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Biomedical subjects

I Levy

Publications and source records attributed to I Levy.

At least 55 records · Page 3Linked to original sources
PubMed1998

Medical, cognitive, emotional, and behavioral outcomes in school-age children conceived by in-vitro fertilization.

Assessed long-term effects of assisted reproduction technologies of in-vitro fertilization (IVF) and related techniques of embryo transfer (ET) on children's adjustment. 51 school-age Israeli children conceived by IVF/ET were compared with 51 control-matched children conceived spontaneously. The assessment included a comprehensive medical evaluation, a psychological examination, teachers' reports, parents' reports, and children's self-reports. As compared with controls, IVF/ET children did not reveal significant differences in physical and neurological status or on cognitive measures of IQ, visual-motor coordination, visual memory, and verbal comprehension. Nevertheless, the IVF/ET children were scored lower by teachers on measures of socioemotional adjustment in school and on self-report measures of anxiety, aggression, and depression. Among IVF/ET children, the tendency to be at a greater risk for emotional disturbances was exacerbated among boys and among children whose parents were older.

Affective Symptoms↗
PubMed1998

Monograph series on aging-related diseases: X. Prostate cancer.

Prostate cancer is the most commonly diagnosed cancer among Canadian men, excluding non-melanoma skin cancer. Prostate cancer incidence increases almost exponentially with age; most cases are diagnosed in men aged 65 years or older. With the possible exception of animal fat consumption, no known widespread modifiable risk factors have been identified. Although the prognosis is good if appropriate treatment occurs in the early stages of disease, the ability of existing early detection techniques to decrease mortality has not yet been demonstrated. The considerable economic and societal burden of prostate cancer and its treatment, coupled with the projected large increase in the number of new prostate cancer cases as the population ages, make this disease a very important public health issue.

Aged↗
PubMed1997

Low mitochondrial glycerophosphate dehydrogenase activity in lymphocytes of women with gestational diabetes.

An abnormally low activity of mitochondrial FAD-linked glycerophosphate dehydrogenase (m-GDH), relative to the paired measurement of glutamate dehydrogenase, was found in CD3+ lymphocytes from 4 out of 14 mothers with gestational diabetes mellitus, but in none of 36 control mothers. The low m-GDH activity coincided with an abnormally high incidence of familial history for non-insulin-dependent diabetes. These findings are compatible with the view that an inherited or acquired defect of m-GDH may participate to the pathogenesis of beta-cell dysfunction in a subgroup of patients with gestational diabetes.

Adult↗
PubMed1997

Infected hydrocele following laparoscopic appendectomy: case report.

In the literature, specific reported complications after laparoscopic appendectomy include bowel injury, hemorrhage, wound infection, and cecal fistula. We report the occurrence of infected hydrocele after laparoscopic appendectomy in a 20-year-old man. This complication, to our knowledge, has not yet been described in the literature.

Adult↗
PubMed1997

Development of an instrument to measure cancer screening knowledge, attitudes and behaviours.

The development of a comprehensive survey instrument to measure the knowledge, attitudes and behaviours of the general public with regard to cancer screening was the goal of this project. A thorough review of the literature was undertaken, and existing survey instruments were identified and organized according to type of cancer screening behaviour being measured; question foci (predisposing, enabling and reinforcing factors); and survey implementation protocol. A comprehensive survey instrument was developed with the intention that, if feasible, the survey of cancer screening behaviours could be implemented nationally by telephone. Separate survey instruments were developed according to sex. Focus groups were held across Canada to determine the comprehensiveness of the survey items; ease of understanding and ability to respond; feasibility with respect to possible sensitivity of some of the question items; and general implementation issues (e.g. length, sex of interviewer). This paper reports on the qualitative portion of the project. Our study supports the use of qualitative methodology for instrument development and implementation.

Canada↗
PubMed1996

[Presence of markers predictive of type I pre-diabetes mellitus status in relatives of patients with type I diabetes mellitus].

BACKGROUND: The aim of this study was to analyze the predictive factors of IDDM in first degree relatives of IDDM patients. SUBJECTS AND METHODS: From 1992 to 1994, 1,053 first degree relatives were screened for measuring islet cell antibodies (ICA) by indirect immunofluorescence (iFl). In all ICA positive subjects, beta cell function was analyzed by intravenous glucose tolerance test (IVGTT) and other immunologic parameters were also studied: anti-insulin antibodies (IAA) by radiobinding and antibodies to glutamic acid decarboxylase (GADAb) by ELISA methods. RESULTS: ICA were found in 3.1% of the first degree relatives. IVGTT showed a significant decrease in acute first phase of insulin response to glucose (IRI 1 minute + 3 minute) in those with ICA > or = 20 JDF units. In patients with ICA > or = 20 JDF units, 20% were found to be positive for IAA and 40% were positive for GAdAb. Thirty-one percent (10/32) of ICA positive first degree relatives fulfilled prediabetes criteria. During follow-up, 40% (4/10) of these prediabetic patients developed IDDM. CONCLUSION: This study confirms the possibility of identifying among first degree relatives of IDDM patients the subgroup with high risk of developing IDDM thus allowing the initiation of therapy for preventing or delaying IDDM onset.

Adolescent↗
PubMed1996

A prospective study of Gram-negative bacteremia in children.

BACKGROUND: Hospital- and community-acquired Gram-negative bacteremia is a significant cause of mortality and morbidity in pediatric medical centers. Gram-negative organisms are isolated in > 50% of pediatric patients with bacteremia. OBJECTIVES: To analyze clinical and epidemiologic variables associated with Gram-negative bacteremia in a tertiary children's medical center. METHODS: A 6-year prospective study of children with Gram-negative bacteremia in a tertiary care children's medical center in Israel. RESULTS: Three hundred seventy-four episodes of Gram-negative bacteremia were studied during 6 years. The predominant isolates were Klebsiella pneumoniae, Pseudomonas aeruginosa and Escherichia coli, which accounted for 109, 81 and 79 episodes (26, 20 and 19%), respectively. Of all episodes 43% occurred in neonates and infants younger than 2 years and 47% were hospital-acquired. Underlying conditions mainly acute leukemia and lymphoma, were present in 55% of the patients. Urinary tract infection followed by lower respiratory tract infection were the most common identified sources of bacteremia. Central intravenous catheters were associated with 53% of the episodes. The crude mortality was 11.4%. Increased mortality was significantly associated with acute leukemia, neutropenia, hospital-acquired infections and previous corticosteroid therapy (P = 0.03, 0.003, 0.006 and 0.01, respectively). Increased antibiotic resistance of hospital-acquired vs community-acquired isolates was noted; 44 to 77% resistance of nosocomial Klebsiella and Enterobacter sp. to second and third generation cephalosporins and 18% were resistant to amikacin. CONCLUSIONS: Klebsiella pneumoniae is currently the most common organism causing Gram-negative bacteremia in children. Because of the relatively high resistance of Gram-negative organisms to second and third generation cephalosporins, we suggest that empiric antibiotic therapy for Gram-negative bacteremia include a combination of an aminoglycoside and an anti-Pseudomonas beta-lactam.

Adolescent↗
PubMed1996

Peripheral intravenous infusion--another cause of air embolism.

We report an unusual complication of intravenous infusion. A 4-week-old baby developed acute cardiopulmonary distress because of air embolism caused by improper preparation of peripheral intravenous set. The estimated amount of infused air was 12 ml (approximately 3.5 ml/kg). The infant recovered promptly after short supportive treatment.

Embolism, Air↗
PubMed1996

Sweet syndrome associated with G-CSF treatment in a child with glycogen storage disease type Ib.

Acute febrile neutrophilic dermatosis (Sweet syndrome) is rare in children and is regularly associated with underlying malignancies or inflammtory diseases. A 5-year-old girl with glycogen storage disease type Ib, neutropenia, and recurrent infections developed characteristic skin eruption of Sweet syndrome after 2 years of granulocyte colony-stimulating factor (G-CSF) therapy. This association points to a possible role of G-CSF-induced granulopoiesis and granulodyte activation in the pathogenesis of Sweet syndrome.

Biopsy↗
PubMed1996

[Retinopathy in patients with insulin-dependent diabetes mellitus of short duration].

To evaluate the role of metabolic control at the beginning of insulin-dependent diabetes mellitus (IDDM) in the development of diabetic retinopathy (DR) a cross-sectional study was performed with a retrospective analysis of 24 patients followed for at least seven years. The following parameters were investigated: 1) At IDDM diagnosis, age, sex, metabolic control (basal serum glucose, HbA1, cholesterol, triglycerides) and endogen insulin secretion (EIS). 2) At one year in the follow-up: EIS. 3) Since IDDM diagnosis and every 3-4 months: body mass index, dose and pattern of insulin administration and metabolic control. 4) At seven years in the follow-up: direct ophthalmoscopy, fluorescein angiography, microalbuminuria and blood pressure. In the seventh year of follow-up five patients (23.8%; 95% CI: 8.2%-47.2%) developed changes in fluorescein angiography secondary to IDDM. Compared with patients with normal fluorescein angiography their metabolic control was poorer (mean HbA1--seven years--: 11.7 +/- 0.5 versus 9.8 +/- 0.3%; p = 0.01); mean basal glycemia--seven years--: 214 +/- 13.3 versus 174 +/- 7.7 mg/dl; p = 0.03) and their systolic blood pressure (SBP) higher (124 +/- 5.5 versus 111 +/- 2.8 mmHg; p = 0.04). Logistic regression revealed that mean HbA1 values for seven years was the only independent risk factor significantly associated with the development of DR (p = 0.04). The conclusion is that in patients with IDDM of short duration, the development of DR is associated with a deficient glucose control and a higher SBP.

Adolescent↗
PubMed1996

Trends in mammography and Pap smear utilization in Canada.

We have examined trends in the utilization of two preventive health procedures for women in Canada based on our analysis of the 1994 National Population Health Survey (NPHS) and comparisons with two previous large population health surveys. The NPHS provides evidence that Canadian women's use of mammography has continued to increase between 1990 and 1994, while use of Pap smears has remained steady. Increases in mammographic utilization are seen for all age groups and in all provinces of Canada. Women who are less than the recommended age of 50-69 years for screening mammography access these services in considerable numbers. Large proportions of women aged 18-24 and 65 or over have never had a Pap smear, and recency of Pap smear is associated with age. Income adequacy and educational attainment are still strong predictors of which women utilize Pap smears and mammograms. We conclude that the NPHS is sufficiently broad-based to be used in a surveillance program to track Pap smear and mammography utilization.

Adolescent↗
PubMed1995

Beneficial effect of digoxin-specific Fab antibody fragments in oleander intoxication.

A 24-year-old man presented to the emergency department with nausea, vomiting, abdominal pain, and an acute confusional state of 6 hours' duration. Ten hours before admission, he had ingested a mixture of orange juice and six ground leaves, later identified as Nerium oleander (common pink oleander) leaves. His blood pressure was 100/80 mm Hg, and his pulse rate was irregular at 40/min. He was disoriented and his speech was dysarthric. Twelve-lead electrocardiography revealed a complete atrioventricular block, with a nodal escape rhythm of 40/min and diffuse ST depression. The presumptive diagnosis of acute oleander intoxication was confirmed by the detection of digoxin (1.0 nmol/L [0.8 ng/mL]) on radioimmunoassay. Despite intensive therapy, the patient's hemodynamic condition deteriorated. His blood pressure decreased to 70/40 mm Hg; he became oliguric and nonresponsive to external stimuli; and his potassium concentration rose to 6.8 mmol/L. Eighteen hours after admission, an empiric 480-mg dose of digoxin-specific Fab antibody fragments was administered intravenously over 30 minutes. Within minutes of the initiation of immunotherapy, the patient woke up; his blood pressure rose to 90/50 mm Hg; and he regained a sinus rhythm of 68/min with a prolonged PR interval. His potassium concentration decreased to 5.1 mmol/L within 15 minutes and normalized within 1 hour of therapy initiation. One day later, the 1 degree atrioventricular block disappeared, but the ST depression persisted for an additional 6 days. The value of digoxin-specific Fab antibody fragments in the treatment of plant glycoside and, in particular, oleander intoxication is discussed.

Adult↗
PubMed1994

[Laparoscopic and thoracoscopic surgery in children and adolescents].

Initial experience with laparoscopic and thoracoscopic surgery in children during the year Sept. 1992-Sept. 1993 is presented. The 36 procedures included 20 appendectomies, 3 cholecystectomies, 10 upper thoracic sympathectomies, 1 bilateral oophorectomy and 2 diagnostic laparoscopies. Indications were appendicitis, symptomatic gallstones, idiopathic primary palmar hyperhidrosis, and gonadal dysgenesis (xo/xy mosaicism) in a 13-year-old girl. 2 diagnostic laparoscopies were performed for chronic abdominal pain and for a possible retroperitoneal lesion, respectively. All procedures were successfully managed without complications. In 2 cases of acute appendicitis it was necessary to change to the open conventional technique because of technical difficulties. Duration of hospitalization for cholecystectomy and sympathectomy was significantly shorter than with the conventional surgical approach and convalescence was excellent, with less postoperative pain. As for the surgical approach in acute appendicitis, we cannot as yet decide whether or not laparoscopy is superior to the conventional technique.

Abdominal Pain↗