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Biomedical subjects

R Schwartz

Publications and source records attributed to R Schwartz.

At least 127 records · Page 7Linked to original sources
PubMed1993

The value of early treatment of deer tick bites for the prevention of Lyme disease.

OBJECTIVE: To determine if the early antibiotic treatment of deer tick bites prevented Lyme disease. DESIGN: Prospective, double-blind, placebo-controlled, antibiotic treatment. SETTING: Private practice in an area endemic for Lyme disease. STUDY PARTICIPANTS: Patients between 3 and 19 years of age who received antibiotic treatment within 3 days following a deer tick bite. INTERVENTIONS: Patients received an antibiotic or placebo and were followed up for stage I and II disease. All patients had blood drawn at the time of presentation and 6 weeks later for immunofluorescent antibodies (IFA). MEASUREMENTS/MAIN RESULTS: One patient in the placebo group developed clinical Lyme disease associated with an IFA titer of 1:32, considered weakly positive. Three other patients in the placebo group developed an IFA titer of 1:32; one had an influenzalike illness and two had no symptoms. None of the study patients developed any neurologic, cardiac, or arthritic symptoms in the 1- to 3-year follow-up. CONCLUSION: Based on the low frequency of illness, the absence of stage II disease, and the inability to establish the efficacy of early antibiotic treatment, we suggest that physicians not routinely use prophylactic antibiotics for deer tick bites.

Adolescent↗
PubMed1993

Infective endocarditis due to Fusobacterium nucleatum: case report and review of the literature.

Endocarditis caused by Fusobacterium nucleatum is exceedingly rare. We report a case of F. nucleatum right-sided endocarditis in a patient with no known intravenous drug abuse. A detailed computer and manual search of the literature using Med-Line and Index Medicus, respectively, revealed a total of five cases of endocarditis due to this species. The clinical characteristics and the patient's hospital course are summarized and reviewed.

Dental Caries↗
PubMed1993

Self-tonometry under microgravity conditions.

During a space mission flown in microgravity early changes in intraocular pressure due to the fluid shift effect in microgravity were analyzed with an automatic self-tonometer. In total, 13 pressure readings per eye were obtained during the mission. The first pressure readings 16 min after reaching microgravity revealed a 92% rise in intraocular pressure compared to the daytime-correlated baseline data on earth followed by an adaptation phase lasting for several hours. Diurnal pressure profiles during the mission showed no relevant difference in altitude and amplitude.

Humans↗
PubMed1993

Phase I/II study of murine monoclonal antibody-ricin A chain (XOMAZYME-Mel) immunoconjugate plus cyclosporine A in patients with metastatic melanoma.

XOMAZYME-Mel (XMMME-001-RTA) is an immunoconjugate comprised of ricin A chain conjugated to a murine monoclonal antibody directed against high molecular weight melanoma antigens. Although not necessarily related to increased toxicity or decreased efficacy, the development of anti-immunoconjugate antibodies may limit repetitive dosing with an immunoconjugate. We evaluated the role of cyclosporine A in blocking the antibody response in patients with melanoma treated with XMMME-001-RTA. Patients received cyclosporine in divided daily doses to achieve serum levels by HPLC of 150-200 ng/ml on days 1-22. On day 3, XMMME-001-RTA was begun at dosages 0.2-0.6 mg/kg daily for 5 days. Treatment was repeated every 35 days. Three patients were treated in each dosage tier (0.2, 0.4, 0.6 mg/kg). Nine patients were entered and all nine were evaluable. Patients had histologically confirmed melanoma. Metastatic sites included skin, soft tissue, and lymph nodes (seven), lung (two), liver (one), and spleen (one). There were four men and five women aged 46-75 years. Toxicities included myalgia, arthralgia, hypoalbuminemia, fatigue, elevations in liver function tests, and increased peripheral edema. Four patients received two to five repeated dosages of XMMME-001-RTA. One wheal-and-flare reaction from an immunotoxin test dose of XMMME-001-RTA was noted after five cycles. After a test dose subsequent to one cycle, two patients experienced chest tightness without ECG changes and were removed from the study. All toxicities resolved without sequelae. One patient experienced partial lymph node remission for 9 months. A second patient had stable mediastinal disease for 20 months. XMMME-001-RTA is safe when given repeatedly with cyclosporine.

Aged↗
PubMed1993

Prenatal diagnosis of familial neonatal hyperinsulinemia.

A kindred with familial neonatal hyperinsulinemia is described. Infant A was macrosomatic and stillborn. Infant B was macrosomatic at birth following a pregnancy uncomplicated by maternal diabetes. Following diagnosis of hyperinsulinemic hypoglycemia, this patient was treated with oral diazoxide. Therapy continued until hyperinsulinemia resolved by two years of age. Based on this history, the pregnancy with infant C was intensively monitored using ultrasonography and amniocentesis. Insulin and C-peptide concentrations in amniotic fluid were markedly increased compared to control pregnancies. Based on these results, infant C was delivered immediately upon obtaining evidence of lung maturation. Neonatal hyperinsulinemia was confirmed by a markedly increased cord plasma insulin concentration. Based on our experience, we recommend that insulin concentrations in amniotic fluid be used as an indicator of fetal hyperinsulinemia in kindreds with prior newborn hyperinsulinemic hypoglycemia. This information may be used to direct timing of delivery and therapy in the immediate postnatal period.

Administration, Oral↗
PubMed1993

[Results of self-tonometry during the 1st German-Russian MIR mission 1992].

The 1st German-Russian MIR mission 1992 is one result of the agreement about technical and scientific cooperation between Germany and the former Soviet Union. Fourteen experiments have been performed during the 8-day manned space mission, one of which was called "TON": self-tonometry in mu-gravity. A total of 70 measurements of intraocular pressure (IOP) was performed in the SOJUS TM capsule as well as in the MIR space station with the automatic self-tonometer. The first pressure readings 16 min after reaching mu-gravity revealed a 92% rise in the IOP compared to the baseline data on earth followed by an adaptation phase lasting several hours. Important information about the handling of the self-tonometer in mu-gravity was obtained. Its use is also planned for the 2nd German D-2 Spacelab-Mission in March 1993.

Adult↗
PubMed1993

[Pressure-induced change in corneal curvature in patients with refractive surgery and unoperated probands].

Helmholtz suspected there was a connection between intraocuclar pressure and lateration of corneal curvature. With a view to potential changes in corneal stability following different refractive procedures, we tried to demonstrate these side effects by increasing the intraocular pressure. A tilting-table was used to induce a rapid pressure increase via the fluid shift. Corneal curvature was measured by photokeratoscopy before and after pressure changes. The results were different in corneas subjected to radial and photorefractive keratotomy than in intact corneas. We suggest a physical model that might provide an explanation.

Adolescent↗
PubMed1993

Capacity building and resource needs of state health agencies to implement community-based cardiovascular disease programs.

State Health Agencies play a critical role in the Nation's efforts for health promotion and disease prevention. This role is especially critical in efforts to reduce the burden of CVD through community-based programs. Resources SHAs need to facilitate implementation of community-based CVD prevention programs fall into three general categories: (a) Adequate time to plan, carry out and evaluate, (b) Financial resources to support staff, community organization and demonstration programs, and (c) Personnel with requisite technical expertise, skills and technological resources. Six critical activities for building state-level CVD program capacity include: (1) Forming a statewide CVD oversight committee, (2) Developing a state CVD plan, (3) Developing quality assurance standards and guidelines, (4) Developing new paradigms of community assessment and evaluation, (5) Planning for institutionalization, and (6) Translation of research to application. SHA roles vary from direct service delivery to serving as a linking agent, transferring information and resources and coordinating efforts between agencies.

Cardiovascular Diseases↗
PubMed1992

Aluminum accumulation in serum, liver and spleen of Fe-depleted and Fe-adequate rats.

The study described here was planned to test the hypothesis that Al absorption and accumulation in the body are inversely related to Fe status. Aluminum3+ and Fe3+ have similar ionic radii and charge densities, pH-solubility relationships, and affinities for ligands, such as citrate and transferrin. Male weanling Sprague-Dawley rats were pair fed an Fe-deficient or Fe-adequate (control) diet for 2 wk. Each diet group was then randomly assigned to receive for four more weeks the Fe-deficient or adequate diet with: 1. 2% AlCl3; 2. AlCl3 + 3.5% Na citrate; or 3. No Al or citrate. Iron depletion, confirmed by measurements of hemoglobin, hematocrit, serum Fe, and Fe binding capacity, increased concentrations of serum, liver, and spleen Al in all groups fed AlCl3. However, the increase owing to Fe deficiency was significant only when Al was fed with citrate. The data suggest that Fe deficiency enhances both Al absorption and accumulation in liver and spleen.

Administration, Oral↗
PubMed1992

Tensile bond strengths of three chemical and one electrolytic etching systems for a base metal alloy.

This study compared the tensile bond strength of Rexillium III disks etched by three chemical etching systems and the electrochemical etching technique. Cast Rexillium III disks were etched by the following etching systems: electrochemical, Assure-Etch, Met-Etch gel, and Etch-It gel. Thermocycled samples were loaded to failure in tension on an Instron testing machine using a crosshead speed of 5 mm/minute. Samples etched electrochemically yielded significantly greater bond strengths than those etched chemically (p less than 0.05). The rank of the groups was: Electrochemical greater than Assure-Etch = Met-Etch greater than Etch-It. Scanning electron micrograph evaluations of the etching patterns supported the bond strength determinations.

Acid Etching, Dental↗
PubMed1992

A population-based study of motorcycle injury and costs.

STUDY OBJECTIVE: To provide a population-based injury and cost profile for motorcycle injury in Connecticut. DESIGN: Population-based retrospective epidemiologic review of Connecticut death certificates, hospital discharge data, and police accident reports. RESULTS: Connecticut death certificates identified 112 deaths from motorcycle injuries for an annual death rate of 1.2 per 100,000 persons. Death rates were highest among 20- to 24-year-old men. Nonhelmeted motorcyclists were 3.4-fold more likely to die than were helmeted riders (P less than .05). An estimated 2,361 motorcycle-related hospital discharges resulted in an annual hospitalization rate of 24.7 per 100,000 persons. Head, neck, and spinal injuries accounted for 22% of all injuries. Total costs exceeded $29 million; 29% of hospitalized patients were uninsured, and 42% of the cost was not reimbursed to the hospitals. CONCLUSION: Motorcycle injuries contribute significantly to Connecticut's mortality, morbidity, and medical costs. Our study suggests that a uniform helmet law would save an estimated ten lives and prevent more than 90 nonfatal injuries in Connecticut each year at a cost savings to the state of $5.1 million. These data are crucial in advocating re-enactment of motorcycle helmet laws.

Abbreviated Injury Scale↗
PubMed1992

High-specificity in-situ hybridization. Methods and application.

We describe a technique of in-situ hybridization using oligonucleotide probes employing the expression of immunoglobulin VH genes as a model. Optimal conditions for hybridization with the 35S-labeled oligonucleotide probes were established with monoclonal B-cell lines that express VH genes of known nucleic acid sequence. The range of sensitivity and specificity achieved with this technique is documented. Under conditions of high stringency, this method can detect the expression of highly related VH hypervariable regions.

B-Lymphocytes↗