Search PubMed⌕ Search

Biomedical subjects

M Levy

Publications and source records attributed to M Levy.

841 records · Page 47Linked to original sources
PubMedDate not supplied

A method of repair for Achilles tendon ruptures without cast immobilization. Preliminary report.

A new technique for the repair of Achilles tendon ruptures has been developed with a Dacron vascular graft used as a tension suture material. The suture is passed through the calcaneal tuberosity and, with two loops applying tension to the tendon at the level of the musculotendinous junction, brings the tendon ends together by creating a solid structure. Post-operative immobilization and its possible adverse sequelae are eliminated by this procedure. The technique was first tested on five dogs with severed Achilles tendons of both hind legs. One side in each animal was repaired with this suture technique; the second leg was left as an untreated control. All the animals recovered from surgery and walked almost normally on the sutured leg within less than three weeks. The dogs did not walk on the unsutured legs. In a second procedure, the control leg was repaired by the same reparative procedure. Equally good results were obtained. The technique was then used on five patients with recent and neglected Achilles tendon ruptures or lacerations. In all instances excellent surgical results were obtained and leg immobilization was virtually eliminated. Physical therapy was begun in the immediate postoperative period. The rehabilitation period was significantly reduced.

Achilles Tendon↗
PubMedDate not supplied

[Association of early-onset nephrotic syndrome and microcephaly. Apropos of 4 cases in 2 families].

The authors report 4 cases in 2 different families of a syndrome characterized by nephrotic syndrome of early onset (during the first 2 years of life) and microcephaly. Such an association was previously reported in 5 cases. In 4 it was familial. The study of families suggests an autosomal recessive transmission. Microcephaly was associated with psychomotor retardation, sometimes dysmorphic facies and various neurologic abnormalities. The nephrotic syndrome was characterized by its early onset and prognostic severity. However, the renal histologic lesions were heterogeneous: either minimal glomerular changes with focal and segmental hyalinosis or mesangial sclerosis, or, so-called "microcystic dysplasia". This heterogeneity does not suggest a single genetically determined disorder.

Age Factors↗
PubMedDate not supplied

Circulating immune complexes in recurrent polyserositis. (Familial mediterranean fever, periodic disease).

Increased levels of circulating immune complexes (CIC) were demonstrated by the Clq binding assay in 22 (27%) out of 81 patients with recurrent polyserositis. The prevalence of increased CIC was significantly higher in Jewish patients of North African origin (42%) than in subjects of other ethnic groups (6%). North African patients also manifested an increased familial incidence, earlier onset of symptoms and a higher frequency of arthritis. There was no correlation between increased CIC levels and disease activity. These findings suggest that the immune response of North African patients differs from that of subjects of other ethnic groups and that this difference is possibly genetically determined.

Adolescent↗
PubMedDate not supplied

[Prognosis of nephrosis].

Renal biopsy, the introduction of immunohistologic methods and electron microscopy have allowed the differentiation of clinicopathologic entities associated to nephrotic syndrome. Two main categories must be differentiated: in the first, diffuse lesions of the glomerulus, including those secondary to specific diseases the same as those that are apparently primary, are responsible for the increased permeability of glomerular capillaries. Any one of the following clinical signs suggests this category: acute onset with nephritic syndrome, moderate nephritic syndrome, moderate nephrotic syndrome, gross hematuria, persistent hypertension and/or renal failure, poor selectivity of proteinuria and drop in complement serum levels (C3). In the second category, known as idiopathic nephrotic syndrome, the mechanism of disorder of the glomerular capillary is unknown and the nephrotic syndrome is more marked. In most cases with idiopathic nephrotic syndrome, minimal glomerular lesions (MGL) are present. The clinicopathologic correlation among these three types of lesions shows that the type with MGL is characterized by selective proteinuria, absence of hematuria, good response to corticosteroids and good outlook; whereas in types with diffuse mesangial proliferation (DMP) and segmentary sclerosis, proteinuria is frequently non selective, hematuria shows in 50 to 75% of the patients; prognosis is poor. However, MGL, DMP and focal segmentary glomerular sclerosis are not different entities, but represent variants of the same disease. Considering that corticosensitive nephrosis to this moment is the most common cause of the nephrotic syndrome, especially in children under 8 years, renal biopsy should be done only under two circumstances: a) when the clinical symptoms suggest diffuse glomerular lesions and b), when resistance to corticosteroids becomes evident.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Unfavorable outcomes (end-stage renal failure/death) in childhood onset systemic lupus erythematosus. A multicenter study in Paris and its environs.

Thirty of 118 cases of childhood onset systemic lupus erythematosus collected in the Parisian area had an unfavorable outcome. Thirteen patients evolved to end-stage renal failure. Seven survived with renal substitution therapy, and 6 other patients subsequently died. Most had diffuse proliferative glomerulonephritis, the pattern of glomerular disease classically responsible for end-stage renal failure. Three patients had membranous nephropathy with segmental lesions, a form of glomerulonephritis whose severe prognosis should be emphasized. In another patient, end-stage renal failure was precipitated by thrombotic microangiopathy. Seventeen other patients died and in most, the causes of death were multiple. In 7, death could be attributed to complications secondary to an infection and in 4 other cases to SLE exacerbation with severe organ involvement. Two patients died suddenly, another showed cardiac failure and another had malignant hypertension. Of the remaining 2 patients, one suffered anticoagulant therapy complications after treatment for renal artery stenosis and the second, an urothelial carcinoma. Unfavorable evolutions were high among patients coming from French departments and territories, and among North African patients. One may speculate that poor outcome is associated with ethnic characteristics or with socioeconomic factors. However, the problem of compliance with treatment is clearly an extremely important factor in the prognosis. Both end-stage renal failure and death were in some of our cases precipitated by treatment interruption, indicating an insufficient understanding of the importance of treatment in this chronic disease.

Adolescent↗
PubMedDate not supplied

Neonatal withdrawal syndrome: associated drugs and pharmacologic management.

Use of addicting drugs among women during pregnancy exposes newborns to potentially serious disorders. A group of symptoms referred to as neonatal withdrawal syndrome (NWS) may occur in infants born to mothers addicted to certain drugs because, at birth, the infants suddenly are cut off from the drug supply. Classes of drugs that cause NWS are those that produce addiction in adults, including the opioids (heroin, methadone, morphine), barbiturates, alcohol, and benzodiazepines. Many of the manifestations of NWS occur regardless of the class of drug, including irritability, hyperactivity, abnormal sleep pattern, high-pitched cry, tremor, vomiting, diarrhea, weight loss, and failure to gain weight. The fact that these symptoms are nonspecific makes it difficult to identify NWS unless it is specifically looked for. The onset, duration, and severity of the disorder differ based on such factors as the addictive drug used, time and amount of mother's last dose, and rate of elimination of the drug from the newborn. Pharmacologic intervention may be required to control severe symptoms and signs. The most common drugs used to modify withdrawal are phenobarbital, paregoric, chlorpromazine, and diazepam. Treatment is complicated by conflicting information on the effectiveness of various agents.

Barbiturates↗
PubMedDate not supplied

[Gastrointestinal damage in osteoarthritis patients].

Seventy-seven patients with symptomatic osteoarthritis of the hip and/or knee, with clinical indication for nonsteroidal anti-inflammatory drugs were studied. However, no patient was submitted to any anti-inflammatory medication seven days, prior the beginning of the study and did not complain of any gastrointestinal disease. Shortly before starting the anti-inflammatory drug therapy all patients were submitted to gastroduodenal endoscopy. This diagnostic procedure revealed that 54.6% of the patients presented at least one gastroduodenal damage, 22.1%, hyperemia, 3.9%, petechias, 23.4%, erosions and 5.2%, peptic ulcers. There results permitted to conclude that to identify and/or exclude damage of the gastrointestinal tract, data obtained in the anamnese are not sufficient. For these patients the endoscopic examination is a need. Anti-inflammatory therapy must be careful associated with dietetic orientation and the prescription of drugs to protect the gastrointestinal mucosa.

Anti-Inflammatory Agents, Non-Steroidal↗