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Biomedical subjects

J Levy

Publications and source records attributed to J Levy.

At least 649 records · Page 36Linked to original sources
PubMedDate not supplied

Brucella meningitis and papilledema in a child.

PURPOSE: To report a rare case of Brucella meningitis with papilledema in a child and to discuss the findings of neurobrucellosis in children. METHODS: A 6-year-old girl was admitted with headache, fever, and vomiting for 1 week. Her family reported intake of raw unpasteurized goat's milk in the past. Meningeal signs were strongly positive. Bilateral moderate optic disc edema with flame-shaped hemorrhages was observed. RESULTS: The diagnosis of Brucella infection was established by positive blood culture for Brucella species, serum agglutination titer of antibodies to Brucella >1:160, and positive CSF culture. After treatment consisting of trimethoprim-sulfamethoxazole, rifampin, and doxycycline, the patient's condition gradually improved. One month later, the papilledema disappeared. One year after presentation, the patient remains free of symptoms. CONCLUSIONS: Brucella meningitis must be ruled out in symptomatic patients reporting ingestion of raw unpasteurized goat's milk. Papilledema is a frequent clinical feature, but irreversible visual impairment is extremely rare.

Agglutination Tests↗
PubMedDate not supplied

Burkitt's lymphoma presenting as oculomotor palsy in an hiv-positive patient.

PURPOSE: To report a case of Burkitt's lymphoma (BL) in an HIV-positive patient presenting as complete third nerve palsy. METHODS: Interventional case report. A 34-year-old man presented with headache, left eye pain, diplopia, and complete ptosis of several hours' duration. Left eye examination disclosed complete third nerve palsy with pupillary involvement. Significant hepatomegalia was noted at physical examination and computed tomography (CT) scan of the abdomen showed multiple solid lesions. RESULTS: Liver biopsy was consistent with Burkitt's lymphoma. Bone marrow biopsy was normal. Brain imaging was normal. Work-up also revealed positivity for human immunodeficiency virus. Chemotherapy treatment was started. Two months later, ocular motility examination was normal. CONCLUSIONS: Although BL affects the central nervous system very rarely, BL should be considered in any immunosuppressed patient presenting with diplopia or ophthalmoparesis.

Adult↗
PubMedDate not supplied

Open heart surgery during pregnancy--case report.

A case of a 32-year-old woman in her 7th month of pregnancy presented with intractable pulmonary edema due to mitral restenosis is reported. Open-heart mitral commissurotomy was done as an emergency procedure. She continued pregnancy to term after the operation and delivered a healthy female baby. The literature related to "the closed" and "open" heart surgery during pregnancy has been reviewed.

Adult↗
PubMedDate not supplied

Evaluation of environmental, nutritional, and host factors in cats with hyperthyroidism.

The pathologic changes associated with hyperthyroidism (adenomatous hyperplasia, adenoma of the thyroid gland) have been well characterized in cats, but the pathogenesis of these changes remains unclear. In this research, we undertook a case-control study to search for potential risk factors for this disease. Owners of 379 hyperthyroid and 351 control cats were questioned about their cats' exposure to potential risk factors including breed, demographic factors, medical history, indoor environment, chemicals applied to the cat and environment, and diet. The association between these hypothesized risk factors and outcome of disease was evaluated by conditional logistic regression. Two genetically related cat breeds (ie, Siamese and Himalayan) were found to have diminished risk of developing hyperthyroidism. Cats that used litter had higher risk of developing hyperthyroidism than those that did not. Use of topical ectoparasite preparations was associated with increased risk of developing hyperthyroidism. Compared with cats that did not eat canned food, those that ate commercially prepared canned food had an approximate 2-fold increase in risk of disease. When these 4 variables (breed, use of cat litter, consumption of canned cat food, and use of topical ectoparasite preparations) from the univariate analysis were selected for further study as candidate risk factors and analyzed by multivariate conditional logistic regression, a persistent protective effect of breed (ie, Siamese or Himalayan) was found. In addition, results suggested a 2- to 3-fold increase in risk of developing hyperthyroidism among cats eating a diet composed mostly of canned cat food and a 3-fold increase in risk among those using cat litter. In contrast, the use of commercial flea products did not retain a strong association. The results of this study indicate that further research into dietary and other potentially important environmental factors (eg, cat litter) is warranted.

Animal Nutritional Physiological Phenomena↗
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[The carotid piezogram in obstetrics].

The carotid piezogram is a very simple test. The graph illustrates the elasticity of the arteries and the peripheral resistance. It is the best way of evaluating the vascular state of the pregnant woman when vascul-renal syndromes occur in pregnancy. The authors have studied three elements in the graph and their modifications resulting from the different types of vasculo-renal syndromes. The piezogram is a valuable test for fetal prognosis: the degree of hypotrophy and the risk of fetal death. Furthermore the piezogram sometimes may be the only alarm signal before the other clinical or paraclinical features for prognosis occur. In any case the piezogram give the best information. Furthermore, it can uncover the rise in peripheral resistance which is the cause of certain fetal hypotrophies when nothing else would point to the vascular system being affected. Often an abnormal piezogram is found for the first time in pregnancy and the graph becomes normal in the months after delivery. Pregnancy may be considered as a "test for vascular function" when vascular functional troubles will show up for a short time, not to declare themselves again for perhaps another ten to twenty years. The piezogram therefore is very valuable as a long-term prognostic tool for the mother.

Arteries↗
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Compression plating for child and adolescent femur fractures.

Twenty-five children ranging in age from 6-16 years underwent AO compression plate fixation for treatment of a femur fracture. Generally, the most common reason for plate fixation was to simplify nursing care and rehabilitation of children with an associated severe head injury or polytrauma. Twenty-three fractures healed in 11 weeks on the average, most by periosteal bone formation. Leg length discrepancy was not a clinical problem. Nursing care and polytrauma rehabilitation were simplified in all children. We believe that plate fixation is a reasonable treatment option for femoral fracture care in children aged less than 11 years with severe head injury or associated polytrauma.

Adolescent↗
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Ovarian stimulation concomitant with pituitary-ovarian axis suppression by different GnRH agonists.

The present study compared the effect of gonadotropin therapy alone with a combination of gonadotropins and GnRH agonist on ovarian stimulation in anovulatory women and in spontaneously ovulating patients in an IVF program. Nineteen infertile patients were treated with combined GnRH agonist/gonadotropin therapy for induction of ovulation. Ten women received combined therapy for ovarian stimulation in the framework of an IVF-ET program. Twenty-one additional patients served as controls, receiving gonadotropins but not GnRH agonist for induction of ovulation or ovarian stimulation stimulation before IVF-ET. This study indicates that the GnRH agonists Buserelin, Decapeptyl, and Decapeptyl CR are similarly effective in their ability to down-regulate pituitary-ovarian axis function. The suppressive effect occurred by 14 days in 77% of the patients, and never required more than 28 days. Stimulation of ovarian function, when carried out in the presence of a suppressed pituitary-ovarian axis, required an increased dose of exogenous gonadotropins (26.4 vs. 16.5 ampules). Our data do not support the view that GnRH analogs can aid in the synchronization process of oocyte maturation.

Anovulation↗
PubMedDate not supplied

[Importance of the early intravenous administration of streptokinase in acute myocardial infarct].

To evaluate the importance of early initiation of fibrinolytic therapy with intravenous streptokinase (IVSK), we studied 34 consecutive patients, within less than six hours of the onset of acute myocardial infarction, who were treated with 1.5 million units of intravenous streptokinase. All the patients had coronary angiograms in the first seventy two hours. We correlated the angiograms with the time of onset of the IVSK. The patients were divided into 3 groups: Group num. 1: From zero to two hours (twelve patients); Group num. 2: From two to four hours (13 patients); and Group num. 3: From four to six hours (nine patients). We had angiographic reperfusion in twenty-four patients (70.2%) P less than 0.05. We observed reopening in the patients of group num. 1 (83.3%); in group 2, nine patients (69%) and in group num. 3, five patients, (55.5%), with statistical significance only in group num. 1 (p less than 0.05). We also demonstrated the utility of the electrocardiographic and enzymatic criteria to predict reperfusion. No mortality was related to the procedure. We concluded that a higher percentage of reperfusion is obtained the sooner intravenous streptokinase therapy is initiated.

Coronary Circulation↗