Search PubMed⌕ Search

Biomedical subjects

L B Weiner

Publications and source records attributed to L B Weiner.

At least 37 records · Page 2Linked to original sources
PubMed1989

Recommended guide to the evaluation of permanent impairment of the temporomandibular joint.

This paper provides a method to evaluate the extent of permanent injury to the temporomandibular joint. The authors, working as the Committee on Permanent Impairment for the American Academy of Head, Facial, Neck Pain and TMJ Orthopedics, have used the same values as the American Medical Association has used in their Guides to the Evaluation of Permanent Impairment for other disk-protected and functional joints. These Guides may then serve as a tool to help physicians and dentists who treat temporomandibular joint injuries to rate the degree of permanent injury. These Guides may be combined with other areas of impairment that are already described and valued in the Guides to the Evaluation of Permanent Impairment published by the AMA. These Guides provide a range and each injury should be evaluated on an individual basis. We urge you to use these Guides conservatively and in harmony with good clinical judgement.

Disability Evaluation↗
PubMed1988

Simultaneous infection with respiratory syncytial virus and other respiratory pathogens.

The presentation and subsequent course of respiratory syncytial virus (RSV) bronchiolitis may be atypical and unusually severe when simultaneous infection due to other pathogenic agents is present. During the past two years, nine of the 189 pediatric patients hospitalized with documented RSV infection were found to have the following simultaneous isolates from initial respiratory tract specimens: four adenovirus, four pneumococcus, one cytomegalovirus, and one Pneumocystis carinii. Noted complications attributable to the second pathogen included thrombocytopenia and anemia (cytomegalovirus), hepatitis and disseminated intravascular coagulation (adenovirus), and sepsis and osteomyelitis (pneumococcus). Three of the four patients with RSV and adenovirus died of severe respiratory failure despite mechanical ventilation; two of these patients received ribavirin therapy. Rapid identification of RSV is important but should not be a substitute for more comprehensive viral and bacterial evaluation.

Adenoviruses, Human↗
PubMed1988

Direct detection of Mycoplasma pneumoniae antigen in clinical specimens by a monoclonal antibody immunoblot assay.

Throat swabs from patients with pharyngitis and sputum specimens from patients with atypical pneumonia were tested for the presence of a Mycoplasma pneumoniae polypeptide with a molecular weight of 43,000 with the use of an M. pneumoniae species-specific monoclonal antibody in an immunoblot assay. This 43,000-dalton polypeptide was detectable in 33 of 33 throat swabs from patients with pharyngitis that were positive for M. pneumoniae by conventional culture as well as a culture-amplified enzyme immunoassay. The 43,000-dalton polypeptide was also detected in three of three M. pneumoniae culture-positive sputum specimens. It was not detected in 3 sputum specimens culture-confirmed for Legionella pneumophila, 10 sputum specimens from normal persons, or 25 throat swabs also from normal persons. This immunoblot assay could be completed within five hours and may be an alternative method for detecting M. pneumoniae antigen directly in sputum or throat swab specimens.

Adult↗
PubMed1988

Prediction of the duration of hospitalization in patients with respiratory syncytial virus infection: use of clinical parameters.

To assess the possibility that clinical data available at the time of hospital admission for patients with respiratory syncytial virus infection could predict the length of hospitalization without antiviral therapy, the charts of all 102 patients admitted with laboratory documented respiratory syncytial virus infection during 1982 to 1985 were reviewed. Two thirds (65) of the patients remained hospitalized greater than three days. Prolonged hospitalization could have been predicted for 40 of the 65 patients (61.5%) based on the need for intubation and ventilation on admission (14 patients) or the presence of underlying cardiac or respiratory disease (28 patients). Of the infants hospitalized when they were less than 2 months of age, 40% required intubation and mechanical ventilation, although only 16% had underlying cardiac or respiratory disease. Mechanical ventilation was required at the time of admission or subsequently for 14% (5/36) of the 2- to 4-month-old infants with respiratory syncytial virus infection. Among the 56 patients without underlying cardiac or respiratory disease who did not require intubation at the time of admission, 25 (45%) remained hospitalized longer than three days (mean hospital stay for these 25 patients, regardless of age, was six days). Neither the respiratory rate nor the presence or absence of fever on admission was useful in predicting the likelihood of a longer hospital stay for the patients who did not require intubation. In addition, none of the initial laboratory data, including the WBC count, the percentage of band forms or polymorphonuclear leukocytes, the presence or absence of hypoxia, or the chest x-ray film findings could be correlated with a longer or shorter duration of hospitalization.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

Rapid detection of herpes simplex virus in MRC-5 cells using low-speed centrifugation enhancement and immunoperoxidase staining 16 h post-inoculation.

The performance of MRC-5 shell vial centrifugation-enhancement and direct immunoperoxidase staining was compared to the traditional WI38 tube cell culture for the detection of Herpes simplex virus on 123 clinical samples. The shell vial technology not only proved to be sensitive (100%) and specific (100%), but could offer up to 20% reduction in cost when compared to routine methods. In addition, a commercially prepared MRC-5 shell vial product proved to be superior with respect to cost, sensitivity, and reliability when compared to an in-house preparation.

Cells, Cultured↗
PubMed1986

Viral and bacterial organisms associated with acute pharyngitis in a school-aged population.

To investigate the causes and clinical characteristics of acute pharyngitis among school-aged children (4 to 18 years), we obtained throat cultures for respiratory viruses, Mycoplasma pneumoniae, group A streptococcus, and Chlamydia trachomatis from 320 patients with sore throat and 308 controls without respiratory complaints. The study was conducted from January to April 1985 in a private pediatric practice in central New York State. Sixty percent of the patients and 26% of the control subjects had positive cultures for at least one organism. Forty percent of patients had positive cultures for group A streptococcus, compared with 11.9% of the controls. Fifty (16%) patients had positive viral cultures, compared with eight (2.6%) controls; the predominant viral isolate was influenza A Philippines. Patients infected with influenza A were significantly more likely to complain of cough and hoarseness, and were less likely to have pharyngeal exudate or tender cervical adenopathy, than were patients who had positive cultures for group A streptococcus. Although 49 (15.8%) patients with acute pharyngitis had cultures positive for M. pneumoniae, 53 (17.6%) asymptomatic controls were also had M. pneumoniae-positive cultures. Thus detection of M. pneumoniae in the throat of school-aged children with pharyngitis may not be sufficient to establish a diagnosis of disease caused by this organism. C. trachomatis was not isolated from any patient or control.

Acute Disease↗
PubMed1986

Efficacy of oral antibiotics for the treatment of persistent otitis media with effusion.

We followed 137 children who were found to have persistent otitis media with effusion (POME) one month after the diagnosis of acute otitis media. Subjects were randomly assigned to either treatment with erythromycin ethylsuccinate and sulfisoxizole or to no treatment. Follow-up utilizing pneumatic otoscopy and tympanometry showed that treated patients were more likely to have normal findings, and less likely to develop acute otitis media during the month following treatment. These data indicate that children with POME one month following acute otitis media may benefit from an additional course of antibiotics.

Administration, Oral↗
PubMed1986

A placebo-controlled trial of topical 8% arildone cream early in recurrent genital herpes.

Arildone is an aryl diketone which is inhibitory in vitro against herpes simplex virus type 2 at a concentration of 2 micrograms/ml or less. One hundred forty-five patients with recurrent genital herpes were enrolled in a multicenter, randomized, placebo-controlled, double-blind trial to evaluate the efficacy and safety of an 8% arildone cream. Patients initiated therapy a mean of 9.9 h and a maximum of 24 h after the reported onset of lesions and applied medication 6 times daily for 7 days. The duration of viral shedding was shorter among women (P less than 0.05) and the duration of local itching was shorter among men (P less than 0.05) in patients that received arildone than in those that received placebo, but there were no significant differences between treatment groups in duration of pain, time to crusting or healing of lesions, or percentage of patients developing new lesions. Mild local irritation after application of ointment was common and occurred equally in both treatment groups. Despite early application, topical arildone cream was ineffective in the therapy of acute recurrences of genital herpes.

Administration, Topical↗
PubMed1985

Inaccurate diagnosis in infants with pertussis. An eight-year experience.

A review was conducted of all patients seen at Upstate Medical Center, Syracuse, NY, from June 1975, to June 1983, whose nasopharyngeal specimens were positive by specific Bordetella pertussis-fluorescent antibody stain. Sixty-one patients were identified; 46 were hospitalized and 15 were outpatients. The age and immunization status of the two groups were compared. Admission diagnosis, indices of illness severity, and clinical course were assessed for the hospitalized patients. Review of the house officers' initial differential diagnoses disclosed that pertussis was considered in the diagnosis in only 45% of the cases. Bronchiolitis was the next most commonly listed diagnosis. Frequent vomiting and severe coughing were the most helpful clinical findings leading to an accurate diagnosis. Abnormal chest roentgenograms and elevated white blood cell counts were present in a minority of our patients, whether the initial diagnosis was correct or not. Younger and less-immunized patients had more severe and prolonged clinical courses. This study demonstrates that the diagnosis of pertussis is often missed or delayed because clinical findings are similar to those of other respiratory infections in infancy. Suspicion of the diagnosis in children with nonspecific respiratory illness is required for early diagnosis, treatment, and prevention of spread to susceptible individuals.

Bronchopulmonary Dysplasia↗
PubMed1985

Infectious complications and duration of intracranial pressure monitoring.

We studied 65 children with acute brain injury to determine how the risk of infectious complications changed with duration of intracranial pressure (ICP) monitoring. More than half of the 72 monitors inserted in these patients were in place at least 7 days (range 1 to 28). Nine infections occurred on days 2 through 11. The overall risk was 1.5 infections per 100 monitor-days. After day 6 the risk of subsequent infection diminished, as did the percent of monitors which subsequently became infected. The declining risk of infection over time suggests that infection is introduced at the time of monitor insertion. These findings justify a protocol in which a single ICP monitoring device is used as long as necessary, with reinsertion of a new monitor only if a malfunction occurs, or if daily surveillance cultures demonstrate an infection. Routine reinsertion of a new monitor might increase risk by unnecessarily re-exposing the patient to contamination at the time of insertion.

Bacterial Infections↗
PubMed1985

Components of the alternative pathway of complement in otitis media with effusion.

An evaluation of the alternative pathway of complement was undertaken in patients with otitis media with effusion (OME). Middle ear fluid (MEF) and serum specimens were obtained from 34 patients at the time of elective myringotomy for OME. Bacterial, viral, and mycoplasma cultures were made for all specimens of the fluids. Immunochemical determinations by radial immunodiffusion were performed for C3, C5, factor B, properdin, factor H, factor I, and albumin. Each patient's recent clinical course and past history were reviewed. The results of all viral and mycoplasma cultures were negative. Three of 55 bacterial cultures were positive for type B Haemophilus influenzae. All components of the alternative pathway measured were found to be present in varying amounts in MEF. When the levels of the complement components were compared to the clinical factors studied, there were no observable differences. These data suggest that components of the alternative pathway of complement are present in OME and are not useful in predicting the clinical course or outcome of this disorder.

Adolescent↗
PubMed1985

Necrotizing enterocolitis: intraluminal biochemistry in human neonates and a rabbit model.

The intestinal contents of 17 neonates with necrotizing enterocolitis were analyzed for pH, carbohydrate, protein, and bacteria. The intraluminal pH was less than 5.0 (16/17). Sufficient carbohydrate and bacteria capable of fermenting the carbohydrate to organic acids were found. The intraluminal protein content was greater than 5 g/dl. The variables of acid and protein were then examined in a rabbit intestinal loop model. The hemorrhagic response in individual loops was measured using Cr51 tagged red blood cells such that the microliters of blood per centimeter intestine could be determined. Loops with organic acid and protein had significantly (p less than 0.01) more intramural blood than control loops. Organic acid (possibly generated by bacterial mixed acid fermentation of carbohydrate) in the presence of protein promotes intramural hemorrhage similar to that seen in neonates with necrotizing enterocolitis.

Animals↗
PubMed1984

Motor disorders of voice and speech in Reye's syndrome survivors.

Disorders of voice and speech were studied in 43 survivors of Reye's syndrome (RS). During hospital convalescence 26 (60%) of 43 were aphonic, hoarse, or had other alterations of speech production. These disorders occurred in those patients with the worst severity of RS. Four patients (9% of survivors) had a persistent motor voice or speech disorder at follow-up examination 1 1/2 to five years after recovery. All of the patients have breathy, low-intensity voice quality, whereas three of the four exhibit rapid and slurred speech. These four children have no difficulty with the symbolic aspects of language and their motor voice and speech impairment cannot be ascribed to global intellectual deficit. Although other neurologic deficits are present in three of these four children, the disorders of voice and speech are the major permanent disabling handicap in our RS survivors.

Adolescent↗
PubMed1984

The placental transfer of ampicillin.

Cord blood ampicillin levels were assayed in 23 neonates whose mothers received the antibiotic by the obstetrical service. The levels ranged from 2.9 to 36.2 micrograms/ml. Nineteen (82.6%) of the 23 had a serum ampicillin level in excess of 5 micrograms/ml at delivery, which is significantly greater than the minimal inhibitory concentration (MIC) to inhibit ampicillin-sensitive enterobacteriacae and far exceeds the MIC for Group B beta-hemolytic streptococci. Antenatal ampicillin therapy results in significant levels in the neonate that may obscure cultures obtained after delivery.

Ampicillin↗