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Biomedical subjects

D Berman

Publications and source records attributed to D Berman.

At least 37 records · Page 2Linked to original sources
PubMed1994

Local prophylactic benadryl injections in an attempt to reduce postinstrumental pain.

This study was done to determine the clinical efficacy of a 15-mg diphenhydremine hydrochloride (Benadryl) local injection as a prophylactic treatment in the prevention of pain resulting from initial instrumentation of necrotic teeth. A double-blind study comprised of 37 subjects, each with one nonvital maxillary tooth, was completed in which patients were divided into two equal groups. The experimental group received a local anesthetic of 3% Carbocaine, followed by an additional injection of the antihistamine. The control group received the local anesthetic and an equivalent quantity of sterile saline. Patients recorded their pain levels at various time intervals: preoperatively, immediately postoperatively, and at 3, 7, 12, and 24 h postoperatively. Graphic analysis using a Quatro-Pro spread sheet program showed that there were no significant differences between the groups pain scores. However, there was a correlation between pain and time elapsed after procedure. In both groups, postoperative pain appeared to increase from 3 to 7 h and decrease from 7 to 24 h.

Adult↗
PubMed1994

The effects of a single treatment of an acaricide, Acarosan, and a detergent, Metsan, on Der p 1 allergen levels in the carpets and mattresses of asthmatic children.

Baseline levels of the house-dust mite allergen, Der p 1, were measured on the carpets and mattresses of 60 pure-mite-sensitive asthmatic children in the Cape Peninsula, by means of an enzyme-linked immunosorbent assay (ELISA). High levels of mite allergens were recorded (range 2-50 micrograms Der p 1/g dust). In order to investigate the efficacy of the application of acaricides to carpets and bedding, 3 groups of 20 children were studied. Carpets and mattresses in group A were treated with a detergent, Metsan (Snowchem), and in group B with Metsan combined with the acaricide, Acarosan (Noristan). Group C was a control group in which no treatment was applied. The level of airway hyperreactivity (PC20) to histamine was measured at the beginning of the study and again 3 months after acaricide treatment. Significant reductions in carpet Der p 1 levels were achieved in group A (22.83 v. 13.26 micrograms Der p 1/g dust; P = 0.04) and group B (21.76 v. 13.26 micrograms Der p 1/g dust; P = 0.01), but mite levels were not reduced in any of the mattresses treated. There was also no improvement in airway hyperreactivity in any of the groups. This study clearly demonstrates that at present it is not possible to reduce Der p 1 antigen levels in mattresses in the Cape Peninsula with the available acaricides, even when one of these is combined with a detergent solution. Until strategies are developed which will significantly reduce Der p 1 levels in the bedding of sensitive individuals, a reduction in ongoing airway inflammation and airway hyperreactivity cannot be expected.

Animals↗
PubMed1994

Comparison between the Acarex R test and a Der p 1 ELISA for the detection of house-dust mites in the homes of asthma sufferers.

Exposure to house-dust mite allergens in early childhood is an important determinant of the subsequent development of asthma. The Acarex R semi-quantitative test (Noristan) is marketed for use in patients' homes to assess mite levels in house dust. In order to evaluate the reliability of the test in a coastal area where house-dust mites are known to be prevalent, house-dust mite levels were estimated in 119 dust samples obtained from the homes of asthmatic children in a comparative study, by means of the Acarex R test and a Der p 1 enzyme-linked immunosorbent assay (ELISA). A linear regression of the 4 Acarex classes against log Der p 1 revealed a significant correlation (P = 0,0001) but there was a poor correlation between low Acarex R scores and the Der p 1 allergen levels determined by ELISA. Acarex R scores of 2 and 3 were usually associated with Der p 1 levels greater than 10 micrograms/g dust. Our studies indicate that the Acarex R test will identify high levels of mite allergens. Although its application may be limited in coastal areas such as the Cape Peninsula, it may be more useful inland, in climates where house-dust mites are not commonly encountered in all homes.

Allergens↗
PubMed1994

Resolution of protein-losing hypertrophic lymphocytic gastritis with therapeutic eradication of Helicobacter pylori.

Lymphocytic gastritis (LG) is a recently described histological entity characterized by increased lymphocytes in the superficial gastric epithelium and foveolae. It includes a subgroup of patients with giant gastric folds and, often, a protein-losing state, a condition termed hypertrophic lymphocytic gastritis (HLG). Despite close endoscopic and clinical similarities to classical Menetrier's disease, the histopathological features of these two diseases are sufficiently distinct that they are regarded as separate entities. The etiology and pathogenesis of HLG are unknown, and the possible etiological role of Helicobacter pylori in particular is controversial. For this reason we report the case of a 48-yr-old female with HLG, hypoproteinemia, and H. pylori infection whose disease resolved clinically, endoscopically, and pathologically with therapeutic eradication of the H. pylori. H. pylori infection may be a treatable cause of at least some cases of HLG and should therefore be carefully sought in any patient with this condition.

Amoxicillin↗
PubMed1994

Comparative feasibility of separate or simultaneous rest thallium-201/stress technetium-99m-sestamibi dual-isotope myocardial perfusion SPECT.

UNLABELLED: Separate or simultaneous rest 201Tl/stress 99mTc-sestamibi dual-isotope SPECT are potentially efficient myocardial perfusion imaging protocols which combine the use of a high-resolution 99mTc tracer for stress perfusion assessment and 201Tl, the current single-photon agent of choice, for viability assessment. METHODS: To investigate the feasibility of dual-isotope myocardial perfusion SPECT protocols using rest 201Tl and stress sestamibi, 201Tl crosstalk into the 99mTc acquisition window (Group 1, n = 26 patients) and 99mTc crosstalk into 201Tl windows (Group 2, n = 25) were studied. For Group 1, treadmill exercise with sestamibi injection and poststress SPECT ("virgin" sestamibi images) were performed, followed by rest 201Tl injection and SPECT acquisition using dual-isotope windows (contaminated or "dual" images). For Group 2, the order was reversed: rest 201Tl SPECT (virgin 201Tl images) was performed first, followed by exercise sestamibi injection and dual-isotope SPECT. RESULTS: The contribution of 201Tl scatter to the dual sestamibi images (Group 1) was measured to be 2.9% +/- 2.1%, while 99mTc crosstalk contributed 26.7% +/- 13.0% to the dual 201Tl images (Group 2). Image quality was considered good to excellent in 92% of the sestamibi (virgin and dual) images and 88% of the virgin 201Tl SPECT, but only in 23% of the dual 201Tl studies. CONCLUSIONS: Technetium-99m crosstalk into 201Tl windows is substantial; therefore, simultaneous dual-isotope protocols, which involve assessment of 201Tl images contaminated by 99mTc, are not recommended. On the other hand, because of the small amount of 201Tl crosstalk into the 99mTc window, a separate acquisition dual-isotope approach employing the rest 201Tl (virgin)/stress sestamibi sequence is acceptable.

Aged↗
PubMed1993

Reflex anuria and uremia from unilateral ureteral obstruction.

A 59-year-old man had anuria of 32 hours' duration that was associated with unilateral calculous ureteral obstruction. Retrograde pyelography showed a normal contralateral collecting system. Initial technetium pentetate (DTPA) scanning showed diminished uptake of radioactivity by the unobstructed kidney compared with the obstructed kidney, whereas a follow-up study, after relief of ureteral obstruction, showed a reversal of this pattern. Previously reported cases of "reflex anuria" are reviewed along with the relevant experimental literature. Vascular or ureteral spasm related in part to abnormality of the autonomic nervous system may underlie this rare entity.

Anuria↗
PubMed1993

Rapid back to back adenosine stress/rest technetium-99m teboroxime myocardial perfusion SPECT using a triple-detector camera.

Technetium-99m-teboroxime is characterized by a high extraction fraction over a wide range of blood flow rates, rapid myocardial clearance and avid hepatic uptake. This study determined the imaging parameters and examined the clinical efficacy of a rapid back to back adenosine stress/rest teboroxime myocardial perfusion SPECT protocol using a triple-detector camera. Acquisition parameters were determined using cardiac phantom studies which were then applied in SPECT studies of 51 catheterized patients (22 with prior myocardial infarction) and 20 patients with a "low" (7.9% +/- 4.3%) likelihood of coronary artery disease. Technetium-99m-teboroxime (20-25 mCi) was injected at the third minute of adenosine infusion. Teboroxime (20-25 mCi) was also injected at rest, 15 min later. Stress followed by rest SPECT were completed within 25 min using a triple-detector camera and sequential, 1-min continuous rotations in alternating directions. Summed raw data from the first to second (1-2 min), second to third (2-3 min) and second to fifth (2-5 min) minutes of imaging following stress teboroxime injection were reconstructed and compared for image quality, degree of liver interference, and accuracy for diagnostic efficacy. In a subgroup of 30 patients, 2-8-min summed images were also reconstructed to compare this more conventional imaging protocol with our rapid acquisition. Image quality was fair to good in 75% of the 1-2-min, 84% of the 2-3-min and 2-5-min studies and 53% of the 2-8-min scans. The frequency of severe liver interference appeared to increase with the duration of imaging time (1-2 min: 3%; 2-3 min: 7%; 2-5 min: 8%) and was greatest (30%, p = 0.08) with 2-8-min images. Three patients (4%) had uninterpretable studies due to intense hepatic uptake. Overall sensitivity (95%) and specificity (71%) were equal for the 2-3-min and 2-5-min stress images and appeared better than in the 1-2-min images (84% and 57%, respectively). For the 2-8-min scans, vessel sensitivity (69%) and specificity (63%) appeared poorer than with 2-3-min studies (83% and 81%, respectively). Normalcy rates were 89% for the 2-3-min and 2-5-min and 79% for 1-2-min images. The back to back adenosine stress/rest teboroxime SPECT can be performed in 30 min using a triple-detector camera. Although overall high sensitivity and normalcy rates were achieved, the protocol is technically demanding. Interference due to intense liver uptake remains problematic.

Adenosine↗
PubMed1992

Effect of the method of preparing monochloramine upon inactivation of MS2 coliphage, Escherichia coli, and Klebsiella pneumoniae.

Monochloramine prepared in situ by first adding chlorine to a suspension of microorganisms, followed by subsequent addition of ammonia, inactivated the MS2 coliphage more rapidly than did exposure of phage to monochloramine prepared either by adding chlorine to ammonia or by adding chlorine and ammonia simultaneously. The rapid viral inactivation was apparently due to the exposure of MS2 to free chlorine before the addition of ammonia. The average 99% CT value of MS2 when exposed to free chlorine was 1.3 and 1.1 at 5 and 15 degrees C, respectively. The average 99% CT values of MS2 briefly exposed to the combined action of free chlorine followed by the addition of ammonia to form monochloramine in situ were 19.3 and 1.5 at 5 and 15 degrees C, respectively. No 99% CT values were calculated for the inactivation of MS2 with preformed monochloramine because less than 1 log (90%) of inactivation occurred during a 4-h contact time. Inactivation of MS2 by monochloramine was more rapid at 15 than at 5 degrees C and when the chlorine to nitrogen weight ratio was 5:1 compared with 3:1. Monochloramine was a more efficient inactivating agent for the coliforms Escherichia coli and Klebsiella pneumoniae than it was for the MS2 coliphage.

Chloramines↗
PubMed1992

Sedation and analgesia.

The control of pain and the alleviation of anxiety are integral components in the management of soft tissue injuries in the Emergency Department. Pharmacologic agents utilized for analgesia and sedation must possess properties favorable for emergency department use. This article reviews the pharmacologic approach to patients who require sedation and/or analgesia for the management of a soft tissue injury in the Emergency Department.

Analgesia↗
PubMed1992

The evaluation and management of pain in the infant and young child with cancer.

In the last decade, there has been a developing awareness of pain in paediatric patients and especially in young patients who may be unable to express their pain. This paper addresses the issue of pain in the infant and young child with cancer. Current understanding of pain and its physiological consequences are explored. Evaluation of pain within a developmental context is outlined. Guidelines are presented for the behavioural and pharmacological management of pain with emphasis on appropriate therapy for the infant and young child.

Acute Disease↗
PubMed1992

Elevated CA19-9 in a case of Mirizzi's syndrome.

At levels greater than 1000 U/ml, the tumor-associated antigen CA19-9 has a specificity approaching 100% for malignant disease. A 67-yr-old woman with known cholelithiasis presented with painless jaundice and a CA19-9 of 1320 U/ml. The diagnosis of Mirizzi's syndrome was made at laparotomy, and the postoperative level fell rapidly to normal. Mirizzi's syndrome should be included among the few benign disorders which can yield such elevations in the CA19-9.

Aged↗
PubMed1991

Clinical significance of aero-allergen identification in the western Cape.

Positive identification and documentation of the seasonal variation of aero-allergens and the immune responses to them has important implications for the timing of allergen avoidance measures and the selection of patients suitable for immunotherapy. The relative abundance of aero-allergens in the Cape Peninsula during 1984-1987 was measured by continuous volumetric air sampling, using a Burkard spore trap. Mould spore counts of greater than 3,000 spores/m3 were found throughout the year and were only exceeded by pollen grains in the months of September and October (range 4,800-7,400 spores/m3). Gramineae and Compositae spores were found perennially in significant numbers. Pollen from allergenic trees peaked at fixed times each year: oak in August; plane in September and pine between August and October. Grasses found on the Peninsula include sweet vernal, Bermuda grass, rye grass, common reed, Johnson grass, brome grass, canary grass, annual meadow and kikuyu. In vivo skin tests in 209 children with known allergic disease were positive to Dermatophygoides pteronyssimus (73%), South African grasses (38%), tree pollens (22.4%), flower and weed pollens (19.6%), cat (27%), dog (12%) and feathers (18.6%). One-third of the 1,372 children screened at Red Cross War Memorial Children's Hospital Allergy Service had positive specific IgE responses to environmental allergens. Investigation of 62 children possibly allergic to grass using the radio-allergosorbent test revealed positive results in 25 (41%). Of these, 92% were positive to Timothy grass, a grass not occurring in the Cape Peninsula. Knowledge of cross-reactivity profiles for local allergens minimises the number of tests required in allergy diagnosis.

Adolescent↗
PubMed1991

Prevalence of Trichosporon beigelii. Colonization of normal perigenital skin.

Although the natural habitat of Trichosporon species is considered to be the soil, the role of normal skin in the carriage of Trichosporon beigelii is unknown. The purpose of this study was to determine the prevalence of T. beigelii colonization on normal perigenital skin. Inguinal skin scrapings were obtained from 322 asymptomatic volunteers. There were 261 males and 61 females ranging in age from 18 to 89; 136 were white, 134 were black, and 52 were Hispanic. Specimens were cultured on Sabouraud's glucose agar containing 500 micrograms ml-1 chloramphenicol, and incubated at 23-26 degrees C for up to 4 weeks. The overall incidence of T. beigelii colonization was 12.4%. However, this varied with patient's age, sex, race and socioeconomic background. The highest prevalence (27.1%) was found in black males who attended a Veterans Affairs hospital. The prevalence was lowest in females (1.6%), and no patients who attended a private clinic were colonized. It was concluded that T. beigelii colonizes normal skin with some regularity.

Adult↗
PubMed1991

Propidium iodide as an indicator of Giardia cyst viability.

The use of propidium iodide, whose uptake indicates cell death or damage, was investigated to assess the viability of heat-inactivated and chemically inactivated Giardia muris cysts. This was done by comparing propidium iodide staining with excystation. We first determined that propidium iodide could be used with an immunofluorescence detection procedure by showing that the percentages of Giardia lamblia cysts stained with this dye before and after subjecting them to a fluorescence detection method were similar. G. muris cysts were then exposed to heat (56 degrees C), 0.5 to 4 mg of chlorine per liter (pH 7.0, 5 degrees C), 0.1 to 10 mg of a quaternary ammonium compound per liter, or 2 mg of preformed and forming monochloramine per liter (pH 7.2, 18 to 20 degrees C). A good positive correlation between percent propidium iodide-stained cysts and lack of excystation was demonstrated for G. muris cysts exposed either to heat or to the quaternary ammonium compound. However, no significant correlation between absence of excystation and propidium iodide staining was found for cysts exposed to chlorine or monochloramines. These results demonstrate that the propidium iodide staining procedure is not satisfactory for determining the viability of G. muris cysts exposed to these two commonly used drinking water disinfectants.

Animals↗
PubMed1991

Immunofluorescence and morphology of Giardia lamblia cysts exposed to chlorine.

Giardia cyst-like objects detected by immunofluorescence in chlorinated water samples often cannot be positively identified by their morphological appearance. To determine the effect of chlorine on cyst immunofluorescence and morphology, Giardia lamblia cysts were exposed to chlorine for 48 h. The majority of cysts exposed to chlorine concentrations of 1 to 11 mg/liter at 5 and 15 degrees C lost their internal morphological characteristics necessary for identification, but most of them were still detectable by immunofluorescence.

Animals↗