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Biomedical subjects

C M Leevy

Publications and source records attributed to C M Leevy.

At least 37 records · Page 2Linked to original sources
PubMed1982

Thiamin in the elderly--relation to alcoholism and to neurological degenerative disease.

Status of thiamin in the elderly North American population is reviewed. Most Americans eat sufficient thiamin but about 5% of those over 60 yr old show impaired thiamin status. This is more marked in the poor, those confined in institutions, or those with illness. Thiamin responsive heart disease and Wernicke Korsakoff CNS syndromes occur in the elderly but there is no increased prevalence. Minor heart or neurological syndromes related to thiamin deficiency cannot be identified. The Recommended Dietary Allowance of thiamin provides at least 50% excess thiamin for those over 60 yr old--this amount is adequate. There is no known toxicity for thiamin.

Adolescent↗
PubMed1981

Ethanol and cell replication in the digestive tract.

Ethanol-induced injury of the intestines, liver and pancreas evokes a regenerative response which is characterized by a series of morphological and biochemical adaptive responses in subcellular organelles, and an increase in chromosomal protein and DNA replication. Patterns of cell replication vary with the system involved, the amount of injury and the presence of essential precursors or catalysts needed for cell replication. Maintenance of normal cell replacement patterns in the digestive tract of the alcoholic requires correction of deficits and interruption of alcohol intake. An inadequate or excessive regenerative response is of key importance in perpetuating tissue injury in the alcoholic. Regenerative capacity has been evaluated in man by measurement of circulating levels of CEA and alpha-fetoprotein; unfortunately, there is often no correlation between cell replication and these parameters in the malnourished alcoholic. Studies of mitoses or organelle changes in biopsies of intestines and liver are valuable; however, accurate monitoring of regeneration is possible only by kinetic studies utilizing incorporation of tritiated thymidine into DNA.

Alcoholism↗
PubMed1980

Effect of diazepam on the lower esophageal sphincter. A double-blind controlled study.

The effect of diazepam on the lower esophageal sphincter (LES) pressure was studied in a controlled randomized double-blind protocol. Twenty-five patients received intravenous saline, diazepam 5 mg. and diazepam 10 mg. on different days. Diazepam 5 mg. and diazepam 10 mg. caused a mean peak reduction in LES pressure of 18.9 and 37.8% respectively. The peak reduction in LES pressure was dose-related and lasted approximately seven minutes. Awareness of diazepam's ability to significantly lower LES pressure is needed to avoid the possibility of falsely diagnosing reflux by endoscopy. The mechanism whereby diazepam lowers LES pressure is not known, however, diazepam may be acting as a smooth muscle relaxant since myogenic influences have been implicated in the genesis of LES pressure.

Adult↗
PubMed1978

Type B hepatitis after needle-stick exposure: prevention with hepatitis B immune globulin. Final report of the Veterans Administration Cooperative Study.

Hepatitis B immune globulin (HBIG) and immune serum globulin (ISG) were examined in a randomized, double-blind trial to assess their relative efficacies in preventing type B hepatitis after needle-stick exposure to hepatitis B surface antigen (HBsAG)-positive donors. Clinical hepatitis developed in 1.4% of HBIG and in 5.9% of ISG recipients (P = 0.016), and seroconversion (anti-HBs) occurred in 5.6% and 20.7% of them respectively (P less than 0.001). Mild and transient side-effects were noted in 3.0% of ISG and in 3.2% of HBIG recipients. Available donor sera were examined for DNA polymerase (DNAP) and e antigen and antibody (HBeAg; anti-HBE). Both DNAP and HBeAg showed a highly statistically significant correlation with the infectivity of HBsAg-positive donors. Hepatitis B immune globulin remained significantly superior to ISG in preventing type B hepatitis even when the analysis was confined to these two high-risk subgroups. The efficacy of ISG in preventing type B hepatitis cannot be ascertained because a true placebo group was not included.

Adolescent↗
PubMed1977

Comparison of lactulose and neomycin in the treatment of chronic portal-systemic encephalopathy. A double blind controlled trial.

A randomized double blind clinical comparison of neomycin and lactulose was performed in 33 cirrhotic patients with chronic portal-systemic encephalopathy (PSE) at seven cooperating hospitals. In order to maintain double blindness, sorbitol syrup was used as a control solution along with neomycin and was compared with lactulose syrup and placebo tablets in a double drug protocol. Twenty-nine patients were studied in a crossover investigation in which each received both therapeutic regimens preceded and followed by control periods. Four additional patients received one or the other agent, but did not receive both. Serial, semiquantitative assessments were made in all patients of mental status, asterixis, and the trailmaking test (TMT) and electroencephalograms (EEG) and arterial ammonia levels. Both neomycin-sorbitol and lactulose were effective in the majority of patients (83 and 90%, respectively). Each of these parameters (mental state, asterixis, TMT, EEG, and NH3) was improved significantly by neomycin-sorbitol and lactulose. The post-treatment levels for each of these measures were similar in the neomycin and lactulose-treated groups. Mean stool pH was reduced by neomycinsorbitol to 6.1 and by lactulose to 5.5. This difference was highly significant statistically. Bowel activity was similar in the two groups. Both drugs were free of toxicity. These investigations demonstrate that both lactulose and neomycin-sorbitol are effective in the treatment of chronic portal-systemic encephalopathy.

Aged↗