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Biomedical subjects

M Levy

Publications and source records attributed to M Levy.

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

A neuropsychological perspective on dual diagnosis.

The purpose of this study was to investigate whether patients experiencing both a major psychiatric disorder and a concurrent substance abuse problem (dual diagnosis) manifest greater neuropsychological dysfunctions than patients experiencing a major psychiatric disorder alone. Differences in diagnostic variability and fluidity between dual diagnosis and non-dual diagnosis patients and the occurrence of polysubstance abuse among the dual diagnosis patients were also investigated. The hypotheses were tested by retrospectively reviewing the psychiatric records of 50 dual diagnosis patients and comparing them to 36 chronically hospitalized non-dual diagnosis psychiatric patients. Results revealed that dual diagnosis patients manifested significantly greater neuropsychological impairments than non-dual diagnosis patients and that dual diagnosis patients showed a greater range of diagnoses and diagnostic fluidity than non-dual diagnosis patients. Results also revealed that over one-half of the dual diagnosis patients abused a variety of different substances. An etiological role of neuropsychological dysfunction in the development of the dual diagnosis syndrome in at least a subgroup of dual diagnosis patients is suggested. More specifically, it is suggested that the neuropsychological dysfunctional pattern that is described may represent an organic substrate of a nonspecific vulnerability to developing both (atypical) psychoses and (poly) substance abuse.

Adult↗
PubMedDate not supplied

Neurological comorbidity in treatment-resistant dual diagnosis patients.

This paper discusses the possible role of neurological dysfunction in the frequent treatment-resistance of dual diagnosis patients. Through case vignettes, the complex treatment process of three dual diagnosis patients is presented. Each case demonstrates how in addition to both psychiatric and substance abuse problems, the patients also experienced neurological difficulties that made treatment even more complicated. The authors suggest that treatment providers should carefully screen for neurological disorders among this patient population. Attending to such comorbid difficulties in addition to patients' psychiatric and substance abuse problems may sometimes play a pivotal role in enabling patients to attain abstinence. The authors also speculate concerning the role of neurological dysfunction in the etiology of the dual diagnosis syndrome in at least a subgroup of dual diagnosis patients.

Adult↗
PubMedDate not supplied

Aging and shiftwork: the effects of 20 years of rotating 12-hour shifts among petroleum refinery operators.

The survey was conducted in a Canadian refinery where operators have been working rotating 12-hour shifts for 20 years. A multidisciplinary approach was adopted, based on 12 sources of data. Descriptive statistics and chronoergonomic observations were used. The most marked consequences of the schedule were observed among former shiftworkers. Among current shift workers, sleep deficit, chronic fatigue, health problems, and disruption of social and family life were the most serious effects observed. Aging and under-staffing, however, interact with schedule by necessitating overtime and reducing the actual number of rest days, which in turn affects fatigue and reliability. In the near future, the low replacement rate of the workforce and the limitations on reassignment of aging workers to day shifts will probably prevent the selection process from playing its "protective" role. Besides, with the 5-year delay of the retirement age, the harmful effects in older operators active over the next 5-10 years may prove greater than those observed in this study.

Adult↗
PubMedDate not supplied

A cytogenic evaluation of long-term colchicine therapy in the treatment of Familial Mediterranean fever (FMF).

Thirty-eight patients suffering from Famlial Mediterranean Fever (FMF) and undergoing colchicine therapy for periods varying from one week to three years were examined cytogenetically. Preparations were derived from short-term lymphocyte cultures; mitotic rate, percent tetraploidy, and chromosome breakage rates were determined. Twenty-one patients were examined prior to treatment, 22 during treatment and 5 both before and during treatment and 5 both before and during treatment. No statistically significant differences were observed in the parameters studied between ten controls and the patient groups. An in vitro experiment indicated a direct correlation between increased colchicine concentration and mitotic rate. However, tetrapoloidy or chromosome damage showed no such association with colchicine concentration. Among the patient group, pregnancy occurred in four patients while under treatment; three pregnancies resulted in the birth of normal children while the fourth has not yet been completed. In one preganancy, cultured fetal amniotic fluid cells demonstrated no effect of colchicine on the cytogenetic parameters invetigated. These results indicate no untoward effects on long-term colchicine treatment in FMF with respect to fertility, teratogenicity and chromosomal damage.

Adolescent↗
PubMedDate not supplied

Monocyte function in familial Mediterranean fever.

Monocytes derived from the peripheral blood of patients with familial Mediterranean fever (FMF) demonstrated a consistently lower phagocytic capacity (38-44%) for 125I-labelled Shigella flexneri when compared to monocytes from healthy subjects. Phagocytosis of both viable and killed Staphylococcus albus was similar in patients and controls. However, FMF monocytes had a two- to eight-fold depressed bactericidal capacity against S. albus in comparison to normal monocytes. Acid phosphatase and beta-glucuronidase monocyte activities were similar in patients and controls. It is suggested that the defects in monocyte function may be of importance in the pathogenesis of FMF. Colchicine had no effect on any of the indices studied.

Adolescent↗
PubMedDate not supplied

Hospital admissions due to adverse drug reactions.

One hundred three (4.1%) of 2,499 patients hospitalized in a general medical ward were admitted because of an adverse drug reaction (ADR). Of 60 drugs involved, the most common were cardiac, antibiotic, and antineoplastic agents. The main reactions included skin rashes, bone marrow depression, arrhythmia, bleeding, and heart failure. Five (4.9%) of the patients died and 11 (10.7%) had life-threatening reactions. Risk factors predisposing to admissions due to ADR were: female sex, decreased renal function, polypragmasia, and the underlying disease. Twenty-seven percent of the admissions could have been avoided by a more careful choice and dosage of drug.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Leukocyte chemotaxis in recurrent polyserositis (familial Mediterranean fever).

Polymorphonuclear leukocyte chemotaxis was investigated in 35 patients with recurrent polyserositis during attacks and during spontaneous or colchicine-induced remissions. Chemotaxis was found to be unchanged in the attack-free period in untreated patients, increased by about 50% during attacks, and decreased by about 50% during colchicine treatment.

Adolescent↗
PubMedDate not supplied

Racial differences in hemodynamic responses to the cold face stimulus in children and adults.

The prevalence of essential hypertension is higher among blacks than whites. One reason for this difference may be that blacks are more reactive to stressors that produce vasoconstrictive responses. Two studies were conducted to test this hypothesis, one with 10- to 14-year-old males (20 whites, 20 blacks) and one with young adult males (10 whites, 10 blacks). Subjects had blood pressure, heart rate, cardiac output, and total peripheral resistance measured before, during, and after exposure to forehead cold stimulation. In both studies, blacks exhibited greater increases in diastolic blood pressure and total peripheral resistance to the stressor than whites. The findings are discussed in relation to blacks' greater pressor reactivity to stress, which appears to be mediated by changes in total peripheral resistance.

Adolescent↗
PubMedDate not supplied

Ethnicity, family history of hypertension and patterns of hemodynamic reactivity in boys.

This study compared blood pressure, heart rate, stroke volume, vascular resistance, and cardiac output responses to a video game challenge and forehead cold stressor in 6- to 15-year-old males who varied in ethnicity and family history of essential hypertension. Controlling for age, significant baseline differences were obtained with black boys exhibiting higher systolic and diastolic pressures than their white cohorts. Positive family history children were found to have higher cardiac outputs and stroke volumes indexed by body surface area during baseline. Controlling for baseline hemodynamic responses and age, positive family history children exhibited greater increases in systemic vascular resistance and systolic and diastolic pressure and greater decreases in heart rate to the cold stressor. The positive family history children exhibited greater decreases in cardiac index during both the video game and cold stressor phases. Implications of the findings and directions for future research are discussed.

Arousal↗
PubMedDate not supplied

The effects of long-term colchicine therapy on male fertility in patients with familial Mediterranean fever.

Four out of 19 male patients suffering from familial Mediterranean fever (FMF) had fertility problems while on colchicine therapy (0.5-2.0 mg daily for as long as 11 years). Three of the patients had had children while off therapy but their wives could not conceive while they were on therapy. In one patient primary sterility remained one year after cessation of colchicine. In this and two other patients the spermiogram was normal but the sperm penetration test was pathological. The fourth patient had azoospermia. Patients should be informed about this possible risk of colchicine therapy. The need for continued follow-up and the value of the sperm penetration test in the detection of fertility problems in male patients on long-term colchicine therapy are stressed. It is concluded however, that overall the benefits outweigh the danger of long-term colchicine treatment in male patients with FMF.

Adult↗
PubMedDate not supplied

A prospective clinical trial comparing metrizamide and iohexol for equine myelography.

A prospective clinical trial comparing adverse postmyelographic effects and myelographic quality of metrizamide and iohexol was conducted. Using a predetermined, randomized assignment, 24 horses exhibiting neurologic signs were administered either metrizamide (180 mgl/ml) or iohexol (180 mgl/ml) via cerebellomedullary puncture. Each horse was evaluated postmyelographically for adverse effects. Myelographic quality was assessed by a numerical scoring method. Adverse effects were observed more frequently with metrizamide (21) compared with iohexol (6) myelography (p < 0.05). Seizures, intensification of preexisting neurologic signs and prolonged anesthetic recovery were the most common complications after myelography. There was no difference in myelographic quality (p > 0.05). We conclude that iohexol is safer than metrizamide for equine myelography and that quality myelograms can be obtained with either contrast medium.

Anesthesia Recovery Period↗
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Parenteral nutrition hypersensitivity.

Total parenteral nutrition (TPN) is widely used. Although mechanical, septic, and metabolic complications are well known, hypersensitivity skin reactions are rare. We describe a 16-year-old boy with Burkitt's lymphoma who developed a urticarial skin rash when treated with TPN and vitamins. The adverse skin reaction was probably caused by the inactive component of excipient, polysorbate.

Adolescent↗
PubMedDate not supplied

Posterior cruciate ligament reconstruction. An in vitro study of femoral and tibial graft placement.

We studied posterior cruciate ligament reconstruction in a cadaveric model using two substitutes: a 1-mm diameter flexible cable and an 11-mm diameter Achilles tendon autograft. The thin cable allowed us to study five femoral and five tibial attachments in each knee. A nearly isometric attachment was located after cutting the posterior cruciate ligament while the tibia was reduced with a 100 N anterior force. The five femoral locations studied were the isometric location and four locations centered around this isometric point. The Achilles tendon reconstruction was used with both an isometric and a nonisometric femoral site, allowing us to confirm the results with the wire cable. Posterior motion limits were measured under a 100 N posterior force in the intact, posterior cruciate ligament-deficient, and posterior cruciate ligament-reconstructed knees. We found that the restoration of knee stability in flexion depended strongly on the femoral attachment location. A femoral attachment that was nonisometric by intraoperative measurement, but within the posterior cruciate ligament anatomic footprint, most closely reproduced the intact knee's posterior motion limits. Variations in the tibial attachment site produced only minor changes in the posterior motion limits. We concluded that the proximal-distal location selected for the femoral attachment of a posterior cruciate ligament substitute was particularly important in the restoration of normal posterior motion limits.

Achilles Tendon↗
PubMedDate not supplied

Breast cancer treatment alternatives: the patient decision-making process.

Today, a woman with breast cancer has many treatment alternatives. To undertake the decision-making process, she must be provided with information, support, and a health care network capable of meeting her needs. Surgeons are now faced with new roles in the decision making process as the choice is no longer theirs. They must be educated not only to keep up with the technical aspects of breast surgery, but also to modify their behavior in order to become more flexible and open-minded.

Breast Neoplasms↗