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Biomedical subjects

M Rubin

Publications and source records attributed to M Rubin.

At least 181 records · Page 10Linked to original sources
PubMed1987

Immunologic studies in subjects with a serum sickness-like illness after immunization with human diploid cell rabies vaccine.

Ten patients developing a serum sickness-like hypersensitivity reaction to human diploid cell rabies vaccine were studied and compared with control subjects matched for previous vaccination history and level of rabies virus-specific IgG response to immunization. The clinical reaction consisted of delayed onset, generalized urticaria, and angioedema, with some arthralgias. Skin biopsy specimens demonstrated a leukocytoclastic vasculitis. Individuals reacting to the vaccine possessed IgE antibodies to human diploid cell rabies vaccine, to mock vaccine lacking viral antigen, and to fetal calf serum (FCS), a vaccine trace contaminant. Increased levels of IgG antibodies to FCS, mock vaccine, and beta-propiolactone-modified FCS, and human serum albumin were also found. Such humoral responses to vaccine components other than rabies virus might be responsible for the hypersensitivity reactions developing after rabies vaccination.

Antibodies, Viral↗
PubMed1987

Combined central and peripheral myelinopathy.

We studied clinical, electrophysiologic, and nerve biopsy findings in two men with evidence of severe central and peripheral demyelinating disease. These patients may be rare examples of MS with associated severe, chronic, clinically evident peripheral demyelinating neuropathy. Alternatively, they may be cases of some other form of combined central-peripheral myelinopathy or fortuitous coincidence of MS with idiopathic inflammatory-demyelinating neuropathy. There have been only five other reports of clinically evident combined central-peripheral myelinopathy, but there have also been reports of only electrophysiologic or nerve biopsy evidence (without clinical manifestation) of peripheral neuropathy in MS patients.

Adult↗
PubMed1987

National standardization of the Auditory Discrimination Test: normative and reliability results.

The Auditory Discrimination Test (ADT), which consists of two alternate forms (Forms 1A and 2A), has been used extensively in clinical, educational, and research settings for nearly 30 years. Until now, two major problems with the clinical and educational use of the ADT have been the lack of representative norms, and the somewhat restricted age range of the test. This article reports on a national standardization of the ADT, and an extension of this test downward for use with four year old children. The sample included over 1.800 children from public and private elementary and preschool settings who were selected from over 30 states across the country. The sample was stratified on the basis of geographic region, age, sex, ethnic background, parent's occupation, and community size. Results indicated developmental differences in auditory discrimination as assessed by the ADT, substantiating the utility of age level norms. In addition, internal consistency reliability was computed for all age levels on the ADT. A median reliability of.78 was found for ADT Form 1A, and.81 for ADT Form 2A, with higher reliabilities found at the younger ages. Overall, the results of this investigation suggest that the ADT is a useful measure of auditory discrimination in young children. Furthermore, the development of national, stratified norms provides renewed utility for the application of test results in norm-referenced decision situations.

Journal Article↗
PubMed1987

Morbidity and recurrence rates after surgical treatment of malignant melanoma by scalpel versus CO2 laser beam.

A retrospective study was carried out on 219 patients who underwent surgical treatment of a malignant melanoma. A scalpel was used in 96 patients in group 1 and CO2 laser beam was used in 123 patients in group 2. The average length of hospitalization for group 2 was longer (16.3 versus 12.8 days for group 1). This was due to failure of the skin graft; 32.5 per cent in group 2 versus 15.6 per cent in group 1 (p = 0.005). The accumulative rate of recurrence for both groups was almost the same although there were significant differences according to the various parameters. Male patients in group 2 had a significantly higher rate of recurrence as compared with female patients in the same group (p less than 0.001) and male patients in group 1 (p = 0.002). In both groups, there was a significantly higher rate of recurrence for ulcerated primary lesions and those lesions more than 1.6 millimeters thick (p = 0.05). Patients in group 2, with lesions more than 3 millimeters in thickness, had a higher rate of recurrence than those in group 1 (54.6 versus 40.6 per cent). In both groups, patients who underwent elective regional dissection of lymph nodes had a lower rate of recurrence (19.4 per cent) than those patients who did not undergo dissection (53.6 per cent) (p = 0.001). It is suggested that thermal damage to the blood and lymph vessels incurred during laser excision may be more extensive than has been reported. These damaged walls may cause the higher rate of distal metastases of malignant melanoma from a primary lesion more than 1.6 millimeters in thickness; primarily in male patients.

Female↗
PubMed1986

Partial splenectomy in Gaucher's disease.

In 11 children with hypersplenism due to Gaucher's disease, partial splenectomy was planned with the aim to prevent the development of postsplenectomy sepsis and also to slow the advance of the disease in the rest of the reticuloendothelial system by permitting continuing accumulation of the beta-glucocerebroside in the remaining splenic tissue. In seven children, partial splenectomy was performed successfully, the weight of the splenic tissue removed ranging from 400 to 3,680 g. The postoperative course was uneventful and the average duration of hospitalization was 12 days. In subsequent follow-up, isotope scanning demonstrated continuing growth of the splenic remnant and there were no episodes of postsplenectomy sepsis nor evidence of increased accumulation of beta-glucocerebroside in the liver or bones. These children showed a marked improvement in the growth curve and dramatic improvement in the hematologic picture. Of the four remaining children, in two, partial splenectomy was followed by complete removal of the remaining spleen due to necrosis, whereas in two, total splenectomy was performed since the huge spleens were extensively infarcted. Our experience suggests that partial splenectomy is the treatment of choice in the management of young patients with hypersplenism due to Gaucher's disease.

Adolescent↗
PubMed1986

Primary hyperparathyroidism in children.

We present here a series of seven children with primary hyperparathyroidism caused by parathyroid adenoma. Chief cells were the primary element in six patients and water-clear cells in one patient. A brief review of the literature on primary hyperparathyroidism in children is included. Emphasis is placed on the clinical characteristics of this rare disease in children.

Adenoma↗
PubMed1986

Respiratory distress following major trauma. Predictive value of blood coagulation tests.

We have evaluated the use of laboratory parameters to predict the risk of adult respiratory distress syndrome (ARDS) at an early stage after major trauma. Patients with lung contusion were excluded. Five of 29 patients fulfilled our criteria of ARDS, i.e. PaO2/FiO2 less than or equal to 38. They showed lower platelet counts and antiplasmin as well as a tendency to lower antithrombin III, fibrinogen, and plasminogen. These changes indicated activation of the coagulation and fibrinolytic systems by trauma. The most sensitive indicator of ARDS seemed to be the platelet count, although it was also related to blood loss and amount of blood transfused. Hence the platelet count should be considered in relation to blood replacement in the patient with major trauma. Tentative laboratory values are suggested to indicate risk levels of developing ARDS.

Aged↗
PubMed1985

New beta-lactam antibiotics in granulocytopenic patients. New options and new questions.

Infectious complications are a frequent cause of morbidity and, at many centers, the major cause of death in patients with cancer. The increased risk and severity of infectious sequelae result from profound alterations in normal host defenses that occur secondary to the underlying malignancy and the treatment thereof. During the last decade, early empiric antibiotic therapy has become standard practice in the initial management of febrile granulocytopenic patients and has contributed significantly to the improved outcome among patients undergoing cancer therapy. Although early death due to unsuspected or inadequately treated bacterial infection has been largely overcome, new problems--also with life-threatening implications--have emerged. As the use of cancer chemotherapy continues to increase, new populations of patients are being placed at increased risk of infection. Defining the host and environmental factors that contribute to this risk assumes central importance for delineating those patients who require the most intense surveillance. Changing medical practices (e.g., increased use of indwelling catheters) have contributed to the emergence of new pathogens. Recent drug developments (e.g., the third-generation cephalosporins and extended-spectrum penicillins) offer new treatment options, as well as generate controversy and confusion. For example, authorities disagree on the optimal duration and modifications in treatment that are required by cancer patients who remain granulocytopenic and who thus are at continued risk of multiple infectious episodes or superinfections. A question of current interest is whether combination therapy with synergistic agents is important in light of the development of the third-generation cephalosporins and extended-spectrum penicillins. Several of these new antibiotics have an exceedingly broad spectrum of activity that includes Pseudomonas aeruginosa, as well as Enterobacteriaceae, Serratia, Citrobacter, indole-positive Proteus, and anaerobes (including Bacteroides fragilis). However, the third-generation cephalosporins are not as active against staphylococci and streptococci as are the first-generation cephalosporins, and none is effective against enterococci. Nonetheless, these agents achieve serum levels that can be 10 to 100 times greater than the minimal inhibitory and bactericidal concentrations of gram-negative bacteria, raising the possibility that these drugs might be effective as single agents. The advantages of the third-generation cephalosporins are their minimal toxicity and long serum half-lives.(ABSTRACT TRUNCATED AT 400 WORDS)

Agranulocytosis↗
PubMed1985

Use of 5-micron filter in administering 'all-in-one' mixtures for total parenteral nutrition.

An assessment was made of the stability of nine total nutrient admixtures (TNA) for total parenteral nutrition (TPN) and of Intralipid 20% filtered through a 5-micron filter. Mixture samples from 3-litre EVA plastic bags were obtained for tests 4 and 24 h after preparation, before and after filtration through a 5-micron filter during a period of 24 h. The filtered mixtures were collected in 3-litre EVA plastic bags and the contents of the filter were also examined. Stability parameters studied were pH, lipid globule size and visual signs of emulsion breakage. Used for assessment of lipid globule size were a light microscope and a Coulter Counter TA II, which measures particles from 1.4 microns to 43.8 microns in diameter. There were no physical signs of instability in any of the mixtures tested while they were being filtered and collected through the 5-micron filter. Examination of mixture samples prior to filtration and of filter contents revealed the presence of large fat globules, precipitates, solid particles and aggregates. Although these were trapped on the surface of the filter there was no slowing of the rate of flow of the mixture. These findings demonstrate the importance of using a 5-micron filter in delivering total nutrient mixtures in order to avoid the hazards posed by the presence of particles larger than 5 microns in size and show that its use does not affect stability.

Journal Article↗
PubMed1985

Tourette syndrome in the classroom: special problems, special needs.

Tourette Syndrome (TS) is an uncommon developmental disability characterized by repetitive and involuntary verbal and motor tics. A survey of all known affiliates of the Tourette Syndrome Association of Ohio was conducted to document the special problems and needs of the TS student. A total of 431 questionnaires was returned, and the types and frequency of interpersonal and academic school problems were found to be pervasive. Problems did not differ by grade level, but students medicating their TS symptoms experienced more problems. In most cases, current students described similar problems to adults, suggesting that recent attempts to provide optimal educational opportunities to all handicapped children have not been successful where TS is involved. The presence of a behavioral or learning disability diagnosis indicated that substantial percentages of respondents were in need of specialized educational services, but not all those in need were receiving them. Parents were generally satisfied with their child's education, but less satisfied when specialized education was involved. Suggestions are offered for more effectively dealing with the TS child in the classroom.

Adolescent↗