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Biomedical subjects

H Lipton

Publications and source records attributed to H Lipton.

16 recordsLinked to original sources
PubMed2000

Bereavement practice guidelines for health care professionals in the emergency department.

A panel of multidisciplinary experts in the field of emergency services was convened by the National Association of Social Workers in 1999 to develop Bereavement Practice Guidelines. Funded by the Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, this paper discusses the best practices in supporting the family and staff when a child dies suddenly in the Emergency Department. Critical stages ranging from preparation to follow-up are discussed that help to enhance the quality of care provided to the family. A final stage addresses the support needs of staff.

Attitude to Death↗
PubMed2000

Emotional reactions to the sudden death of a child: the challenge to emergency care providers.

The death of a child has the potential to traumatize everyone involved. Child deaths caused by auto crashes, suicides, murders, gun accidents, drowning, fires, natural disasters, sudden illness, and other events trigger painful and profound emotional grief reactions in family members, and, at times, for emergency care providers. What grief reactions do family members experience when their child dies suddenly? What emotional struggles take place with siblings? How do emergency care providers cope with the tragic and painful deaths of children? We are guided by the literature and by our own experiences in pediatric emergency departments in trying to supply answers to the questions posed.

Adaptation, Psychological↗
PubMed1993

The operative treatment of intraarticular fractures of the distal radius.

Surgical management of 13 complex intraarticular (pilon) fractures of the distal radius was remarkably effective. Most of the fractures were the result of high-energy impact, with associated soft-tissue trauma in seven cases. The preoperative planning, fracture classification, surgical tactics, and results are presented in detail. Only three patients had any residual functional problems. Follow-up motion showed wrist dorsiflexion/palmar flexion to be 74% of the opposite side, and grip strength was 76% of the opposite side. Twelve of the 13 patients showed no roentgenographic evidence of posttraumatic arthritis at an average follow-up period of 2.5 years.

Adult↗
PubMed1990

Detection of restricted predominant epitopes of Theiler's murine encephalomyelitis virus capsid proteins expressed in the lambda gt11 system: differential patterns of antibody reactivity among different mouse strains.

Intracerebral injection of mice with Theiler's murine encephalomyelitis virus results in chronic demyelination in susceptible strains, and serves as a model system for the study of multiple sclerosis. The role of individual epitopes in the disease process remains to be elucidated. Random fragments of DNA from the viral capsid protein genome covering the coding regions from VP1, VP2, and VP3 have been expressed in the lambda gt11 vector system. Fusion proteins from the clones were expressed and probed with antibodies from both resistant and susceptible strains of mice. Each strain displays a distinctive pattern with certain fusion proteins recognized by all of the strains and others recognized uniquely by either the susceptible or the resistant strains.

Animals↗
PubMed1989

The effect of cyclosporine on the use of hospital resources for kidney transplantation.

Over the past decade the clinical results of kidney transplantation have improved substantially, with much of the benefit being attributed to the introduction in late 1983 of the immunosuppressive drug cyclosporine. To assess the effect of cyclosporine on the use of hospital services, we studied 702 patients who received kidney transplants at the University of California, San Francisco, between July 1982 and June 1986. All services were priced in constant 1985 dollars, and multiple regression analysis was used to adjust for changing patient and hospital characteristics. The introduction of cyclosporine for patients receiving kidneys from cadavers was associated with a significantly shorter adjusted mean postoperative stay (26.4 days as compared with 37.0 for patients not taking the drug; P less than 0.0001) and lower adjusted mean hospital charges ($28,649 as compared with $37,895; P less than 0.0001), although cyclosporine was not associated with changes in the use of services by patients who received transplants from living related donors. Cyclosporine was also associated with a reduction in the use of certain ancillary services, such as laboratory tests and radiographic procedures. In patients without diabetes who received cadaver kidneys, a sequential cyclosporine regimen (in which a combination of antilymphoblast globulin, prednisone, and azathioprine was given before cyclosporine) reduced the use of hospital services even more than did a cyclosporine regimen in which the combination was not given. The results suggest that new medications, such as cyclosporine, that reduce the frequency of complications and improve outcomes may also reduce the use of hospital resources.

Adult↗
PubMed1987

Lansing poliovirus infection in mice: antibody demonstrable by enzyme-linked immunosorbent assay (ELISA) and immunoprecipitation but not by neutralization.

Adult mice infected intracerebrally (i.c) with the Lansing strain of type 2 human poliovirus (HPV2) failed to develop a systemic neutralizing antibody response until 2 months post-infection (p.i). In contrast, an enzyme-linked immunosorbent assay (ELISA) demonstrated an antibody response of IgM and IgG classes beginning at day 1 p.i. with peak levels reached by 5 weeks p.i. This response was slightly greater in paralyzed than in nonparalyzed animals. Immunoprecipitation of poliovirus proteins from cytoplasmic extracts and disrupted purified virion preparations revealed antibodies to three capsid proteins, two capsid precursor proteins, and one nonstructural protein. Finally, neither neutralizing antibody nor definite virus replication was detected after oral, intraperitoneal, or intravenous routes of inoculation. We conclude that the lack of a systemic neutralizing antibody response in mice is probably due to an insufficient amount of infectious virus and consequently viral neutralizing epitopes reaching extraneural lymphoid tissues.

Animals↗
PubMedDate not supplied

Cryopreserved cadaveric allografts for treatment of unexcised partial thickness flame burns: clinical experience with 12 patients.

Partial thickness burns (PTB) usually heal within 3 weeks. Prevention of infection and desiccation of the wounds are crucial for optimal healing. Early tangential excision of the burn eschar and allografting prevent deepening of the burns, and are therefore advocated for treatment with the best functional and aesthetic results. For superficial partial thickness burns (SPTB) conservative use of topical antimicrobial agents with frequent dressing changes are implemented. We compared the conservative treatment for PTBs and SPTBs to grafting cryopreserved cadaveric allografts with no prior excision. Twelve patients with flame PTB areas were allografted after mechanical debridement without excision of the burn wounds. The allografts were cadaveric skin cryopreserved by programmed freezing and stored at -180 degrees C for 30-48 months. Matching burns for depth and area were treated with silver sulfadiazine (SSD) one to two times daily until healing or debridement and grafting were required. It was found that 80 per cent of the cryopreserved allografts adhered well and 76 per cent of the treated areas healed within 21 days, whereas only 40 per cent of the SSD-treated burns healed within 21 days. Partial thickness burns can be treated successfully with viable human allografts (cryopreserved cadaveric skin) with no prior surgical excision. The burn wounds heal well within 3 weeks. For deep partial thickness burns (DPTB) treatment with allografts has no advantage if they have not been previously excised.

Adolescent↗
PubMedDate not supplied

Induction of Theiler's murine encephalomyelitis virus (TMEV)-induced demyelinating disease in genetically resistant mice.

Theiler's murine encephalomyelitis virus-induced demyelinating disease, a murine model for multiple sclerosis, is the result of persistent infection which leads to a T cell-mediated immunopathology. Susceptible strains develop virus-specific DTH responses while resistant strains do not, and this response has been proposed as the basis for inflammation and demyelination. (C57BL/6 x DBA/2)F1 hybrid animals, normally resistant to TMEV-induced demyelinating disease, become susceptible when treated in vivo prior to infection with low dose cyclophosphamide. Comparable pretreatment of other resistant animals, C57BL/6 and CB6 (BALB/c x C57BL/6) F1 hybrids, does not render them susceptible (despite the H-2 identity of CB6F1 and B6D2F1 hybrids). Thus the "latent" susceptibility in B6D2F1 hybrids must be attributed to non-H-2 genes from the susceptible D2 parent. Resistance can be restored to CY-treated B6D2F1 animals by the adoptive transfer of splenic cells (including T cell enriched populations) from non-CY-treated donors. Resistance to TMEV-IDD in these animals, therefore, may involve active inhibition of a "latent" disease susceptibility.

Animals↗