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J Levine

Publications and source records attributed to J Levine.

At least 163 records · Page 9Linked to original sources
PubMed1994

A two factor model of denial of illness: a confirmatory factor analysis.

Analyses of the data obtained by the use of a reliable semi-structured interview format, the Levine Denial of Illness Scale (LDIS) confirmed the existence of two distinct, but interrelated factors of denial of illness. The two factors were termed denial of cognitions and denial of affects. One hundred medical patients from four different patient groups (cardiac, epilepsy, stroke, hypertensive) were interviewed and assessed. Confirmatory factor analytic procedures were used, and they demonstrated that these two factors accounted for a major proportion of the variance in the observed data that reflected denial of illness. A moderate but significant correlation between these two factors, in addition to their discriminant validity, also supported the validity of the unifying and overarching construct, denial of illness. The concurrent and discriminant validity of the two factors was further supported by the different relationships of the two factors with external criterion measures. The reliability, validity and the potential predictive validity of these two factors may be useful in further investigations of the use of denial. Further studies of their different influences on the initial and continued resistance of seriously ill patients to comply with medical treatment and prescribed self care are indicated. When seriously ill patients persist in denial, appropriate interventions may help them to give up their evasive behavior and they may comply with medical recommendations.

Adult↗
PubMed1994

Cytokine dysregulation and the initiation of systemic autoimmunity.

Autoimmunity (AI) exemplifies the potent and destructive activity expressed by the immune system when normal constraints against self-reactivity are lost or compromised. We have previously described a dramatic and intrinsic defect in cytokine expression in macrophages (M phi) from young AI-prone mice [1-3]. There are two points in particular that we believe speak to the importance of this observation: (i) Cytokine dysregulation is distinguished from many of the aberrancies reported in AI-prone mouse strains in that, as an inherent trait, it cannot arise as a consequence of the disease process. (ii) This defect is a remarkably consistent characteristic of M phi from strains that develop manifestations of systemic AI, including MRL/+, NZB, NZB/W F1, BXSB, and NOD, and distinguishes these strains from mice whose disease is predicated on defects in apoptosis (e.g., the lpr and gld mutations). The multigenic basis for disease and renal pathology in the former strains more closely mirror human lupus than do the disease manifestations of lpr and gld mice. In light of clear evidence that cytokines are key mediators of lymphocyte growth and function, a defect in the cytokine network has the potential to disrupt the normal regulation of self-reactivity, leading to the initiation of systemic AI.

Animals↗
PubMed1994

Differences in postoperative pain severity among four ethnic groups.

Subjects (N = 543) reporting on acute postoperative dental pain were classified into four major ancestral groups: Asian (N = 96), black American (N = 65), European (N = 296), and Latino (N = 88). Pain severity was measured using a 10-cm visual analogue scale following a standardized operative procedure. The subjects of European descent reported significantly less severe pain than those of black American or Latino descent. They also reported less pain than Asians, although this finding did not reach significance. Evaluation of covariates, including gender, age, education, generation in the United States, and difficulty of the surgical extraction, demonstrated that gender was significant, with men reporting less pain than women regardless of ancestry. Possible implications of these findings are discussed in terms of potential differences in physiology, in addition to social learning.

Adolescent↗
PubMed1994

CSF inositol in schizophrenia and high-dose inositol treatment of schizophrenia.

Inositol is a key metabolite in the phosphatidylinositol cycle, which is a second messenger system for serotonin-2 receptors that have been implicated in the pathophysiology of schizophrenia. Cerebrospinal fluid inositol levels were measured in 20 schizophrenic patients and 19 age- and sex-matched controls and no difference was found. However, the patients were all neuroleptic-treated. A controlled double-blind crossover trial of 12 g daily of inositol for a month in 12 anergic schizophrenic patients, twice the dose given before in schizophrenia, did not show any beneficial effects. However, the number of patients studied was small and the length of time of inositol administration may not have been sufficient.

Adult↗
PubMed1994

Interleukin-2-induced lung injury. The role of complement.

Pulmonary edema and sepsis-like syndrome are grave complications of interleukin-2 (IL-2) therapy. Recent animal studies have suggested IL-2-induced microvascular injury as the underlying mechanism. Since complement factors have been shown to mediate increased vascular permeability in diverse conditions that lead to pulmonary injury and recombinant human IL-2 is known to activate the complement system in patients undergoing IL-2 therapy, we hypothesized that complement factors play a pivotal role in the development of increased vascular permeability after IL-2 treatment. To test this hypothesis, we evaluated the capacity of recombinant soluble human complement receptor type 1 (sCR1, BRL 55730), a new highly specific complement inhibitor, to attenuate IL-2-induced lung injury in the rat. Recombinant human IL-2 (intravenously for 60 minutes) at 10(6) U per rat (n = 4) elevated lung water content (37 +/- 6%, P < .05), myeloperoxidase activity (162 +/- 49%, P < .05), and serum thromboxane B2 (30 +/- 1 pg/100 microL, P < .01) and had no effect on serum tumor necrosis factor-alpha sCR-1 at 30 mg/kg (n = 5), but not at 10 mg/kg (n = 6), attenuated the elevation of lung water content (18 +/- 2%, P < .05) and myeloperoxidase activity (42 +/- 9%, P < .05) but failed to alter serum thromboxane B2 response to IL-2. These data suggest the involvement of complement in the pathogenesis of IL-2-induced pulmonary microvascular injury and point to the potential therapeutic capacity of complement inhibitors in combating this toxic effect of IL-2 therapy.

Animals↗
PubMed1993

Inositol treatment raises CSF inositol levels.

Inositol is a key precursor for synthesis of phosphatidylinositol in a major second messenger signalling system. It is biologically active in syndromes such as respiratory distress syndrome but has been thought to be excluded from CNS by the blood-brain barrier. Oral inositol treatment of 8 patients is shown to significantly increase CSF inositol by almost 70%, suggesting possible CNS therapeutic applications of this compound and possible CNS side-effects of systemic therapy.

Adult↗
PubMed1993

Fibroblast transplantation in rats: transduction and function of foreign genes.

The purpose of this study was to develop a method of transduction of normal skin fibroblasts with a retroviral vector expressing the human factor IX (hF-IX) gene and transplantation of the transduced cells into rats. A retroviral vector containing the hF-IX gene, as well as a selectable marker (hygromycin B resistance; HB), was used to transduce cultured normal skin (rat and human) fibroblasts. Transduced fibroblasts were selected with HB; resistant clones were propagated and assessed for expression of active hF-IX in vitro. Transduced cells secreted significant amounts of hF-IX in vitro (327.9 +/- 14.2 ng/10(6) cells) which showed measurable clotting activity, indicating terminal processing of the gene-transcribed hF-IX product by the transduced fibroblasts. Integration of the proviral gene into rat and human fibroblast genomic DNA was confirmed by polymerase chain reaction. Transduced rat fibroblasts were attached to collagen-coated microcarriers and transplanted intraperitoneally into syngeneic recipients. Transplanted microcarrier-attached cells formed aggregates in the peritoneal cavity and exhibited positive immunohistochemical staining for hF-IX up to 8 weeks following transplantation, the time of termination of the experiment. These experimental results may have significant implications in developing strategies for future clinical therapy for hemophilia B.

Animals↗
PubMed1993

[Chemonucleolysis. Its effectiveness in the treatment of lumbar diskopathies caused by compressive or rotational injuries].

One hundred patients who meet McCulloch's indicators for treatment of lumbar disc herniation by chemonucleolysis were entered in this study. Chemonucleolysis in the patients suffering from sciatica secondary to a compression injury, especially with clinical and radiographic evidence of nerve root compression at a single level, can be expected to attain good to excellent results. Chemonucleolysis is far less efficacious in patients suffering from either torsional injury or multiple level abnormality, especially in the absence of neurological deficit. Meticulous attention to patient selection will yield optimal results. The result was excellent or very good in 60% of patients, while in 40% the procedure failed. The rate of success at the L.5/S.1 level was 70%, at the L.4/5 level it was 63% and 37% were successful when multiple levels were treated.

Adult↗
PubMed1993

Nonlinear control of biotechnological processes with growth-production decoupling.

Nonlinear control design techniques for a class of continuous biological processes with growth and production decoupling are investigated. We establish, under realistic assumptions on the kinetics, that though neither the inlet substrate concentration nor the dilution rate can achieve linearization of the global dynamics, we can maximize the dimension of the linear system obtained after feedback and get stable zero dynamics by choosing output functions having a physical meaning. More precisely, if the manipulated variable is the inlet substrate concentration, then the output can be chosen as the biomass concentration. But if the chosen input is the dilution rate, then a suitable output corresponds to yields.

Biotechnology↗
PubMed1993

Does transesophageal echocardiography improve postoperative outcome in patients undergoing coronary artery bypass surgery?

The incidence and characteristics of ischemic episodes as detected by transesophageal echocardiography (TEE) and their relationship to postoperative myocardial infarction (MI) and adverse clinical outcome were studied in patients undergoing coronary artery bypass grafting (CABG). Seventeen of 50 patients had 21 TEE-defined ischemic episodes: 4 patients (8%) had 4 ischemic episodes in the pre-cardiopulmonary bypass (CPB) period, and 15 patients (30%) had 17 ischemic episodes in the post-CPB period, whereas 19 patients had 20 ECG ischemic episodes: 3 patients (6%) had 3 ischemic episodes in the pre-CPB period and 17 (34%) had 17 ischemic episodes in the post-CPB period. In 14 patients, ischemic episodes were detected by both TEE and ECG. Clinicians were made aware of the TEE data and appropriate treatments were undertaken during ischemic episodes: of the 15 patients with TEE-defined post-CPB ischemia, 4 had an additional saphenous vein graft placed, 8 had an intra-aortic balloon pump (IABP) inserted, 3 were given sublingual nifedipine, and 13 received nitroglycerin. These treatments resulted in improvement in regional wall motion abnormalities (RWMA) by the end of surgery in 11 of the 15 patients (73%), including the 4 with postoperative MI and 2 who died with cardiogenic shock. The authors conclude that: (1) significantly more patients had TEE-defined ischemic episodes in the post-CPB period (30%) than in the pre-CPB period (8%); (2) a poor graft and/or inadequate myocardial protection were strongly suggestive of post-CPB ischemia, which was significantly related to adverse outcome; and (3) TEE was a useful tool enabling detection of problem areas at an early stage and timely and appropriate treatment to support and sustain patients.

Adult↗
PubMed1993

Negative symptom assessment of chronic schizophrenia patients.

A new scale for assessing negative symptoms in schizophrenia, the Negative Symptom Assessment (NSA), was administered to 101 male chronic, inpatient schizophrenia patients. Factor analysis of the NSA yielded seven factors, but most of the explained variance resided in Factor 1, Restricted Affect/Emotion. The factors that emerged from this study closely resembled NSA factors derived from an earlier study of outpatient schizophrenia patients, which indicates the factor structure of the NSA is robust. A constellation of variables reflecting long-term or chronic illness were significantly related to six of the seven factors. These results suggest that "institutionalism" may play a role in the evolution of some negative symptoms.

Activities of Daily Living↗
PubMed1993

Shifts of dependency in the resolution of folie à deux.

We have presented a case of folie à deux in which the wife was the primary (dominant) partner and the husband the secondary (submissive) partner. The husband's symptoms seemed to have resolved as his dependency shifted from his wife back to his mother. Treatment is recommended by deliberately shifting dependencies only when there is advantage in doing so. For most patients, the aim should be independence.

Adult↗
PubMed1993

Treatment of resistant akathisia with ECT--a case report.

We present a case of neuroleptic induced akathisia resistant to traditional drug therapy which improved with electroconvulsive therapy. If confirmed in further cases, these findings call for well designed studies on the efficacy of this treatment, especially in nonresponders to traditional therapy or in a subgroup of patients suffering from akathisia and depression.

Akathisia, Drug-Induced↗