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Biomedical subjects

A Levy

Publications and source records attributed to A Levy.

At least 199 records · Page 11Linked to original sources
PubMed1995

[Misdiagnosis and labeling in psychiatry and their consequences: Part II].

The complexity of arriving at a correct psychiatric diagnosis in cases in which physical and mental disorders are interrelated is discussed. A case is presented in which a psychiatric diagnosis had been made and malingering suspected, although the patient actually had a severe neurological disorder. The psychiatric diagnosis had not been changed despite recurrent medical and psychological examinations which clearly indicated a physical disorder. The difficulties that follow misdiagnosing organic disorders as psychiatric disorders are illustrated. Various aspects of the effects of psychiatric misdiagnosis on functional, legal and civil aspects of life are discussed. Emphasis is given to the problems facing those discharged from military service for medical reasons, especially mental disorders. Important measures are currently being applied to overcome some of these problems. It is strongly emphasized that there is need for greater openness and tolerance among psychiatrists when making psychiatric diagnoses.

Adult↗
PubMed1995

The future of forensic psychiatry: the suggested Israeli model.

The expansion of knowledge in medicine lead to the emergence of specialties and to sub-specialties limited in breadth and expanded in depth. The increasing health-care costs created a three-level model: general mental health workers (general practitioners and non-psychiatric mental health professionals), primary psychiatrists and the subspecialist experts. The paper defines forensic psychiatry as a subspecialty, describes its development and the pros and cons concerning its independent existence. We describe the state of forensic psychiatry in Europe and in Israel. In Israel there are no binding rules regulating the forensic services. The first steps of professional development were taken in the late 1980s by introducing lectures in forensic psychiatry at the Tel Aviv University, creating the Forum of District Psychiatrists and founding the Israeli Forensic Psychiatry Association. We discuss the problematic relationship of law and psychiatry. Most of the requirements for making forensic psychiatry an independent discipline have already been fulfilled in Israel. In order to gain full formal acknowledgement we have to establish appropriate recruitment, licensing and training procedures. The authors present five different models concerning the training of forensic psychiatrists, and describe in details the model chosen by the Forensic Psychiatric Association to be submitted for approval to the Medical Association.

Cross-Cultural Comparison↗
PubMed1995

New subordinate psychiatric legislation in Israel.

The 1991 Mental Health Act left considerable scope for the promulgation of regulations, which were indeed enacted a year later, in 1992. The 1992 regulations are analysed here. The innovations and improvements introduced, as well as the problems and difficulties created by the regulations are discussed. It is vital to review and revise psychiatric legislation constantly.

Commitment of Persons with Psychiatric Disorders↗
PubMed1995

Stigma, labelling and psychiatric misdiagnosis: origins and outcomes.

The sources and consequences of inaccurate psychiatric diagnosis are discussed. The philosophy of the DSM diagnosis system is described, and the hazards of the practice of labelling together with its resulting social stigma are explored. The dangers and complications of psychiatric misdiagnosis are illustrated with a case example. Recommendations are made for extreme caution to be exercised in the making of psychiatric diagnoses and the need to revise misdiagnoses is strongly emphasized.

Adult↗
PubMed1995

The response of "de novo" Parkinson's disease patients to bromocriptine in a "low and slow" regimen is predictive for prognosis.

It is possible that Bromocriptine only determines a complete antiparkinson effect in a subset of P.D. patients that have a good dopaminergic reserve. Our study intent to demonstrate that a good short-term response to Bromocriptine used in a "low and slow" regimen is a marker of long term good prognosis. We studied a series of 36 sequential "de novo" P.D. patients treated with Bromocriptine in a "low and slow" regimen. The principal end-point was the introduction of Levodopa. "Good prognosis" was defined as no need of Levodopa until five years of follow-up. An improvement greater than 33% in the Columbia rating scale, at the 6th month of treatment, was the cut-off point to decide that a patient had a good short term response to Bromocriptine. Nine patients fulfilled the criteria for being good short term responders. Multiple regression analysis showed that this outcome could not be predicted by the clinical characteristics of the patients at admission. The sensitivity and the specificity of the short term response to Bromocriptine to predict a good prognosis were 70% and 90.5% respectively. We conclude that Bromocriptine in monotherapy is an efficient antiparkinson agent in 1/3 of "de novo" P.D. patients and good short term response to Bromocriptine is an acceptable marker for a good prognosis. Therefore it is possible that the response to Bromocriptine is a discriminator for a subset of P.D. patients in the early phases of the disease.

Adult↗
PubMed1994

Yeast artificial chromosome and radiation hybrid map of loci in chromosome band 8p22, a common region of allelic loss in multiple human cancers.

Polymorphic alleles at loci such as LPL (lipoprotein lipase) and MSR (macrophage scavenger receptor) in chromosome band 8p22 are frequently lost during the genesis of several types of human cancer, including colorectal, non-small cell lung, hepatocellular, and prostatic carcinomas. A physical map of 31 published or novel probes and sequence-tagged sites in this genetic region was constructed using a radiation hybrid panel and the CEPH (Centre d'Etude du Polymorphisme Humain) yeast artificial chromosome (YAC) library. Thirty-six overlapping YACs defined a physical order for the following polymorphic markers: tel-D8S26-D8S511-D8S549-MSR-D8S254-D8S233- D8S261-D8S21-LPL-D8S258-cen. These maps unify small consensus regions of allelic loss on chromosome 8p defined by restriction fragment length polymorphisms with more informative PCR-based polymorphisms and widely available YAC mapping resources.

Alleles↗
PubMed1994

The effects of long-term corticosterone administration on hippocampal morphology and cognitive performance of middle-aged rats.

The main objective of this research was to study the relationship between glucocorticoids, aging and the deterioration of cognitive functions. Towards this end, an attempt was made to develop an animal model which will enable the investigation of such interactions, using subcutaneously implanted sustained-release corticosterone pellets. The goal was to achieve moderately high concentrations of corticosterone in plasma, comparable to the peak basal levels or to those found under mild stress. Middle-aged (12 months old) Fischer-344 rats, used in this study, were divided before the prolonged hormonal treatment into cognitively 'impaired' and 'non-impaired' groups using the Morris water maze. The cognitive impairment, which was induced by the long-term corticosterone administration, was exhibited during acquisition of the 8-arm radial maze only in the 'non-impaired' group. Behavioral scores for drug-treated 'impaired' rats were not statistically different from those of the placebo-treated 'impaired' group. The morphological deterioration in hippocampal areas of the brain was quantified and revealed high correlation with the behavioral data. This animal model may become extremely useful in testing projected prophylactic therapy against the brain damage and cognitive deficits induced by the high corticosteroid-aging combination.

Aging↗
PubMed1994

A new strategy for prolonging xenograft survival.

A new strategy based on a clonal reduction hypothesis has been developed for prolonging concordant cardiac xenograft survival. Splenocytes from Golden Syrian hamsters were transfused intravenously into Lewis rats 14 days before the time of a donor-specific heart transplant into the recipient. Cyclophosphamide was administered from days -11 to -7 to reduce or eliminate proliferating xenoreactive clones. Low dose CsA was administered after the cyclophosphamide to prevent emergence and expression of xenoreactive cells. Finally, rapamycin 1.0 mg/kg was given for 5 days after transplant as further immunosuppression since it acts synergistically with CsA. In the group that received no immunosuppression after day +8, mean graft survival was 33.2 +/- 7.0 days with 10 of 17 xenografts surviving > 28 days. Extending either CsA therapy or rapamycin therapy after day +8 did not prolong graft survival. Each component of the therapy was found to be necessary for the effect.

Animals↗
PubMed1994

Aging, stress, and cognitive function.

Stress was implied as involved in "enhanced aging," and prolonged administration of corticosterone was claimed to lead to central neuronal lesions. This study describes an animal model that simulates the steroid elevation associated with stress by a continuous slow-release administration of corticosterone, in young (3 months old) and middle-aged (12 months old) Fischer 344 rats. Plasma concentrations of corticosterone were stable throughout the day, with no diurnal variation, within the range associated with mild stress. Corticosterone prolonged treatment resulted in morphological changes mainly in the CA1, CA4, and dentate gyrus areas of the hippocampus. Middle-aged rats showed higher vulnerability to the long-term COR treatment than young ones, even when COR treatment was prolonged in young rats from 63 to 90 days. Middle-aged rats were screened before the corticosterone treatment, using the Morris water maze, and divided between cognitively "impaired" and "nonimpaired" subpopulations. Severe cognitive damage during acquisition of the eight-arm radial maze was shown, after the continuous hormonal treatment, in rats initially defined as "nonimpaired" in the Morris water maze. This animal model might be useful for testing the protective effects of drugs against brain changes and cognitive damage, during either pathological or normal aging.

Aging↗
PubMed1994

Activation of specific ATP receptors induces a rapid increase in intracellular calcium ions in rat hypothalamic neurons.

We have used real-time dynamic video imaging of Fura-2 fluorescence to study the acute effects of external ATP on [Ca2+]i in cultured rat hypothalamic neurons. The addition of ATP at microM concentrations, but not adenosine, AMP, ADP or GTP, produced a rapid, dose-dependent increase in cytosolic Ca2+. The hydrolysis-resistant ATP analogues 3-thio-ATP and beta,gamma-imido-ATP produced a similar response but alpha,beta-methylene ATP had much lower efficacy. The ATP response was inhibited by 10 microM nifedipine, abolished by 50 microM cadmium and by the absence of extracellular Ca2+, but was unaffected by ryanodine or omega-conotoxin GVIA. The P2-purinoceptor antagonist suramin reversibly and selectively inhibited the ATP response but had no effect on other neurotransmitter-induced Cai2+ responses. Antagonists to muscarinic, nicotinic, NMDA, non-NMDA, GABA, 5-HT and adenosine receptors had no effect on the ATP response. Thus the Ca2+ response of hypothalamic neurons to ATP is mediated by specific suramin-sensitive ATP-receptors, activation of which is independent of ATP hydrolysis and results in an influx of extracellular Ca2+ largely through high voltage-gated Ca2+ channels. These findings support the assertion that ATP acts in the CNS as an excitatory neurotransmitter.

Adenosine↗
PubMed1994

A double-blind trial of carbamazepine in negative symptom schizophrenia.

Twenty-eight residual schizophrenics hospitalized in a chronic institution with a 9 to 30 year history of disease, with predominantly negative symptoms were given carbamazepine. Carbamazepine was administered in a double-blind trial and therapeutic effects were measured by the Scale for the Assessment of Negative Symptoms (SANS). Patients were also assessed for positive symptoms using the Brief Psychiatric Rating Scale (BPRS), for depression using the Hamilton Depression Scale, for extrapyramidal symptoms by the Simpson and Angus scale, to rule out these symptoms as sources of secondary negative symptoms. The study continued for 7 weeks with therapeutic carbamazepine levels achieved during the last 5 weeks. There was no significant positive effect of carbamazepine on negative symptoms.

Adult↗
PubMed1994

Loss of chromosome arm 8p loci in prostate cancer: mapping by quantitative allelic imbalance.

A previous study of 18 primary or metastatic prostate cancers showed loss of genetic markers on chromosome 8; 10, or 16 in more than 50% of cases [Bergerheim USR et al. (1991) Genes Chromosom Cancer 3:215-220]. The small size and infiltrative nature of primary prostatic tumors have hindered efforts to assess allelic losses by traditional restriction fragment length polymorphism (RFLP)/Southern blotting methods. To improve the sensitivity and specificity of this analysis in early prostate cancer, we have amplified polymorphic microsatellite repeats by polymerase chain reaction (PCR), and have quantitated allelic imbalances with phosphor imaging technology. In this study, 63 primary prostate tumors and matched benign tissues obtained by radical prostatectomy were examined at 28 genetic loci on chromosome 8, all but five of which were located on the short arm. Twenty-nine (46%) of the 63 cases showed loss of at least one locus. Multiple adjacent loci, usually including the LPL and MSR genes in 8p22, were lost in 28 cases. In 10 of these, losses were observed at all informative loci on the p arm. In another 15 tumors, losses were restricted to subregions of the p arm by loci retained either distally toward the p terminus or proximally at the 8p12-8p21 border, or both. In three tumors, two discrete regions of loss were observed within 8p, separated by several retained loci. Allelic loss of 8p loci was associated with higher tumor grade. These data are complementary to previous reports of allelic deletions in colorectal, hepatocellular, and non-small cell lung cancers and suggest the existence of one or more pleotropic tumor suppressor genes on 8p.

Alleles↗
PubMed1994

Morphological hippocampal changes during normal aging and their relation to cognitive deterioration.

Cognitive and memory capacities were assessed in two strains of rats of various age groups prior to histological evaluation of their brains. Male Wistar rats, at the age of 3, 12, 17 and 24 months, were tested using the 8-arm radial maze and male Fischer 344 rats, aged 3, 12 and 16 months, were tested in the Morris water maze. Significant memory impairments were found in both strains already at the age of 12 months in about 50% of the population. Morphological analysis of the brains revealed age-related structural changes in the hippocampal formation starting with the middle-age group. Degenerative CA1 and CA3 pyramidal cells characterized the hippocampus of cognitive-impaired rats, while non-impaired animals exhibited intact hippocampus irrespective of age. This characteristic was supported by quantitative morpho-analysis. The best correlation between the decrease of area or number of cells and working memory impairment was found for CA3 region in both strains. Age-related decline in the density of muscarinic receptors in Wistar rats' brain corresponded with the pattern of cognitive deficit. The results of the present study support the hypothesis which associates hippocampal integrity with normal memory function. It is concluded that chronological age by itself is not an adequate indicator of age-related brain alterations and individual evaluation of performance, based on behavioral scores, is recommended.

Aging↗