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Biomedical subjects

M Levy

Publications and source records attributed to M Levy.

At least 559 records · Page 31Linked to original sources
PubMed1982

The effect of quality assurance review on implementation of an automatic stop-order policy.

Because of problems associated with overutilization of antimicrobial drugs, particularly antibiotics, Long Island Jewish-Hillside Medical Center, New York, conducted a hospitalwide study to ensure that physicians' orders for antimicrobial drugs complied with an automatic stop-order policy. The original study, conducted in 1980, revealed a compliance rate of only 18.5% for antibiotics. However, after implementation of an extensive educational program for physicians and nurses, a restudy, conducted one year later, showed that compliance with the automatic stop-order policy increased to 54%--a 300% improvement over the first study. In addition, the follow-up study also revealed a 6% decrease in the percentage of patients who received antibiotics.

Anti-Bacterial Agents↗
PubMed1982

Alport's syndrome: experience at Hôpital Necker.

We review the characteristic morphologic features identifiable by electron microscopy that have been described in patients presenting with Alport's syndrome. They are diffuse thickening and splitting of the glomerular basement membrane (GBM), which are either isolated or associated with thinning. In occasional cases, only diffuse thinning can be seen. Our study of 100 families followed in Necker's hospital, of which 60 patients have had electron microscopic examination of their renal parenchyma, demonstrates that these GBM changes are highly suggestive of Alport's syndrome. All the patients included in the study fulfilled the following clinical criteria: familial incidence, nerve deafness in the propositus or in another member of the family, renal disease with progression to renal failure in the proband or in another member of the kindred. Although a failure in the proband or in another member of the kindred. Although a normal GBM was found in five patients, the GBM changes should be one of the criteria for the definition of the syndrome. Results dealing with a few other problems raised by this syndrome are reported. They concern the antigenicity and the biochemical composition of the GBM, the incidence of macular and perimacular changes, and the genetic transmission of the disease. It is concluded that Alport's syndrome is genetically heterogeneous and that the GBM ultrastructural changes are observed in most patients whatever the type of genetic transmission.

Adolescent↗
PubMed1982

Renal abnormalities in the Bardet-Biedl syndrome.

Four cases of BARDET-Biedl syndrome (BBS) are described which all suffer from renal abnormalities. Polyuria or polydipsia with impairment of renal concentration capacity were the earliest signs of renal dysfunction. Renal insufficiency developed in 3 cases and hypertension in two. Urographic abnormalities were demonstrated in all patients. The most remarkable features were cystic spaces communicating with the calices and lobulation of kidney. Caliceal clubbing and caliectasis surrounded by narrowed, unscarred parenchyma were frequent findings. Previous investigators reported various renal histological pictures in BBS. We found tubulo- interstitial lesions in all cases. Features of dysplasia and cystic formations were less frequent. Mesangial proliferation was not noted. Ultra-structural changes in the glomerular basement membrane were not observed in this study. Thirty-one of 32 recently reported cases of BBS included renal lesions which are the major cause of death. It is therefore suggested that renal abnormalities are accepted as the cardinal feature of this syndrome.

Adolescent↗
PubMed1982

Familial hypoplastic glomerulocystic kidney. A new entity?

Two pairs of female siblings of French and Italian origin presented with the histological picture of glomerulocystic kidneys. The cases differ from the patients previously described with glomerulocystic kidneys by the absence of major extrarenal malformations, the reduction of kidney size with absence of renal papillae and by the presence of stable chronic renal failure, starting during the first months of life. Both mothers of the patients also had chronic renal failure with similar urographic abnormalities.

Biopsy↗
PubMed1982

Medical admissions due to noncompliance with drug therapy.

In 34 (2.9%) of 1184 medical admissions monitored at the Hadassah University Hospital in Jerusalem, noncompliance with drug therapy appeared to be the principal factor leading to hospitalization. The main diseases presented on admission were cardiovascular conditions and exacerbation of chronic pulmonary and inflammatory diseases. The reasons given for noncompliance were the occurrence of adverse reaction (39% of the cases), lack of symptoms (19%), too many drugs (16%), and forgetfulness (10%). The main drugs involved were diuretics, digoxin, and antibiotics. Nonprofessional employment, low level of education, as well as old age in males were identified as factors associated with hospitalization due to noncompliance. Poor knowledge of possible adverse reactions and results from noncompliance were evident in the entire patient population. Educational measures are required to increase patient participation in the therapeutic process.

Adult↗
PubMed1981

Fabricating a shoulder somatoprosthesis.

A technique for the fabrication of a shoulder prosthesis has been described. The prosthesis has proven to be an effective means of rehabilitating a patient following an intrascapulothoracic amputation. The patient may once again wear clothing without having it adjusted to conform to the defect. Such rehabilitation has been of great psychologic value for patients and their families as well. The impression and processing procedures are effective for the fabrication of a shoulder prosthesis. The principles of this technique may be applied to the fabrication of other large somatoprostheses.

Alginates↗
PubMed1981

Severe "suction injury" due to implosion of an underwater camera casing: mechanism of injury.

The dynamics of a "suction injury" of soft tissues in a deep-sea diver caused by the implosion of a home-made camera casing at a depth of 40 m have been investigated. An unprotected rubber ring holding the window on the outside of the camera casing was apparently not sufficiently rigid to prevent the outward movement of the glass at the periphery and shattering inwards at the center as a result of pressure of 500 kg at a depth of 40 m.

Adult↗
PubMed1981

Granulomatous hepatitis secondary to carbamazepine.

Three cases of carbamazepine-induced granulomatous hepatitis are reported. Each patient had ingested carbamazepine for less than 1 month before presenting with a febrile illness suggestive of biliary tract infection. After withdrawal of carbamazepine, symptoms disappeared rapidly. Histologically, all patients had granulomatous hepatitis. Two patients also had acute cholangitis. Carbamazepine-induced liver injury can be confused clinically and pathologically with biliary tract infection.

Carbamazepine↗
PubMed1981

A serum C3-activating factor: its characterization and its presence in glomerular deposits.

A non-IgG C3 activating factor (C3AF) isolated from the serum and plasma of a patient with membranoproliferative glomerulonephritis with subendothelial and subepithelial deposits (type III) was studied to define its molecular structure, functional characteristics, and presence in renal biopsies. Alternative complement pathway (ACP) activation of C3 was comparable to that of zymosan, but significantly less than that of IgG C3 nephritic factor (C3NeF). Functionally active isolate contained beta 1H globulin (beta 1H) and the C3AF protein, which had a gamma-electrophoretic migration. beta 1H present in the isolate exhibited an altered gamma-beta electrophoretic mobility. The function of this complex is heat labile. Time/temperature studies demonstrated that inactivated preparations of this isolate show a return to the normal beta migration of beta 1H followed by the development of an alpha 2 electrophoretic migration of the previously gamma-migrating material of functionally active isolate. Normal human serums contain an alpha 2 protein that shows complete antigenic identity with the gamma protein of C3AF, but this alpha 2 protein lacks C3 activating function. On polyacrylamide gel electrophoresis, the C3AF isolate contains a high m.w. protein of 500,000 to 590,000 that is composed of 2 major subunits. Carbohydrate is not demonstrable, and the protein is antigenically distinct from plasma fibronectin. Immunofluorescence studies of renal biopsies of patients with types I and III MPGN revealed the presence of C3AF antigen in granular deposits in 10 of 16 cases. The presence of this antigen in glomerular deposits was associated with C3 and beta 1H, but was independent of Ig. These studies suggest that the mechanism of ACP activation by C3AF results from interference with beta 1H function. The presence of this material in renal biopsies from some MPGN patients further suggests a pathogenetic role in mediating glomerular pathology.

Chemical Precipitation↗
PubMed1981

Complement activation in nonsystemic glomerular diseases in children.

All forms of glomerulonephritis (GN) in man seem to be immunologically mediated and the complement system appears as one of the most important mediators of renal injury. The study of complement activation is therefore of great help in the identification of the immunopathogenic process involved in the various types of glomerular diseases. After a review of the molecular events of complement activation and the methods used to study the complement system in man, we will attempt to summarize current knowledge concerning complement in nonsystemic glomerular diseases frequently encountered in children. The terms used are those descriptive of glomerular morphology as defined either by light microscopy and electron microscopy (endocapillary-proliferative GN with humps, extramembranous GN, membranoproliferative GN) or by immunofluorescent microscopy (mesangial IgA GN).

Basement Membrane↗
PubMed1981

Therapy with vitamin B6 with and without surgery for treatment of patients having the idiopathic carpal tunnel syndrome.

Blood samples from four patients at the time of surgery to relieve the compression of the carpal tunnel syndrome, which was diagnosed by clinical and electromyographic evaluation, were differentially assayed to determine the specific activities and the % deficiencies of the erythrocyte glutamic oxaloacetic transaminase (EGOT). The data from these assays revealed that these four patients had a severe deficiency of vitamin B6. These data, in conjunction with previous biochemical and clinical results over five years, underscore the desirability, and even necessity, of testing by the EGOT analysis for the presence of a severe deficiency of vitamin B6 in all such patients before surgery. Treatment with vitamin B6 (pyridoxine) for a minimum period of 12 weeks, depending upon the duration and severity of the symptoms, has been effective without exception. Surgery may relieve compression, but does not correct a deficiency of vitamin B6. Surgery in addition to therapy with vitamin B6 should be reserved for those patients who have had the deficiency for so many years that much tissue damage is irreversible by pyridoxine, and additional relief from pain can be achieved through the surgery.

Adult↗