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Biomedical subjects

M Levy

Publications and source records attributed to M Levy.

At least 217 records · Page 12Linked to original sources
PubMed1994

Effect of schedule and maintenance on the antiemetic efficacy of ondansetron combined with dexamethasone in acute and delayed nausea and emesis in patients receiving moderately emetogenic chemotherapy: a phase III trial by the National Cancer Institute of Canada Clinical Trials Group.

PURPOSE: This study examines whether the schedule of ondansetron significantly influences its antiemetic efficacy in the first 24 hours after chemotherapy, whether the administration of oral ondansetron after 24 hours is effective in preventing delayed emesis, and whether the efficacy of ondansetron is preserved over multiple courses of moderately emetogenic chemotherapy. PATIENTS AND METHODS: A multicenter double-blind study randomized 302 cancer patients to one of three treatment arms. Arm A received dexamethasone 10 mg intravenously (i.v.) plus ondansetron (Zofran; Glaxo Canada Inc, Toronto, Canada) 8 mg i.v. prechemotherapy plus ondansetron 8 mg orally every 12 hours postchemotherapy for nine doses. Arm B received dexamethasone 10 mg i.v. plus ondansetron 16 mg i.v. prechemotherapy plus placebo orally postchemotherapy in the same schedule as arm A. Arm C received dexamethasone 10 mg i.v. plus ondansetron 8 mg prechemotherapy plus ondansetron 8 mg orally postchemotherapy for one dose followed by placebo orally every 12 hours for eight more doses. Response was assessed by the number of reported episodes of vomiting and by severity of nausea measured on a visual analog scale (VAS). RESULTS: The two schedules of ondansetron used in the first 24 hours were no different in their antiemetic efficacy, with similar rates for complete responses (76.7% v 72.0%, P = .472), complete plus major responses (90.2% v 82.0%, P = .135), and severity of nausea (P = .348). Oral ondansetron after 24 hours was more effective than placebo in preventing delayed nausea and emesis, with superior rates of complete responses (59.6% v 42.1%, P = .012 by one-sided test), complete plus major responses (80.9% v 66.3%, P = .018 by one-sided test), and less severe nausea (9.2 mm v 18.6 mm on a 100-mm VAS, P = .002). The efficacy of ondansetron was maintained over subsequent courses of chemotherapy. CONCLUSION: The schedule of ondansetron in the first 24 hours does not influence its efficacy. The use of oral maintenance ondansetron is effective in preventing delayed maintenance ondansetron is effective in preventing delayed nausea and emesis after moderately emetogenic chemotherapy.

Antineoplastic Agents↗
PubMed1994

1-year stability and prediction of cardiovascular functioning at rest and during laboratory stressors in youth with family histories of essential hypertension.

Blood pressure (BP). heart rate, cardiac index, and total peripheral resistance index were measured at rest and in response to postural change, forehead cold stimulation, and a video game challenge in a sample of 128 White and 155 African-American normotensive youth with family histories of essential hypertension (EH). These measurements were readministered 1 year later (12.5 +/- 3.2 months). Moderate temporal stability was observed for all resting and absolute stress responses. Reliability estimates for reactivity change scores were lower, although some were within acceptable ranges. African-American youth exhibited greater BP and peripheral resistance index reactivity to forehead cold on both evaluations. After controlling for various anthropometric and demographic parameters and the pertinent previous year's resting cardiovascular (CV) parameter, mean video game systolic blood pressure (SBP) responses were predictive of resting SBP whereas absolute forehead cold and video game diastolic responses predicted resting diastolic blood pressure (DBP) 1 year later. Mean video game DBP responses were also predictive of resting peripheral resistance index after controlling for significant demographic and anthropometric measures. CV reactivity is discussed with regard to possible value in prediction of changes in resting BP and cardiac structure prior lo establishment of EH.

Journal Article↗
PubMed1994

The ascending aorta: how much does transesophageal echocardiography see?

We assessed the ability of transesophageal echocardiography (TEE) to examine the entire length of the ascending aorta. TEE-derived data were compared with anatomic measurements and epiaortic scanning. There were 27 patients (19 male, 8 female; aged 67 +/- 12 yr) studied during cardiac surgery. The surgeon measured the distance between the aortic anulus near the right coronary artery to the origin of the innominate artery (AV-->IN) and to the level of the aortic cannulation site (AV-->C). Independently, the ascending aorta was imaged by biplane TEE and the maximum length of aorta visualized was measured (TEE-MAX). Additionally, TEE was used to detect atheromas in the aorta and to visualize the aortic cannula. Epiaortic scanning was also performed in 14 patients. Direct measurement of the ascending aorta revealed a length of 8.9 +/- 1.3 cm (mean +/- SD) and the TEE-MAX was 7.4 +/- 1.1 cm. The range of the difference between the two measurements was 0.2-4.5 cm. The aortic cannula was visualized only in 1 of 27 patients, and severe atherosclerotic plaques (> 3 mm thick), not seen on TEE, were detected in five patients with epiaortic scanning. As much as 42% (4.5 cm of 10.7 cm) of the length of the ascending aorta was not visualized and potentially embolic plaques were not imaged by TEE. These findings suggest that even biplane TEE may have limited use in the precannulation assessment of the aorta for plaque and the detection of distal ascending aortic pathology.

Aged↗
PubMed1994

Malignant meningioma in Gorlin's syndrome: cytogenetic and p53 gene analysis. Case report.

Gorlin's syndrome, also known as multiple basal cell carcinoma syndrome, is a familial tumor condition with autosomal-dominant inheritance. Patients develop multiple basal cell carcinomas beginning in childhood. They also have a typical dysmorphic facies, skeletal malformations, and a particular type of epithelial cyst of the jaws. Recent evidence localizes a Gorlin's syndrome locus on chromosome 9 at band q31. Both tumors and malformations of the central nervous system occur with Gorlin's syndrome. Medulloblastoma is the primary brain tumor most frequently associated with this syndrome; over 40 such cases have been reported. However, only seven cases of meningioma associated with Gorlin's syndrome have been described. The authors report the case of a woman with Gorlin's syndrome whose mother and maternal grandfather also had the condition. The patient was found to have a medulloblastoma at 4 years of age and presented with a large bifrontal meningioma at 19 years of age. The meningioma was histologically malignant and had a complex karyotype with multiple translocations including a t(5;9) with the breakpoint on chromosome 9 located at 9q32. The constitutional karyotype of the mother was normal. No mutations of exons 5 to 9 of the p53 gene were detected using single-stranded conformational polymorphism analysis.

Adult↗
PubMed1994

Evaluation of a yoga based regimen for treatment of osteoarthritis of the hands.

OBJECTIVE: Yoga and relaxation techniques have traditionally been used by nonmedical practitioners to help alleviate musculoskeletal symptoms. The objective of this study was to collect controlled observations of the effect of yoga on the hands of patients with osteoarthritis (OA). METHODS: Patients with OA of the hands were randomly assigned to receive either the yoga program or no therapy. Yoga techniques were supervised by one instructor once/week for 8 weeks. Variables assessed were pain, strength, motion, joint circumference, tenderness, and hand function using the Stanford Hand Assessment questionnaire. RESULTS: The yoga treated group improved significantly more than the control group in pain during activity, tenderness and finger range of motion. Other trends also favored the yoga program. CONCLUSION: This yoga derived program was effective in providing relief in hand OA. Further studies are needed to compare this with other treatments and to examine longterm effects.

Aged↗
PubMed1994

Evaluation in patients with Alport syndrome of knowledge of the disease and attitudes toward prenatal diagnosis.

Cloning of the COL4A5 gene has now made possible prenatal testing for Alport syndrome with X-linked dominant inheritance. We interviewed 27 females and 24 males with Alport syndrome to evaluate their knowledge of the disease and its transmission, and their attitudes to prenatal testing. Twenty-two males and 8 females were on renal replacement therapy. In all cases transmission was compatible with X-linked disease. Only 59% of the interviewees (74% of women, 42% of men) knew that gender was the major determinant in progression of the disease. Knowledge of the mode of inheritance was adequate in only 25%, in both sexes. Seventy percent of the participants (78% of women, 63% of men) would use prenatal testing. Of the women in favor of prenatal diagnosis, 67% and 39% would terminate pregnancy in the case of an affected male or female fetus, respectively. Of the men in favor of prenatal diagnosis, 53% would consider termination of an affected fetus. In summary, a majority would use prenatal testing, but only one or two thirds of them wished to use selective abortion. As in other inherited disorders, there is a discrepancy between the demand for prenatal diagnosis and the decision to terminate pregnancy. Most of the participants who would terminate a pregnancy had, however, little knowledge of the clinical and genetic aspects of Alport syndrome on which to base such a decision. An important aspect of genetic counselling is to assist consultants in reaching a decision regarding future reproductive behaviour which is appropriate to their situation. This study underlines the need to improve education and counselling to assure appropriate use of prenatal testing.

Abortion, Eugenic↗
PubMed1994

Evaluation of an orally administered vaccine, using hydrogels containing bacterial exotoxins of Pasteurella haemolytica, in cattle.

Poly(methacrylic acid) hydrogels were tested for oral delivery of a vaccine against Pasteurella haemolytica infection in cattle. Culture supernatants of P haemolytica, the most common bacterium associated with pneumonia in cattle, were used as the antigens in the vaccine. Hydrogels containing culture supernatants were administered orally to calves. Calves were then challenge-exposed with virulent P haemolytica. Calves were euthanatized 3 days after challenge exposure. The lungs of each calf were scored for severity and size of pneumonic lesions. Results indicated that vaccinated calves had smaller, less severe pneumonic lesions and lived longer than nonvaccinated calves. These results indicated that hydrogels can be used to deliver vaccines orally to calves to enhance resistance to pneumonia caused by P haemolytica.

Administration, Oral↗
PubMed1994

Colchicine disposition in patients with familial Mediterranean fever with renal impairment.

OBJECTIVE: To assess the pharmacokinetics of serum colchicine in patients with familial Mediterranean fever (FMF) with renal impairment. METHODS: Using a specific radioimmunoassay we determined serum colchicine concentration at various time points following oral administration of a single dose of the drug. RESULTS: Patients with renal insufficiency had a mean +/- SD apparent total colchicine clearance of 0.168 +/- 0.063 l/h/kg, apparent volume of distribution of 4.56 +/- 1.64 l/kg and elimination half-life (t1/2) of 18.8 +/- 1.2 h. Patients with FMF with normal kidney function had a mean clearance of 0.726 +/- 0.110 l/h/kg, volume of distribution of 4.87 +/- 2.05 l/kg and terminal t1/2 of 4.4 +/- 1.0 h. CONCLUSION: The kidneys have an important role in the clearance of colchicine. Caution should be exercised in the use of colchicine in patients with renal insufficiency.

Administration, Oral↗
PubMed1993

Childhood immunisation in general practice.

General practitioners provide 50% of childhood vaccination services in Australia. The routine schedule has been relatively stable for over 20 years, but new vaccine developments and an improved understanding of the epidemiology of the vaccine-preventable diseases will soon result in several major changes. General practitioners should review vaccination documentation and storage of vaccines, to ensure that the service they provide is of the highest standard. National targets for "age-appropriate" vaccination could be the basis for individual practices to assess their own performance.

Australia↗
PubMed1993

Separate neural pathways respond to different noxious stimuli affecting respiratory pump frequency in Aplysia fasciata.

Neural circuits responsible for both conditioned and unconditioned respiratory pumping to three stimuli modulating respiratory pumping were examined. The stimuli used were: (i) reduction of pH; (ii) increase and (iii) decrease in seawater concentration. Ablation of the osphradium, but not of the rhinophores, abolished responses to all 3 stimuli. Cutting the pleural-abdominal connectives led to a decrease in responses to lowered pH, but did not affect responses to changes in seawater concentration. Further lesions showed that integrity of the cerebral-pleural ganglion is needed for animals to respond to a decrease in pH. Thus, neural circuitry entirely within the abdominal ganglion and the periphery innervated by the ganglion is sufficient for mediating responses to changes in seawater concentration, while the cerebral ganglion is needed to respond to lowered pH. Different transmitter mechanisms are also used by pathways responding to changes in seawater concentration and to decreased pH: 5,7-dihydroxytryptamine in concentrations which cause depletion of serotonin blocked the response to lowered pH, but not to altered seawater concentrations.

5,7-Dihydroxytryptamine↗
PubMed1993

Synthesis and antifungal activity of medicagenic acid saponins on plant pathogens: modification of the saccharide moiety and the 23 alpha substitution.

The study of structure-antifungal activity relationships of medicagenic acid saponins was widened to include synthetic glycosides of mannose, galactose, cellobiose, and lactose as well as a 23 alpha-hydroxymethyl analog of medicagenic acid, namely, methyl 2 beta,3 beta-dihydroxy-23 alpha-hydroxymethyl-delta (12)-oleanene-28 beta-carboxylate, against Sclerotium rolfsii, Rhizoctonia solani, Trichoderma viride, Aspergillus niger, and Fusarium oxysporum. The native glucose-containing saponin was a more effective antifungal agent than the aforementioned saponins, except in the case of the cellobiose-containing derivative and F. oxysporum. A carboxyl substituent at the 23 alpha position of the sapogenin brought about higher fungistatic activity than a methyl carboxylate which, in turn, was more effective than an hydroxymethyl group at the same position.

Antifungal Agents↗