Biomedical subjects
Publications and source records attributed to M Gelfand.
Listeria monocytogenes is an uncommon cause of mycotic aneurysms, endocarditis, and other endovascular infections. When they occur, these infections usually involve patients with relatively normal host defenses, but with abnormal vascular intima or cardiac valves. We have reported a Listeria monocytogenes infection at the site of a posttraumatic aortic aneurysm.
Post and core systems anchored and supported by endodontic files, Para Posts, Boston Posts and Flexi Posts were subjected to tensile testing in an Instron testing machine. All forces were applied to the cores until the post-core system was removed. The test results revealed no statistically significant difference among post and core systems built up with Para Posts, Boston Posts or Flexi Posts. The endodontic files proved to be significantly less retentive than the other post systems evaluated. Under the conditions of this study, the use of endodontic files as retentive posts is not supported.
Regional ventricular wall stress is a critical determinant of cardiac function. There are, however, no validated methods for accurately estimating this stress. We have shown in the isolated ventricular septum that, during steady-state indentations, the transverse stiffness (the ratio of indentation stress [pressure acting on indenter face] to indentation strain [amount of indentation/nonindented thickness]) can be used as an estimate of the in-plane wall stress. Because of the long acquisition time for those transverse stiffness determinations, it was not possible to follow changes in wall stress over a single contraction. We recently developed a dynamic indentation system that can determine transverse stiffness in as little as 10 ms, allowing estimation of wall stress over a single contraction cycle. The apparatus consists of an indentation probe coupled to a linear motor. This indentation system was tested on two beating canine ventricular septa that were mounted in a biaxial system the could apply strains in the plane of the septa and measure the resulting in-plane stresses. The probe indented the septa with peak displacements of 0.1-0.5 mm at frequencies of 20 and 50 Hz. The transverse stiffness was calculated as the slope of the relation between the indentation stress and indentation strain during each high-frequency indentation. Consistent with earlier studies, the transverse stiffness was related to the inplane stress. In contrast to earlier studies, however, these dynamic transverse stiffness determinations could be made during a single contraction. Thus, dynamic transverse stiffness determinations allow estimation of wall stress in the isolated septa by minimal surface contact, and may lead to methods for estimating wall stress in the intact heart.
As part of a controlled, clinical trial conducted to compare medical and psychological outcomes of a birth room and a conventional hospital setting, we examined the behavior of fathers toward their partners and infants. One hundred fourteen couples were systematically assigned to either locale by strict alternation. They learned about this allocation on arrival at the hospital in labor. Observations of fathers' behavior were made at midlabor and during home visits at three months and one year. During labor, fathers assigned to the conventional setting were more involved in helping and encouraging their partners. Parenting behavior was not influenced by the birth setting. Unexpectedly, fathers were more involved with their infants when the mothers had expressed less satisfaction with childbirth. Compensation behavior may explain these results, which can be seen as appropriately adaptive in the face of perceived environmental deficiencies affecting the laboring woman and the infant.
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Eighty-five menopausal women (mean age 56 years) with endometrial hyperplasia without (65 patients, group 1) and with cytologic atypia (20 patients, group 2) were followed up prospectively from 2 to 12 years (mean 7 years) to shed insight into their respective response to oral medroxyprogesterone acetate therapy. In group 1 9 of 65 patients (14%) had persistence, 4 (6%) had recurrence, and none developed carcinoma. In group 2 10 of 20 patients (50%) had persistence and 5 had recurrence with cytologically atypical disease. Five of 20 patients (25%) developed adenocarcinoma at 2 to 7 years (mean 5.5 years) after starting medroxyprogesterone acetate therapy. The data suggest that most women with hyperplasia respond to progestogenic therapy and are not at increased risk of developing cancer. The patients with an unfavorable response to medroxyprogesterone acetate and a significant elevation in cancer risk can be identified on the basis of cytologic atypia.
The retentive strength of post and cores fabricated entirely of composite material was compared to the retentive strength of Para Posts with composite cores in etched and unetched post preparations. Under tensile forces exerted upon the cores, only one post was removed. In all other samples the posts remained firmly embedded within the roots. The core material fractured at the occlusal surface of the roots. The Para Post with Composite core cemented into etched preparations was significantly more resistant to fracture than all other samples.
Computed tomographic scanning of the brain is useful but not always conclusive in delineating central nervous system involvement in patients with bacterial endocarditis. Two patients are described in whom computed tomographic findings were normal, but magnetic resonance imaging revealed evidence of multiple brain abnormalities. Magnetic resonance imaging appears to be more sensitive than computed tomography for detecting central nervous system involvement in patients with bacterial endocarditis and should be employed when computed tomographic findings are normal in a patient with endocarditis and neurologic deterioration.
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Clinical features suggesting a diagnosis of Huntington's chorea in several siblings in a Black Rhodesian family are described. A progressive and eventually fatal mental deterioration accompanied by gradually worsening choreiform movements has until the present time occurred in only a single generation of this family, which precludes a definitive diagnosis based on the triad of family history, chorea and dementia. It is suggested that Huntington's chorea is the most likely diagnosis.
A series of 105 patients with organophosphate poisoning admitted to Harari Hospital during the past 4 years is described. Poisoning with organophosphate compounds is being seen more frequently in hospital practice in Rhodesia. Many of the cases are attempted suicides, but frequently there is no positive history of contact with the poison. The majority of patients exhibit the classic clinical features of parasympathetic overactivity, but diagnosis may be obscured by atypical presentation. Rapid diagnosis and utilization of the treatment regimen outlined in this article should reduce the mortality to less than 15%.