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Biomedical subjects

N B Levy

Publications and source records attributed to N B Levy.

At least 55 records · Page 3Linked to original sources
PubMed1980

Is there a ventral neural ridge in chick embryos? Implications for the origin of adenohypophyseal and other APUD cells.

Two- to ten-somite chick embryos were studied in order to ascertain whether, as has been proposed, there exists a 'ventral neural ridge' which gives rise to the hypophyseal (Rathke's) pouch. Serial sections and stereo-microscopy were used. The neural ridges arch around the rostral end of the embryo onto the ventral surface of the head, but no evidence was found for their extension to form a 'ventral neural ridge' reaching the stomodaeum: in fact a considerable expanse of non-thickened surface ectoderm was seen to separate the ventral portions of the neural ridges from the stomodaeum. The thickening of neural ectoderm which does appear on the ventral surface of the head results from apposition and fusion of the opposite neural ridges flanking the neural plate and thus the tip of the anterior neuropore--the classically accepted mode of closure of the neuropore. These findings are in accord with the generally accepted concept of the origin of the hypophyseal pouch rather than with its derivation from a 'ventral neural ridge'. No sign of neural crest formation was encountered ventrally; this observation excludes the possibility that endocrine cells of the APUD series could originate from neural crest in this region.

APUD Cells↗
PubMed1979

The chronically ill patient.

Psychiatry's renewed interest in its identity as a medical specialty and its increased therapeutic armamentarium make its involvement with chronically medically ill patients more feasible than ever before. These patients face problems which include economic ones, conflicts between independency and dependency, those connected with self-image, intra-family stresses including sexual ones, social isolation and the threat of death. Patients respond to these stresses with psychological symptomatology which includes depression, suicidal behavior, anxiety, delirium, dementia and psychosis. The treatment of the consequences of these stresses is the daily work of the liaison psychiatrist.

Anxiety↗
PubMed1979

Current attitudes of medical students and house staff toward terminal illness.

A survey questionnaire about attitudes toward terminal illness was administered to all medical students, interns, and all medical, surgical, and psychiatric residents at the Downstate Medical Center. The majority of students and new physicians surveyed reported that patients with terminal illness should be told their diagnosis--a reversal of attitudes as compared with those revealed by studies done before 1970. Most of the respondents also expressed the view that they would want to be told of their own fatal illness. The attitudes at different levels in medical school, internship, and residency did not differ significantly despite the differences in formal education and clinical experience of the respondents. Implications of these findings are discussed with particular emphasis on the need to teach an individualized approach to the dying patient.

Attitude of Health Personnel↗
PubMed1979

Psychological problems of the patient on hemodialysis and their treatment.

Patients treated by maintenance hemodialysis are subjected to many stresses. As a result, many of these patients have psychological problems. Depression is the most common psychological complication seen in them. This is reflected in a high suicide rate in these patients. Other psychological problems seen in these patients are anxiety, sexual dysfunctions, problems connected with difficulties in rehabilitation, the problem of the 'uncooperative' patients, and psychosis. Vigilant attention is required so that diagnosis may be made early and treatment started soon thereafter. Important methods of treatment are supportive psychotherapy, behavioral techniques for sexual dysfunctions, and the use of psychologically active drugs.

Anxiety↗
PubMed1979

The teaching of liaison psychiatry in the hemodialysis center.

The hemodialysis unit is usually a uniquely desirable place for liaison teaching because of the importance and variety of behavioral problems seen there. The trainee may be educated at these units about the syndrome of delirium because of the potential for his seeing in a given patient the presentation and resolution of the syndrome before and after each run. Because of the abject dependency of these patients, issues surrounding patient dependency "needs" and frustration of their independence are common with patient "uncooperativeness", an important area in which the professional staff need education and patients need intervention. Depression, common among these patients because of their many losses, is among the host of psychological problems to be potentially diagnosed and treated by the liaison trainee and/or teacher. The theme of life setting conductive to medical illness and the setting of realistic rehabiliation goals are also important areas of liaison training, particularly suitable for demonstration there. Therefore, hemodialysis centers offer usual wide variety and often untapped resources for liaison education.

Education, Medical↗
PubMed1975

The quality of life on maintenance haemodialysis.

Eighteen haemodialysis patients were interviewed in order to rate their quality of life. The data revealed a striking change in the life of most patients compared with the period before illness. Most patients had severe loss in income and for many family life deteriorated. Emotional adaptation tended to be successful in those patients before their illness. Ratings of quality of life of "good" were given to only six patients, "fair" to five, and "poor" to seven. Women seem to enjoy a better adaptation to life maintained by haemodialysis than men.

Activities of Daily Living↗
PubMed1975

Reluctance to accept life-saving treatment.

The patient is a twenty-three-year-old man with end-stage kidney disease who has major conflicts about receiving maintenance hemodialytic treatment. These conflicts stem in part from the patient's hospitalization at the age of seven and the witnessing of heroic medical procedures used in an attempt to treat his father's eventually successful suicide. His unconscious doubts of his manliness result in a pseudoindependent behavior and a pose of hypermasculinity which induce a rejection of passivity and the dependent position necessitated by being a patient on hemodialysis. Rejection of hemodialysis may be a conscious or unconscious suicide attempt. In this patient, it may be a consequence of guilt in relation to his father's death and of other psycho-social factors. Effective treatment for this patient should include allowing him to exercise his independence in as many ways as is possible. Home dialysis and renal transplantation lend themselves to greater feelings of independence and may be preferable to center hemodialysis in this patient. The feelings surrounding the death of his father should be explored with a liaison physician or psychiatrist.

Adult↗