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Biomedical subjects

E Gross

Publications and source records attributed to E Gross.

At least 73 records · Page 4Linked to original sources
PubMed1996

Cancer screening in primary care: strategies for your office. A program of the Connecticut Division of the American Cancer Society.

Primary-care physicians' compliance with cancer screening guidelines has been in general unsatisfactory. Mailings have not had the desired effect upon these busy physicians who are preoccupied with many other issues. The Ohio Division of the American Cancer Society developed a program of in-office cancer screening education of primary-care physicians which resulted in a significant improvement in compliance to cancer screening guidelines. The Connecticut Division of the American Cancer Society has pursued this concept with their own program of visits targeted at physicians and their office staffs. A description of this program, which is still in its initial phases, is presented. The impact will be evaluated in due time, however additional volunteers to conduct these visits are needed.

Connecticut↗
PubMed1996

[Nurses' and patients' experience of combined health service delivery to all population groups in a hospital].

In a community hospital in Gauteng, the hospital management had, on short notice, to provide combined health services to all population groups. In the past different health services were delivered to each population group. The integration of health service delivery was a sudden change. Based on this, research questions arose, namely: how do nurses and patients experience this change, and how could they be assisted to adjust to the change. The research objectives were twofold, namely: to explore and describe nurses and patients' experience of combined health delivery to all population groups and based on the results to make recommendations to assist them with adjustment to a combined health delivery system. An exploratory, descriptive and contextual research design was followed. Trustworthiness was ensured by applying Guba's approach. Phenomenological and individual focus interviews were conducted with forty nurses and patients who were selected purposively. Field notes were written after completion of each interview. The transcribed data was analysed by using Giorgi's and Kerlinger's methods combined. Results were discussed and a literature control completed. The most important conclusions reached were: there was an insufficient administrative structure in the hospital as a result of insufficient preparation for the combined health service delivery for all population groups; the whites' perception of different populations groups is based on an ethnocentric Western approach. This led to their experience of culture shock that resulted in feelings of anger/frustration, fear and sadness; the willingness of other populations groups to adjust to combined health service delivery led to their experience of happiness; there exists communication problems between population groups because of their not being able to communicate in their own language and the difference in communication styles; the verbalised Christian viewpoint and values of whites nurses and patients are not congruent with their prejudiced perception of people of other population groups and cultures, and the different population groups do not know each other's lifeworlds and that leads to prejudices that block open communication. Several recommendations were made based on these conclusions.

Black or African American↗
PubMed1995

[Hepatosplenic fungal abscesses in the immunocompromised].

A rare, newly recognized variant of systemic fungal infection is the occurrence of focal hepatosplenic microabscesses in the immunocompromised patient. A patient with persistent unexplained fever should have a CT or ultrasound scan of the abdomen. The presence of multiple splenic lesions strongly suggests fungal disease. If antifungal therapy does not result in complete resolution of fever and splenic lesions, splenectomy is recommended.

Abdomen↗
PubMed1995

[Platelet transfusions in neonatology].

Thrombocytopenia occurs in 20% to 40% of infants admitted to a neonatal intensive care unit. Approximately 30% of the newborns with severe thrombocytopenia below 50.10(9)/l platelets receive platelet transfusions. The etiology may be: bacterial infection, DIC and immune mediated thrombocytopenia. The consequences of thrombocytopenia are significant risks of severe intracranial hemorrhage and neurologic morbidity. Therapeutic platelet transfusions are given to actively bleeding neonates with less than 50.10(9)/l platelets. Prophylactic platelet concentrates are usually given to infants with platelets counts below 20.10(9)/l. The standard platelet concentrate (CMV-negative donor) is the product of choice for newborns. Fetal intracranial hemorrhage is possible as soon as 20 weeks of gestation in allo-immune thrombocytopenia. Actually percutaneous umbilical blood sampling is very useful to measure fetal platelets count in order to decide in utero maternal platelet transfusion. Maternal irradiated plateletpheresis concentrates are preferentially infused in this indication. At the end of pregnancy, cesarean section is preferred to normal vaginal delivery if fetal thrombocytopenia below 100.10(9)/l is observed. In pregnant women with auto-immune thrombocytopenia, the decision to carry out percutaneous umbilical blood samples should be weigh relatively to the 3-5% estimated risk of serious consequences. Platelets transfusions are particularly successful in immune thrombocytopenia but less effective in other clinical circumstances.

Female↗
PubMed1995

An outbreak of venomous spider bites in a citrus grove.

An outbreak of necrotizing spider bites in citrus groves in the Aravah valley of southern Israel is reported. Bites were clinically diagnosed to be due to the brown recluse spider Loxosceles rufescens (Dufour, 1820) (Loxoscelidae), one of the most common spiders identified in the groves. The distribution of L. rufescens in this area appears to be restricted to one locality, suggesting that it was a point introduction. This report suggests a previously unreported risk for workers in citrus groves and describes an ecologic intervention consisting of tree pruning and clearing of ground cover that appears to have been successful in reducing the incidence of bites.

Adult↗
PubMed1995

Older children and adolescents living with perinatally acquired human immunodeficiency virus infection.

OBJECTIVE: To describe the clinical, immunologic, and psychosocial characteristics of children living with perinatally-acquired human immunodeficiency virus (HIV) infection beyond the age of 9 years. METHODS: This is a descriptive cohort study of 42 surviving perinatally infected children older than 9 years followed at the Children's Hospital Acquired Immunodeficiency Syndrome (AIDS) Program (part of a university-based inner city medical center) as of June 1993. The study is based on medical record data of clinical, immunologic, and psychosocial parameters. RESULTS: The cohort includes 20 boys and 22 girls with a mean age of 136 months. The mean age at diagnosis of HIV infection was 88 months, and 59.5% were asymptomatic at the time of diagnosis. Currently, after a mean follow-up period of 48 months from diagnosis, 23.8% remain asymptomatic, 19.1% have non-AIDS-defining HIV-related symptoms, and 57.1% have AIDS; 85.7% of the cohort did not develop HIV-related symptoms until after 48 months of age (late-onset prolonged survivors). There was an average annual decline of 71.4 CD4+ cells/microL in the cohort from the ages of 7 to 16 years, and 21.4% have a current CD4+ lymphocyte count of greater than 500 cells/microL, 28.6% between 200 and 500 cells/microL, and 50% less than 200 cells/microL; 76% are orphaned as a result of maternal death, with the majority of the cohort (60%) cared for by extended family members. Disclosure of diagnosis has occurred in 57.1%. The vast majority of the cohort (76%) are attending regular school, with the remainder in special education. CONCLUSIONS: Although close to one quarter of the children and adolescents ages 9 to 16 years living with perinatally acquired HIV infection described in this cohort remain asymptomatic and have a relatively intact immune system, the remainder are living with significant HIV-related symptoms, many of which are chronic in nature and have an impact on daily living. The children in this cohort had both significant immunologic deterioration and symptomatic disease progression during the mean follow-up period of 48 months from the time of diagnosis with HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1994

[Surgical treatment of choledochal cyst].

Our experience with 11 cases of cystic dilation of the biliary tract is reported. 10 children with choledochal cyst were treated by cystduodenostomy (5 cases) and excision of the cyst with hepaticojejunostomy (5 cases). 1 patient who presented with Caroli's disease was not operated. At long term follow-up, all patients except 1 are asymptomatic. A 16-year-old girl who presented with acute pancreatitis 13 years following cystduodenostomy, early in our experience, underwent excision of the choledochal cyst and hepaticojejunostomy, with uneventful postoperative course. We conclude that in the era of modern imaging, accurate preoperative diagnosis may contribute to better planning and outcome of the surgical treatment of these relatively rare congenital biliary anomalies.

Adolescent↗
PubMed1994

[Reduced-size liver transplants in children].

Orthotopic liver transplantation is now used for children with end-stage liver disease, but the scarcity of size-matched liver allografts for children has limited its use. Reduced-size liver transplantation, in which only part of the liver is used as a graft, overcomes size disparity and increases significantly the potential donor pool for children. A 4-year-old boy with fulminating hepatic failure due to hepatitis became the first case of reduced-size liver transplantation in Israel. A left hepatic lobe allograft from an adult donor was used. The boy is home and well 9 months after transplantation. Reduced-size liver transplantation was first performed in a child by Bismuth and Houssin in 1984. Reports from several centers show that survival of recipients of reduced-size liver allografts and the rate of retransplantation does not differ significantly from that in recipients of full-sized livers.

Child↗
PubMed1994

Isolation of lipoprotein (a) using the regenerate of a dextran sulfate cellulose LDL apheresis system.

A simple method for the preparation of lipoprotein (a) is presented. The procedure uses the eluate of an LDL apheresis system operating on the basis of LDL adsorbing dextran sulfate cellulose. The eluate is concentrated by tangential flow membrane filtration and subjected to ultracentrifugation, first at a density of 1.125 kg/liter and then at 1.050 kg/liter. The crude lipoprotein (a)-containing fraction is chromatographed on agarose (Bio-Gel A-15m) to remove contaminating low-density and high-density lipoproteins. As demonstrated by immunoelectrophoresis with intermediate gel, the method provides lipoprotein (a) completely free of LDL. SDS-polyacrylamide gel electrophoresis showed that apolipoprotein E was associated with purified lipoprotein (a). On agarose gel electrophoresis and two-dimensional immunoelectrophoresis, lipoprotein (a) prepared by the proposed method cannot be distinguished from native lipoprotein (a). The major advantage of the procedure is that it allows the isolation of large amounts of lipoprotein (a) from a single donor.

Adsorption↗
PubMed1994

Manometric study of the voluntary inhibition action in normal volunteers.

PURPOSE: A voluntary inhibition action whereby a voluntary squeeze of the external sphincter causes reflex relaxation of the rectum has been previously proposed but not proven. Such a reflex would enable the subject to defer defecation to a socially acceptable time. The purpose of this study was to determine whether or not such a reflex exists. METHODS: We measured rectal compliance with and without a voluntary squeeze using a specially designed balloon catheter in nine subjects. RESULTS: When corrected for increased intra-abdominal pressure caused by inadvertent Valsalva's maneuver during voluntary squeezing, there was a significant increase in rectal compliance during voluntary contraction of the external sphincter (P < 0.01). CONCLUSION: This lends support to the proposed existence of the voluntary inhibition action.

Adult↗
PubMed1994

Distinct electric potentials in soma and neurite membranes.

Structurally similar voltage-dependent ion channels may behave differently in different locations along the surface of a neuron. A possible reason could be that channels experience nonuniform electrical potentials along the plasmalemma. Here, we map the electrical potentials along the membrane of differentiated N1E-115 neuroblastoma cells with a potential-sensitive dye. We find that the intramembrane potential gradient is indeed more positive in the membranes of neurites than in the membranes of somata. This is not attributable to differences in ion conductances or surface charge densities between the membranes of neurites and somata; instead, it can be explained by differences in lipid composition. The spatial variation in intramembrane electrical potential may help account for electrophysiological and functional differences between neurites and somata.

Animals↗
PubMed1994

Dual-wavelength ratiometric fluorescence measurement of the membrane dipole potential.

The electrostatic potentials associated with cell membranes include the transmembrane potential (delta psi), the surface potential (psi s), and the dipole potential (psi D). psi D, which originates from oriented dipoles at the surface of the membrane, rises steeply just within the membrane to approximately 300 mV. Here we show that the potential-sensitive fluorescent dye 1-(3-sulfonatopropyl)-4-[beta[2-(di-n-octylamino)-6- naphthyl]vinyl]pyridinium betaine (di-8-ANEPPS) can be used to measure changes in the intramembrane dipole potential. Increasing the content of cholesterol and 6-ketocholestanol (KC), which are known to increase psi D in the bilayer, results in an increase in the ratio, R, of the dye fluorescence excited at 440 nm to that excited at 530 nm in a lipid vesicle suspension; increasing the content of phloretin, which lowers psi D, decreases R. Control experiments show that the ratio is insensitive to changes in the membrane's microviscosity. The lack of an isosbestic point in the fluorescence excitation and emission spectra of the dye at various concentrations of KC and phloretin argues against 1:1 chemical complexation between the dye and KC or phloretin. The macromolecular nonionic surfactant Pluronic F127 catalyzes the insertion of KC and phloretin into lipid vesicle and cell membranes, permitting convenient and controlled modulation of dipole potential. The sensitivity of R to psi D is 10-fold larger than to delta psi, whereas it is insensitive to changes in psi S. This can be understood in terms of the location of the dye chromophore with respect to the electric field profile associated with each of these potentials. These results suggest that the gradient in dipole potential occurs over a span s5 A, a short distance below the membrane-water interface. These approaches are easily adaptable to study the influence of dipole potentials on cell membrane physiology.

Animals↗
PubMed1994

An outbreak of phytophotodermatitis due to celery.

BACKGROUND: Celery is known to contain psoralens, a group of substances that cause a toxic dermal reaction on exposure to ultraviolet A rays (UVA). An outbreak of phytophotodermatitis amongst 11 workers in a celery harvest in southern Israel is reported. METHODS: Analysis of the trigger factors was carried out. The patients were questioned regarding their working conditions. Samples of the celery that the workers had been harvesting were analyzed for levels of total psoralens by means of high performance liquid chromatography (HPLC). Levels of UVA were measured. RESULTS: It was found that the celery harvested in the south of the country contained 84 micrograms/g fresh weight (f.wt.) total psoralens as compared to 35 micrograms/g f.wt. in celery harvested in the north of the country at the same time. The following year the celery harvested in the south contained only 26 micrograms/g f.wt. total psoralens. Other risk factors noted were that the subjects had fair skin, wore no protective clothing, and worked with moist hands. In addition, the days were clear and sunny thus ensuring maximal UV radiation for that time of the year. CONCLUSIONS: Multiple factors contributed to the outbreak of phytophotodermatitis. A late harvest in the south of the country is incriminated as the cause of the unusually high levels of psoralens in the celery of that year.

Agricultural Workers' Diseases↗
PubMed1994

Hyperextension fracture-dislocation of the thoracic spine with paraplegia in a patient with diffuse idiopathic skeletal hyperostosis.

The case is described of a hyperextension thoracic spine fracture in a patient with diffuse idiopathic skeletal hyperostosis (DISH). A 70-year-old woman awoke paraplegic after retroperitoneal surgery after having been positioned in the hyperextended axially rotated position. Imaging demonstrated a T9-10 fracture-dislocation with severe pressure on the spinal cord, as well as findings typical of DISH. This case emphasizes the danger inherent in manipulating the ankylosed hyperostotic spine. It is proposed that patients undergoing surgery in this position should be evaluated for DISH as an additional risk factor.

Aged↗
PubMed1994

[Colo-anal pouch after total rectum resection].

The coloanal anastomosis is in low rectal cancer for oncological reason the appropriate procedure, if the sphincter is not involved, but is followed often by impaired continence. For better continence a colonic-J-pouch anal anastomosis was performed in 11 consecutive operated patients after rectal resection predominantly for rectal cancer. The clinical and physiological results in 10 out of 11 patients having a colonic-J-pouch anastomosis (CPA) and in 11 out of 21 patients having a straight coloanal anastomosis (SAA) were compared. 1 CPA patient and 2 SAA patients were incontinent. 7 SAA and no CPA patient had minor incontinence. 9 CPA and 2 SAA patients were fully continent. The stoolfrequency per 24 hours was 3 in the CPA while it was 6 in SAA on average (p < 0.005) 5 months after closure of the protective colostomy. There was no significant difference in anal resting pressure and squeeze pressure and in the frequency of the sphincterinhibitory reflex in the two groups. The compliance was different in both groups (4.4 in CPA vs 1.9 in SAA patients) but not significantly. The patients with a colonic J-pouch had a better continence than the patients with a straight coloanal anastomosis. The better continence is associated with an higher compliance, which results in a more favorable reservoir function.

Adult↗
PubMed1994

[Preperitoneal implantation of Dacron mesh for treatment of recurrent inguinal hernia and bilateral inguinal hernia].

UNLABELLED: The preperitoneal approach with implantation of a dacron sheet was applied in 37 patients with recurrent hernias and in 30 patients with primary bilateral hernias. In total 120 hernias were repaired. The patients were controlled prospectively for serious complications. The patients were examined every 3 months in the first and every 6 months in the second year after operation. The mean follow-up time was 17.2 months. COMPLICATIONS: In one patient with a combined hernia an indirect hernia sac was not detected intraoperatively, so it persisted. Recurrences were not observed. COMPLICATIONS (hematoma, fluid collections, wound infections, intraabdominal adhesions) occurred in 13.2 of the patients. CONCLUSIONS: The preperitoneal implantation of a dacron sheet is a safe and reliable procedure for treatment of recurrent groin hernias and primary hernias with a high risk of recurrence. The rate of infection is low under preventing measures.

Adult↗