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Biomedical subjects

M Neumann

Publications and source records attributed to M Neumann.

At least 145 records · Page 8Linked to original sources
PubMed1993

[Involuntary outpatient commitment: ethical and legal aspects].

In 1991 the Israeli Knesset (parliament) drafted new legislation for the treatment of the mentally ill. One of the innovations was involuntary outpatient commitment (IOC), which allows the district psychiatrist to order a patient to attend a clinic and receive ambulatory care. IOC is an attempt to address the problem of the "revolving door" patients, chronic mental patients who after discharge do not continue medication and therefore relapse and have to be readmitted.

Ambulatory Care↗
PubMed1993

The effects of ambient NO2 on lung function in primary schoolchildren.

The effect of ambient NO2 on lung function was investigated in a sample of 423 schoolchildren. At each of four locations NO2 was monitored continuously. Over a 6-month period from January to June 1990 two surveys were performed and spirometry recorded each time for each child. Linear regression was used to estimate the effect of NO2 for different time intervals preceding lung function testing. A decrease of NO2 between surveys was significantly associated with a higher forced vital capacity (FVC) at the second survey. For each microgram/m3 NO2 decrease the model predicted an increase in FVC of 1.5 ml [for the 2-hr mean (P < 0.05)] and 3.1 ml [for the 12-hr mean (P < 0.01)]. We conclude that even at NO2 levels below current air-quality standards children demonstrate significant changes in lung function.

Air Pollutants↗
PubMed1993

Productive expression state confers resistance of human immunodeficiency virus (HIV)-2-infected lymphoma cells against superinfection by HIV-1.

In the past, positive as well as negative results pertaining to HIV-1/HIV2 interference have been obtained. Therefore, in the present study attention was paid to the viral expression state of preinfected cells at the time of exposure to secondary virus. A clonal HIV-2 infected HUT-78 cell line was derived by endpoint dilution and subsequently inoculated with cell-free HIV-1. Superinfection with HIV-1 was ruled out by Western blot and PCR analysis. The chronically HIV-2 infected cells used for these studies showed a highly productive expression state, as evidenced by immunoperoxidase staining (IPS), Western blot profile and levels of reverse transcriptase (RT) activity. We discuss several mechanisms of interference in productively infected cells, which may confer resistance to superinfection with secondary virus.

Blotting, Southern↗
PubMed1993

Central microbial keratitis in a Swedish city population. A three-year prospective study in Gothenburg.

An analysis of central microbial keratitis with respect to etiology, recovery, complications and visual outcome was carried out in Gothenburg, Sweden, during a 3-year period. Gram positive bacteria were found in 22 out of 48 cases; Staphylococcus aureus and Staphylococcus epidermidis accounted for more than 50% of these Gram positive cases. Pseudomonas was the most common Gram negative bacterium. No case with etiology of fungus was found. The contact lens wearers showed mainly the same bacterial spectrum as non-wearers. The initial 'shotgun' therapy with cefuroxime and gentamycin seemed adequate for this bacterial spectrum. Seventy percent of the eyes healed within 3 weeks. Contact lens wear and trauma were found to be the two major predisposing factors in the cases with microbial keratitis. The lens wearers had shorter recovery times than the non wearers. The visual results after one month were good in 50% of the eyes, and another 12% attained useful vision.

Adolescent↗
PubMed1993

Pseudopregnancy and postpartum psychosis: a case study.

We report on an uncommon case of a woman who presents with pseudopregnancy. In the past she suffered from postpartum psychosis and an episode characterized by pseudohallucinations. No such association was reported in the literature survey we have made. We discuss the distinction between the overvalued idea as presented in pseudopregnancy and delusion as presented in the postpartum psychosis and suggest that the two phenomena can be viewed as a continuum rather than dichotomized, especially in cases like the one reported here.

Adult↗
PubMed1993

The psychiatrist as a psychotherapist: the problem of identity.

Becoming a psychotherapist is a complicated process for individuals from any discipline but for physicians the process is even more difficult. We consider the identity issue to be central to the integration of psychotherapy into the training of psychiatrists. Residents can be taught that seemingly contradictory aspects of identity can coexist successfully. It is important to address this issue early in the training of residents and to provide a setting in which a positive professional identity can develop. Failure to do so can lead to frustration, anger, demoralization, and devaluation, inhibiting optimal development of skills.

Combined Modality Therapy↗
PubMed1993

[Assessment of whole cell deformability of individual erythrocytes with a capillary rigidometer--possibilities for standardization and modification].

Human erythrocyte deformability is determined by cell geometry and volume, membrane elasticity and cytoplasmic viscosity. The deformability of red blood cells and their distribution among the total cell population, can be studied with the Capillary Rigidometer. This device is based on the kinetic measurement of red blood cell deformability, which has been developed, by modifying the micropipette aspiration technique. In order to investigate the validity of the method and the measuring parameters, a number of determining factors (heat treatment, osmolarity-changed cells) influencing the deformability were studied, and the sensitivity of the defined parameters for changes in deformability discussed. The results are examined in connection with different flow rates in the micropipette and show that the parameters are influenced by the flow conditions, so that they have to be related to these conditions. Initial studies using microspheres aimed at standardising the method are described.

Erythrocyte Deformability↗
PubMed1993

The selling of mental health services: some ethical reflections.

Since the introduction of public mental health services in Israel, the main principle of our work has been to provide equal and free of charge health services to all patients. We were proud of our ability to provide optimal treatment to all patients in all our facilities, regardless of cost or status of insurance. During the last decade, the cost of providing good quality public health services, including mental health services, has constantly increased, and the system has reached a state of financial distress resulting in insufficiency and inability to perform properly. In order to maintain the level of mental health services, the health authorities started planning a system of payment for various mental health services which, until now, were supplied free of charge. This change of policy and attitude towards the population in need poses severe ethical and practical questions and problems. It is questionable that the amount of income ensuing from the sale of mental health services and whether a relatively small financial profit justify possible injury of the population in need of these services, especially the sicker and weaker members of it. This article raises some ethical doubts involved in charging money for psychiatric services that are given to this special group of the mentally ill, and claims that the feasibility of selling services in this area of public health should be reinvestigated.

Cost Control↗
PubMed1993

The role of iodine-123-Tyr-3-octreotide scintigraphy in the staging of small-cell lung cancer.

The purpose of this study is to investigate the role of 123I-Tyr-3-octreotide scintigraphy in staging small-cell lung cancer (SCLC), its efficacy for the discrimination of limited and extensive disease stages and its regional sensitivity for different metastatic locations. Twenty patients with histologically confirmed SCLC and 50 radiologically staged tumors sites were investigated by an imaging protocol including dynamic (0-30 min p.i.), static (30 min, 90 min, 4 hr, 24 hr p.i.) and SPECT (90 min p.i.) studies. The primary tumor site was visualized in 84%, whereas the best delineation was noted in early planar (15-30 min p.i.) and SPECT studies, due to a rapidly decreasing tumor-to-background ratio. Lymph node metastases were seen in 73%, but SPECT was needed for anatomical localization. All three adrenal metastases could be identified in sequential planar images. One clinically unsuspected brain metastasis was seen, whereas a second clinically overt metastasis was not visualized. The global and regional sensitivity for liver and bone metastases was unsatisfactory. In summary, 78% (7/9) of the patients with extensive disease were correctly identified by scintigraphy alone. We conclude that 123I-Tyr-3-octreotide scintigraphy is a substantial tool in the staging work-up of SCLC if it is performed initially to allow fast identification of patients with extensive disease stages and save additional radiological or invasive examinations. Yet, 123I-Tyr-3-octreotide scintigraphy cannot substitute liver sonography or conventional bone scanning in patients who have no scintigraphic evidence of distant tumor spread.

Carcinoma, Small Cell↗
PubMed1993

[Bronchial hyperreactivity to distilled water].

For an epidemiological study 446 children were challenged with distilled water. The protocol consisted of 10 minutes tidal inhalation of an ultrasonically nebulized aerosol of distilled water. For children presenting with a clinical diagnosis of asthma the odds ratio for a positive challenge test was 9.1 compared to non-asthmatics [95% confidence intervals: 2.4-34.9; p = 0.001]. Symptoms cough (p = 0.03), cough at night (p = 0.03) and atopy defined by prick-test (p = 0.001) were also significantly associated with a positive challenge. The easy conduct of our protocol, the--from a pathophysiological point of view--"close to asthma" stimulus, and the small number of side-effects, indicate that the challenge with distilled water can be regarded as an alternative to metacholine provocation testing.

Aerosols↗
PubMed1992

[Spontaneous dissection of the internal carotid artery].

A typical case history of spontaneous dissection of the internal carotid artery is presented. In young patients with cerebral ischemia, initial pain in the affected side of the head and neck, a possible provocative mechanism and a transient or even persistent Horner's syndrome are highly suggestive. The angiographic picture of carotid artery dissection is characteristic. Spontaneous resolution is common, and recurrence rare. Surgical treatment can therefore be reserved for individual cases with recurrent ischemia and caused by emboli originating in the dissected segment of the artery.

Aortic Dissection↗