Search PubMed⌕ Search

Biomedical subjects

P Singer

Publications and source records attributed to P Singer.

At least 55 records · Page 3Linked to original sources
PubMed1995

Phagocytosis and oxidative burst of granulocytes in the upper respiratory tract in chronic and acute inflammation.

Acute diseases and chronic conditions may be associated with altered neutrophil functions. The aim of this investigation was to study the number and function of granulocytes in the upper respiratory tract in acute and chronic airway inflammation. The 136 participating subjects were assigned to 6 groups; group 1: controls; group 2: smokers, < 10 cigarettes/day; group 3: smokers, > 10 cigarettes/day; group 4: patients with allergic rhinitis; group 5: patients with obstructive sleep apnea; group 6: patients with acute viral upper respiratory tract infection. Whole blood and nasal lavage fluid were obtained and a cell count was performed. Phagocytosis of opsonized bacteria and the oxidative burst was measured. Total cell counts and absolute number of neutrophils in nasal lavage (NAL), but not in blood, were elevated in all groups compared to controls. Highest increases of neutrophils were observed in group 4 (7-fold) and group 6 (25-fold), p < .01. Phagocytosis and oxidative burst of granulocytes recovered by NAL were found to be increased in group 4 (25% and 15%, respectively) and group 6 (35% and 21%) only, but decreased in the other groups. We conclude that conditions leading to acute or chronic inflammation in the upper respiratory tract are associated with altered functions of granulocytes recovered by NAL but not blood, suggesting local modulating factors. We speculate that chronic inflammation, in contrast to acute conditions, is associated with impaired granulocyte function.

Adult↗
PubMed1995

Preliminary report of a prospective randomized study of octreotide in the treatment of severe acute pancreatitis.

BACKGROUND: Experimental and clinical studies on the effect of octreotide in the treatment of patients with acute pancreatitis have presented controversial results. Since January 1992, we have been conducting a prospective randomized study on the clinical effect of octreotide in severe acute pancreatitis, at three hospitals in Israel. STUDY DESIGN: The entering criteria included three or more of the Ranson's prognostic signs and computed tomographic findings of severe pancreatitis. Patients were randomly assigned to conservative treatment either with or without octreotide (0.1 mg injected subcutaneously three times a day). The end points of the study included: complication rate (adult respiratory distress syndrome [ARDS], sepsis, renal failure, pseudocyst, fistula, and abscess), length of hospital stay, and mortality. RESULTS: During the first two years (from January 1992 to December 1993), 51 patients entered the study. After evaluation, 13 patients were excluded due to failure to meet the entering criteria, incomplete data, or incorrect diagnosis. Of the remaining 38 patients, 19 were assigned to octreotide (treatment group) and 19 to conservative treatment alone (control group). The two groups were matched with regard to age, sex, etiology, and severity of disease. The complication rate was lower in the treatment group compared with the control group with regard to sepsis (26 compared with 74 percent, p = 0.004) and ARDS (37 compared with 63 percent, p = 0.1). The hospital stay was shorter in the treatment group compared with the control group (17.9 compared with 34.1 days, p = 0.02). Death occurred in two patients in the treatment group and six patients in the control group. CONCLUSIONS: Although some of the parameters did not reach statistical significance, these preliminary results suggest that octreotide may have a beneficial effect in the treatment of patients with severe acute pancreatitis. This study is scheduled to continue for two more years.

Abscess↗
PubMed1995

Advance directives in COPD.

Completed when a person is capable, advance directives guide future health care decisions when the person has become incapable. Advance directives are based on the ethical principle of respect for auronomy, and are legally recognized in many jurisdictions. Although the advance directives currently available are generic, a disease-specific directive may be useful for people with COPD. In clinical practice, advance directives raise a number of challenging questions: With whom should the topic be raised? Should a proxy or instruction directive be used? What should be done if the patient changes his/her mind about treatment? How should people insure their advance directive is available when needed? A research for advance directives is outlined.

Advance Directives↗
PubMed1994

Glutamine metabolism and utilization: relevance to major problems in health care.

Glutamine plays an important role in normal and pathophysiological states. In this review we describe the biochemical synthesis and degradation pathways of glutamine, as well as its utilization by the immune system and in rapidly dividing cells. Also discussed are glutamine behaviour in catabolic states and the therapeutic implications of this amino acid in total parenteral nutrition, digestive diseases and cancer.

Animals↗
PubMed1994

Bioethics and the limits of tolerance.

Since 1989 there has been an ongoing controversy about the limits of public discussion of bioethical issues in the German-speaking world. While a number of scholars have been involved, Peter Singer and Helga Kuhse have been the principal targets of those seeking to limit bioethical debates. Those who have supported silencing discussion of certain issues have argued that such public discussion leads to a loss of freedom. In the article we argue that toleration is not based on subjectivism but rather on reason. Furthermore, the efforts to suppress debate are often based on a failure to understand our position. Such efforts at suppression also rest on an elitist view of society that must assume that the general public cannot debate such topics.

Attitude↗
PubMed1994

AIDS presenting as progressive multifocal leukoencephalopathy with clinical response to zidovudine.

Progressive multifocal leukoencephalopathy (PML) due to JC virus can be the initial manifestation of AIDS. A 40-year-old man seropositive for HIV-1 presented with aphasia, hemiparesis, and hemianopsia, and with magnetic resonance imaging of the brain typical of PML. He quickly became bed bound, incontinent, and mute. The diagnosis of PML was established by histopathology in a brain biopsy with positive immunocytochemistry for polyomavirus capsid proteins, and detection of JCV DNA by polymerase chain reaction using JCV-specific primers. High dose zidovudine therapy was initiated (1200 mg/day). Within two weeks the patient began to respond, and after three months he was able to walk and care for himself and was discharged. He lived for two years from the onset of PML. While cytarabine has been the drug most widely used for PML treatment, this is the second confirmed case with apparent response to zidovudine. High dose zidovudine may benefit some previously untreated AIDS patients with onset as PML.

AIDS Dementia Complex↗
PubMed1994

A comparison of 6 months' compliance of patients with rheumatoid arthritis treated with tenoxicam and naproxen. Use of patient computer data to assess response to treatment.

OBJECTIVE: To assess longterm compliance in patients with rheumatoid arthritis (RA) of 20 mg tenoxicam or 500-1000 mg naproxen taken daily and to evaluate patient computer data collection. METHODS: Three hundred and seven patients were treated in a double blind, randomized multicenter study for 6 months. The first 4 weeks of treatment data were collected daily via patient operated computers in parallel with standard assessment at weekly visits to the clinics. RESULTS: Daily patient data collection was more sensitive than weekly clinical assessments. Six months' compliance was 62% for tenoxicam and 67% for naproxen with comparable rates of withdrawal due to lack of efficacy or adverse drug experiences in both groups. The spectra of adverse drug events found were very similar for both drugs but the rates were higher than in short term studies. CONCLUSION: Daily computer data collection by patients is superior to classical clinical evaluation in drug studies. The longterm compliance of tenoxicam and naproxen are comparable when treating patients with RA.

Age Distribution↗
PubMed1993

Voluntary euthanasia and the nurse: an Australian survey.

This article presents the results of a survey of the attitudes and practices of nurses in Victoria with regard to requests for active or passive help in dying from patients who were suffering from a terminal or incurable disease. Questionnaires were sent to 1942 nurses who had been selected at random, 943 nurses (49%) of whom returned completed questionnaires. The survey indicates that a clear majority of those who responded to the questionnaire support active voluntary euthanasia. Many nurses have collaborated with doctors in the provision of active voluntary euthanasia and a few have acted without consulting a doctor. Seventy-eight per cent of nurses thought the law should be changed to allow doctors to take active steps to bring about a patient's death under some circumstances; and 65% of nurses indicated that they would be willing to collaborate with doctors in the provision of active voluntary euthanasia if it were legal.

Adult↗
PubMed1992

Hypercaloric glycerol in injured patients.

BACKGROUND: This study investigates the effects of glycerol as a fuel source in the hypermetabolic patient (after injury). METHODS: Twenty-two patients were studied after multiple trauma and randomly assigned to either glucose or glycerol as the carbohydrate source (220 gm glycerol or 320 gm dextrose) during a lipid-based system of parenteral nutrition. In the immediate postoperative period, measurements were made of nitrogen balance, substrates, energy expenditure, insulin, glucagon, and liver function tests. RESULTS: In the glycerol group glucose concentrations in plasma were significantly lower, whereas glycerol levels increased nearly twentyfold. Insulin and glucagon levels increased in both groups; however, the rise in insulin level was greater in the glucose group, whereas glucagon increased in both groups to a similar degree. Nitrogen balance was restored to equilibrium in the glycerol group while remaining negative in the glucose group. No abnormalities in liver function test results or differences in serum albumin levels were noted in either group. A 12% thermic effect was noted in the glucose group but not in the glycerol group. CONCLUSIONS: Glycerol seems to be a viable fuel source in the traumatized patient, being associated with nitrogen retention and minimal thermal effect. A marked rise in plasma levels of glycerol does occur, but this does not appear to have any associated toxicity.

Adolescent↗