Biomedical subjects
M Levin
Publications and source records attributed to M Levin.
Religious objection to transfusion.
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Two Agar-less Media for the Rapid Isolation of Corynebacterium and Neisseria.
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The Intersection of Arbitrary Chains and Its Boundary.
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Scientific misconduct.
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Analysis of coronary outflow dilution curves for the estimation of cellular uptake rates in the presence of heterogeneous regional flows.
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A clinical evaluation of long-term continuous use of norethynodrel-mestranol for contraception.
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Healing the Children: medical missions.
In 1993, I started documenting medical missions organised by the American-based, non-profit organisation Healing the Children (HTC). With 14 chapters in 21 states, HTC has helped tens of thousands of children worldwide since it was founded in 1979. The organisation arranges specialised medical treatment and surgical care for children whose families cannot afford it or whose communities do not offer it. HTC relies entirely on volunteers. In 1995, the northeast chapter of HTC alone provided more than $7.5 million in services to about 2300 children. HTC also provides treatment and assistance to disadvantaged children in US communities, arranges special care in the USA for children from nearly 60 countries, and recruits organisations to provide supplies and refurbished equipment to hospitals in underdeveloped countries. In October, 1994, I travelled with an HTC team of over 50 medical personnel on a cardiac trip to Guatemala City. More recently, in April, 1996, I documented a team of 11 who travelled to Cochahamba, Bolivia, to carry out soft tissue surgery.
Understanding the genetic basis of susceptibility to mycobacterial infection.
Genetic factors have long been suspected of determining susceptibility and resistance to mycobacterial infection. The recent identification of families with a unique susceptibility to mycobacterial infection, and the identification of mutations in the genes for either the interferon-gamma (IFN-gamma) receptor or the interleukin (IL)-12 receptor as the cause of the defect, has provided an important clue to the pathways critical for resistance to mycobacterial infection in humans. Although the genetically determined absence of key cytokines or their receptors results in susceptibility to lethal mycobacterial infections in early childhood, it is likely that more subtle mutations that result in only partial dysfunction of macrophage upregulation pathways may play a role in susceptibility to tuberculosis (TB) and leprosy in the general population.
Risk of hepatitis A virus infection among sewage workers in Israel.
Sewage workers are exposed to a wide range of chemicals and biological agents, including the hepatitis A virus. Inasmuch as Israel is an endemic area for hepatitis A, it is unclear if sewage workers are at increased risk for hepatitis A or which factors contribute to such risk. The authors compared seropositivity of hepatitis A in 100 sewage workers with that in 100 blue-collar worker controls. Hepatitis A seropositivity was highly prevalent, but nonsignificant, in both sewage workers and controls (82% and 91%, respectively). In sewage workers, the major risk for serological positivity was age (odds ratio = 4.5, 95% confidence interval = 1.6, 12.4 for every 10 y). The factors associated negatively with seropositivity were years of education and years of seniority. The authors concluded that exposure to sewage is not a risk factor for hepatitis A infection in Israel, and, therefore, sewage workers do not require special attention in this regard.
Surface charge of red blood cells in insulin-dependent diabetic patients with incipient and overt nephropathy.
The negative surface charge of red blood cells was studied in adults with insulin-dependent diabetes mellitus, using a chemical assay based on the binding of the cationic dye Alcian-blue 8GX to anionic sites on the cell surface. Twenty-one healthy non-diabetic adults, 21 normo-albuminuric diabetic patients, 25 diabetic patients with incipient nephropathy, and 19 diabetic patients with overt nephropathy were studied. The diabetic patients were matched for age, duration of diabetes, and glycaemic control. The red cell surface charge was nearly identical in the four groups studied. Our study does not suggest that loss of membrane negative charge is a generalized phenomenon in insulin-dependent diabetic patients with albuminuria.
Pathophysiology and management of meningococcal septicaemia.
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More than standards and regulations are needed to provide safe and effective devices.
Medical devices that met standards have been recalled. Quality systems that were said by internal audits to be in compliance with FDA regulations or ISO quality standards received serious questions after external auditing. Devices meeting standards or produced by quality systems felt to be in compliance have put patients at risk by failing at critical moments. Something more than just meeting standards and regulations is needed to provide safe and effective medical devices.
Perception of chassis leakage current.
The issue of chassis leakage currents flowing through areas on the surfaces of patients' bodies is again being discussed, probably because of increasing acceptance of International Electrotechnical Commission (IEC) Standard 601-1, the use of more instruments with computational capability but with generally higher chassis leakage currents at the bedside, the absence of evidence that the 500-microampere chassis current limitation of IEC 601-1 has been harmful, and the lack of data to substantiate the lower limit currently applied in the United States. Reported relevant experiments have not attempted to duplicate the conditions existing for the situations of concern--an open ground, a person touching the chassis of the device that has an open ground condition, and this person then touching the patient; or a grounded patient touching an ungrounded chassis. In terms of perception of current, the patient touching an ungrounded chassis and being grounded would generally be the more sensitive, since the conductive path of just one person, the patient, is involved. A small test was conducted that simulated a person touching a chassis with an open ground wire and then touching a patient. The results did not confirm previous findings in another study that currents ranging from 261 to 500 microamperes caused pain. They were closer to those of a study of perception of 60-Hz current, in which similar currents elicited only perception.
Ovulation induction for in vitro fertilisation using clomiphene citrate and low-dose human menopausal gonadotrophin.
Ovulation induction using a low dose of human menopausal gonadotrophins and clomiphene citrate for in vitro fertilisation and embryo transfer is described. Sixty-two cycles of ovulation induction were initiated in 37 patients. Forty-six laparoscopies were performed, yielding 116 oocytes. Of these, 90 (77.6%) cleaving embryos developed, and in 36 transfers 10 pregnancies (27.8%) were established. The use of low-dose hMG in conjunction with a programme on an outpatient basis may prove to be optimal for the purpose of in vitro fertilisation and embryo transfer.
Emergency care curriculum of the Beer Sheva Medical School.
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Use of genetic algorithms to solve biomedical problems.
Many problems in the biomedical sciences can be formulated as searches in some appropriate space. The genetic algorithm offers a domain-independent approach to searching that is often able to provide good answers to questions with difficult search spaces. This paper discusses when to use this genetically inspired approach, how to model problems as searches, how to define appropriate spaces, representations, and fitness functions, and how to implement a program using a genetic algorithm.