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Biomedical subjects

R Spira

Publications and source records attributed to R Spira.

34 records · Page 2Linked to original sources
PubMed1981

An assessment of the role of scan speed in perceived image quality of body computed tomography.

Forty-three chest (noncardiac) and 75 abdominal computed tomographic (CT) examinations were studied by obtaining four sections of a pertinent area using 2.25-, 4.5-, 9-, and 18-second scan speeds. Chest scans obtained with the three faster speeds were perceived to be qualitatively similar to one another but were rated better than the 18-second sections. While these qualitative differences were statistically significant, most were relatively unimportant clinically. Analysis of the abdominal sections showed significant qualitative improvement with each successively faster scan speed. The only sections rated unreadable and/or showing large numbers of motion artifacts were abdominal studies, primarily 18-second studies. A statistically significant loss of diagnostic information was noted with 18-second scans, especially in the upper abdomen.

Evaluation Studies as Topic↗
PubMed1980

Further observations on the medical efficacy of computed tomography of the chest and abdomen.

A review of 262 consecutive 2-second CT scans (101 thoracic and 161 abdominal) revealed that 36% contributed information critical to diagnosis, prognosis or therapy. As a result of CT-derived data, major surgery was cancelled in 16 cases and planned surgery modified in 11. Similarly, CT contributed to treatment planning in 20 instances. Forty-four per cent of the studies produced new information but did not have definite clinical impact. Marked improvement in efficacy is noted when these data are compared to our previous study of 2 1/2-minute CT examinations. The improvement is ascribed to better imaging (faster scan speed), improved diagnostic skill, better patient selection, and improved credibility of CT-derived data.

Adenoma, Islet Cell↗
PubMed1980

CT diagnosis of benign mediastinal abnormalities.

Thoracic CT scanning was performed in 49 adult male patients to evaluate a suspected mediastinal mass. A correct diagnosis would have been made in only 20 instances on the basis of conventional chest radiography. Specific diagnoses established by CT included 14 cases of local or diffuse mediastinal fat deposition, five mediastinal cysts, and six anomalies or aneurysms of the great vessels. Four miscellaneous lesions were also clarified. Thoracic angiography would undoubtedly have diagnosed vascular abnormalities, but was obviated in most instances. CT accurately defined anatomic relationships and distinguished vascular from nonvascular masses in the 16 patients who underwent diagnostic thoracotomy or mediastinoscopy. When CT demonstrated a fatty or cystic lesion, no attempt at tissue confirmation was undertaken in all but two of the asymptomatic patients. Clinical follow-up from 6 months to 3 years in conjunction with select correlative radiologic procedures have supported the CT findings in the nonoperated group. CT should be the initial procedure for evaluating most patients with mediastinal abnormalities detected by plain chest radiography. If the patient is asymptomatic and the information provided by CT indicates a benign process, conservative management with careful follow-up is justified.

Adult↗
PubMed1976

Physiological effects of a sports rehabilitation program on cerebral palsied and post-poliomyelitic adolescents.

Thirty-four spastic cerebral palsied (CP) post-poliomyelitic (P) adolescents (mean age--17.9 years) participated in a twice-a-week mild conditioning program, lasting 12 months. Nine CP adolescents served as a control inactive group. The post-conditioning submaximal heart rates of the CP active group were significantly lower during 75 and 150 kpm/min work loads on an arm ergometer, compared with the respective values at the beginning of the program. Peak O2 uptake values, directly measured during an all-out arm pedalling test, were improved by some 8% in the CP active group. Neither CP inactive nor P active showed any significant changes attributable to conditioning in physiological variables obtained during the submaximal or maximal tests. Adiposity level of each of the three groups remained unchanged. The mechanical efficiency of all subjects was low (16.2%) and remained so following conditioning.

Adolescent↗
PubMed1975

Autosomal recessive oculopharyngeal muscular dystrophy.

Oculopharyngeal muscular dystrophy is known as a rare automsomal dominant disease. A family is reported suggesting that there may be genetic heterogeneity in oculopharyngeal muscular dystrophy and that in some families the mode of inheritance may be autosomal recessive.

Adult↗
PubMedDate not supplied

Thin ribs in neonatal myotonic dystrophy.

The recently described thin ribs seen in a neonate suffering from myotonic dystrophy represents a valuable sign for early detection of this condition. Thin ribs were found on chest radiographs of two siblings a short time after birth. This led in retrospect to the diagnosis of neonatal myotonic dystrophy. The diagnosis was confirmed by clinical and electromyographic data of myotonic dystrophy in the mother who was not previously known to have the disease. Both children died at the age of 2 days from respiratory distress. All children of affected mothers should have a chest radiograph soon after birth in order to help in diagnosis and to establish the frequency of this sign.

Female↗
PubMedDate not supplied

[Preventing the transmission of HIV-1 from mother to child in Africa in the year 2000].

African women of childbearing age are particularly vulnerable to HIV infection, and this has led to an increase in the number of pediatric HIV infections reported due to the risk of mother-to-child transmission (MTCT) of HIV during pregnancy, delivery and breastfeeding. Various approaches to preventing MTCT have been, or are being, evaluated in developing countries, especially in Africa. New data from these trials are becoming available and have implications for population-based intervention programs that require urgent consideration. We performed a critical review of 18 randomized trials and other relevant studies from developing and industrialized countries, to assess public health perspectives and to identify new research issues. Most African results relate to trials of antiretroviral drugs (ARVs) given to mothers during the last month of pregnancy, and for up to one week after delivery, and to the neonate during the first week of life, or simpler and shorter regimens. They indicate that zidovudine treatment, with or without lamivudine, and nevirapine treatment given alone, reduce transmission during the first six months of life by 30 % to 50%. Preliminary results suggest that zidovudine treatment is effective in the long term. One randomized study showed that the replacement of breast feeding with breast milk substitutes was effective at reducing the overall risk of MTCT. Antiseptic disinfection and micronutrient supplementation have been shown to reduce maternal and infant mortality and morbidity, but not the MTCT of HIV. Voluntary, confidential HIV counseling and testing for pregnant women, a short course of peripartum ARVs and alternatives to breast feeding such as early weaning and breast milk substitutes from birth, are currently the best means of reducing the MTCT of HIV in Africa. Pilot programs based on these findings are currently being implemented in several African countries. Prevention of the MTCT of HIV should also be considered as part of the wider management of maternal and infant health during prenatal, delivery and postnatal care. Several complementary issues require further investigation. Some results, such as the long-term efficacy of a short course of ARVs once the mother has finished breast feeding, and the long-term safety of these treatments, require confirmation. Further studies are required into the prevention of postnatal transmission, particularly in light of the unknown consequences of different feeding options and the possibility of post-perinatal prophylaxis with ARVs. The reduction of MTCT of HIV in Africa is a true challenge in efforts to control the HIV pandemic, but recent progress in the identification of effective treatments provides some hope. Large-scale implementation of these new treatments is required, and should provide practical information and perhaps identify more potent, and possibly cheaper, strategies.

Acquired Immunodeficiency Syndrome↗