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Biomedical subjects

R Loewenson

Publications and source records attributed to R Loewenson.

At least 37 records · Page 2Linked to original sources
PubMed1984

Perceptions of childhood diarrhoea and its treatment in rural Zimbabwe.

In the course of a study on the acceptability and feasibility of home-based oral rehydration therapy in rural Zimbabwe, information was collected on attitudes and beliefs about diarrhoea and on action taken in response to an episode of diarrhoea in a child. Diarrhoea was found to be a perceived threat at community and family level and numerous possible causes of diarrhoea were described which were assigned to two broad classes: (1) 'physical' causes, such as a polluted environment, diet and teething and (2) 'social and spiritual' causes such as those associated with a depressed fontanelle. These domains were not, however, mutually exclusive; 76% of the described episodes of diarrhoea were attributed to 'physical' causes, 15% to 'social and spiritual' causes and 8% to a combination of both. Reported utilization rates of the formal health services were unexpectedly high. In contrast, we recorded a low demand for indigenous herbalists (n'angas). Home management was common and comprised the administration of indigenous herbal remedies, of sugar and salt solutions, of over-the-counter drugs or of enemas. These remedies were given on their own or alongside the treatment prescribed by a health worker. A number of variables were examined to assess their influence on health-seeking behaviour: perceived cause and severity of the illness, socio-demographic characteristics of the respondent or child and accessibility of the health services.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

B-mode real-time ultrasonic carotid imaging: impact on decision-making and prediction of surgical findings.

The roles of B-mode real-time ultrasonic imaging (USI) and carotid angiography (CAG) in deciding on endarterectomy were analyzed. When greater than 50% stenosis and/or complicated ulceration were predicted by both techniques, endarterectomy was undertaken in 21/25; by only CAG in 5/8; and by only USI in 10/21. In vessels with adequate surgical data, stenosis was accurately predicted by CAG in 27/32, USI in 20/32, and ulceration by both CAG and USI in 21/29. USI results were sometimes used to justify endarterectomy despite unimpressive CAG. CAG is a better predictor of stenosis, whereas both are limited in predicting ulceration.

Arterial Occlusive Diseases↗
PubMed1983

B-mode, real-time carotid ultrasonic imaging. Correlation with angiography.

B-mode, real-time ultrasonic imaging was prospectively evaluated as a screening test for atherosclerotic occlusive vascular disease in the carotid bifurcation region, as defined by carotid angiography in 100 carotid systems in 50 patients. Preliminary reliability studies for each technique assessed agreement between examiners. Sensitivities of ultrasonography for stenosis greater than 50% of luminal diameter, complicated plaque ulceration, complete occlusion, and "surgical disease" by any of these parameters were 79%, 26%, 25%, and 73%, respectively. Thirty-seven percent of the 100 carotid systems were found to contain surgically relevant disease by angiography, compared with 19% and 56%, respectively, of the carotid systems with negative and positive ultrasonographic results. Judicious use of ultrasonography as a screen for angiography requires awareness of these limitations.

Aged↗
PubMed1983

The electroencephalogram of elderly subjects revisited.

The EEGs of 98 elderly volunteers were compared with those of 84 patients with a recent cerebral infarction who had achieved a stable clinical course. All subjects were uniformly evaluated according to a special protocol. The elderly volunteers were accepted for the study if they had no history, signs or symptoms of central nervous system disease. The EEGs were found to be significantly different between the two groups of subjects in several aspects. These included not only possible abnormalities, focal or diffuse, but also some normal features, such as alpha frequency and responses to photic stimulation and to hyperventilation. Groups of these differentiating features were analyzed. Using the single variable of ER (evoked response), discrimination of 80% was achieved. The variables that distinguish the volunteers from the patients may be used in the future to determine whether they are helpful in differentiating normals from patients with conditions other than stroke.

Aged↗
PubMedDate not supplied

Factors influencing serum levels of carbamazepine and carbamazepine-10,11-epoxide in children.

Carbamazepine-10,11-epoxide (CBZ-E), the principal metabolite of carbamazepine (CBZ), is reported to have antiepileptic and toxic effects similar to CBZ. Steady-state CBZ and CBZ-E levels (high performance liquid chromatography, HPLC assay) were reviewed in 225 outpatient children and young adults taking CBZ with or without other antiepileptic drugs (AEDs). In patients on CBZ alone, mean serum concentration of CBZ was 7.9 +/- 1.9 micrograms/ml and of CBZ-E was 1.5 +/- 0.6 micrograms/ml. The CBZ-E/CBZ ratio was 19.6 +/- 2.4%. Serum CBZ increased with increasing age and with CBZ dose. CBZ-E increased with increasing CBZ dose but was unaffected by age. The CBZ-E/CBZ ratio progressively declined with age. Co-medication with barbiturates or valproic acid significantly increased CBZ-E. Phenytoin showed a similar trend while ethosuximide caused the least change. Patients on CBZ and two or more other AEDs had highest CBZ-E levels and CBZ-E/CBZ ratio. CBZ and CBZ-E levels are variably affected by age, CBZ dose, and co-medication with other AEDs. When other AEDs are administered, careful monitoring is especially indicated in order to avoid toxicity.

Adolescent↗