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Biomedical subjects

A Gottlieb

Publications and source records attributed to A Gottlieb.

117 records · Page 7Linked to original sources
PubMedDate not supplied

Phase II trial of ifosfamide and mesna in previously treated patients with non-Hodgkin's lymphoma: Cancer and Leukemia Group B study 8552.

Ifosfamide (1.25 g/m2 intravenously/day x 5) with mesna (20 per cent of the ifosfamide dose x six doses on each day of ifosfamide therapy) was administered to 46 previously treated patients with non-Hodgkin's lymphoma of which 31 were eligible and evaluable. A 29 per cent response rate (9/31) was observed (two CR and seven PR) with a median duration of response of 2.5 months. Myelosuppression was dose-limiting. Hemorrhagic cystitis was observed in three patients (10 per cent). Nausea and vomiting was generally mild or moderate. One patient developed transient neurotoxic symptoms with confusion and disorientation. An additional patient developed an anaphylactic-type reaction with shortness of breath and respiratory stridor during the fourth course of therapy. Ifosfamide, as a single agent, produces remissions of limited duration in non-Hodgkin's lymphoma in patients in second or third relapse.

Adolescent↗
PubMedDate not supplied

Treatment of gonorrhea with first- and second-generation cephalosporins and other new beta-lactam antibiotics.

Aqueous procaine penicillin, ampicillin, and amoxicillin have been used successfully in treatment of gonococcal infections for many years. Many of the new beta-lactam antimicrobial agents subsequently have proved effective for treating these infections as well. First-generation cephalosporins are less active (by weight) than second-generation cephalosporins, which, in turn, are less active than third-generation drugs. Single-dose therapy of uncomplicated mucosal gonococcal infections with first-generation cephalosporins has resulted in generally unacceptably low cure rates of less than 90% in most studies, whereas parenterally and orally administered second-generation cephalosporins show good clinical efficacy. Both second- and third-generation cephalosporins are active against beta-lactamase-producing Neisseria gonorrhoeae. The extended-spectrum and ureido-penicillins are active in vitro against non-beta-lactamase-producing N. gonorrhoeae and have parallel activity in vivo. Single doses of aztreonam, the first monobactam studied in humans, have also shown excellent clinical efficacy.

Anti-Bacterial Agents↗
PubMedDate not supplied

Recurrent herpes labialis in skiers. Clinical observations and effect of sunscreen.

Recurrent orofacial herpes infection may be triggered by high altitude skiing, presumably because of solar ultraviolet radiation exposure. Six (12%) of a group of 51 subjects with a history of skiing-triggered herpes observed during 1 week of high altitude skiing experienced reactivations of orofacial herpes a median of 3 1/2 days after exposure. Within this group, application of a sunscreen with a sun protection factor (SPF) of 15 failed to influence the reactivation rate as compared with a placebo. Reactivation of herpes triggered by skiing is common. As application of a sunscreen with an SPF of 15 did not appear to influence the reactivation rate, alternate approaches to the control of recurrent orofacial herpes are needed.

Adult↗
PubMedDate not supplied

Cheerleaders are athletes too.

The athletic demands of cheerleading are often overlooked. In order to identify risks and develop injury prevention plans for this population, cheerleaders must first be recognized as the athletes they are. Recommendations for specifics of the preparticipation physicals for cheerleaders are provided. The need for evaluation of their development, nutrition, and associated risk cannot be overstressed.

Adolescent↗
PubMedDate not supplied

The effect of posture on the induction of epidural anesthesia for peripheral vascular surgery.

BACKGROUND AND OBJECTIVES: A study was done to determine whether a difference existed in the quality and time to maximum anesthesia between the induction of lumbar epidural anesthesia in the sitting and supine position in patients undergoing infrainguinal arterial reconstruction. METHODS: An epidural catheter was inserted at L3-L4 in 40 patients who were randomly assigned to two groups. In group 1, with the patient sitting, 3 mL lidocaine 1.5% with 5 micrograms/mL epinephrine was given as a test dose, followed 3 minutes later by 12 mL bupivacaine 0.75% injected over 2 minutes through the catheter. After remaining in the sitting position for 5 minutes, the patient was placed supine and the quality of anesthesia assessed at 3-minute intervals for 30 minutes. Anesthesia was assessed by loss of sensation to pinprick and the Bromage scale for loss of motor function. In group 2, after placement of the catheter, the patient was immediately placed supine, the same doses of local anesthesia were given at the same time intervals as in group 1, and the onset of anesthesia was similarly assessed. In addition to a comparison between groups in the quality and time to maximum anesthesia, a correlation was sought between these variables and the age, weight, height, and body surface area (BSA) of the patients in each group. RESULTS: The demographically similar groups showed no difference in maximum cephalad spread of anesthesia (median, interquartile range; group 1: T4, T2.5-T6; group 2: T4, T2.5-T7), motor block (group 1: 3, 2-4; group 2: 4, 4-6), or time to maximum motor block (mean +/- SD; group 1, 17.4 +/- 8.7 minutes; group 2, 17.9 +/- 6.8 minutes). The time to maximum cephalad spread of anesthesia was shorter in group 1 (13.8 +/- 6.9 minutes; group 2, 18.6 +/- 6.6 minutes; P = .03). Neither the age nor weight of the patients in either group had any influence on the quality and time to maximum anesthesia. There was, however, a significant correlation between the height (r = 0.48, P = .0303) and BSA (r = 0.48, P = .0318) of the patients in group 1 and the time to maximum cephalad spread of anesthesia. CONCLUSIONS: When lumbar epidural anesthesia was induced in the sitting rather than supine position, the time to maximum cephalad spread was shorter and correlated directly with the height and BSA of the patient. The position of the patient during induction had no effect on the final level of cephalad spread and degree of motor block.

Age Factors↗
PubMedDate not supplied

Cardiac arrest caused by coronary spasm in two patients during recovery from epidural anesthesia.

BACKGROUND AND OBJECTIVES: In order to reduce the surgical stress on the heart, anesthesiologists frequently use regional anesthesia in patients with coronary artery disease. METHODS: Two patients underwent reconstructive peripheral vascular surgery under continuous epidural anesthesia with bupivacaine. During the surgery and later in the recovery room, they received continuous electrocardiographic (ECG), invasive arterial blood pressure, and oxyhemoglobin saturation monitoring. RESULTS: In both patients, the anesthetic course during surgery was uneventful, but while recovering from the anesthesia, they developed ECG changes consistent with myocardial ischemia, followed by malignant dysrhythmias and cardiac arrest. The clinical pictures, ECGs, coronary angiogram, and (in one patient) autopsy findings suggested coronary artery spasm as the cause of the malignant dysrhythmias and cardiac arrests. CONCLUSIONS: It is possible that the coronary spasms were caused by an altered balance between sympathetic and parasympathetic nervous activity during recovery from epidural anesthesia. Therefore, patients with coronary artery disease must be closely monitored for signs and symptoms of myocardial ischemia during the entire recovery period from epidural anesthesia.

Aged↗