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Biomedical subjects

D Rosenthal

Publications and source records attributed to D Rosenthal.

At least 73 records · Page 4Linked to original sources
PubMed1998

Australian and South African undergraduates' HIV-related knowledge, attitudes, and behaviors.

To understand safe sex behavior in two countries which have been differentially affected by the HIV/AIDS epidemic, the present study compared the AIDS-related knowledge, attitudes, and behaviors of 920 heterosexual undergraduate students in Australia and 228 heterosexual undergraduate students in South Africa. South African students were found to have significantly less knowledge about HIV/AIDS, and significantly less favorable attitudes toward safe sex behavior than their Australian counterparts. They were also more likely to report that they have avoided various groups of people for fear of contracting AIDS. Experience from Australia over the period 1986-1995 suggests that significant improvements in the AIDS-related knowledge, attitudes, and behaviors of South African undergraduates are achievable.

Acquired Immunodeficiency Syndrome↗
PubMed1998

AIDS impact.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Safe sex or safe love: competing discourses?

The way in which sex may be constructed as safe through its relationship with 'love' is the concern of this study. Interviews with 112 heterosexual women and men from discos and bars in Melbourne, Australia, catering to single adults revealed the pervasive construction of sex within the discourses of 'love' and 'romance'. The relationship of these discourses to unsafe practices is discussed and the article presents an analysis of the normative function of the sex-as-love/sex-as-desire opposition in terms of safe sex and HIV/AIDS prevention. We conclude that health messages which emphasize that 'sex is unsafe' may be counterproductive. We illustrate how women and some men construct casual sex as a strategy for obtaining the possibility of 'love'. For these women and men, 'safe sex' as 'unprotected sex' is viewed as a strategy for maximizing the possibility that the casual encounter will result in a longer term relationship. On the other hand, 'unsafe sex' as 'unprotected sex' is viewed as a strategy that is more likely to interrupt the construction of romance in the causal encounter thus risking the possibility of love as the desired outcome.

Adult↗
PubMed1998

Thoracoscopic microsurgical technique for vertebral surgery--anesthetic considerations.

BACKGROUND: The thoracoscopic microsurgical technique (TMT) for vertebral and spinal cord surgery is associated with the benefits of reduced postoperative pain, accelerated return to physical activity and reduced complication rates. However, because of the surgeon's requirement of a non-ventilated lung, it confronts the anesthesiologist with the need for extremely long duration of single-lung ventilation (SLV). METHODS: We describe our experiences with 82 patients, whom we anesthetised from 1993 until 1996 for TMT. Because of the potential risk of depression of hypoxic pulmonary vasoconstriction during SLV by volatile anesthetics, we primarily used a total intravenous technique (55 patients). With more experience, we also used a combination of volatile and intravenous anesthetics (16 patients) and, finally, volatile anesthetics only (11 patients). Data from patients anesthetised for TMT were compared with data from 22 patients operated with open thoracotomy from 1984 until 1992. RESULTS: While the operating time (290.1 +/- 133.2 min for TMT vs. 312.3 +/- 113.6 for thoracotomy) and the anesthesia time (431.2 +/- 140.3 for TMT vs. 416.4 +/- 102.1 for thoracotomy) showed no significant differences, the TMT required an extremely long time of SLV (270.2 +/- 133.2 min) to gain access to the spine using left-sided double-lumen tubes. While the oxygenation index (PaO2/FiO2), as a marker for pulmonary oxygenation capacity, decreased significantly after initiation of SLV for TMT, it was markedly enhanced with increasing duration (270.2 +/- 133.2 min) of SLV. Oxygenation index showed no significant difference when comparing the different anesthetic techniques for TMT. CONCLUSION: We conclude that despite the long duration of SLV, TMT is a reasonable alternative to open thoracotomy for thoracic neurosurgical spine procedures because of the substantial clinical benefits of accelerated return to physical activity, reduced complication rates and reduced intensive care unit and hospital stay.

Activities of Daily Living↗
PubMed1998

Can academic radiology departments become more efficient and cost less?

PURPOSE: To determine how successful two large academic radiology departments have been in responding to market-driven pressures to reduce costs and improve productivity by downsizing their technical and support staffs while maintaining or increasing volume. MATERIALS AND METHODS: A longitudinal study was performed in which benchmarking techniques were used to assess the changes in cost and productivity of the two departments for 5 years (fiscal years 1992-1996). Cost per relative value unit and relative value units per full-time equivalent employee were tracked. RESULTS: Substantial cost reduction and productivity enhancement were realized as linear improvements in two key metrics, namely, cost per relative value unit (decline of 19.0% [decline of $7.60 on a base year cost of $40.00] to 28.8% [$12.18 of $42.21]; P < or = .001) and relative value unit per full-time equivalent employee (increase of 46.0% [increase of 759.55 units over a base year productivity of 1,651.45 units] to 55.8% [968.28 of 1,733.97 units]; P < .001), during the 5 years of study. CONCLUSION: Academic radiology departments have proved that they can "do more with less" over a sustained period.

Academic Medical Centers↗
PubMed1998

Iliofemoral venous thrombosis caused by compression of an internal iliac artery aneurysm: a minimally invasive treatment.

PURPOSE: To report the success of a minimally invasive treatment for phlegmasia cerulea dolens without gangrene caused by compression from an internal iliac artery aneurysm. METHODS AND RESULTS: An 81-year-old male with a 1-month history of paralysis owing to a hemorrhagic stroke presented with massive edema and skin mottling of the right lower extremity. Imaging confirmed right iliofemoral deep vein thrombosis caused by compression from a 4-cm internal iliac artery aneurysm. With thrombolysis ruled out, a minimally invasive treatment plan was undertaken, featuring percutaneous coil embolization of the aneurysm and surgical venous thrombectomy with proximal arteriovenous fistula creation and iliac vein stent placement. Failure of the coils to embolize the iliac aneurysm prompted the use of an endovascular graft to exclude the aneurysm. The patient's symptoms subsided, and he has a patent right iliofemoral venous system and internal iliac artery at his latest (16-month) follow-up. CONCLUSIONS: This case demonstrates that minimally invasive endovascular and open techniques can be combined to achieve an optimum outcome in patients at high risk for standard surgical approaches.

Aged↗
PubMed1998

Changes in renal hemodynamics and tubular function of surgically cured primary hyperparathyroid patients are probably due to chronic hypercalcemic nephropathy.

To understand the mechanisms responsible for the persistent hypercalciuria and reduced glomerular filtration rate (GFR) previously found in 6 of 10 patients surgically cured of primary hyperparathyroidism (PHPx), the tubular handling of lithium, sodium, calcium, and phosphate as well as the renal hemodynamics were evaluated in these 10 PHPx patients, in 10 control subjects, and in 5 patients with renal hypercalciuria (RH), during fasting and after an oral calcium load. A positive correlation between the fractional excretions of calcium and sodium was found in all groups, but the PHPx patients excreted more calcium for the same amount of sodium than control subjects. The fractional proximal sodium reabsorption (FPRNa), distal delivery, and fractional phosphate reabsorption were similar in all groups; a significant positive correlation was found between the fractional calcium reabsorption and the FPRNa, indicating that proximal tubular function was preserved and that the urinary calcium losses in RH and in the hypercalciuric PHPx patients (h-PHPx) occurred in the distal nephron. However, only h-PHPx patients had reduced renal plasma flow, renal blood flow, and GFR, as well as a high renal vascular resistance, which was even more evident after the calcium challenge. These findings lead us to conclude that RH and h-PHPx patients are very different, as far as kidney dysfunction is concerned, and that a hypercalcemic nephropathy is the most probable cause of the alterations in distal calcium reabsorption and renal hemodynamics found in the h-PHPx patients.

Adenoma↗
PubMed1998

Popliteal artery aneurysm treated with a minimally invasive endovascular approach: an initial report.

PURPOSE: To report a minimally invasive approach to popliteal artery aneurysm (PAA) treatment. METHODS AND RESULTS: A 48-year-old male with a 3-cm PAA was treated electively with an endovascular in situ saphenous vein bypass and transluminal antegrade coil embolization of the PAA prior to completion of the proximal anastomosis. Two short incisions at the anastomosis sites resulted in no wound complications, and the patient was discharged after 2 days. After 14 months of follow-up, the patient is asymptomatic with continued patency of the in situ bypass and occlusion of the PAA. CONCLUSIONS: This endovascular approach for minimally invasive femoropopliteal in situ saphenous vein bypass grafting appears feasible for treatment of PAAs. This method may reduce the rate of wound complications attending classic open in situ bypass grafts.

Anastomosis, Surgical↗
PubMed1998

Autoradiographic thyroid evaluation in short-term experimental diabetes mellitus.

Previous studies have shown that in vitro thyroid peroxidase (TPO) iodide oxidation activity is decreased and thyroid T4-5'-deiodinase activity is increased 15 days after induction of experimental diabetes mellitus (DM). In the present study we used thyroid histoautoradiography, an indirect assay of in vivo TPO activity, to determine the possible parallelism between the in vitro and in vivo changes induced by experimental DM. DM was induced in male Wistar rats (about 250 g body weight) by a single i.p. streptozotocin injection (45 mg/kg), while control (C) animals received a single injection of the vehicle. Seven and 30 days after diabetes induction, each diabetic and control animal was given i.p. a tracer dose of 125I (2 microCi), 2.5 h before thyroid excision. The glands were counted, weighted, fixed in Bouin's solution, embedded in paraffin and cut. The sections were stained with HE and exposed to NTB-2 emulsion (Kodak). The autohistograms were developed and the quantitative distribution of silver grains was evaluated with a computerized image analyzer system. Thyroid radioiodine uptake was significantly decreased only after 30 days of DM (C: 0.38 +/- 0.05 vs DM: 0.20 +/- 0.04%/mg thyroid, P < 0.05) while in vivo TPO activity was significantly decreased 7 and 30 days after DM induction (C: 5.3 and 4.5 grains/100 micron 2 vs DM: 2.9 and 1.6 grains/100 micron 2, respectively, P < 0.05). These data suggest that insulin deficiency first reduces in vivo TPO activity during short-term experimental diabetes mellitus.

Analysis of Variance↗
PubMed1998

Thoracoscopic microsurgical excision of herniated thoracic discs.

OBJECT: The authors began using thoracoscopy to treat pathological conditions of the spine in 1992. In this study they delineate their clinical experience in which this procedure was used to resect herniated thoracic discs. METHODS: Fifty-five patients underwent thoracoscopy for the resection of herniated thoracic discs. Thirty-six patients presented with myelopathies and 19 with incapacitating thoracic radicular pain. Forty-three patients underwent a single-level, 11 a two-level, and one a three-level discectomy. The mean operative time for thoracoscopic microdiscectomy was 3 hours and 25 minutes (range 80-542 minutes) and the mean blood loss was 327 ml (range 124-1500 ml). Compared with thoracotomy, which was performed in 18 patients, thoracoscopy was associated with a mean of 1 hour less operative time and less than one-half of the blood loss, duration of chest tube drainage, usage of pain medication, and length of hospitalization. Compared with costotransversectomy, which was performed in 15 patients, thoracoscopy permitted more complete resection of calcified and midline thoracic discs because it provided a direct view of the entire anterior surface of the dura. Thoracotomy was associated with a significantly greater incidence of prolonged, disabling intercostal neuralgia compared with the mild transient episodes of intercostal neuralgia associated with thoracoscopy (50% compared with 16%). Thoracotomy also was associated with a significantly higher incidence of postoperative atelectasis and pulmonary dysfunction than thoracoscopy (33% compared with 7%). Clinical and neurological outcomes were excellent (mean follow-up period 15 months). Among the 36 myelopathic patients, 22 completely recovered neurologically; five improved functionally but had some residual myelopathic symptoms; and nine stabilized. Among the 19 patients with isolated thoracic radiculopathies, 15 recovered completely and four improved moderately; no patient had worsened radicular pain. CONCLUSIONS: Thoracoscopic microdiscectomy is a reliable surgical technique that can be performed safely with excellent clinical and neurological results.

Adult↗
PubMed1997

Topical calcipotriol in childhood psoriasis.

BACKGROUND: The use of topical calcipotriol in adults with psoriasis is safe and effective. OBJECTIVE: Our purpose was to study the efficacy and safety of calcipotriol in children. METHODS: A multicenter, prospective, 8-week, double-blind, parallel group study was conducted in 77 children. Response to treatment was assessed by means of the Psoriasis Area and Severity Index (PASI) in that the intensity of redness, thickness, and scaliness as well as the area involved are scored. The children were 2 to 14 years of age and had stable psoriasis, involving less than 30% of the body surface. Forty-three children were assigned to receive calcipotriol ointment and 34 to receive placebo. Nine children dropped out of the study, six in the calcipotriol-treated group and three in the placebo-treated group. RESULTS: Both treatment groups (calcipotriol and placebo) showed significant improvement in PASI from baseline to the end of treatment, and the difference was not statistically significant. No serious side effects, in particular including those relating to calcium and bone metabolism, were recorded. CONCLUSION: Calcipotriol ointment was statistically significantly more effective than its vehicle in terms of the investigator's overall assessment and reduction in redness and scaliness but not in terms of PASI score.

Administration, Topical↗
PubMed1997

Angioscopy in vascular surgery.

The role of intraoperative angioscopy continues to evolve. To better define the role of angioscopy in vascular surgery, a review of the recent literature was performed. The most well-established indication for angioscopy is preparation of the saphenous vein for in situ bypass; however, angioscopy has also been demonstrated to be useful in the assessment of carotid endarterectomy, femoral vein valve repair, thromboembolectomy, and may be beneficial during endovascular stent grafting. Angioscopy is now a valuable adjunct in the management of the patient with peripheral vascular disease.

Angioscopes↗
PubMed1997

Topical undecylenic acid for herpes simplex labialis: a multicenter, placebo-controlled trial.

A multicenter, patient-initiated, double-blind, placebo-controlled trial of 15% undecylenic acid cream was conducted with 573 patients with recurrent herpes labialis. Treatment was applied 5 or 6 times daily until crusting and then thrice daily until healing. Patients were assessed daily until 48 h after crusting and then every other day until healing. Undecylenic acid significantly reduced the incidence and duration of viral shedding and the duration and severity of itching but did not increase abortive episodes or reduce times to healing, crusting, or progression of lesion size. When treatment was initiated during the prodrome, the time to crusting was reduced (P = .02) and the area under the symptom-time curve for pain and tenderness was reduced, approaching statistical significance (P = .06). Active treatment was well tolerated but caused dysgeusia and local irritation. Undecylenic acid 15% cream reduces viral shedding in recurrent herpes labialis, but clinical benefits are minimal and largely restricted to patients initiating therapy during the prodrome.

Administration, Topical↗
PubMed1997

Sex, alcohol and drugs? Young people's experience of Schoolies Week.

The 'Schoolies Week' phenomenon attracts more than 10,000 school leavers to Surfers Paradise in November and December each year. In a survey of these young people (N = 1796), from Queensland, New South Wales (NSW), and Victoria, about two-thirds of the young men and one-third of the young women expected to have sexual intercourse while in Surfers Paradise. Of these, about 80 per cent expected to use condoms. Most expected to be drunk most nights or every night of their holidays and 27 per cent of young men and 17 per cent of young women expected to be 'stoned' most nights or every night. Most young men and a significant proportion of young women achieved these expectations, with respondents from NSW and Victoria being more likely to do so than Queensland residents. Over one-third of the sample had engaged in sexual intercourse prior to interview, and of these, two-thirds of young men and over half the young women always used condoms with casual partners. The rates for sexual intercourse with regular partners were slightly lower. Those who were inconsistent condom users on holiday were likely to have a history of inconsistent condom use and to have multiple casual partners and/or regular partners in addition to casual partners. It is recommended that the NSW and Victorian governments accept some responsibility for the behaviour of young people attending Schoolies Week. A coordinated intervention strategy is required because there are significant prior indicators of young people's risk practices in Surfers Paradise during Schoolies Week.

Adolescent↗
PubMed1997

Traumatic carotid artery dissection and pseudoaneurysm treated with endovascular coils and stent.

PURPOSE: To report a case of post-traumatic internal carotid artery dissection and pseudoaneurysm formation at the C-1 level successfully treated by a percutaneous endovascular technique. METHODS AND RESULTS: A 20-year-old female presented 72 hours after a motor vehicle accident with incomplete occulosympathetic paresis (Horner's syndrome), carotidynia, and leftsided 1.5-cm x 2.5-cm pseudoaneurysm at the C-1 level. Neuroradiologists embolized the pseudoaneurysm with Guglielmi detachable coils and controlled the dissection with placement of a Wallstent. CONCLUSIONS: This report illustrates successful percutaneous endovascular treatment of a carotid dissection and pseudoaneurysm near the base of the skull.

Accidents, Traffic↗
PubMed1997

Pituitary-thyroid axis in short- and long-term experimental diabetes mellitus.

Short-term experimental diabetes mellitus (DM) produces a significant decrease in serum thyroid hormones, a decreased or normal serum thyroid-stimulating hormone (TSH) and a reduction in hepatic and renal T4-5'-deiodination. However, little is known about the effects of chronic diabetes mellitus on the pituitary-thyroid axis function. We evaluated the changes induced by very short-term (6 days), short-term (15 days) and chronic (6 months) streptozotocin-induced diabetes mellitus in 3-month old female Dutch-Miranda rat serum T4, serum TSH and T4-5'-deiodinase activity in the thyroid and pituitary glands. Serum hormones were determined by specific radioimmunoassays. Iodothyronine-5'-deiodinase activities were assayed in the thyroid and pituitary microsomal fractions using 2 microM T4 as substrate. Mean serum T4 was significantly decreased from 3.3 to 2.0 micrograms/dl 6 days after diabetes mellitus induction, and from 2.2 to 1.5 micrograms/dl after 15 days of DM, with no significant changes in serum TSH, indicating a decreased pituitary TSH responsiveness to the diminished suppression by T4, even though pituitary T4-5'-deiodinase activity was unchanged. Thyroid T4-5'-deiodinase was unchanged after 6 days of diabetes mellitus, but was significantly increased from 20.6 to 37.0 pmol T3/mg protein after 15 days. Six months after diabetes mellitus induction, both serum T4 and thyroid T4-5'-deiodinase returned to normal ranges and serum TSH was unchanged, although pituitary T4-5'-deiodinase was now significantly decreased from 2.7 to 1.7 pmol T3/mg protein. These findings indicate that some kind of adaptation to chronic insulinopenia may occur at the thyroid level, but this does not seem to be true for the pituitary.

Animals↗
PubMed1997

Thyroid hormone induces protein secretion and morphological changes in astroglial cells with an increase in expression of glial fibrillary acidic protein.

Thyroid hormone (T3) induces in vitro differentiation of astrocytes from the developing rat brain. T3 treatment induced the appearance of long processes in cultured cerebral hemisphere and mesencephalon astrocytes from embryonic and newborn rats. T3 treatment also produced a change in the morphology of cultured cerebellar astrocytes from 10-day-old rats, but not in cerebellar astrocytes from newborn rats. An increased expression of glial fibrillary acidic protein (GFAP) was also seen in the T3-treated newborn cerebral hemisphere and mesencephalic astrocytes. The morphological changes were induced earlier when the astrocytes were treated with conditioned medium (CM) obtained from cultures previously exposed to T3. Our results show that astrocytes from the developing rat brain are not homogeneous in their responsiveness to T3. Furthermore, the fact that CM produces a response similar to that obtained with T3 treatment but in less time, suggests that T3 might induce the secretion of factors by cultured astrocytes. These factors might, by an autocrine/paracrine effect, induce the expression of GFAP and differentiation in developing brain astrocytes.

Animals↗