5 cm in diameter. The patient denied pain, change in bowel habits, or weight loss. There were no other abdominal masses, no sign of ascites, and no regional lymphadenopathy. A skin biopsy from the nodule showed mucinous adenocarcinoma. Immunohistochemical staining was positive for carcinoembryonic antigen, and negative for cytokeratin (CK)7 and CK20. These results were consistent with a Sister Mary Joseph's nodule and led to the diagnosis of an occult colon carcinoma. The patient had no risk factors for colorectal carcinoma. The patient underwent surgery in another hospital, and died 3 months after the initial diagnosis of Sister Mary Joseph's nodule. CASE 2: A 73-year-old woman was referred to the dermatology clinic for evaluation of a painful, ulcerated, 3-cm lesion in the umbilicus (Figure 1). She was otherwise asymptomatic. A skin biopsy showed neoplastic glandular cells infiltrating among collagen bundles (Figure 2). Stainings for mucin and for CK7 were positive, while staining for CK20 was negative. An abdominopelvic CT scan demonstrated a 3.5-cm space-occupying lesion in the liver. Results of gastroscopy, colonoscopy, chest computed tomographic (CT) scan, and mammography were normal. Serum levels of the tumor-associated protein CA125 were elevated to 164 units, while those of CA 19-9 and carcinoembryonic antigen were within normal range. A gynecologic examination and a transvaginal ultrasound were normal. The patient had no personal or family history of any malignancy or any risk factors for developing a carcinoma. The patient was scheduled for a palliative resection of the umbilical nodule, combined with a laparoscopic inspection in search of the undetected primary tumor. She refused surgery and was lost to follow-up. She died 4 months after the initial diagnosis of umbilical metastasis. CASE 3: A 51-year-old man was aware of a silent mass in his umbilicus for 2 years without seeking medical advice. Following 2 weeks of increasing pain in this area, he was referred to the emergency room for a suspected incarcerated umbilical hernia. Surgery revealed a mass attached to the fascia and peritoneal fat. The mass was removed and diagnosed as a poorly differentiated adenocarcinoma, staining positively for carcinoembryonic antigen, and negatively for CK20, CK7, prostate-specific antigen, and prostatic acid phosphatase. Both gastroscopy and colonoscopy failed to detect the primary tumor. An abdominopelvic CT scan was normal, but a CT scan of the chest disclosed a nodule measuring 2.5 x 1.5 cm in the lower lobe of the right lung. On bronchoscopy, it was found to be an invasive adenocarcinoma, consistent with a primary tumor of the lung. The patient was a heavy smoker (45 pack-years). The patient received 4 cycles of combined chemotherapy with carboplatine and gemcitabine, with no improvement. A month later, the patient complained of abdominal pain. Following demonstration of intra-abdominal spread of disease by CT scan, a second line chemotherapy was instituted with paclitaxel. A month later the patient's condition deteriorated and he complained of cough, sweating, and pain along the right leg. A bone scan revealed bone metastases in the right femur and left tibia. Two weeks later he was admitted to the hospital with intestinal obstruction and underwent laparotomy. He had massive intra-abdominal spread of cancer and ascites. Only a palliative colostomy was performed. The patient died 3 weeks later, 9 months after the diagnosis of adenocarcinoma of the lung. The clinical data on the three patients are summarized in Table I.
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Davidovici BB, Pavel D, Cagnano E, Rozenman D, Halevy S. Acute generalized exanthematous pustulosis following a spider bite: Report of 3 cases. J Am Acad Dermatol 2006; 55:525-9. [PMID: 16908368 DOI: 10.1016/j.jaad.2006.05.010] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2006] [Revised: 05/04/2006] [Accepted: 05/05/2006] [Indexed: 11/22/2022]
Abstract
Acute generalized exanthematous pustulosis (AGEP) is a rare severe cutaneous adverse reaction caused mostly by drugs. Three of 22 AGEP cases (13.6%), recruited by us as part of two prospective multinational studies, occurred 24 to 48 hours after a spider bite. We suggest that a spider bite is a possible trigger for AGEP.
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Dyachenko P, Rozenman D, Bennett M. Unusual skin and testicular lesions in a patient with CMML. Eur J Intern Med 2006; 17:290-1. [PMID: 16762782 DOI: 10.1016/j.ejim.2005.09.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2005] [Revised: 09/23/2005] [Accepted: 09/30/2005] [Indexed: 11/18/2022]
Abstract
Chronic myelomonocytic leukemia (CMML) is a clonal disorder of hematopoetic stem cells with myelodysplastic and myeloproliferative features. Skin infiltration by leukemic cells is rare in CMML. A case is presented with severe dermatological involvement and concomitant testicular infiltration. An unusual feature was the evidence that the skin was the primary site of an acute leukemic transformation.
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Abstract
BACKGROUND Uremic pruritus is one of the most common disabling problems in patients with chronic renal failure. Few studies have evaluated itching and cutaneous manifestations in hemodialysis-dependent patients. OBJECTIVES The aim of this prospective study was to identify the prevalence of pruritus and cutaneous changes affecting patients undergoing hemodialysis. METHODS The degree of itching in 70 patients treated at the Haemek Medical Center Hemodialysis Unit, in northern Israel, was scored according to presence and severity. We examined the relationship between the quality of dialysis and the frequency of pruritus, and identified concurrent cutaneous disorders. RESULTS Pruritus was a common problem in the study cohort and affected 74.3% of hemodialysis patients at some point. The main characteristics of pruritus were a general pattern in 65.7% and mild intensity in 78.3% of observed patients. Duration of hemodialysis varied between 3 months and 13 years. There was no correlation between occurrence of pruritus and demographic or medical parameters (sex, type of kidney disease, regular medications or duration of hemodialysis) of the patients. Higher dialysis efficacy, as expressed by dialyser clearance, volume distribution of area, dialysis duration (Kt/v), may reduce the prevalence of pruritus (P < 0.02). None of the blood and chemical values considered (hemoglobin, creatinine, urea, phosphorus, calcium, albumin, parathormone and alkaline phosphatase) revealed any statistically relevant differences between pruritus groups. The appearance of foot ulcers was different between diabetic and nondiabetic individuals undergoing hemodialysis (P < 0.001). CONCLUSIONS Pruritus is still a common problem in hemodialysis-dependent patients. The prevalence of xerosis and excoriations was high in patients undergoing replacement therapy. Efficient replacement hemodialysis may provide a clinical benefit.
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Dodiuk-Gad RP, de Morentin HM, Schafer J, Harel A, Neudorfer M, Misonzhnik F, Gitstein G, Rozenman D, Tur E, Brenner S. Minocycline-induced cutaneous hyperpigmentation: confocal laser scanning microscope analysis. J Eur Acad Dermatol Venereol 2006; 20:435-9. [PMID: 16643143 DOI: 10.1111/j.1468-3083.2006.01436.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Minocycline has a characteristic yellow-green fluorescent emission. This fluorescence has been previously demonstrated only in type 1 minocycline-induced skin hyperpigmentation. OBJECTIVE To investigate whether the fluorescence can be detected in other types of minocycline-induced cutaneous hyperpigmentation, and to study the possible mechanisms. METHODS Biopsies of pigmented and nonpigmented skin from 3 patients with different types of skin hyperpigmentation induced by minocycline were analysed by light microscopy and Confocal Laser Scanning Microscope (CLSM). RESULTS A yellow-green fluorescence was observed in the hyperpigmented skin of two patients with type 2, and one patient with type 4 minocycline-induced cutaneous hyperpigmentation. No fluorescence was detected in the non-pigmented skin. CONCLUSION Minocycline can possibly serve as a fluorescent probe in the diagnosis of all types of minocycline-induced cutaneous hyperpigmentation.
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Dyachenko P, Ziv M, Raz R, Chazan B, Lev A, Rozenman D. Cat scratch disease encephalopathy in an immunocompetent patient. Eur J Intern Med 2005; 16:610-1. [PMID: 16314249 DOI: 10.1016/j.ejim.2005.04.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2005] [Revised: 03/31/2005] [Accepted: 04/25/2005] [Indexed: 10/25/2022]
Abstract
Cat scratch disease (CSD) is typically a self-limited regional lymphadenopathy in children and young adults that is caused by Bartonella henselae. The majority of CSD cases resolve spontaneously; however, many systemic complications have been described. We report an unusual case of CSD presenting as an epitrochlear arm mass and complicated by encephalopathy. Identification of B. henselae DNA in the affected lymph node and cerebrospinal fluid confirmed the diagnosis of CSD. Systemic antibiotic therapy was administered and the patient improved without any neurological deficit.
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Shani-Adir A, Kamil S, Rozenman D, Schwartz E, Ramon M, Zalman L, Nasereddin A, Jaffe CL, Ephros M. Leishmania tropica in northern Israel: A clinical overview of an emerging focus. J Am Acad Dermatol 2005; 53:810-5. [PMID: 16243129 DOI: 10.1016/j.jaad.2005.07.026] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2005] [Revised: 07/06/2005] [Accepted: 07/09/2005] [Indexed: 11/24/2022]
Abstract
BACKGROUND In Israel, most cutaneous leishmaniasis (CL) is caused by Leishmania major. Recently a new focus of CL caused by Leishmania tropica has been described in Tiberias and the surrounding area of northern Israel. OBJECTIVE The aim of this study was to evaluate clinical (size, number, location, and type of lesion) and laboratory (culture and polymerase chain reaction [PCR] analysis) parameters at diagnosis, response to treatment, and outcome of patients with CL due to L tropica. METHODS Between September 2002 and March 2004, patients with direct smear-confirmed CL were evaluated; clinical records were reviewed and a telephone survey was performed. RESULTS Forty nine patients, 34 (69%) male and 15 (31%) female, were studied. Mean age was 31.1 years (median 26 years, range 1-70); 76% of patients live in Tiberias and the surrounding area. The mean number of lesions was 2.6 (median 2, range 1-10). Lesions were commonly located on the face (61%) and upper limbs (57%). PCR analysis was performed in 27 patients and was positive for L tropica in 26. Fifty percent of patients studied received multiple therapeutic regimens because of incomplete response or treatment failure. Topical paromomycin was used in 44 patients (90%), with a complete response reported in only 17 (39%); of the 9 patients treated with intralesional sodium stibogluconate, a complete response was reported in 6 (67%); of the 5 patients treated with intravenous sodium stibogluconate, 4 (80%) were cured. LIMITATIONS The relatively small number of patients studied combined with the fact that some were assessed retrospectively limit our conclusions. In addition, 50% of the patients studied received multiple therapeutic regimens because of failure of, or incomplete responses to, their initial therapy, thereby making comparisons difficult. CONCLUSIONS The cure rate in those completing a course of antimony therapy, either 10 or more days of intravenous therapy or therapy administered intralesionally, was 75% (95% confidence interval [CI], 50.5-99.5%) as compared with 45% (95% CI, 28.9-60.5%) among those completing at least 10 days of topical paromomycin. To date, no standardized, simple, safe, and highly effective regimen for treating L tropica exists. Large, controlled clinical trials to evaluate current treatment regimens as well as new medications for CL, and especially CL attributed to L tropica, are urgently needed.
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Dyachenko P, Ziv M, Kamil S, Dodiuk-Gad R, Chazan B, Rozenman D. Bullous haemorrhagic cellulitis caused by Enterobacter cloacae. J Eur Acad Dermatol Venereol 2005; 19:763-4. [PMID: 16268890 DOI: 10.1111/j.1468-3083.2005.01246.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Guttman-Yassky E, Kra-Oz Z, Dubnov J, Friedman-Birnbaum R, Segal I, Zaltzman N, Roth T, Schwartz F, Linn S, Rozenman D, David M, Silbermann M, Barchana M, Bergman R, Sarid R. Infection With Kaposi’s Sarcoma–Associated Herpesvirus Among Families of Patients With Classic Kaposi’s Sarcoma. ACTA ACUST UNITED AC 2005; 141:1429-34. [PMID: 16301390 DOI: 10.1001/archderm.141.11.1429] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Classic Kaposi's sarcoma (CKS) primarily affects elderly Mediterranean or Eastern European men. Incidence rates of CKS in Israel are among the world's highest. In practically all cases, antibodies against Kaposi's sarcoma-associated herpesvirus (KSHV) can be detected. A relatively high seroprevalence rate of KSHV in Israel generally correlates with the incidence of CKS. A sexual mode of virus transmission is recognized among homosexual men, whereas the precise transmission routes in the heterosexual population and those with CKS are still unclear. OBJECTIVE To better assess the transmission routes of KSHV in Israeli patients with CKS and their first-degree relatives as compared with a control group. DESIGN Serum was collected from all study participants and tested for KSHV antibodies by means of latent and lytic immunofluorescence assays. An open reading frame 65 (ORF65) Western blot assay was applied as a confirmatory tool. SETTING Three dermatological departments in Israel. PATIENTS Sixty-four Jewish patients with CKS, 143 of their first-degree relatives, and 186 hospital-based control subjects. RESULTS Seropositivity to KSHV was detected in 62 (96.9%) of the patients with CKS, in 56 (39.2%) of their first-degree relatives, and in only 21 (11.3%) of the hospital controls (P<.001). The specific relationship with the index patient (spouse, offspring, or sibling) had no significant effect on the prevalence of serpositivity in the family members. CONCLUSION Our serologic evidence of familial clustering of KSHV infection suggests a predominantly nonsexual horizontal transmission route of the virus.
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David M, Tsukrov B, Adler B, Hershko K, Pavlotski F, Rozenman D, Hodak E, Paltiel O. Actinic damage among patients with psoriasis treated by climatotherapy at the Dead Sea. J Am Acad Dermatol 2005; 52:445-50. [PMID: 15761422 DOI: 10.1016/j.jaad.2004.11.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Dead Sea climatotherapy is highly effective in the treatment of psoriasis. However, its potential side effects, especially the risk of skin cancer, are unclear. OBJECTIVE We sought to determine the prevalence of solar damage and skin cancer among patients with psoriasis who underwent Dead Sea climatotherapy compared with control patients. METHODS This multicenter controlled cross-sectional study was carried out at the Dead Sea Solarium Clinic and outpatient clinics of the participating centers. A total of 1198 participants (460 patients with psoriasis and 738 control patients) aged 20 to 70 years were included. A standard questionnaire including demographic parameters and sun exposure habits was administered to all participants. Patients were questioned about previous psoriatic treatments and climatotherapy at the Dead Sea. All participants underwent a structured physical examination of the skin. We compared the prevalence of solar damage for patients with psoriasis and control patients and assessed the extent of photodamage among patients with psoriasis according to exposure time at the Dead Sea in univariate and multivariate analyses. RESULTS Elastosis ( P < .001), solar lentigines (P = .03), poikiloderma (P < .001), and facial wrinkles (P < .001) were significantly more common among patients with psoriasis compared with control patients and showed a dose response with increased Dead Sea exposure time. Self-reported previous skin cancers were more common in control patients compared with patients with psoriasis (8.2% vs 3.5%, P = .002), however, the prevalence of nonmelanoma skin cancer on examination did not differ between the two groups. No cases of malignant melanoma were detected in either group. CONCLUSIONS Dead Sea climatotherapy is not associated with an increased risk of malignant melanoma or nonmelanoma skin cancer for patients with psoriasis in Israel. However, UV exposure at the Dead Sea may play a role in the development of solar damage.
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Chazan B, Colodner R, Polacheck I, Shoufani A, Rozenman D, Raz R. Mycetoma of the foot caused by Cylindrocarpon lichenicola in an immunocompetent traveler. J Travel Med 2004; 11:331-2. [PMID: 15544718 DOI: 10.2310/7060.2004.19110] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Cylindrocarpon is a cosmopolitan soil fungus, which rarely causes human disease. It has infrequently been reported as causing keratitis, mycetoma, osteomyelitis and peritonitis in chronic peritoneal ambulatory dialysis patients and disseminated infection in leukemic neutropenic hosts. This report describes a case of invasive infection caused by Cylindrocarpon lichenicola, localized in the right foot of an otherwise immunocompetent traveler.
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Glickman YA, Filo O, David M, Yayon A, Topaz M, Zamir B, Ginzburg A, Rozenman D, Kenan G. Electrical impedance scanning: a new approach to skin cancer diagnosis. Skin Res Technol 2003; 9:262-8. [PMID: 12877689 DOI: 10.1034/j.1600-0846.2003.00022.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND/AIMS Skin cancer diagnosis depends, to a great extent, on visual inspection and histopathological examination of excised tissues. The aim of this study is to evaluate the ability of electrical impedance scanning to differentiate between benign and malignant skin lesions. METHODS A preclinical study was conducted on 40 nude mice injected subcutaneously with a human melanoma strain. Impedance measurements were recorded every week to correlate electrical changes with tumor growth and histological findings. A clinical study was also performed on 178 human suspicious skin lesions before excision. The impedance measurements were correlated to the histopathological results. RESULTS Normalized conductivity and capacitance, recorded on growing skin tumors in nude mice, were shown to change relative to lesion size. Necrosis, present in most of the larger lesions, was associated with a decrease in the electrical conductivity. Similar electrical parameters were used to classify human melanoma lesions with 92% sensitivity and 67% specificity. In addition, four out of five BCC lesions were correctly diagnosed. Moreover, dysplastic lesions were diagnosed with 91% sensitivity and 59% specificity. For comparison, physicians diagnosed melanoma lesions with 75% sensitivity and 87% specificity and dysplastic lesions with 46% sensitivity and 80% specificity. CONCLUSIONS The animal study showed that electrical impedance measurements reflect morphological changes related to the growth of a cancerous skin lesion. These findings are in agreement with a preliminary clinical study. Electrical Impedance Scanning can therefore be considered as an objective and non-invasive tool for differentiation between benign and malignant skin lesions.
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Grempel H, Rozenman D, Zuckerman F. [Herpes zoster treated with acyclovir]. HAREFUAH 1994; 126:380-3, 426. [PMID: 8200584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
During the past 5 years, 99 patients with herpes zoster were hospitalized and followed. Age, sex, localization of rash, complications, duration of hospitalization and treatment were analyzed. Most patients were in their 6th and 7th decades. Cranial nerve involvement was frequent (35%). A generalized rash was more common in those with immunodeficiency. Acyclovir (Zovirax) inhibited to some extent the spreading of the rash and reduced the frequency of herpetic neuralgia. Our findings are in accord with those in the literature.
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Dgani R, Rozenman D, Lifschitz-Mercer B. Granulosa cell tumor arising in an ovary with mature cystic teratoma. Int J Gynaecol Obstet 1993; 41:287-9. [PMID: 8102994 DOI: 10.1016/0020-7292(93)90562-b] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Rozenman D, Fradis M, Podoshin L. Hereditary angioneurotic edema--an often misdiagnosed entity. EAR, NOSE & THROAT JOURNAL 1991; 70:254-5. [PMID: 1874160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Ohana N, Keness J, Verner E, Raz R, Rozenman D, Zuckerman F. Skin-isolated, community-acquired Staphylococcus aureus: in vitro resistance to methicillin and erythromycin. J Am Acad Dermatol 1989; 21:544-6. [PMID: 2789236 DOI: 10.1016/s0190-9622(89)70223-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
During a 10-month period, skin culture specimens were taken from 1680 healthy outpatients with a variety of community-acquired skin infections. Staphylococcus aureus was found in 1035 (61.6%) of these patients. In vitro resistance to methicillin and erythromycin was 1.0% and 42.9%, respectively. Resistance rates to erythromycin in patients with furunculosis and impetigo were 51.5% and 26.2%, respectively (p less than 0.001). The emergence of erythromycin-resistant strains may be the result of widespread use of this drug in our geographic area. There is also the possibility that certain bacteriologic features associated with erythromycin resistance may foster the development of furunculosis.
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Blickstein I, Lancet M, Rozenman D, Nissim F. Isolated necrosis of the tubal fimbriae in a prepubertal girl. ZEITSCHRIFT FUR KINDERCHIRURGIE : ORGAN DER DEUTSCHEN, DER SCHWEIZERISCHEN UND DER OSTERREICHISCHEN GESELLSCHAFT FUR KINDERCHIRURGIE = SURGERY IN INFANCY AND CHILDHOOD 1989; 44:172-3. [PMID: 2750345 DOI: 10.1055/s-2008-1043229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A report of haemorrhagic necrosis of the tubal fimbriae in a prepubertal girl is presented. The presumptive aetiology for this is the isolated torsion of the fimbrial end which, to the best of our knowledge, has not been previously described. A high index of suspicion of torsion and early intervention is emphasised. Laparoscopy should usually precede laparotomy in doubtful cases but during laparotomy as little as possible should be done in order to retain future fertility.
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Borenstein R, Shoham Z, Yemini M, Barash A, Fienstein M, Rozenman D. Tamoxifen treatment in women with failure of clomiphene citrate therapy. Aust N Z J Obstet Gynaecol 1989; 29:173-5. [PMID: 2803130 DOI: 10.1111/j.1479-828x.1989.tb01711.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Fourteen pregnancies were achieved with tamoxifen therapy in 12 women who failed to conceive with clomiphene citrate. There were no side-effects and fewer treatment cycles were required than with clomiphene citrate treatment. Ovulation and cervical score with tamoxifen therapy were significantly higher (p less than 0.005).
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Dgani R, Rozenman D, Shoham Z, Lancet M, Nissim F, Pfeffermann R, Levy E, Shani A. Ovarian malignancies in pregnancies complicated by colonic perforation. ISRAEL JOURNAL OF MEDICAL SCIENCES 1988; 24:241-4. [PMID: 2837441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Primary or secondary ovarian carcinoma in pregnancy is very rare. The entity is difficult to diagnose and is not infrequently fatal. Two unusual cases of ovarian carcinoma during pregnancy, complicated by perforation of the colon, are described. Treatment depends upon the time of diagnosis, the stage of growth, and possible complications. More attention should be paid to complaints concerning bowel function during pregnancy, and pelvic sonography and bowel studies may enable earlier diagnosis.
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Rozenman D, Eliraz A, Lancet M. [Sexual function in asthmatic women]. HAREFUAH 1987; 112:121-3. [PMID: 3609930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Kessler I, Lancet M, Appelman Z, Rozenman D. [Juvenile metrorrhagia]. HAREFUAH 1985; 108:169-72. [PMID: 4007659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Abstract
A 15-year-old boy with onchocerciasis had severe generalized pruritus of five months' duration. He had been born and raised in Ethiopia and had emigrated to Israel one year earlier. A biopsy specimen of an area of depigmentation on the right thigh disclosed microfilaria of Onchocerca volvulus in the dermis. The discovery of an unusual disease in a nonendemic area is an example of the increased complexity of differential diagnosis resulting from the ease of travel from one geographic region to another.
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