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Biomedical subjects

M Friedman

Publications and source records attributed to M Friedman.

At least 811 records · Page 45Linked to original sources
PubMedDate not supplied

Treatment of hypoxemia in obstructive sleep apnea.

Many patients suffering from obstructive sleep apnea (OSA) have intermittent oxygen desaturation associated with periods of apnea or hypopnea. Oxygen saturation levels below 90% are considered harmful. Usually, treatment is directed at correcting the apnea, which will in turn prevent hypoxemia. Unfortunately, many patients fail or are not candidates for nasal continuous positive airway pressure (CPAP) or surgical correction of their OSA. Forty-three patients with persistent OSA and nocturnal hypoxemia below 90% who were not candidates for additional surgical or CPAP therapy were treated with nocturnal oxygen supplementation. Standard symptoms associated with OSA and the Epworth Sleepiness Scale (ESS) were recorded before treatment and 30 days after the start of the treatment. In 21 patients, polysomnography studies were performed to compare the Respiratory Disturbance Index (RDI) score and minimum oxygen saturation levels when the patients were breathing room air or breathing 4 L/minute of oxygen by nasal cannula. Subjective symptoms of obstructive sleep apnea improved, and the ESS score significantly decreased after a 30-night treatment with oxygen. Split-night polysomnography showed a significant increase in minimum oxygen saturation during oxygen administration. The RDI did not significantly change with treatment. Oxygen administration for the correction of OSA-related nocturnal hypoxemia was both safe and effective in alleviation of OSA-related symptoms. It also appeared to have a beneficial effect on minimum oxygen saturation levels. Thus, oxygen therapy may be considered a treatment option in patients who fail to comply with CPAP and are not candidates for a surgical procedure.

Adult↗
PubMedDate not supplied

Commercial sex workers in Kathmandu Valley: profile and prevalence of sexually transmitted diseases.

This paper presents a socioeconomic profile and the prevalence of sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), among 341 female commercial sex workers (CSWs) in Kathmandu Valley. Most of the CSWs are from outside the valley, but from within Nepal. Over 50% of the CSWs have a secondary or higher level of education. The average age of the CSWs is 21 years. The average age of first sexual intercourse was 16 years; and, at entering the sex trade, 18 years. The most frequently reported type of sexual activity is vaginal intercourse followed by anal intercourse. Although a large proportion of CSWs are aware of condoms, only one-fifth of them reported using condoms most of the time they had intercourse. The majority of the CSWs are aware of general types of STDs. Slightly over 60% are aware of AIDS, and the majority of them know of at least one mode of AIDS transmission. Gynecological examination based on symptoms revealed that 72% of the CSWs were infected with some type of STD. About 47% had vaginal discharges, 36% had pelvic inflammatory disease, 24% had ulcerative disease, and 4% had urethritis. Blood tests of the CSWs revealed that 28% had VDRL (a test for syphilis), hepatitis B, or HIV. The prevalence of VDRL was the most common, followed by hepatitis B. Of the 341 CSWs, 3 (0.9%) were HIV-positive.

Asia↗
PubMedDate not supplied

Inhibition of plaque accumulation under periodontal dressing by sustained-release varnish of chlorhexidine.

Slow-release varnish containing chlorhexidine was applied prior to the application of a periodontal dressing. The ability of the slow-release varnish to inhibit accumulation of dental plaque under the dressing was compared to a placebo varnish. Seven volunteers were fitted with periodontal dressing on the lower and upper jaws. One jaw was pre-coated with slow-release varnish containing chlorhexidine, while the other was coated with a placebo. A week later the dressings were removed and the plaque under the dressing was scored. Significantly less plaque was found on teeth pre-coated with the slow-release varnish containing chlorhexidine as compared to the control. An increase in the amount of gingival fluid was observed in both the control and experimental groups after removing the periodontal dressing.

Adult↗
PubMedDate not supplied

Local application of sustained-release delivery system of chlorhexidine in Down's syndrome population.

The effect of local applications of sustained-release delivery polymer containing chlorhexidine as an adjunct to mechanical plaque removal was studied in institutionalized children with Down's syndrome. Thirty children, ages 8-13, participated in the study. Clinical parameters (P1I, GI, papillary bleeding) were recorded and bacterial samples from selected permanent teeth were collected and processed before and following treatment. Following the registration of clinical findings and collection of plaque, all children had their teeth scaled and polished and were randomized into three treatment groups of ten subjects each: Subjects in group I had their teeth coated with ethyl cellulose containing chlorhexidine; those in group II had their teeth coated with placebo polymer and those in group III received no further treatment. Individual oral hygiene habits were not interfered with. The application of the solutions to the respective groups was done every 3 days for 21 days. Chlorhexidine treatment significantly reduced the PLI, GI total aerobic counts and S. viridans counts compared to no treatment. The placebo group showed similar effects to that of the chlorhexidine-treated group except for the total aerobic counts which were not affected. The results suggest that the use of chlorhexidine in a sustained-release dosage form applied to the tooth surfaces may prove useful in the control of plaque and its sequela in children with Down's syndrome.

Adolescent↗
PubMedDate not supplied

The effect of sustained-release varnish of chlorhexidine in dental plastic shells on salivary Streptococcus mutans.

The suppression of S. mutans is a predominate factor in preventing tooth decay. Sustained-release-delivery varnish of chlorhexidine was applied to dental plastic shells and administered to eight volunteers to be worn while sleeping. Salivary bacterial samples were taken on days 0, 7, 14, 21, 28, 35. A statistically significant reduction in S. mutans counts was recorded during the course of the study while a non-significant reduction in the total bacterial counts was found. Our results indicate that the application of chlorhexidine in the form of slow-release varnish in plastic shells is an effective intraoral drug delivery system resulting in reduction of S. mutans.

Chlorhexidine↗
PubMedDate not supplied

Topical varnish containing strontium in a sustained-release device as treatment for dentin hypersensitivity.

The purpose of this study was to assess the effect of topical application of a sustained-release device in form of a varnish containing strontium chloride on dentinal hypersensitivity. Sixty teeth were selected in ten patients. The teeth were divided in a) varnish application containing strontium chloride, b) varnish application with no active ingredient, c) untreated teeth. Varnish application was carried out by the patients once daily for 30 days. Results show a marked decrease in hypersensitivity to both mechanical (54%) and thermal stimuli (38%) as compared to the placebo and untreated group.

Delayed-Action Preparations↗
PubMedDate not supplied

Benign lymphoepithelial parotid tumors in AIDS patients: CT and MR findings in nine cases.

Benign lymphoepithelial parotid neoplasm with associated cervical adenopathy is a newly described head and neck manifestation of HIV infection, characterized previously as purely cystic masses on both CT and MR evaluations. The CT and MR findings in nine cases of surgically proved benign lymphoepithelial parotid lesions are presented. Five (56%) of the nine cases demonstrated masses that appeared other than cystic, reflecting a greater variety of radiologic appearances than previously reported. The majority of these cystic masses contained solid components and therefore could not be labeled as cysts; instead, they were considered to be benign lymphoepithelial parotid lesions. For patients with parotid gland enlargement, the lack of a characteristic CT/MR appearance of these lesions necessitates an evaluation of clinical history and a determination of whether cervical adenopathy is present in order to determine their underlying origin.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

True aneurysm in a prosthetic aorto-femoral dacron graft.

Aneurysms occurring in prosthetic grafts are a very rare phenomenon. However, false aneurysms are a known complication which can appear in the anastomotic site of the graft, but very seldom in the middle of the prosthetic graft. True aneurysm of a dacron graft is extremely rare, and very few have been reported in the literature. We present a case report of true aneurysm of a dacron graft that was implanted seven years before, found on a routine examination and confirmed on a pathological examination and successfully operated upon.

Aged↗
PubMedDate not supplied

Needle aspiration of 310 thyroid lesions.

Needle aspirations of benign and malignant epithelial lesions of the thyroid were investigated in 265 patients. An 18-gauge needle connected to a 20-cc glass syringe was used to puncture each tumoral mass. Smears were stained by the Wright-Giemsa method. The material obtained consisted of 180 nontoxic goiters, 18 toxic goiters, 15 cases of thyroiditis and 52 malignant lesions. Aspirations taken from 21 patients (8%) were either blank or contained only blood and insufficient material for diagnosis. Results were correlated with clinical findings and laboratory tests. Biopsies were obtained only in selected patients to establish the final diagnosis. One false positive and one false negative were recorded. Although well-preserved follicular patterns can be seen on the cytologic specimens, the differentiation of thyroid adenoma from early follicular carcinoma based on cytologic criteria only if fraught with many difficulties. Cell density, nuclear structure and presence of nucleoli are sometimes helpful in making the cytologic diagnosis of thyroid carcinoma.

Biopsy, Needle↗
PubMedDate not supplied

Problem-based clinical confrontation modules planned and conducted by students.

A course has been described which attempts to introduce clinical relevancy to the basic science knowledge. It has been demonstrated how senior students' feedback about curricular shortcomings can be redirected to their constructive participation in the educational process. The described Clinical Confrontation course develops problem-solving skills and self-learning habits in the learners while they are processing and rearranging prior knowledge. At the same time, both the scientific base of medicine and the internal logic of the disciplines are preserved.

Clinical Competence↗
PubMedDate not supplied

Comparison of interlaboratory variation in amino acid analysis and rat growth assays for evaluating protein quality.

Estimates of inter- and intralaboratory variation of protein efficiency ratio (PER), relative PER (RPER), net protein ratio (NPR), relative NPR (RNPR), and nitrogen utilization (NU) were compared with those of amino acid analysis in the same batches of 7 protein sources (ANRC casein, egg white solids, minced beef, soy assay protein, rapeseed protein concentrate, pea flour, and whole wheat flour). Interlaboratory variation (estimated as between-laboratories coefficients of variation, CV) of NPR and RNPR (up to 6.0%) was lower than that of PER (up to 20.2%) and RPER (up to 18.5%). The interlaboratory determination of NPR and RNPR was also more reproducible than that of most essential amino acids (CV up to 10.0%), especially tryptophan (CV up to 23.7%), cystine (CV up to 17.6%), and methionine (CV up to 16.1%). Intralaboratory variation (estimated as within-laboratories CV) of amino acid analysis (up to 4.7%), however, was comparable to that of protein quality indices in most protein sources (up to 6.0%). The significant (P less than 0.01) positive correlations (r = 0.68-0.74) between amino acid scores and protein quality indices based on rat growth were further improved when amino acid scores were corrected for digestibility of protein (r = 0.73-0.78) or individual amino acids (r = 0.79-0.82).

Amino Acids↗