Biomedical subjects

A Shupak

Publications and source records attributed to A Shupak.

78 records · Page 5Linked to original sources

PubMed1984

Hyperbaric oxygen therapy for gas gangrene casualties in the Lebanon War, 1982.

Four gas gangrene casualties from the Lebanon War, 1982, were treated with hyperbaric oxygen (HBO). Myonecrosis was diagnosed in three and intraabdominal spread of clostridial infection in one. In all four cases, HBO treatment, in combination with meticulous but conservative surgical debridements and proper antibiotic coverage, was begun within 24 h of diagnosis. HBO therapy was terminated when bacteriostasis was attained, as evidenced by no further spread of myonecrosis and the alleviation of systemic toxic symptoms. All four patients recovered from the clostridial infection, but one died later from other causes. HBO therapy enhances the survival rate of patients with gas gangrene, lowers the anesthetic risk, allows for maximal tissue preservation and helps avoid radical mutilating surgery.

Adolescent↗

PubMedDate not supplied

Congenital middle ear encephalocele initially seen with facial paresis.

Congenital middle ear encephalocele (CMEE) is a rare entity, previously reported in only 29 patients. It might originate from dehiscence of the tegmen tympani or antri or the bony plate of the posterior fossa. The common presenting symptoms are spontaneous cerebrospinal fluid (CSF) otorrhea and/or rhinorrhea, persistent "serious otitis media," conductive hearing loss, and, occasionally, recurrent meningitis. We report a case of CMEE initially seen with progressive facial paresis, review the previously reported cases of CMEE, and discuss the pathogenesis and surgical management.

Cerebrospinal Fluid Otorrhea↗

PubMedDate not supplied

Early hyperbaric oxygen therapy for retinal artery occlusion.

PURPOSE: To assess whether early hyperbaric oxygenation (HBO) treatment has a beneficial effect on visual results after retinal artery occlusion (RAO). METHODS: A comparative retrospective study in which medical records of all HBO-treated RAO patients in our department were reviewed and compared with matched RAO patients not treated by HBO (from a different medical center). Mean visual acuity (VA) at completion of treatment, the presence or absence of improvement in VA between admission and discharge, and the mean change in VA between admission and discharge were noted. All patients treated by HBO had treatment no later than 8 hours after the beginning of visual symptoms. RESULTS: Mean VA at discharge was 0.2981 (6/20) in the treated group and 0.1308 (6/46) in the control group (p < 0.03). In the treated group, 82.9% had an improvement in VA between admission and discharge, compared with 29.7% of the control group (p < 0.00001). Mean improvement in VA was 0.1957 in the treated group and 0.0457 in the control group (p < 0.01). Differences in outcome measures between treatment and control groups were found to reflect the difference between treated and untreated hypertensive patients. No difference was found between treated and untreated non-hypertensive patients. CONCLUSIONS: Early HBO therapy appears to have a beneficial effect on visual outcome in patients with RAO. Further large-scale prospective controlled studies are needed to confirm this.

Aged↗

PubMedDate not supplied

The vestibulo-ocular reflex (VOR) under the influence of cinnarizine.

In a double-blind, placebo controlled, crossover study, we evaluated the effects of cinnarizine on the VOR of 55 healthy young subjects. VOR was evaluated by the Sinusoidal Harmonic Acceleration (SHA) test at frequencies of 0.01, 0.02, 0.04, 0.08 and 0.16 Hz. There was a reduction in VOR gain in 16 of the 20 SHA trials performed under the influence of cinnarizine alone (25 mg and 50 mg) and cinnarizine 25 mg in combination with 10 mg domperidone or 1 transdermal scopolamine patch. This decrease in VOR gain was significant in only a few SHA trials. Phase lead was not consistently affected by cinnarizine. No notable side effects were found for any of the drug groups. Our findings are in accord with the contention that increased resistance to seasickness produced either by drugs, or by the natural process of habituation to sea conditions, may be reflected by a decrease in VOR gain.

Adult↗

PubMedDate not supplied

Clinical features of mal de debarquement: adaptation and habituation to sea conditions.

A survey conducted among 116 crew members of seagoing vessels confirmed that mal de debarquement (M-D) is a transient feeling of swinging, swaying, unsteadiness, and disequilibrium. None of the subjects requested medical attention, although there were isolated cases in which a strong sensation of swinging and unsteadiness caused transient postural instability and impaired the ability to drive. In most cases, the sensation of M-D appeared immediately on disembarking and generally lasted a few hours. In addition, subjects usually described bouts or attacks of M-D associated with changes in body posture, head position, or with closing of the eyes. M-D was reported by 72% of our subjects. Sixty-six percent of subjects reported a high incidence following their first voyages. A significant positive correlation was found between M-D and seasickness susceptibility. The nature of M-D may be explained within the framework of multisensorimotor adaptation and habituation to a new or abnormal motion environment. It is suggested that M-D represents a dynamic, multisensorimotor form of CNS adaptive plasticity.

Adaptation, Physiological↗

PubMedDate not supplied

The vestibulo-ocular reflex and seasickness susceptibility.

VOR parameters were compared in subjects at the extremes of the seasickness susceptibility scale. Thirty-nine subjects highly susceptible to seasickness and 30 nonsusceptible subjects participated in the study. The VOR was evaluated by the Sinusoidal Harmonic Acceleration (SHA) test at frequencies of 0.01, 0.02, 0.04, 0.08, and 0.16 Hz. In subjects susceptible to seasickness, VOR gain was significantly higher at 0.02 and 0.04 Hz, and phase lead was significantly lower at 0.01, 0.02, 0.04, and 0.08 Hz, than in nonsusceptible subjects. Our findings are in agreement with the notion that the vestibular response will be more intense in subjects susceptible to motion sickness. The present results support the contention that a natural insusceptibility, or increased resistance to seasickness produced by adaptive responses to repeated sea exposures, may be reflected by lower VOR gain and higher phase lead.

Acceleration↗