Search PubMed⌕ Search

Biomedical subjects

P Levine

Publications and source records attributed to P Levine.

At least 19 recordsLinked to original sources
PubMed2005

Nationwide microbiological baseline data collected by sponge sampling during 1997 and 1998 for cattle, swine, turkeys, and geese.

During 1997 and 1998, the U.S. Food Safety and Inspection Service completed nationwide microbiological baseline studies on four separate categories of livestock and poultry. Data were collected by sponge-sampling techniques. These studies were designed to provide nationwide estimates of the prevalence of Salmonella and prevalence and concentrations of Escherichia coli in cattle (n = 1,881), swine (n = 2,127), turkeys (n = 1,396), and geese (n = 102) in establishments under federal inspection. Salmonella prevalence ranged from 1.2% in cattle to 6.9% in swine, 13.7% in geese, and 19.6% in turkeys. The prevalence of E. coli was 16.6% in cattle (geometric mean = 0.26 CFU/cm2), 44.1% in swine (mean = 0.78 CFU/cm2), 92.7% in turkey (mean = 2.46 CFU/cm2), and 96.5% in geese (mean = 1.97 CFU/cm2). These values are similar to or somewhat lower than previous baseline values obtained for steers and heifers, cows and bulls, market hogs, and young turkeys. This study is the first in which nationwide microbiological baseline data have been compiled for geese. These data will be useful to individuals working with hazard analysis critical control point plans and risk assessment and to the research and academic communities.

Abattoirs↗
PubMed2001

Serotype distribution of Salmonella isolates from food animals after slaughter differs from that of isolates found in humans.

If raw meat and poultry are the primary point of entry for Salmonella species into human populations, a correlation might be expected between the serotype distribution of Salmonella species isolated from animals at the time of slaughter and that of isolates found in humans. For 1990-1996, sufficient national data were available to permit such a comparison. A mathematical model was developed to predict serotype distributions of Salmonella isolates among humans on the basis of animal data. There was a significant mismatch between the serotype distributions among humans predicted by the model and those actually observed. This mismatch raises questions about the validity of the "standard" assumptions about Salmonella transmission on which the model was based-namely, that raw animal products are the primary source for human salmonellosis, that the risk of transmission to humans is equal for all food product categories, and that all Salmonella serotypes have an equal ability to cause human illness.

Abattoirs↗
PubMed2001

Mental practice combined with physical practice for upper-limb motor deficit in subacute stroke.

BACKGROUND AND PURPOSE: This case report describes a patient with upper-limb hemiparesis (ULH) who received a program combining physical therapy for the affected side with mental practice. CASE DESCRIPTION: The patient was a 56-year-old man with stable motor deficits, including ULH, on his dominant side resulting from a right parietal infarct that occurred 5 months previously. He received physical therapy for an hour 3 times a week for 6 weeks. In addition, 2 times a week the patient listened to an audiotape instructing him to imagine himself functionally using the affected limb. The patient also listened to the audiotape at home 2 times a week. Pretreatment and posttreatment measures were the upper-extremity scale of the Fugl-Meyer Assessment of Sensorimotor Impairment (Fugl-Meyer Scale), the Action Research Arm Test (ARA), and the Stroke Rehabilitation Assessment of Movement (STREAM). OUTCOMES: The patient exhibited reduction in impairment (Fugl-Meyer Scale) and improvement in arm function, as measured by the ARA and STREAM. DISCUSSION: Mental practice may complement physical therapy to improve motor function after stroke.

Activities of Daily Living↗
PubMed2001

A randomized efficacy and feasibility study of imagery in acute stroke.

OBJECTIVE: To compare the feasibility and efficacy of a programme combining imagery and occupational therapy with a programme of therapy only. DESIGN: Randomized, controlled case series. SETTING: Subacute outpatient clinic. SUBJECTS: Thirteen consecutively admitted patients between four weeks and one year post stroke exhibiting stable motor deficits in their affected upper limbs. INTERVENTION: All patients received an hour of therapy three times a week for six weeks administered by the same physical and occupational therapists. During the same period, eight patients participated in 10-minute guided imagery sessions after each therapy session, as well as practising imagery at home twice each week. Five patients participated in a control intervention consisting of exposure to stroke information. MAIN OUTCOME MEASURES: The Fugl-Meyer Assessment of Motor Recovery (Fugl-Meyer) and Action Research Arm Test (ARA). RESULTS: After intervention, Fugl-Meyer and ARA scores of patients in the therapy only group remained virtually the same; therapy plus imagery group scores improved by 13.8 and 16.4 points, respectively, on the Fugl-Meyer and ARA. CONCLUSIONS: Imagery is a clinically feasible, cost-effective complement to therapy that may improve outcomes more than participation in therapy only.

Aged↗
PubMed2001

Pathogen testing of ready-to-eat meat and poultry products collected at federally inspected establishments in the United States, 1990 to 1999.

The Food Safety and Inspection Service (FSIS) conducted microbiological testing programs for ready-to-eat (RTE) meat and poultry products produced at approximately 1,800 federally inspected establishments. All samples were collected at production facilities and not at retail. We report results here for the years 1990 through 1999. Prevalence data for Salmonella, Listeria monocytogenes, Escherichia coli O157:H7, or staphylococcal enterotoxins in nine different categories of RTE meat and poultry products are presented and discussed. The prevalence data have certain limitations that restrict statistical inferences, because these RTE product-testing programs are strictly regulatory in nature and not statistically designed. The cumulative 10-year Salmonella prevalences were as follows: jerky, 0.31%; cooked, uncured poultry products, 0.10%; large-diameter cooked sausages, 0.07%; small-diameter cooked sausages, 0.20%; cooked beef, roast beef, and cooked corned beef, 0.22%; salads, spreads, and pâtés, 0.05%; and sliced ham and luncheon meat, 0.22%. The cumulative 3-year Salmonella prevalence for dry and semidry fermented sausages was 1.43%. The cumulative 10-year L. monocytogenes prevalences were as follows: jerky, 0.52%; cooked, uncured poultry products, 2.12%; large-diameter cooked sausages, 1.31%; small-diameter cooked sausages, 3.56%; cooked beef, roast beef, and cooked corned beef, 3.09%; salads, spreads, and pâtés, 3.03%; and sliced ham and luncheon meat, 5.16%. The cumulative 3-year L. monocytogenes prevalence for dry and semidry fermented sausages was 3.25%. None of the RTE products tested for E. coli O157:H7 or staphylococcal enterotoxins was positive. Although FSIS and the industry have made progress in reducing pathogens in these products, additional efforts are ongoing to continually improve the safety of all RTE meat and poultry products manufactured in federally inspected establishments in the United States.

Animals↗
PubMed2000

Spinocerebellar syndrome in patients infected with human T-lymphotropic virus types I and II (HTLV-I/HTLV-II): report of 3 cases from Panama.

Cerebellar symptoms at onset are unusual in HTLV-I/II-associated tropical spastic paraparesis (TSP). A prospective study of neurological disorders in Panama (1985-1990) revealed 13 patients with TSP and 3 with HTLV-I/II-associated spinocerebellar syndrome (HSCS) presenting at onset loss of balance, wide-based stance and gait, truncal instability, and mild leg ataxia (vermian cerebellar syndrome), with absent upper limb dysmetria but with postural tremor, downbeat nystagmus, and dysarthria. In 4-5 years, spinal cord manifestations of TSP developed, including spastic paraparesis, pyramidal signs, bladder and sphincter disturbances. Two patients were infected with HTLV-I and another one, a Guaymi Amerindian woman, with HTLV-II. Magnetic resonance imaging (MRI) demonstrated cerebellar atrophy involving predominantly the superior vermis. Mild axonal peripheral neuropathy in the lower limbs, dorsal column involvement and inflammatory myopathy were found by neurophysiology studies. There are 14 similar cases reported in Japan and Canada, but to our knowledge these are the first documented cases of HSCS in the tropics. A cerebellar syndrome constitutes another form of presentation of HTLV-I/II infection of the nervous system.

Cerebellum↗
PubMed1998

Color flow-directed Doppler studies of ovarian masses. Computer analysis.

OBJECTIVE: To determine if analyzing the entire color Doppler image (CDI) pulse wave of an ovarian mass can improve the ability to predict its histopathology. STUDY DESIGN: The CDI of 42 histopathologically diagnosed adnexal masses were retrospectively analyzed. Using an image analysis software program, the following parameters were calculated: area under the curve, compactness, Feret diameter, perimeter, shape factor and width of the waveform. Using an automated curve-fitting software program, the up and down slopes were processed separately for the optimal equation and coefficient for each slope. Two computerized neural networks were created, both consisting of an input layer, one hidden layer and an output layer of three neurons: benign, borderline and malignant. The first network contained two input neurons: pulsatility index (PI) and resistance index (RI). The second network contained 10 input neurons consistent with the shape and slope parameters calculated. The coefficient of determination (R2) was determined for each network. RESULTS: The neural network utilizing RI and PI failed to train (1,397 runs, 67,056 facts, R2 = 0.59, 0.12 and 0.43 for benign, borderline and malignant masses, respectively). The network using the 10 calculated parameters achieved an R2 of 0.96 after 685 runs and 27 facts. CONCLUSION: Analyzing the CDI studies of ovarian masses, using the entire pulse wave, improved the ability to differentiate between their benign, borderline and malignant histopathology.

Diagnosis, Differential↗
PubMed1997

Neoadjuvant chemotherapy in stage IB2 squamous cell carcinoma of the cervix.

To determine the effects of neoadjuvant chemotherapy (NAC) in the management of cervical carcinoma Stage IB2 (tumor diameter > 4 cm), we reviewed 52 surgically treated patients diagnosed between January 1987 and December 1993. There were 20 patients treated with preoperative neoadjuvant chemotherapy and 32 treated by primary radical hysterectomy. Mean tumor diameter was significantly larger in the neoadjuvant, compared with the primary surgery group (6.5 +/- 1.8 vs 5.4 +/- 0.7, P = 0.003). In the NAC group, 5 of 20 patients were treated with three courses of cisplatin, methotrexate, and bleomycin every 21 days, whereas 15 of 20 patients received three courses of cisplatin, vincristine, and bleomycin every 10 days. Postoperative adjuvant therapy consisting of either radiation or chemotherapy was employed in 13/20 patients (65%) in the NAC group and 20/32 patients (63%) in the primary surgical group. At a median follow-up of 52.5 months, 4/20 patients (20%) in the NAC group recurred vs 11/32 (34%) in the primary surgery group. The overall response rate to NAC was 90%, with 2/20 complete clinical responders and 16/20 partial responders. High-risk pathologic factors were less commonly observed in the NAC group when compared with the primary surgical group with the incidence of nodal metastases, positive vascular space involvement, undiagnosed parametrial disease, and > or = 75% depth of invasion observed in 10.0% vs 37.5%, 20.0% vs 46.9%, 0.0% vs 15.6%, and 30.0% vs 68.8%, respectively. No differences were noted in operative time or blood loss. Cox proportional-hazards analysis indicated that the most significant prognostic factor was depth of invasion. Although the patients who received neoadjuvant chemotherapy had significantly larger tumors at baseline, their 5-year survival rate was slightly higher than that of the primary surgery group (80.0% vs 68.7%, P = 0.162). Patients receiving neoadjuvant chemotherapy, despite having significantly larger pretreatment tumors, had fewer high-risk pathologic factors, postoperatively. Although this was a small, nonrandomized study, the relative improvement in pathologic response and long-term outcome associated with neoadjuvant chemotherapy was encouraging. This highlights the need for a prospective randomized clinical trial to establish whether neoadjuvant chemotherapy can significantly improve the long-term outcome of women with Stage IB2 squamous cell carcinoma of the cervix.

Adult↗
PubMed1996

Access to primary health care among persons with disabilities in rural areas: a summary of the literature.

Despite the prevalence of disabilities among persons living in rural areas, scarce data exist on their health care needs. While rural residents generally experience barriers to access to primary health care, these problems are further exacerbated for people with disabilities. This article summarizes findings from the published literature on access to primary health care among people with disabilities living in rural locations. A comprehensive computerized literature search turned up 86 articles meeting the study criteria, focused on the following rural populations affected by disabilities: children and adolescents, working-age adults, the elderly the mentally ill, and people with AIDS. For each of these populations, substantial problems in accessing appropriate health care have been documented. The literature consistently emphasizes the failure of local health care systems in nonmetropolitan areas to adequately address the complex medical and related needs of individuals with disabilities. In the absence of specialized expertise, facilities, and primary care providers trained specifically to care for disabled persons, local programs rely heavily on the use of indigenous paraprofessionals and alternative models of care. Further research is needed to identify and test the efficacy of innovative service delivery strategies to improve health care access for this population.

Acquired Immunodeficiency Syndrome↗
PubMed1994

A note on migration with borrowing constraints.

"This note examines an important conflict between the theory and evidence on migration in LDCs. While the Harris-Todaro class of models explain the phenomenon of migration mainly by expected income differential between the economically advanced and the backward regions, the actual evidence in some cases suggests that migration could actually rise following a rise in income in backward areas. We resolve this puzzle by analysing migration in the context of the existence of imperfect credit markets in LDCs. We show that under certain plausible conditions, the rate of migration from the rural to the urban areas may actually rise when rural wages rise, as they ease the constraints on borrowing by potential migrants."

Demography↗
PubMed1993

Antimicrobial-resistant Salmonella spp isolated from healthy broiler chickens after slaughter.

Of 105 Salmonella organisms of any serotype selected from a sample of 1,824 serotyped salmonellae isolated during a nationwide bacteriologic survey of healthy broiler chickens after slaughter, 60 (57%) were resistant to 1 or more antimicrobial agents and 47 (45%) were resistant to 2 or more agents. Highest resistance was to tetracycline (45%), streptomycin (41%), sulfisoxazole (19%), gentamicin (10%), and trimethoprim/sulfamethoxazole (8%). Additional isolates of S typhimurium, heidelberg, agona, and enteritidis were selected from the sample of 1,824 isolates for testing because of the high frequency with which these 4 serotypes are isolated from human patients. The highest frequency of resistance among 104 isolates of S heidelberg, 92 isolates of S typhimurium, and 30 isolates of S agona was to streptomycin (33 to 57%), sulfisoxazole (33 to 50%), tetracycline (26 to 50%), and gentamicin (13 to 40%); 51 to 63% of these isolates were resistant to 1 or more agents and 37 to 59% were resistant to 2 or more agents. Resistance to ampicillin among these 3 serotypes was uncommon (0 to 4%). In contrast, 15 of 19 tested isolates (79%) of S enteritidis were resistant to ampicillin and 13 of the 19 isolates (68%) were resistant only to ampicillin. This pattern of resistance was associated with a specific bacteriophage type and indicated the potential role of bacterial clones in determining the frequency and patterns of antimicrobial resistance in populations of broiler chickens. Resistance to gentamicin and trimethoprim/sulfamethoxazole was higher than that previously reported and is of public health concern because of the frequency with which these drugs are used to treat bacterial infections in human patients.

Animals↗
PubMed1993

Human immunodeficiency virus infection and invasive cervical carcinoma.

BACKGROUND AND METHODS: To determine the relationship between cervical cancer and human immunodeficiency virus (HIV) infection, 84 women of known HIV status with invasive cervical carcinoma were assessed. Sixteen of 84 patients (19%) were HIV seropositive. The disease characteristics, recurrence rates, survival rates, and immune status of 16 seropositive and 68 seronegative women were compared. RESULTS: HIV-infected women with cervical cancer had significantly more advanced disease than those who were not infected with the virus. Only 1 of 16 (6%) HIV-infected women had early-stage surgical pathologic disease compared with 40% in the HIV-negative group. The response to therapy and prognosis were poorer among HIV-infected women, with higher recurrence and death rates compared with uninfected women. The mean CD4 counts, CD4:CD8 ratios, and percentage of CD4 cells were 360/mm3, 0.57, and 26.8% in HIV-infected women compared with 830/mm3, 1.71, and 41.2% in HIV-negative group. The patient's immune status had a significant impact on subsequent disease because only seropositive patients with CD4 counts greater than 500/mm3 had prolonged or disease-free follow-up. Surgery was performed safely in patients with relatively good immune function. CONCLUSIONS: HIV-infected women represent a unique subset of patients with cervical carcinoma that have more aggressive disease and a poorer prognosis. However, positive serostatus alone does not uniformly confer an unfavorable outcome because patients with initial adequate immune status may do well. HIV testing is recommended in all relatively young women with cervical cancer, and unique therapeutic strategies are advocated in women with these two potentially fatal diseases.

Adenocarcinoma↗
PubMed1992

Substance use among women at risk for HIV infection.

This article reports results from a survey of culturally diverse women at risk for HIV infection in south Florida. Data concerning their substance use and its association with HIV risk behaviors are presented. Results indicate levels of consumption which exceed expectations based on general estimates of female substance use. Further, substance use was associated with specific behaviors and lifestyles which placed the women at increased risk for HIV infection.

Adult↗
PubMed1991

Patterns of chromosomal breakpoint locations in Burkitt's lymphoma: relevance to geography and Epstein-Barr virus association.

We have examined, by Southern blotting, the patterns of chromosomal breakpoint locations in 55 cases of Burkitt's lymphoma (BL) with respect to geography and Epstein-Barr virus (EBV) association. We have confirmed the association between chromosome 8 breakpoint and geography: 74% of endemic (eBL) but only 9% of sporadic BL (sBL) had breakpoints outside the HindIII fragment encompassing the c-myc gene (P2 less than .00001). Conversely, not only did 91% of sBL manifest a rearranged HindIII fragment, but at least 56% of these cases, in contrast to 17% of eBL cases, had a breakpoint within the first exon or intron of c-myc (P2 less than .004). Breakpoints outside the switch mu (S mu) region (ie, the HindIII fragment encompassing S mu) on chromosome 14 were twice as common overall (73%) as those within S mu (27%), but in the 15 tumors with S mu breakpoints, 13 (87%) had a rearranged c-myc gene. Breakpoints outside the HindIII fragment encompassing c-myc on chromosome 8 were predominantly associated with non-S mu breakpoints on chromosome 14 (85%) and this was the combination most frequently associated with eBL (65%; 6% of sBL, P2 less than .00001). In sBL, the most frequent breakpoint combination was a rearranged c-myc gene with a non-S mu breakpoint (63%; 13% of eBL). Twenty-eight percent of sBL and 13% of eBL had breakpoints both within c-myc and within S mu. EBV DNA was present in 19 of 20 tumors with breakpoints outside c-myc, in none of 7 with a breakpoint in the immediate 5' region of c-myc, in 4 of 5 tumors with breakpoints in the first exon, and in 7 of 12 tumors with breakpoints in the first intron. These data suggest that the pathogeneses of eBL and sBL differ with regard to the mechanism of c-myc deregulation, and probably also with regard to the state of differentiation of the target cell for malignant transformation. We have formulated a testable hypothesis regarding the potential role of EBV in pathogenesis: that it is required to contribute to the deregulation of c-myc in the presence of some, but not all, types of c-myc damage arising from the chromosomal translocations.

Blotting, Southern↗
PubMed1991

Monoclonal antipeptide antibodies against amino acid residues 1101-1106 of human C4 distinguish C4A from C4B.

Comparison of amino acid sequences of the alpha-chain fragment of human C4, C4d, has shown C4A- and C4B-specific sequences at residues 1101-1106 in which the aspartic acid-histidine substitution at position 1106 may be related to the amide and ester bond forming properties of these molecules. Peptides containing twelve amino acid residues of the C4A- or C4B-specific sequences were synthesized and injected into female Balb/c mice. Serum from 2 mice, one immunized with the C4A-specific peptide and the other with the C4B-specific peptide, gave strong isotype-specific responses in an enzyme-linked immunosorbent assay against affinity-purified C4A3 and C4B2B1. Spleen cells from these mice were fused with the mouse myeloma SP2/0-Ag 14, and two cloned cell lines, AII-1 and BII-1, were established from hybrids. Enzyme-linked immunosorbent assay and western blotting of monoclonal antibodies AII-1 and BII-1 show that the former reacts with the C4A but not with the C4B alpha-chain and the latter with C4B but not with the C4A alpha-chain. Furthermore, immunoblotting of C4 allelic variants showed that AII-1 reacted with all C4A allotypes tested, including A6, A4, A3 and A2, whereas BII-1 reacted with all C4B allotypes tested, including B5, B3, B2, and B1.

Amino Acid Sequence↗
PubMed1991

AIDS knowledge and risk behaviors among culturally diverse women.

This article reports results from a survey of women at risk for HIV infection. The sample (n = 620) included black (50.6%), white (28.7%), Hispanic (13.4%), and Haitian (5.0%) adult women from south Florida. Data concerning their AIDS knowledge, prevalence of risk behaviors, and perceived vulnerability are presented. Results indicate differences in certain knowledge areas and risk behaviors by race/ethnicity and a consistent incidence of unprotected sex with their main partners across all racial/ethnic groups.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Neurologic diseases associated with the HTLV-1 virus in Panama].

Studies of the prevalence of the human T-cell lymphotropic virus (HTLV-1) in 1984 to 1986 in the Republic of Panama revealed a national seroprevalence of 1 to 2%. Since 1985 clinical epidemiological studies of neurological diseases associated to HTLV-1 are being done. Two hundred and fitly six clinical cases of thirty eight different neurological diseases of unknown etiology studied in the Neurology Services of the Santo Tomas Hospital and the Social Security Metropolitan Hospital Complex have been associated in some way to the HTLV-1. Twelve cases of progressive spastic paraparesis were identified and related to HLTV-1 as an etiologic agent. The ratio of men to women was maintained at 1:1 with the average age at onset at 44 years and without racial preference. There are important doubts about the association of this virus to multiple sclerosis. The seroprevalence of the HTLV-1 virus in Panama is found to be similar to that reported in neighboring countries and the association of tropical spastic paraparesis to THLV-1 infection is identified.

Adult↗