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Biomedical subjects

D L Levy

Publications and source records attributed to D L Levy.

At least 73 records · Page 4Linked to original sources
PubMed1982

Premature rupture of membranes prior to term: consequences of nonintervention.

Consequences of nonintervention in the management of prematurely ruptured membranes prior to term were assessed in 143 maternal charts and 145 corresponding infant records during a 2-year period. Patients were hospitalized at bed rest and were not given tocolytics or steroids. Antibiotics were used only when clinical examination indicated infection. Labor was induced in 13 patients. Time in utero was extended 1 week or more in 19% of cases. Maternal infection was identified in 15 women, all of whom recovered. There were 18 neonatal deaths and 4 stillbirths in the series. Three deaths might have been prevented by earlier delivery. Nonintervention in the management of premature rupture of the membranes did not have adverse effects on the incidence of maternal or neonatal infection but was relatively ineffectual in achieving significant extensions of time in utero

Anti-Bacterial Agents↗
PubMed1981

Maternal and cord blood complement activity: relationship to premature rupture of the membranes.

Human complement levels are known to reflect the presence of clinical infection, with low levels indicative of increased utilization in the body's immune response. Premature rupture of the membranes (PRM) is associated with an increased maternal-fetal infectious morbidity, yet histopathologic and bacteriologic parameters often do not reflect this. In this prospective study maternal and cord serum total hemolytic complement activity (CH50) was measured in 102 patients without evidence of infection, with and without PRM, to determine if there exists within the maternal-fetal unit an immunologic response to this event. It was found that maternal serum CH50, regardless of length of gestation, is similar to that of the nonpregnant adult population, except in cases of PRM greater than 12 hours in which it is significantly lower. The CH50 in term newborn infants was significantly lower than that of matched maternal samples and dropped with decreasing gestational age. CH50 in cord serum from babies of mothers with PRM failed to show a significant decrease when compared to those of mothers without PRM.

Complement System Proteins↗
PubMed1981

Maternal and infant transport program in Louisiana.

The concept of maternal transport has evolved from that of neonatal transport as part of a regionalized perinatal care system. Experience has suggested that perinatal outcome for infants transported before delivery is improved over that for infants transported neonatally. This report describes the initial 2 years' experience of the first such program in Louisiana. When compared with infants transported after delivery, those transported before delivery had a slightly better corrected survival rate (90 versus 87%) and a shorter average stay in the neonatal intensive care unit (11.8 versus 21.4 days), but the differences were not statistically significant as measured by the chi2 test.

Female↗
PubMed1980

Deviant eye tracking in twins discordant for psychosis. A replication.

An earlier study of smooth-pursuit eye movements (SPEMs) in monozygotic (MZ) and dizygotic (DZ) twins discordant for functional psychosis reported high concordance of pursuit abnormalities in MZ pairs and moderate concordance in DZ pairs. That study was repeated with younger pairs of twins and with some quantitative refinements in scoring. Results show the same levels of concordance for pursuit dysfunctions, thus replicating the earlier study. The data support an interpretation of genetic factors contributing to variability in SPEMs.

Adult↗
PubMed1980

Fetal response to cardiopulmonary bypass.

The fetal heart rate (FHR) was continuously monitored by ultrasonography during a mitral valve replacement in a patient at 22 weeks' gestation. The changes in FHR were analyzed in relationship to events of cardiopulmonary bypass. The baseline FHR dropped substantially during bypass with initial loss of variability. After the pump run, a brief episode of fetal tachycardia was followed by stabilization to preoperative levels. The patient delivered at 30 weeks' gestation and the infant did well.

Adult↗
PubMed1978

Vestibular responses in schizophrenia.

In a study of vestibular responses to caloric stimulation that controlled opportunity for fixation and state of alertness, we evaluated previous findings of diminished nystagmus in schizophrenia. We failed to replicate earlier reports in these respects: (1) None of the psychotic patient groups, when compared with normal controls, showed lower response intensity, latency, or culmination time of the nystagmic response. (2) The schizophrenic groups did not manifest a prevalence of clinically significant asymmetry. We did, however, observe that chronic deteriorated schizophrenics and recent schizophrenics have significantly greater dysrhythmic responses. This diminished orderliness of nystagmus may explain previous reports of absent or diminished nystagmus in the schizophrenics. The results are not compatible with peripheral vestibular disease in schizophrenia, but they may reflect state-related phenomena consistent with disturbances in alertness, which are not necessarily voluntary or motivational in origin.

Acute Disease↗
PubMed1977

Visual interference on vestibular response. A case study.

Eliminating opportunity for visual fixation as well as providing for the maintenance of an optimal degree of a patient's mental alertness are necessary for a valid assessment of nystagmic response to caloric stimulation. Controlling only for alertness can result in suppressed, absent, or dysrhythmic nystagmus. Data from four normal patients dramatically illustrate the suppressing effects of fixation opportunity despite an alert state. A new clinical instrument for obtaining optimal control over visual influences is described.

Adult↗
PubMed1977

Abnormal-pursuit eye movements in schizophrenia. Evidence for a genetic indicator.

Disordered smooth-pursuit eye movements occur in a high percentage of schizophrenic patients and their first-degree relatives. A Test of the hypothesis that these disorders represent a genetic indicator of schizophrenia was undertaken by testing pursuit eye movements in a sample of monozygotic and dizygotic twins discordant for clinical schizophrenia. Deviant eye tracking is significantly concordant within monozygotic twin pairs, and less so with dizygotic twin pairs discordant for schizophrenia. A genetic interpretation is consistent with these results.

Adult↗
PubMed1976

Smooth pursuit eye movements, attention, and schizophrenia.

In previous studies, smooth pursuit eye movements (SPEM) have been shown to be disordered in about 70% of schizophrenics and about 45% of their first-degree relatives. In this report, the role of attention in these eye movements is addressed in three experiments (using as subjects schizophrenics, their first-degree relatives, and normals administered chloral hydrate) that recruit focused attention to the task. These studies show that voluntary attention in the form of inattention, "heedless negligence," or failure to cooperate, is not the specific attentional quality that is disordered in SPEM of schizophrenics and their relatives. Rather, the data both indicate that nonvoluntary attending is specifically disordered in these persons, and implicate a neurophysiological substrate that can be described as a failure of inhibitory, synchronizing integrating systems which may be located in the brain stem.

Adult↗
PubMed1976

Persistent brow presentation: a new approach to management.

When the fetal vertex is extended on the spinal column and the brow becomes the presenting part, it is termed "brow presentation." Persistent brow presentation occurs when there is no spontaneous conversion after the onset of active labor. Since there is a risk in the vaginal delivery of such fetuses, it should not be attempted where there is known maternal disease or evidence of acute or chronic intrauterine fetal distress. During labor, cesarean section is indicated if there is cephalopelvic disproportion, if the fetal head is not in the frontoanterior position, if there is abnormal labor, or if there is evidence of fetal distress. Continuous lumbar epidural anesthesia should be given, and only manual conversion is used. The fetus is monitored continuously.

Anesthesia, Epidural↗
PubMed1976

47,XXX karyotype obtained by amniocentesis.

A 29-year-old pregnant patient, gravida 4, para 3, sought genetic counseling because of a daughter who had Down's syndrome. Amniotic fluid obtained by amniocentesis indicated the fetal karyotype to be 47,XXX. The pregnancy was terminated and the karyotype was confirmed by typing venous blood from the fetus and the finding of double Barr bodies in the histologic sections of fetal tissue.

Abortion, Induced↗