Biomedical subjects
L Berman
Publications and source records attributed to L Berman.
Letters across the Pacific.
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Comparison of awake endotracheal intubation in patients with cervical spine disease: the lighted intubating stylet versus the fiberoptic bronchoscope.
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Sputum eosinophilia predicts benefit from prednisone in smokers with chronic obstructive bronchitis.
A reliable predictor of benefit from corticosteroid treatment in patients with chronic airflow limitation is needed. In a single-blind, sequential crossover trial of placebo and prednisone (30 mg/day) treatment, with each given for 2 wk, we investigated whether an increased proportion of sputum eosinophils (>= 3%) predicts a beneficial effect of prednisone in smokers with severe obstructive bronchitis. Patients were seen before and after each treatment. Clinical measurements were made blind to the laboratory findings and vice-versa. Eighteen of 20 patients completed the study. Eight had sputum eosinophilia and similar clinical and physiologic characteristics to those of 10 patients without a finding of sputum eosinophilia. Only in patients with sputum eosinophilia did prednisone, as compared with placebo, produce a statistically significant and clinically important mean effect on effort dyspnea of 0.8 (95% confidence interval [CI]: 0.3 to 1.2), p = 0.008, and in quality of life of 1.96 (95% CI: 0.5 to 3.3), p = 0.01, associated with a small improvement in FEV1 of 0.11 L (95% CI: - 0.04 to 0.23 L), p = 0.05. In these patients, prednisone also produced a significant decline in the median sputum eosinophil percentage, from 9.7% to 0.5% (p = 0.002), eosinophil cationic protein (ECP), from 6, 000 microgram/L to 1,140 microgram/L (p < 0.001), and fibrinogen, from 25. 3 mg/L to 5.4 mg/L (p < 0.001). These findings indicate that in smokers with severe airflow limitation, sputum eosinophilia predicts a beneficial effect of prednisone treatment. Improvement in FEV1, after prednisone treatment in this population, is small, and may not be appreciated in clinical practice.
Three-dimensional spatial compounding of ultrasound images.
One of the most promising applications of 3-D ultrasound lies in the visualization and volume estimation of internal 3-D structures. Unfortunately, the quality of the ultrasound data can be severely degraded by artefacts and speckle, making automatic analysis of the 3-D data sets very difficult. In this paper we investigate the use of 3-D spatial compounding to reduce speckle. We develop a new statistical theory to predict the improvement in signal-to-noise ratio with increased levels of compounding, and verify the predictions empirically. We also investigate how registration errors can affect automatic volume estimation of structures within the compounded 3-D data set. Having established the need to correct these errors, we present a novel reconstruction algorithm which uses landmarks to register each B-scan accurately as it is inserted into the voxel array. In a series of in vitro and in vivo trials, we demonstrate that 3-D spatial compounding is very effective for improving the signal-to-noise ratio, but correction of registration errors is essential.
Wantedness of pregnancy and prenatal health behaviors.
This study examined the relationships between wantedness of pregnancy and the initiation of prenatal care as well as smoking and drinking alcohol during pregnancy. Three hundred and eighty post-partum women were interviewed in a randomly selected sample of Chicago area hospitals. Approximately half of the women said that they had wanted their recently completed pregnancy. Unadjusted analyses revealed that women who wanted their pregnancies were more likely to begin prenatal care in the first trimester and were less likely to smoke while there was no relationship between wantedness and alcohol use during pregnancy. After adjustment for sociodemographic variables, women who wanted their pregnancies were less likely to have smoked cigarettes or drunk alcohol during pregnancy, but were not more likely to have initiated prenatal care in the first trimester. These results suggest that positive health behaviors during pregnancy are influenced by wantedness of pregnancy as well as sociodemographic characteristics. Therefore, efforts to reduce unwanted pregnancies are an important strategy to improve the health of women and children.
Postvention in schools: affective or effective?
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Endogenous IL-10 protects mice from death during septic peritonitis.
IL-10 production during endotoxic shock is part of a protective mechanism that involves IL-10-induced inhibition of TNF synthesis. We sought to determine the role of IL-10 in septic peritonitis induced by cecal ligation and puncture (CLP). CLP led to a rapid induction of IL-10 mRNA in various organs of C57BI/6 mice. In liver, IL-10 mRNA was detectable within 1 h following CLP, while in spleen and lungs, IL-10 mRNA was detected from 2 to 4 h and onward. IL-10 protein became detectable in plasma 2 h after CLP, reaching peak concentrations after 12 h (12.7 +/- 5.7 ng/ml). Pretreatment (-2 h) with anti-IL-10 mAb resulted in higher plasma TNF levels following CLP when compared with mice treated with control mAb. Plasma IL-1 activity and IFN-gamma remained undetectable in virtually all mice. Anti-IL-10 enhanced mortality after CLP (p < 0.05 by log-rank test). Addition of anti-TNF mAb did not influence the increased mortality associated with anti-IL-10 treatment. Septic peritonitis is associated with sustained production of IL-10 in various organs, which serves to protect the host against lethality.
X-Ray photon correlation spectroscopy study of Brownian motion of gold colloids in glycerol.
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The incidence and significance of acute post-hysterectomy pelvic collections.
In a prospective study, 32 consecutive patients underwent endovaginal pelvic scanning in the first post-operative week following hysterectomy. Twenty-four attended for a further scan at clinical follow up. Vaginal vault fluid collections were identified in 19 women (59%) on the first post-operative scan. Fifteen of the 19 with collections had no significant pyrexia. Out of the entire sample of 32 subjects, six patients (19%) had significant post-operative pyrexia of whom four were in the group with post-hysterectomy vaginal vault collection and two had no collection on their early post-operative scans. All collections detected on the early scans had resolved or were smaller on follow-up scan but two asymptomatic patients who had no collection on the early scan had developed vaginal vault fluid collections on the late follow-up scan. No statistically significant association was demonstrated between the presence of a collection and post-operative pyrexia, surgical approach or operative blood loss The results of this study indicate that the demonstration of vaginal vault collection following hysterectomy is a frequent finding in both febrile and afebrile subjects and does not indicate the need for drainage.
Letters across the Atlantic.
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Letters across the Atlantic.
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The irritable hip: immediate ultrasound guided aspiration and prevention of hospital admission.
A protocol for the management of irritable hip was assessed; this protocol avoids hospital admission while detecting all other serious causes of hip pain, in particular septic arthritis, at the earliest possible opportunity. Fifty children with painful hips were studied prospectively with immediate ultrasound guided aspiration and Gram stain of all hip effusions. Bone scintigraphy performed at an early stage was reserved for patients with unremitting symptoms. Thirty six hips were aspirated. Only two patients were admitted. The final diagnoses were transient synovitis (45 cases), Perthes' disease (three cases), fracture (one case), and septic arthritis (one case). The single case of hip sepsis was diagnosed on presentation. The traditional approach to management is questioned and the advantages of the protocol highlighted, including earliest diagnosis of sepsis and other serious pathology, avoidance of hospital admission, and the relief of pain by joint decompression.
Technical note: identifying and aspirating hip effusions.
Ultrasound has become a routine investigation in the investigation of the painful hip in children. It has been recommended that all effusions demonstrated by sonography be drained. Based on the experience of 800 hip aspirations, the authors describe an approach to the demonstration and aspiration of hip effusions with some of the pitfalls that result in false positive and false negative diagnoses.
Adsorption-site investigation of Rb/Cu(111) using the x-ray standing-wave method.
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A comprehensive approach to studies of porous media (rocks) using a laboratory spectrometer and logging tool with similar operating characteristics.
The value of NMR spectrometry as a way to understand the porosity and permeability of rocks is well documented. Other more esoteric parameters, such as restrictive diffusion, grain size distribution, and fluid viscosities have received less notice but are also available from the NMR measurements as laboratory studies have shown. With the introduction of gradient field spin-echo NMR well logging, all of these parameters become available in a routine way. To accomplish the goal of having a well log that systematically provides this complete array of NMR answers requires consideration of the measurement principles that can be applied. Magnetic field strength and the relative merits of gradient versus homogeneous magnetic fields methods, as well as the limitations presented by the well bore and wireline systems are a few examples of the factors that must be considered. As important, to the end user, is being provided a definitive link between the well logging response and laboratory measurements on rock samples that prove the meaning of the log. This is ideally accomplished when the laboratory measurements are attained using an apparatus that has the same operating characteristics as the log. For most well logging systems this is seldom accomplished to the degree desired, but it is readily attainable with NMR technologies. The consideration of these factors and the features and benefits of having such a capability are the focus of this paper. The technical attributes of such a comprehensive system, the Numar Corporation's "MRIL" and "CoreSpec1000", plus actual examples of laboratory and well bore data are provided to show the value of such an approach.