Search PubMed⌕ Search

Biomedical subjects

M Levy

Publications and source records attributed to M Levy.

At least 127 records · Page 7Linked to original sources
PubMed1997

Characteristics of pregnant women who engage in binge alcohol consumption.

OBJECTIVE: To characterize pregnant women who engage in binge drinking and to identify other risk behaviour that these women engage in. DESIGN: Observational study based on retrospective review of records. SETTING: A telephone and outpatient counselling service in Toronto that advises pregnant women about exposure to drugs, chemicals, radiation and infections during pregnancy and lactation. PARTICIPANTS: All pregnant women who sought counselling concerning fetal risk of exposure to binge drinking from 1985 to 1994 as well as those counselled by telephone from 1993 to 1994, and an equal number of control women who sought counselling. OUTCOME MEASURES: Information about binges, demographic factors, history of elective and spontaneous abortion, and use of psychotropic drugs and cigarettes as well as marijuana, cocaine and other illicit drugs. RESULTS: Of the 3800 women seen in the clinic, 119 (3.1%) reported binge drinking during pregnancy; of the 19,991 women counselled by telephone, 153 (0.8%) reported binge drinking during pregnancy. The mean number of drinks per binge was 7.2 (standard deviation 2.5). None of the women was an alcoholic; 83.1% had binged fewer than 10 times during their pregnancy. A large majority (84.0%) of the women had a binge early in the first trimester (before 6 weeks' gestation). In comparison with control women, the women who had engaged in binge drinking were significantly younger (mean 30.0 v. 27.9 years, p < 0.0001) and more likely to be single (12.2% v. 54.6%, p < 0.0001), to be white (69.2% v. 92.9%, p < 0.004), to smoke (19.3% v. 57.1%, p < 0.0001) and to use cocaine (1.1% v. 11.0%, p < 0.0001), marijuana (3.0% v. 19.3%, p < 0.0001) and other illicit drugs (0.7% v. 9.2%, p < 0.0001). CONCLUSIONS: Pregnant women who report binge alcohol consumption often report use of cigarettes, cocaine, marijuana and other illicit drugs as well, all of which represent a significant risk to the fetus. Rigorous efforts should be made to prevent the socially accepted binge consumption of alcohol among young, sexually active women.

Adult↗
PubMed1997

Impairment of the metabolism of dipyrone in asymptomatic carriers of the hepatitis B virus.

BACKGROUND: The pharmacokinetics of a number of drugs has been shown to be impaired in patients with acute or chronic viral liver disease. OBJECTIVE: To examine the effect of the asymptomatic hepatitis B virus carrier state on the metabolism of dipyrone (INN, metamizole) as a model drug. METHODS: The pharmacokinetics of the metabolites of dipyrone-4-methylaminoantipyrine, 4-aminoantipyrine, 4-formylaminoantipyrine, and 4-acetylaminoantipyrine-after a 1.0 gm oral dose of dipyrone were evaluated in nine asymptomatic carriers of hepatitis B virus with normal liver function tests and nine healthy subjects. All subjects displayed the slow acetylator phenotype. RESULTS: The nonrenal (metabolic) clearance of 4-methylaminoantipyrine was significantly reduced (mean +/- SEM) (123.3 +/- 15.8 versus 182.9 +/- 15.1 ml.min-1, respectively; p < 0.02) in the carriers of hepatitis B virus compared with the healthy subjects, and the elimination half-life of this metabolite was significantly longer (3.69 +/- 0.35 versus 2.64 +/- 0.28 hours, respectively; p < 0.03). The formation clearances of 4-aminoantipyrine and 4-formylaminoantipyrine were significantly smaller in the carriers of hepatitis B virus compared with healthy subjects (33.8 +/- 6.2 versus 55.2 +/- 6.4 ml.min-1; p < 0.03, and 16.7 +/- 2.2 versus 34.2 +/- 4.2 ml.min-1; p < 0.002; respectively). However, the elimination half-life of 4-formylaminoantipyrine was found to be slightly shorter in the carriers of hepatitis B virus. No significant differences were noted between the groups in the pharmacokinetics of 4-acetylaminoantipyrine. CONCLUSION: The metabolism of dipyrone is impaired in asymptomatic carriers of hepatitis B virus. Clinically latent infection with hepatitis B virus seems to exert a differential effect on metabolism of the drug. Oxidative pathways to produce 4-aminoantipyrine and 4-formylaminoantipyrine were significantly affected, whereas acetylation remained intact. This study provided an additional example of the effect of a virus on the disposition of a drug.

Adult↗
PubMed1997

Relationships between children's cardiovascular stress responses and resting cardiovascular functioning 1 year later.

Resting cardiovascular parameters were predicted from anthropometric data, resting baseline cardiovascular data, and cardiovascular responses to three laboratory stressors completed 1 year earlier. Subjects were 106 male and female children (72 Whites, 34 Blacks) aged 6-7 years at the initial evaluation. During initial testing, blood pressure, heart rate, cardiac output, and total peripheral resistance were assessed at rest and also during a forehead cold pressor task, postural change, and treadmill exercise. The same cardiovascular parameters were then assessed at rest 1 year later. After controlling for significant anthropometric measures and the pertinent previous year's resting data, systolic and diastolic responses to the cold pressor were predictive of respective follow-up resting levels. Postural change heart rate responses were predictive of follow-up resting heart rate after controlling for initial resting levels. Exercise cardiac index reactivity predicted follow-up cardiac index after controlling for earlier resting levels and adiposity. Follow-up total peripheral resistance index was predicted by earlier resting levels.

Blood Pressure↗
PubMed1997

The posterior cruciate ligament in total knee arthroplasty.

The purpose of this study was to answer 2 questions: Does the posterior cruciate ligament (PCL) produce femoral rollback in a single-design, cruciate-sparing total knee arthroplasty (TKA)? Does the PCL prevent posterior tibial displacement when it is retained after a single-design, cruciate-sparing TKA? Knee kinematics and limits of motion were measured with the knees in the following states: (1) intact knee, (2) anterior cruciate-deficient knee, (3) PCL-retaining total knee of a single design (TKA), (4) PCL-retaining TKA with PCL cut, and (5) PCL-substituting TKA. Femoral rollback was then calculated from the above data. The results showed that the PCL was able to prevent posterior translation and maintain femoral rollback when it was preserved during TKA. Therefore, the PCL can be functional after TKA, in a single-design, cruciate-sparing TKA. When the PCL was cut, significant changes in knee kinematics were observed.

Aged↗
PubMed1997

Strategy for the detection of Helicobacter species by amplification of 16S rRNA genes and identification of H. felis in a human gastric biopsy.

The aim of the present work was to develop polymerase chain reactions (PCRs) based on the conserved nucleotide sequence of the 16S rRNA gene for detection of bacteria of the Helicobacter genus in human antral biopsy samples. The assay for Helicobacter spp was developed by amplifying a 399-bp 16S rRNA gene sequence specific to the genus Helicobacter. The identity of the amplicon was confirmed by hybridization with an internal probe and by restriction by endonuclease VspI showing two expected fragments of 295 and 104 base pairs. A total of 65 dyspeptic patients from France and New Caledonia were screened for Helicobacter spp infection through the use of the following diagnostic assays on biopsy specimens collected through endoscopy: direct detection of bacteria in histological sections by Giemsa and Warthin Starry staining, urease test and bacterial isolation, PCR for Helicobacter pylori ureC/glmM gene, and PCR targeted to 16S rRNA genes. The 16S rRNA gene PCR assay was able to detect down to 680 bacterial cells, as assessed by agarose gel electrophoresis, and down to 4 bacterial cells by hybridization of amplicon with the internal probe. The 16S rRNA PCR test was 100% specific and sensitive; results obtained with this test were in agreement with the visualization of bacteria by histology. Urease test and culture were 86.4% and 22.7% sensitive, and 96.5 and 100% specific, respectively. The H. pylori ureC/glmM gene-based PCR was 100% specific and only 95.4% sensitive, since one biopsy from a Melanesian patient contained a Helicobacter strain other than H. pylori. For this Melanesian patient, a branch-specific PCR targeting the epsilon branch of Proteobacteria was used to amplify a 967-bp amplicon. This amplicon was sequenced and matched with the H. felis sequence. This was confirmed using an H. felis-specific urease PCR test.

Biopsy↗
PubMed1997

Liver hemangioma. A perioperative Tc-99m RBC SPECT correlation.

Scintigraphic diagnosis of a liver hemangioma may be difficult when its size approaches the spatial resolution of a gamma camera, and it may not be visualized on a Tc-99m tin-colloid liver SPECT study. The contribution of Tc-99m labeled RBC scintigraphy is shown in a patient with a liver hemangioma discovered during laparoscopic cholecystectomy for chronic cholecystitis. Despite negative CT, US, and Tc-99m tin-colloid SPECT of the liver, Tc-99m labeled RBC SPECT disclosed a focus of increased activity consistent with the hemangioma.

Colloids↗
PubMed1997

D-penicillamine-induced crescentic glomerulonephritis and antimyeloperoxidase antibodies in a patient with scleroderma. Case report and review of the literature.

Therapeutic use of D-penicillamine has been associated with a range of adverse effects. We present a patient with scleroderma, treated with D-penicillamine for 5 years, who developed severe renal failure due to rapidly progressive glomerulonephritis with both crescents and subepithelial immune deposits on renal biopsy. Serological findings included perinuclear antineutrophil cytoplasmic antibodies and antihistone antibodies. She was treated with cyclophosphamide, prednisone, discontinuation of D-penicillamine, and hemodialysis. Therapy resulted in partial recovery of renal function. The clinical course of our patient is in keeping with D-penicillamine-induced chronic membranous nephropathy, followed by rapidly progressive crescentic glomerulonephritis. We discuss the effects of D-penicillamine in our patient, and review the literature on immune-mediated renal disease associated with the use of this drug.

Aged↗
PubMed1997

A study of the Lund-Manchester research criteria for frontotemporal dementia: clinical and single-photon emission CT correlations.

We evaluated the Lund-Manchester research criteria (LMRC) for frontotemporal dementia (FTD). With single-photon emission CT, we diagnosed 30 patients with FTD. These patients were compared with 30 with a research diagnosis of Alzheimer's disease (AD). We scored every patient on each LMRC item and compared the two groups. A discriminant function showed that loss of personal awareness, hyperorality, stereotyped and perseverative behavior, progressive reduction of speech, and preserved spatial orientation differentiated 100% of FTD and AD subjects. Items relating to affect and physical findings were not different in FTD versus AD. Loss of personal awareness, eating, perseverative behavior, and reduction of speech are the LMRC items that most clearly differentiate FTD from AD.

Alzheimer Disease↗
PubMed1997

Role of viral infections in the induction of adverse drug reactions.

A spectrum of adverse drug reactions that are caused by the combined action of drugs and viruses has been described: ampicillin rash in acute infectious mononucleosis; Reye's syndrome; hypersensitivity reactions to sulphonamides in patients with HIV infection; drug-induced agranulocytosis; paracetamol (acetaminophen) hepatotoxicity; aspirin (acetylsalicyclic acid)-induced asthma; Epstein-Barr virus-associated lymphoma and methotrexate; and AIDS-related Kaposi's sarcoma and nitrite use. Changes in pharmacokinetics have been reported for: caffeine, sulfamethoxazole and fluconazole in patients with HIV infection; theophylline, following influenza and influenza vaccination; and recently, dipyrone metabolites in carriers of the hepatitis B virus. In addition increased drug- and drug metabolite-related toxicity has been observed in virally infected cells. Pathogenetic mechanisms for the interaction between drugs and viruses are varied, and include biological mechanisms (often immunological) and changes in drug metabolism. The combined effects of chemical and biological exposure provide a unique model for the study of disease induction.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Atrial natriuretic peptide: renal effects in cirrhosis of the liver.

Atrial natriuretic peptide is one of a family of natriuretic peptides thought to play a role in the altered sodium balance of advanced liver disease and ascites. Its level is usually increased in the plasma of cirrhotic patients, probably due to relative plasma volume expansion. When exogenous ANP is administered intravenously to dogs or rats with experimental liver cirrhosis and ascites, an heterogeneous natriuretic response is obtained with about half of the population not responding. Similar observations are recorded for patients with clinical cirrhosis. In dogs, attenuation of the ANP-induced natriuresis may depend on a reduction in renal cortical bradykinin activity. In patients with cirrhosis, the ability to release ANP in response to central volume expansion is dissociated from the accompanying natriuresis. Attenuation of the renal tubular response to ANP in this setting may be correlated to the degree of intrahepatic sinusoidal hypertension and associated augmented reflex sympathetic nervous activity to the kidneys. Actual tubular resistance to ANP may be due to reduced Na+ delivery to the inner medullary collecting duct and/or increased degradation of cyclic guanosine monophosphate.

Animals↗
PubMed1997

[Control of tuberculosis in refugees and displaced].

As a result of national and international conflicts, the number of refugees and displaced persons in various countries of the world is increasing. The complex and protracted nature of these conflicts often forces refugees to remain away from their countries for long periods, living in refugee camps. Many refugees come from countries where tuberculosis is endemic and, once the immediate problems of establishing a camp are overcome, this disease becomes the principal problem affecting refugee camps. In order to advise the persons in charge of refugee camps on how to set up tuberculosis control programs, this document details the general requirements and specific recommendations of WHO for the implementation of such programs, as well as guidelines for their evaluation and monitoring, including criteria that would justify camp closure.

Humans↗
PubMed1996

Heparin-coated bypass circuits in cardiopulmonary bypass: improved biocompatibility or not.

Heparin bonding to bypass circuits has been found to reduce bleeding complications. Here, this process is reviewed with special attention to markers of inflammation and clinical outcome. Indicators of inflammation (i.e. cytokine levels, elastase and complement components) are decreased when using heparin bonded circuits compared to conventional bypass circuits. The decrease in the levels of these response modifiers appears minimal. Clinical outcomes, other than bleeding complications, have not been studied to any great extent with this technology. These lower levels of the various biological response modifiers are not correlated with lower levels of complications or shorter hospital stays. We conclude based on this data that it is not clear if this decrease translates into a clinical benefit in routine operative cases that require cardiopulmonary bypass.

Anticoagulants↗
PubMed1996

Colchicine in breast milk of patients with familial Mediterranean fever.

OBJECTIVE: To clarify whether colchicine is excreted in breast milk, and to compare its concentrations in the serum and breast milk of lactating women who have familial Mediterranean fever (FMF). METHODS: Using a specific radioimmunoassay, we determined colchicine concentrations in the serum and breast milk of 4 patients at various time points, following oral administration of the drug. The study evaluated 4 patients with FMF who had been taking colchicine on a long-term basis. RESULTS: Colchicine was found to be excreted in breast milk. Its levels ranged between 1.9 and 8.6 ng/ml, which were similar to those found in the serum (parallel concentration time curves). However, there appeared to be a considerable variation in colchicine milk concentration among the different patients, which might be related to individual breast milk composition and, possibly, to other nutritional or metabolic factors. CONCLUSION: The extensive peripheral tissue binding and relatively low concentration of colchicine in breast milk suggests that the amount ingested by the infant is small. Furthermore, based on our clinical experience, nursing appears to be safe for lactating women with FMF who continue to take colchicine.

Administration, Oral↗
PubMed1996

Membranous nephropathy following perinatal transmission of hepatitis B virus infection--long-term follow-up study.

In children with hepatitis B-associated membranous glomerulonephritis, the time of onset of the infection and the duration of the carrier state before diagnosis of the renal disease are always unknown. Moreover, follow-up is usually short. We report the unique observation of a French girl who was infected with hepatitis B virus by her mother who had acute hepatitis during the immediate postpartum period; the girl developed proteinuria at 6 years of age. The onset of the infection in the perinatal period, the mild liver abnormalities, and the absence of nephrotic syndrome did not justify any treatment. Spontaneous seroconversion to anti-HBe antibody positive occurred at 12 years of age. Proteinuria gradually diminished and was absent at 18 years. However, HBs antigenemia persists.

Adult↗
PubMed1996

Prebiotic synthesis of diaminopyrimidine and thiocytosine.

The reaction of guanidine hydrochloride with cyanoacetaldehyde gives high yields (40-85%) of 2,4-diaminopyrimidine under the concentrated conditions of a drying lagoon model of prebiotic synthesis, in contrast to the low yields previously obtained under more dilute conditions. The prebiotic source of cyanoacetaldehyde, cyanoacetylene, is produced from electric discharges under reducing conditions. The effect of pH and concentration of guanidine hydrochloride on the rate of synthesis and yield of diaminopyrimidine were investigated, as well as the hydrolysis of diaminopyrimidine to cytosine, isocytosine, and uracil. Thiourea also reacts with cyanoacetaldehyde to give 2-thiocytosine, but the pyrimidine yields are much lower than with guanidine hydrochloride or urea. Thiocytosine hydrolyzes to thiouracil and cytosine and then to uracil. This synthesis would have been a significant prebiotic source of 2-thiopyrimidines and 5-substituted derivatives of thiouracil, many of which occur in tRNA. The applicability of these results to the drying lagoon model of prebiotic synthesis was tested by dry-down experiments where dilute solutions of cyanoacetaldehyde, guanidine hydrochloride, and 0.5 M NaCl were evaporated over varying periods of time. The yields of diaminopyrimidine varied from 1 to 7%. These results show that drying lagoons and beaches may have been major sites of prebiotic syntheses.

Acetaldehyde↗