Search PubMed⌕ Search

Biomedical subjects

E Kaufman

Publications and source records attributed to E Kaufman.

At least 127 records · Page 7Linked to original sources
PubMedDate not supplied

Israeli dentists: a survey of infection control office practices and care of medically compromised patients.

A survey was conducted by interviewing a randomly selected sample of practicing dentists in Israel in 1991. The aim of this study was to evaluate methods of infection control in current use and to learn about the access to care for medically compromised patients. One hundred seventeen dentists were interviewed. This group represented a majority of graduates from Israeli schools (66). With respect to infection control, only 28% of the population surveyed routinely uses gloves, but 43% use steam autoclave, and 70% use dry-heat sterilization. A very high percentage (87%) took a verbal medical history, while a small minority (27%) had their patients fill out a written questionnaire. Only occasionally was the name of the patient's physician requested or recorded, implying a flaw in interprofessional communications. Only 26% of the dentists said they would treat patients with hepatitis and/or AIDS. Only about half the dentists accepted patients on chemotherapy or radiotherapy or those who were taking anticoagulant drugs. Physical access for dental patients in wheelchair or stretcher was markedly limited, with referral to regional hospitals the routine for these patients.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Automated RIBA HCV strip immunoblot assay: a novel tool for the diagnosis of hepatitis C virus infection in hemodialysis patients.

Hemodialysis (HD) patients remain a high-risk group for hepatitis C virus (HCV) infection. Serological assays (enzyme-linked immunosorbent assays, ELISAs) are the only tests currently approved by the Food and Drug Administration in the United States for the diagnosis of HCV. The RIBA HCV Strip Immunoblot Assay (SIA) is an established method for supplemental testing of repeat reactive hepatitis C ELISA patients on HD. However, the current manual procedure is labor intensive, requiring subjective band scoring and result interpretation. Recently, the automated CHIRON RIBA HCV Processor System has been designed to perform RIBA supplemental testing. The CHIRON RIBA HCV Processor System consists of a bench-top instrument that provides objective evaluation of the RIBA immunoblot strips, by measuring the light differentially reflected from the developed bands and white background, creating a density of reflectance. The CHIRON RIBA HCV Processor System assesses the intensity of each of the reactive bands in relation to the intensity of the internal control bands on each RIBA HCV strip. Comparison between processor and manual protocols was performed using a large (n = 200) cohort of ELISA 3.0 HCV negative and positive patients on maintenance HD. The test characteristics of RIBA HCV 3.0 SIA were identical with manual and automated runs. The relative intensity values of antigenic bands by the CHIRON RIBA HCV 3.0 Processor System between anti-HCV positive and negative patients were significantly different; only 15 of 784 (1.9%) antigenic bands had borderline reactivities. The correlation of test results between manual and automated runs was very high (kappa value 0.989). Among positive results by RIBA HCV 3.0 SIA, there was a strong concordance between manual and automated runs with regard to the pattern of reactivity (kappa value 0.943). The discordant results between manual and automated protocols were attributable to increased variability of antigen scores close to the cutoff value for both tests. In conclusion, the CHIRON RIBA HCV 3.0 Processor System is capable of performing RIBA HCV 3.0 SIA in the HD population accurately with minimal operator involvement. The test characteristics of RIBA HCV 3.0 SIA were identical by manual and automated runs. There was a strong correlation between the results of the manual and automated runs; the few discordant results between the two procedures were mostly due to increased variability of antigen scores close to the cutoff value for both tests. The Centers for Disease Control and Prevention in the USA have recently included chronic HD patients among those persons for whom routine HCV testing is recommended; HCV-infected patients on HD often have a high rate of indeterminate results by manual RIBA technology which is operator dependent for band scoring and result interpretation. The CHIRON RIBA HCV 3.0 Processor System may be very useful for supplemental anti-HCV testing of ELISA repeat reactive specimens in clinical practice within dialysis units.

Hepatitis C, Chronic↗
PubMedDate not supplied

Receptor depletion in diabetes mellitus: correction with therapy.

This report describes two patients with diabetes mellitus, presenting with insulin resistance and depression of erythrocyte insulin receptor binding to less than one-third of normal. Scatchard analysis of the data was consistent with a depletion in insulin receptors in these poorly controlled diabetic patients. Therapy with tolbutamide and reduced insulin administration resulted in restoration of erythrocyte receptor binding, clinical resolution of the insulin resistance, and amelioration of hyperglycemia. These data suggest a role for transient depletion and/or dysfunction of cellular receptors of insulin activity in the evolution of insulin resistance in diabetes.

Adult↗
PubMedDate not supplied

Family systems and family therapy of substance abuse: an overview of two decades of research and clinical experience.

Substantial recent progress has been made in the study of family systems and in the field of family therapy. The gradual application of these new technologies to the field of substance abuse is discussed. A shift has occurred toward quantitative assessment of the three generational systems of the substance abuser as well as inclusion of that entire system in the family therapy. Family therapy treatment methods have been developed to motivate substance abusers, detoxify them, and work with the family when the identified patient is not involved in treatment and to restructure the entire family. The field of family therapy evaluation is in its infancy but plans are underway for elaborate scientific investigation of efficacy.

Alcoholism↗
PubMedDate not supplied

Critical aspects of the psychodynamics of substance abuse and the evaluation of their application to a psychotherapeutic approach.

A model of psychotherapy is proposed which integrates psychodynamic theory, AA and other 12-step groups, family therapy, and dual-diagnosis issues into a phase-specific method. This therapy is done in three stages: (1) dryness (assessment and detoxification); (2) sobriety (achieving stable abstinence); and (3) wellness (using sobriety as a basis for personal growth and intimacy. The utility of an evolving concept of countertransference and new studies demonstrating the efficacy of psychotherapy are also discussed. Several challenging research questions are presented which, if answered, would assess the efficacy of this model.

Alcoholics Anonymous↗
PubMedDate not supplied

Side effects of triazolam in children.

PURPOSE: This study examined the incidence of side effects occurring with three doses of orally administered triazolam in children undergoing restorative dental procedures. METHODS: Thirty children, aged 39-81 months, participated in the study. The children were pretested for gait ataxia, amnesia, visual acuity, stereoscopic depth perception, and diplopia during a screening session. In a subsequent appointment, children received one of three triazolam dosages (0.005, 0.015, and 0.030 mg/kg) prior to dental treatment. Dosage assignment was random and double blind. Each child received a single triazolam dosage. Tests for gait ataxia, amnesia, and visual disturbances were repeated following drug administration. RESULTS: The proportion of children experiencing ataxia, amnesia, and diplopia increased with increasing triazolam dosages. The 0.030-mg/kg triazolam dosage impaired visual acuity and stereoscopic depth perception. CONCLUSION: Triazolam produces ataxia, amnesia, and diplopia in a dose-dependent manner in children.

Administration, Oral↗
PubMedDate not supplied

Temperature ofthe pulp chamber during impression taking of full crown preparations with modelling compound.

Temperature elevations were measured in the pulp chamber of full cast crown preparations during impression taking with modelling compound in copper bands. Uncontrolled flaming, controlled flaming, and water heating of the bands produced temperatures of 53, 44, and 41.5 C, respectively. The time involved in restoring the temperature in the pulp to 37 C was determined. The implications of delayed chilling are discussed.

Copper↗
PubMedDate not supplied

Transient suppression of involuntary movements in cerebral palsy patients during dental treatment.

The efficacy of nitrous oxide (N2O) and oxygen (O2) inhalation in reducing involuntary movements in cerebral palsy (CP) dental patients was examined using electromyography (EMG) and H-reflex techniques. Quantification and analysis of the EMG data revealed a progressive elimination of these movements to a point resembling the state of a normal muscle at rest. There was a gradual decline in the number of bursts and an increase in the silent periods of the EMG while under N2O. The recovery period after cessation of N2O was characterized by a successive increase in the number of bursts and a simultaneous decrease in the silent periods of the EMG to a state similar to the baseline recorded prior to inhalation of N2O/O2. The H-reflex also was found to decrease gradually during inhalation of N2O/O2 to about one-half of the baseline. This parameter also returned to baseline after N2O wash-out. Our findings demonstrate quantitatively the effectiveness of N2O in reducing the central motor neuron pool excitability to an extent that suppresses involuntary movements and allows more controllable and comfortable dental management.

Adolescent↗
PubMedDate not supplied

Sensory experience induced by nitrous oxide analgesia.

Preliminary findings on a group of 15 dental patients, treated with nitrous oxide indicated frequent occurrence of several, well-defined sensory experiences related to various modalities. A subsequent controlled experiment carried out on 44 volunteers, inhaling a 35% N2O + 65% O2 sedative gas-mixture as well as O2 alone in two different sessions confirmed a large variety of sensations not related to external stimuli. Taste and/or odor and thermal sensations were often reported as well as changes in auditory or visual perception of the environment in addition to reports of general heaviness, relaxation or tingling.

Adolescent↗
PubMedDate not supplied

An experimental study of the control of the gag reflex with nitrous oxide.

Gagging represents a management problem during dental procedures. A controlled, double blind experiment on human volunteers evaluated the efficacy of nitrous oxide for suppressing experimentally-induced gagging. The ability of the subjects to tolerate palatal and oropharyngeal stimulation was evaluated by measuring the distance of the anatomic palatal and oropharyngeal structure which produce gagging. It was observed that under N(2)O/O(2) inhalation subjects tolerated a significantly more intrusive (deeper) oropharyngeal stimulation than under control conditions.

Adult↗
PubMedDate not supplied

Nitrous oxide analgesia in selected dental patients.

Nitrous oxide analgesia is presented as the analgesic method of choice in medically compromised patients. The resemblance between the action of nitrous oxide and that of morphine is emphasized. The combination of the opiate-like action of nitrous oxide with the advantages of an inhalation technique makes it preferable and superior to parenteral opiate administration. It may thus be termed as an inhalation "opiate".Since its introduction into clinical use by Wells in 1844 (1), nitrous oxide (N(2)0) has been applied as an anesthetic and analgesic agent in various medical situations, including dentistry (2). The development of equipment affording safe administration of accurate concentrations of either pre-mixed or adjustable N(2)0 and oxygen enabled the application of "relative analgesia" as an important technique in the relief of pain. The pharmacological action and analgesic properties of N(2)0 received renewed interest after Berkowitz et al (3) showed the resemblance between its mode of action and that of opiates. Recent human and animal studies indicated that N(2)0 activates the endogenous opiate system(s) in a manner similar to that of morphine (4). The availability of an analgesic gas which, on the one hand, mimics opiate action whilst on the other hand its administration is continuously adjustable, as opposed to other modes of sedation, makes it into an ideal adjunct in dental procedures. Owing to its minimal side effects, the use of N(2)0 is especially recommended in the management of anxious children and medically compromised patients.This report presents three illustrative patients in whom nitrous oxide proved to be the drug of choice during dental procedures.

Anesthesia, Dental↗
PubMedDate not supplied

Analgesic action of intravenous diazepam.

Intravenous diazepam is commonly used in clinical dentistry to produce sedation for dental procedures. Its chief benefit seems to derive from its sedative and amnesic properties. The literature contains conflicting reports about the direct analgesic effects of the drug. In the present study, we observed significant increases for conventional pain threshold measures in response to electric tooth pulp stimulation and decreased sensitivity to a fixed painful stimulus when diazepam was administered intravenously using clinical criteria for conscious sedative dosages. The data support the possibility that intravenously administered diazepam in conscious sedative doses may have some analgesic action in addition to its better documented sedative and amnesic properties.

Adult↗
PubMedDate not supplied

Comprehensive dental treatment under general anesthesia for patients with homocystinuria.

Continued investigation in genetic biology has helped the medical profession to prevent complications in patients with this defect. Moreover, early diagnosis and treatment are recommended, in order to prevent mental retardation and visual deterioration. Refinement of techniques concerning preparation of the patient for general anesthesia and postoperative care merit further investigation. Simple measures undertaken in the two patients described made the completion of dental treatment possible without serious complications.

Adolescent↗