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Biomedical subjects

D Levine

Publications and source records attributed to D Levine.

At least 109 records · Page 6Linked to original sources
PubMed1994

Sonography of ovarian masses: poor sensitivity of resistive index for identifying malignant lesions.

OBJECTIVE: Current research suggests that the resistive index of adnexal masses is a sensitive measure for distinguishing between benign and malignant ovarian masses. We devised a study to determine how morphologic findings on sonograms compare with the resistive index of benign and malignant lesions. SUBJECTS AND METHODS: Pelvic sonograms were obtained in 34 women with 36 adnexal masses that were likely neoplastic or non-self-limiting (such as an endometrioma). Transabdominal and transvaginal sonograms were obtained, and the resistive index was calculated. A threshold resistive index of 0.4 was used to differentiate benign from malignant lesions. Masses were characterized prospectively as probably benign or possibly malignant on the basis of their sonographic appearance. Pathologic proof was obtained for 35 masses, and one mass was diagnosed on the basis of CT findings. RESULTS: Seventeen lesions were deemed probably benign, and pathologic examination showed that all 17 were benign. The resistive index was greater than 0.4 in 14 of these 17 cases. Nineteen lesions were characterized as possibly malignant. On pathologic examination, six were benign neoplasms, five were nonneoplastic masses, and eight were malignant neoplasms. The resistive index was greater than 0.4 in 10 of the 11 benign lesions. It was less than 0.4 in only two of the eight lesions that were classified as malignant on the basis of both morphologic and pathologic findings. CONCLUSION: Sonography is sensitive but not specific for distinguishing between benign and malignant ovarian neoplasms. Although use of the resistive index might improve specificity in the assessment of possibly malignant lesions, reliance on this parameter is potentially misleading, as six of eight malignant lesions in this series were miscategorized on the basis of their resistive index.

Adult↗
PubMed1994

Physician knowledge of the CAGE alcohol screening questions and its impact on practice.

A cross-sectional survey of physicians (n = 301) and patients (n = 321) at a university-based department of medicine was completed to determine physician's ability to list CAGE alcohol screening questions and how this knowledge is associated with practice patterns. Forty-five percent of the physicians had heard of the CAGE, but only 14% could list all four of the questions correctly. Physicians who knew the CAGE were more likely to report counseling and referral of their patients who abuse alcohol. However, as assessed by patient interview and chart review, patients with an alcohol abuse problem were no more likely to have been recognized by or to have received more aggressive care from residents who knew the CAGE than patients cared for by residents who did not know the CAGE. Knowledge of an alcohol screening test is not sufficient to change physician practice related to care of patients with an alcohol abuse problem. More attention must be directed towards the development of effective strategies which integrate into clinical practice screening and initial treatment of patients who abuse alcohol.

Adult↗
PubMed1994

False positive EBNA IgM and IgG antibody tests for infectious mononucleosis in children.

OBJECTIVES: To assess the reliability of the Monolert test, a new enzyme-linked immunosorbent assay for the diagnosis of acute infectious mononucleosis (IM). DESIGN: A retrospective laboratory and clinical analysis of 38 children diagnosed with acute IM. SETTING: A suburban pediatric practice in Connecticut. PATIENTS: Thirty-eight children (ages 18 months to 17 years) who were diagnosed with acute IM using the Monolert test during the period October 1992 to August 1993. RESULTS: Eighty-three percent of these children had no evidence of Epstein-Barr virus infection on subsequent investigation. The false positive results of the Monolert test could not be explained on the basis of elevated antibody titers to either cytomegalovirus or Borrelia burgdorferi. CONCLUSION: Monolert is a poor screening test and is of little apparent value as a diagnostic test for acute Epstein-Barr virus infection in pediatric patients.

Acute Disease↗
PubMed1993

Recombinant human growth hormone therapy does not increase microalbuminuria in children with short stature.

OBJECTIVE: Concerns have been raised about possible adverse effects of growth hormone on renal function. We measured microalbuminuria as a sensitive index of early glomerular damage in children being treated with recombinant human growth hormone. DESIGN AND PATIENTS: Microalbuminuria was measured in a group of 17 children with short stature being treated with recombinant human growth hormone and in a group of 13 patients with idiopathic short stature not receiving therapy. MEASUREMENTS: Microalbuminuria was measured by a commercially available ELISA and urinary creatinines were determined using a Beckman creatinine analyser. RESULTS: The level of microalbuminuria was 0.484 +/- 0.275 g albumin/mol creatinine (mean +/- SD) in the patients receiving growth hormone and 0.681 +/- 0.574 g albumin/mol creatinine in the untreated controls. There was no statistically significant difference between these values. CONCLUSIONS: Treatment with recombinant human growth hormone does not cause an increase in microalbuminuria in children with normal renal function. This supports the safety of this medication in growth hormone deficient children with normal renal function.

Albuminuria↗
PubMed1993

Dietary calcium modulates blood pressure through alpha 1-adrenergic receptors.

To investigate the role of adrenergic receptor activity in dietary calcium-induced alterations in blood pressure, weanling spontaneously hypertensive rats (SHR) were placed on either high-calcium (2.0%) or low-calcium (0.1%) diets for 1-2 wk. Baseline blood pressure was higher and pressor responses to exogenous norepinephrine (NE) were greater in the SHR on low-calcium diets than high-calcium diets. There was no difference between diet groups in circulating NE or in the pressor response to angiotensin II. The difference in basal blood pressure was eliminated by the alpha 1-adrenergic receptor blockers phentolamine and prazosin but was not altered by alpha 2-, beta 1-, or beta 2-adrenergic receptor blockade (idazoxan, metoprolol, and butoxamine, respectively). Furthermore, hypotension produced by either calcitonin gene-related peptide, captopril, or nitroprusside failed to eliminate the diet-induced difference in blood pressure. The results suggest the possibility that diet-induced differences in alpha 1-adrenergic activity may be responsible, in part, for variations in blood pressure on different calcium diets.

Adrenergic Agonists↗
PubMed1993

Effects of two toothbrushes on plaque, gingivitis, gingival abrasion, and recession: a 1-year longitudinal study.

Plaque removal is an important part of good oral hygiene. Many short-term studies have compared the effectiveness of an electric toothbrush in plaque removal to that of a conventional, manual toothbrush. Previous studies proved the electric toothbrush to be more effective on a short-term basis; however, little is known about its long-term effects. In a study that examined 32 patients over a 12-month period, the authors found electric toothbrushing to be more effective in plaque removal. The study measured the differences in abrasion, gingival recession, gingival bleeding, and plaque scores. The study also concluded that no significant gingival abrasion was caused by electric toothbrushing.

Adult↗
PubMed1993

Observations of the anterior loop of the inferior alveolar canal.

The inferior alveolar nerve may extend beyond the mental foramen as an intraosseous anterior loop. The purpose of this study was to determine if panoramic radiography accurately identifies the anterior loop of the inferior alveolar canal. Adult skulls (n = 25) were radiographed using two panoramic machines both with and without radiopaque markers placed into the inferior alveolar canal and anterior loop. The anterior loop was also measured directly using flexible tubing (2 mm in diameter). Significantly fewer loops were detected in radiographs as compared with anatomic assessment (P < .001). A significant loop (> 2 mm) was identified in 92% to 96% of the direct measurements, whereas radiographs identified only 56% (Panelipse) and 76% (Orthoralix). Analysis of variance demonstrated that the skeletal length of the anterior loop was significantly greater than that measured radiographically (P < .0001). The average length of the anterior loop based on direct measurements was 6.95 mm, whereas radiographic measurements were 3.18 mm (Panelipse) and 3.45 mm (Orthoralix). The difference in detection of anterior loops among the radiographic procedures studied was not significant (P > .05).

Adult↗
PubMed1993

Elements of cognitive rehabilitation after right hemisphere stroke.

There are two basic approaches to cognitive training: (1) impairment training and (2) task specific training. Impairment training addresses impairments common to a number of tasks and attempts to offer a general benefit to all of the tasks at once. Task specific training focuses on the impairments that arise in a single task and attempts to improve performance on that task. Impairment training of spatial disorders following right hemisphere stroke has shown some success when curricula are properly designed. The success, however, is quite limited because of normal cognitive constraints and those occurring after brain damage. Task specific training in conjunction with the combined application of various cognitive principles appears more promising, but as yet, only a few studies exist. The neurologic factors are likely to be the same factors that influence recovery. The factors that influence trainability are lesion topography (size and location of the focus plus premorbid atrophy), lesion chronicity, and the presence of additional cognitive impairments (anosognosia, confusion, and abulia). Other interventions that may be beneficial, even for training resistant patients, include behavior modification, cognitive prostheses, and drugs.

Aged↗
PubMed1992

The olive on end: a useful variant of the "shoulder" sign in the barium X-ray diagnosis of idiopathic hypertrophic pyloric stenosis.

We describe a radiographic sign of infantile hypertrophic pyloric stenosis. This sign, elicited during firm compression of the barium-coated pyloric region, is a round or avoid filling defect caused by the hypertrophied pyloric muscle protruding en face into the gastric lumen. This filling defect typically reveals a barium-containing central depression or stellate indentation, representing the proximal end of the obstructed pyloric channel. This sign, like the closely related "shoulder sign", appears to establish the diagnosis of hypertrophic pyloric stenosis without need for filling of the pyloric channel or for additional radiographic maneuvers.

Barium Sulfate↗
PubMed1992

Simple adnexal cysts: the natural history in postmenopausal women.

Transabdominal and transvaginal ultrasound (US) examinations were performed in 184 asymptomatic postmenopausal volunteers to determine prospectively (a) the frequency and natural history of simple adnexal cysts in healthy postmenopausal women and (b) the relationship between cyst activity and both hormone replacement and length of time since menopause. Eighty-three simple adnexal cysts were found in 52 women. Thirty-two of 184 women (17%) had 37 cysts identified at initial examination; 46 new cysts appeared in 31 women (11 of whom previously had cysts). Forty-nine women with 72 cysts were reevaluated with subsequent US scanning over a period of 3-23 months. Thirty-eight of the 72 cysts (53%) disappeared completely, 20 (28%) remained constant in size, eight (11%) enlarged by 3 mm or more, two (3%) decreased in size by 3 mm or more, and four (6%) both increased and decreased in size on repeated examinations. No statistical relationship was found between presence of cysts or cyst activity with respect to the type of hormone replacement or length of time since menopause.

Adnexal Diseases↗
PubMed1992

Taurine attenuates renal disease in chronic puromycin aminonucleoside nephropathy.

Repeated administration of low doses of puromycin aminonucleoside (PAMN) to rats induces a proteinuric renal disease that resembles focal segmental glomerulosclerosis (FSGS). Reactive oxygen molecules may be involved in the progressive course of this nephropathy. Therefore we evaluated whether taurine, an endogenous antioxidant, could limit the extent of renal injury. Sprague-Dawley rats received low-dose injections of PAMN, 2 mg/100 g body wt, over a 12-wk period. Two groups were studied: 1) controls given tap water (n = 23), and 2) an experimental group that drank 1% taurine-supplemented water (n = 22). Taurine-treated nephrotic rats had a reduction in albuminuria, as assessed by the urinary albumin-to-creatinine ratio (26 +/- 4 vs. 44 +/- 4, P less than 0.0001). After 12 wk, creatinine clearance was 0.33 +/- 0.03 (experimental) vs. 0.17 +/- 0.03 ml.min-1.100 g body wt-1 (control) (P less than 0.001), and inulin clearance (n = 6 pairs) was 0.26 +/- 0.04 (experimental) vs. 0.13 +/- 0.02 ml.min-1.100 g body wt-1 (control) (P less than 0.025). Administration of taurine reduced the percentage of segmentally sclerosed glomeruli (9.8 +/- 1.7 vs. 16.2 +/- 1.8%, P less than 0.02) and the tubulointerstitial injury score (1.36 +/- 0.19 vs. 2.61 +/- 0.25, P less than 0.0025) in experimental vs. control rats. Taurine treatment normalized the elevated renal cortical malondialdehyde level in rats with PAMN nephropathy (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗