Biomedical subjects
Publications and source records attributed to R Levin.
Postpartum female rats deprived of suckling stimulation while being kept continuously with pups nonetheless suspended ovarian cyclicity for an average of 16 days and responded to uterine trauma by forming deciduomata. These results show that the extramammary stimulation afforded by young is alone capable of sustaining prolactin output from the adenohypophysis of the postpartum rat.
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There is an increasing interest by health care providers, not only in the effectiveness of cancer treatments, but also in patients' quality of life (QOL). The objective of the present study is to validate the Functional Assessment of Cancer Therapy-General (FACT-G) Version 2 as a measure of the QOL in a sample of 140 Uruguayan patients with cancer of varied sites, at different stages of the disease and under different forms of treatment. Reliability of the FACT-G was evaluated and showed high coefficients (Cronbach's alpha) in each of the subscales and in the total questionnaire score. It was also capable of discriminating among different groups of patients. We conclude that the FACT-G is a brief and easy to use questionnaire, that showed acceptable reliability and validity and good feasibility for use as a research instrument among Uruguayan cancer patients.
The electromyographic (EMG) exam and creatine kinase (CK) are commonly used to evaluate patients with neuromuscular diseases. Prior studies have demonstrated minimal elevation of CK following monopolar needle examination, indicating that a false positive elevation does not occur in normal individuals. We studied the magnitude and time course of CK change resulting from concentric (CNEMG) and monopolar (MNEMG) needle EMG examination on healthy volunteers. CK increased in all subjects following CNEMG and MNEMG. Statistically significant mean CK elevations over baseline were observed at 4, 8, 12, and 24 hours for CNEMG and at 12 and 24 hours for MNEMG. Maximum elevation occurred at 12 and 24 hours for both CNEMG (mean, 178% of baseline) and MNEMG (mean, 134% of baseline). CK returned to baseline by 48 to 72 hours. In 25-30% of subjects CK elevation significantly exceeded the normal range. The magnitude of CK elevation is greater and the time course more prolonged than previously reported. CK measurements should be avoided 4 to 48 hours following CNEMG because of the potential for false positive results. Measurements immediately after and at 72 hours are not affected by the CNEMG or MNEMG. The time course for CK change following MNEMG is similar to CNEMG, but the magnitude is less.
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The rate of positive tuberculin skin tests for Latino children was examined to help define high risk groups. We reviewed 330 charts of subjects, 18 years of age or younger, with one or more tuberculin (5 tuberculin units, purified protein derivative) skin test readings in a 5-year period. Overall 9% of United States-born and 53% of foreign-born Latinos had positive tuberculin tests (P less than 0.01). Repeat applications identified 35 converters and a greater proportion of United States-born Latinos were in this group (P less than 0.05). Radiographic changes on chest films consistent with active tuberculous disease were found in four of the foreign-born converters. The calculated tuberculin conversion rate of these Latinos is 15 to 30 times that of the United States general population. Unsuspected transmission of tuberculosis may be one possible explanation. We recommend that: clinicians should perform routine tuberculin skin tests in healthy Latino children whether born in the United States or in a foreign country; and active screening for tuberculosis of Latino immigrants by local health departments be conducted with appropriate funding support.
The literature on psychosocial dimensions of epilepsy has been reviewed utilizing the framework developed by Dodrill et al. (Epilepsia 1980; 21:123-35). Factors considered were family background, emotional adjustment, interpersonal adjustment, vocational adjustment, financial status, adjustment to seizures, and medicine and medical management. The published studies highlighted a number of issues and sometimes rendered varying and contradictory conclusions. In general, epilepsy fosters certain reactions in family members. If negative, these reactions may be detrimental to the person with epilepsy. The association between specific emotional adjustment factors and epilepsy is not conclusive. Studies have been published which support as well as refute this association. Studies indicate that persons with epilepsy experience lower rates of marriage and more sexual difficulties than do nonepileptic persons. Studies report greater unemployment and underemployment in epileptic persons than in the population at large. Studies suggest that some persons with epilepsy manifest an attitude of nonacceptance of self. Some are reluctant to disclose their disability to others. The studies also indicate the presence of a discriminatory attitude by some nonepileptic persons toward epileptic persons. Several factors are associated with successful medical management of epilepsy. The emphasis in research studies with regard to psychosocial aspects of epilepsy focuses predominantly on individual deficiencies rather than on strengths and abilities.
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Many studies have assessed the benefits of nutrition support in cancer patients. Except for studies directed at the treatment of severe malnutrition, most clinical trials have failed. Although prospective randomized controlled clinical trials (Phase III) remain the most reliable means of evaluating the efficacy of therapy, the available literature reports only results from small trials (Phase II to III), most of which appear to be contradictory and none of which conclusively answer the question being considered. To address this gap in knowledge, tools such as meta-analysis have been adapted from the field of statistics. Meta-analysis involves pooling results across several studies and provides a more precise estimate of treatment effect than can each individual study. However, clinical trials selected for meta-analysis, although broadly similar, can differ significantly in terms of therapies used and clinical populations studied. Major cancer types with differing effects on food intake and malnutrition (eg, the mechanical obstruction in head and neck cancer vs the cytokine-induced metastases associated with lung, ovarian, colon, and breast cancer) cannot be subject to the same analytic criteria. In this paper, the current state of clinical outcome trials in nutrition and cancer is examined, and the desired design for future studies is proposed. Research priorities include the conduct of Phase II clinical trials that use as outcome measures quality of life, performance status, and survival to identify optimal cancer-specific and patient-specific nutrition support. The next round of Phase III efficacy studies should establish the appropriate use of nutrition support in cancer therapy.
Teaching hospitals are the principal site of many specialized surgical procedures. The recipients of these procedures tend to be younger, male, and nonwhite and tend to reside in either the poorest or the most affluent neighborhoods. Although the numbers of these procedures performed at major teaching hospitals increased dramatically between 1989 and 1995, they accounted for only a modest proportion of hospital discharges and patient days. Concentration of specialized surgical procedures in major teaching hospitals will likely continue. This trend has implications not only for these hospitals but for health care purchasers, policymakers, medical educators, and clinical researchers as well.
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Osteoblastoma is a very rare bone tumor infrequently reported in the podiatric literature. The authors present a review of this tumor and the types of modalities that may be used to detect and diagnose these tumors. They also present a surgical approach to the resection of these bone tumors.