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Biomedical subjects

D Levi

Publications and source records attributed to D Levi.

At least 19 recordsLinked to original sources
PubMed1992

Analysis of clinical course and prognosis of culture-positive spontaneous bacterial peritonitis and neutrocytic ascites. Evidence of the same disease.

The clinical significance and prognosis of culture-negative neutrocytic ascites in cirrhotic patients is a controversial topic. In the present study, the clinical and humoral presentation and the short- and long-term prognosis were analyzed in 36 patients with cirrhosis and culture-positive spontaneous bacterial peritonitis and in 28 patients with cirrhosis and ascitic fluid polymorphonuclear count greater than 250/mm3, a negative ascitic fluid culture, and without previous antibiotic therapy. On admission there were no significant differences between groups related to age, sex, alcoholism, fever, abdominal pain, serum albumin, serum urea, serum creatinine, Child-Pugh score, polymorphonuclear count, and total protein concentration in ascitic fluid. A greater frequency of positive blood culture was found in patients with spontaneous bacterial peritonitis (15/21 vs 2/18) (P < 0.001). Mortality during the first episode was 36% in patients with spontaneous bacterial peritonitis and 46% in patients with culture-negative neutrocytic ascites (NS). Mortality during follow-up was high and survival probability at 12 months was 32% in spontaneous bacterial peritonitis and 31% in culture-negative neutrocytic ascites. The probability of recurrence at 12 months was 33% in spontaneous bacterial peritonitis and 34% in culture-negative neutrocytic ascites. Our results show that spontaneous bacterial peritonitis and culture-negative neutrocytic ascites are variants of the same disease with a high mortality and poor prognosis.

Aged↗
PubMed1992

Paracentesis with Dextran 70 vs. paracentesis with albumin in cirrhosis with tense ascites. Results of a randomized study.

Forty-one patients with cirrhosis and tense ascites were randomized to receive daily paracentesis of 5 liters associated with Dextran 70 as volume expander (6 g for each 1000 ml of ascites removed) (group I = 20 patients) or paracentesis with albumin (6 g for each 1000 ml of ascites) (group II = 21 patients). The basal clinical features, laboratory data, and plasma renin activity were similar in both groups. The volume of ascites removed was 12.9 +/- 4.4 and 10.9 +/- 3.7 liters in group I and II, respectively (n.s.). No significant changes were observed in liver and renal function tests, KPTT, platelet count, factor VIII, serum electrolytes or plasma renin activity 24 and 96 h after the last paracentesis in both groups, except for a decrease in bilirubin in group I and a transient increase of serum albumin in group II. Four patients developed complications in each group, mainly hyponatremia, while one patient in each group developed renal impairment. One patient from group I died with hepatic encephalopathy. Moreover, the probability of survival and readmission to the hospital because of tense ascites were similar in both groups of patients during the follow-up. The treatment cost with Dextran 70 was 15.50 dollars vs. 364.30 dollars with albumin for each patient treated. These results indicate that repeated large volume paracentesis associated with Dextran 70 is as effective and safe as paracentesis associated with albumin in cirrhotic patients with tense ascites. However, due to its reduced cost, paracentesis with Dextran 70 may be considered the treatment of choice in cirrhotic patients with tense ascites without liver cancer and renal failure.

Ascites↗
PubMed1991

Noninvasive measurement of portal venous blood flow in patients with cirrhosis: effects of physiological and pharmacological stimuli.

The present study aims to evaluate the usefulness of combined pulse Doppler-real-time ultrasonography as a noninvasive method for the measurement of portal blood flow in man. This measurement technique was performed on 12 healthy subjects and 20 patients with portal hypertension. Ten patients (group 1) were evaluated prior to and after ingestion of a standard meal (Ensure Plus) or placebo. In the remaining 10 patients (group 2), the effects of isosorbide dinitrate (5 mg/SL) administration or placebo were studied. In group 1, food intake caused a significant increase of portal blood flow (from 1038 +/- 539 to 1572 +/- 759 ml/min, P less than 0.02); this effect was due to a significant rise in mean blood velocity (from 18.5 +/- 3.7 to 23.9 +/- 3.9 cm/sec, P less than 0.02). In group 2, isosorbide dinitrate significantly reduced portal blood flow (from 985 +/- 491 to 625 +/- 355 ml/min, P less than 0.05); a significant decline of mean blood velocity (from 18.8 +/- 4.5 to 14.5 +/- 2.5 cm/sec, P less than 0.02) was observed. Placebo administration had no significant hemodynamic effects in either group. Our results suggest that Doppler measurements gave accurate noninvasive estimations of portal blood flow and that this technique may be used to monitor physiological and pharmological stimuli in patients with portal hypertension.

Adult↗
PubMed1990

Modulation of alkaline phosphatase activity in alveolar type II like cells.

Alveolar type II like cells (ALT II) represent a small subpopulation of alveolar type II cells, which is able to proliferate, can be passaged and possess many characteristics of differentiated adult type II cells. A correlation was found between the growth and development of ALT II cells in culture and their alkaline phosphatase activity. Unlike alveolar type II cells, which lose the activity in culture, ALT II cells regain the activity and maintain it for a long culture period. Quantitative histochemical analysis of the stained cells indicate that 80% of the cells at days 15-20 in culture are alkaline phosphatase positive. Inhibition studies indicate that alkaline phosphatase from ALT II cells and freshly isolated type II cells were similar. The inhibition of ALT II alkaline phosphatase by L-levamisole and its heat stability are similar to that of the bone enzyme and differ from the intestinal enzyme. Alkaline phosphatase expression is considered part of the differentiated phenotype of these cells. Therefore, the presence of this enzyme in ALT II cells adds support to the notion that these cells maintain many aspects of mature alveolar type II cells.

Alkaline Phosphatase↗
PubMed1990

Treatment compliance and hostility levels of head-injured psychiatric outpatients.

Twenty-eight head-injured psychiatrically ill patients were compared in terms of compliance with psychiatric treatment and hostility levels to a matched control group of 28 non-head-injured psychiatrically ill patients attending a community mental health clinic. Results indicated that the two groups did not differ in treatment compliance. However, the head-injured group had significantly less rapport with their therapists. Hostility measures revealed that male head-injured patients scored significantly higher on the assaultive scale; and the severity of the head injury correlated positively with levels of hostility and with reported problems at school.

Adult↗
PubMed1989

[Treatment and surgery of abdominal septic states: comparison of two antibiotic therapies].

A prospective, randomized controlled study was carried out in 104 patients to compare clavulanate-potentiated amoxycillin ('Augmentin') with a combination of cephalosporins (cefazoline and cefadroxil) supplemented with metronidazole in the treatment of abdominal septic states, suspected or proven after surgical intervention. Patients on 'Augmentin' received 1.2 g (1 g amoxycillin plus 200 mg clavulanic acid) intravenously 3-times daily for a mean of 6.6 days, then 375 mg (250 amoxycillin plus 125 mg clavulanic acid) orally for a further 6.4 days. Patients on the standard therapy received 1 g cefazoline intravenously 4-times daily plus 500 mg metronidazole intravenously 3-times daily for 7 days, then 500 mg cefadroxil orally 4-times daily for a mean of 6.6 days. Evaluation of the patients' condition was undertaken after 24 hours, 3 days and 7 days. The results showed a significantly better response to treatment in the 'Augmentin' group, as judged by the amelioration of clinical symptoms, bacteriological findings, and tolerance. All the patients treated with 'Augmentin' showed an excellent or satisfactory overall response at Day 7 compared with 76% of those receiving the standard therapy.

Abdomen↗
PubMed1988

Epithelioid hemangioendothelioma of the liver: report of two cases.

This report describes two patients with hepatic epithelioid hemangioendothelioma: a 33-year-old woman and a 28-year-old man. The first case presented with a palpable abdominal mass and has survived without treatment for 6 years since diagnosis, with ascites but a good general condition. The other patient presented with abdominal pain and cholestasis. He had a rapid course and death occurred 6 months after the onset of symptoms. Histologically the tumors consisted of a proliferation of neoplastic cells with an angiogenic tendency embedded in a myxohyaline stroma. Positivity for the factor VIII-related antigen, for UEA-I and for vimentin and negativity for keratin of the neoplastic cells in the immunohistochemical investigation permitted identification of their endothelial origin. In both cases, the initial diagnosis was erroneous.

Adult↗
PubMed1988

The need for victimization screening in a poor outpatient medical population.

Recent reports indicate that violence toward others is a major public health problem in the black community; however, there are few empirical studies that delineate the severity of the problem. The authors have compiled the results of a victimization screening form obtained from a poor outpatient medical population. These results are compared with a similar survey performed on a poor outpatient psychiatric population. Recommendations are made that poor medical populations should be screened for histories of victimization, because early identification of patients at risk may reduce their chances of future victimization.

Adolescent↗
PubMed1985

Skin penetration of minerals in psoriatics and guinea-pigs bathing in hypertonic salt solutions.

Penetration of electrolytes through the human skin was measured in healthy volunteers and in psoriatic patients after bathing in the Dead-Sea or in simulated bath-salt solutions. Significant increases in the levels of serum Br, Rb, Ca and Zn were noticed only in the psoriatic patients after daily bathing in the Dead-Sea for a 4-week regimen. Guinea-pigs "bathed" in simulated Dead-Sea bath-salt solutions containing radionuclides of Ca, Mg, K and Br. Traces of each radionuclide were detected in the blood and in some internal organs after 60 minutes of bathing. The radionuclides showed a physiological pattern in their organ distribution. Even though the whole investigation was carried out in hypertonic solutions, there is a definite penetration of salts through healthy (human and guinea-pigs) and damaged (psoriatic) epidermis. This finding suggests that improvement of the psoriatic condition after bathing in the Dead-Sea, may be partly attributed (in addition to ultraviolet irradiation) to the minerals' effect on the psoriatic skin.

Adolescent↗
PubMed1985

Stereo-deficients and stereoblinds cannot make utrocular discriminations.

In two separate experiments, we show that stereo-deficient observers are no better than stereonormals at discriminating the eye-of-origin of a monocular stimulation. Stereo-deficient observers are considered to have a preponderance of monocular neurons throughout their visual system, including the visual cortex. The results indicate that, in spite of their clear anatomical and physiological structure, such monocular neurons do not convey eye-of-origin information to consciousness.

Depth Perception↗
PubMed1983

[Management of a lump in the breast?].

Cancer is the primary concern in a patient with a nodule of the breast. Diagnosis is based on clinical, radiological and pathological data. After the preoperative workup, tumorectomy with intraoperative pathological examination is the first step of the surgical procedure. Resection can be extended to radical mastectomy when malignancy is demonstrated. Additional radio, chemo, hormono or immunotherapy may be given according to tumor staging. In non-malignant disorders, isolated nodules must be distinguished from multiple ones. A single nodule may be either a fibroadenoma, if it is solid, or a cyst accompanying a mastopathy. Multiple nodules rise the difficult problem of the management of Reclus disease. Other nodules are uncommon, such as cystosarcoma phyllodes, gigantic fibroadenoma, scirhus, and tumor of the galactophorus duct.

Breast Neoplasms↗
PubMed1983

[Digestive endometriosis: a diagnostic pitfall not to be ignored].

Seven selected cases illustrate the problems which arise in the diagnosis and management of digestive endometriosis. The site is variable but the rectosigmoid region is most commonly involved. Digestive endometriosis, which is often mistaken for intestinal carcinoma, may have various clinical presentations: latent form discovered during laparotomy, subacute intestinal obstruction, acute abdominal syndrome, or cyclic gynecologic or digestive symptoms. Finally, the therapeutic means of curing these patients and avoiding unnecessary extensive intestinal resection are discussed.

Adult↗
PubMed1982

Serum bromine levels in psoriasis.

Serum bromine levels in psoriatic Danes increased 2- to 3-fold during a 4-week bathing course in the Dead Sea. This increase correlated well with the improvement in their clinical and psychic condition. Serum bromine levels in psoriatic Danes were somewhat lower than those in healthy subjects residing in Denmark, but the difference was not significant. Israelis working in the open air in the Dead Sea area (air bromine 20-fold higher than in Jerusalem) had higher bromine levels than psoriatic or healthy Israelis residing in Jerusalem or healthy Israelis working in air-conditioned rooms in the Dead Sea area (p less than 0.05), but those levels were still within the normal range. As our animal experimentation indicates that the skin is a major target organ for 82Br, applied either by bathing or as an aerosol, we conclude that the higher bromine levels noticed in the psoriatic Danes after their 4-week stay at the Dead Sea may be equally due to their contact with the bromine-containing aerosol and the high bromine level of the Dead Sea waters.

Adult↗
PubMed1981

Binocular facilitation in the visual-evoked potential of strabismic amblyopes.

Electrophysiological correlates of abnormal binocular function were investigated by studying the monocular and binocular visual-evoked potentials (VEPs) of strabismic amblyopes. Steady-state evoked potentials were elicited by sinusoidal gratings which were temporally modulated in counterphase and logarithmically swept in spatial frequency from 0.2 to 20 c/deg in a 20 sec epoch. The VEP spatial frequency tuning functions of amblyopic eyes are abnormal in that they tend to show a reduced cutoff spatial frequency in relation to the nonamblyopic fellow eye. In contrast, the binocular interactions in strabismic amblyopes are similar in many respects to those of normal observers. These binocular interactions depend upon the spatial frequency and contrast of the stimulus, and may vary from inhibition to marked facilitation. The results suggest that some binocular function may be preserved in the cortex of patients with strabismic amblyopia, and that caution should be exercised in attempting to use the steady-state VEP to differentiate normal from abnormal binocular vision.

Adolescent↗
PubMed1979

Successful control of pheochromocytoma in pregnancy. Case report.

A patient found to have a pheochromocytoma in the 16th wk of pregnancy was successfully managed by medical treatment with phenoxybenzamine hydrochloride and propranolol. In the 38th wk of pregnancy she was electively delivered by cesarean section, and the tumor was simultaneously removed.

Adrenal Gland Neoplasms↗