Varicella-zoster virus pneumonitis.
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Chickenpox↗
Biomedical subjects
S Feldman
Publications and source records attributed to S Feldman.
Managed mental health--community mental health revisited?
Despite the considerable differences between them, community and managed mental health care have much in common, particularly with regard to their values and objectives. While their differences in such things as auspice and funding may be more apparent than their commonalities, both community and managed mental health emphasize alternatives to hospitalization, continuity of care, and responsibility for a defined population. Neither managed nor community mental health care was welcomed by a mental health establishment that resisted change, although the source of the opposition was somewhat different. Inflated expectations led to disenchantment with community mental health care and could well have the same effect on managed mental health.
Continuity of Patient Care↗
Neurological sequelae of the operation "baby lift" airplane disaster.
The aircraft disaster of the first flight of Operation "Baby Lift", which departed from Saigon, Vietnam, April 4, 1975, was survived by 149 orphaned children on their way to adoptive homes in the West. It had 157 passenger fatalities. The aircraft disaster exposed the surviving children to a complex disaster environment in which subatmospheric decompression, hypoxia, and deceleration were experienced, many children suffered a transient unconsciousness. We examined 135 surviving children between 1978 and 1985. The U.S. resident children were examined in the years 1979 to 1982 at an average age of 8 years and 6 months. They displayed the following symptomatology: attention deficit (> 75%), hyperactivity (> 65%), impulse disorder (> 55%), learning disabilities (> 35%), speech and language pathology (> 70%), and soft neurological signs (> 75%). The European children were examined in the years 1983 to 1985. On arrival at the adoptive home, 2 weeks after the accident they displayed the following symptomatology: muscle hypotonia (26%), seizures (2.5%), and regressed developmental milestones (33%). At the time of the diagnostic evaluations (1983 to 1985) the average age was 11 years and 8 months. They displayed the following symptomatology: attention deficit (59%), hyperactivity (52%), impulse disorder (48%), learning disabilities (43%), soft neurological signs (43%), epilepsy (16%), and speech and language pathology (34%). We conclude that a complex disaster environment can cause brain damage in children without prolonged unconsciousness, and that victims of disasters require a thorough evaluation from a multidisciplinary team.
Accidents, Aviation↗
[Experience and present status: glibenclamide (Daonil), a reference molecule].
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Blood Glucose↗
Outbreak and control of varicella in a neonatal intensive care unit.
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Adult↗
Hypothalamic norepinephrine depletion inhibits CRF-41 release following neural stimuli.
The effects of depletion of hypothalamic norepinephrine (NE) on median eminence (ME)-corticotropin-releasing factor (CRF-41) content, serum ACTH and corticosterone (CS) levels, following photic and acoustic stimulation, were investigated. While in intact rats these stimuli caused depletion in CRF-41 and a rise in ACTH and CS level, in rats pretreated with 6-hydroxydopamine (6-OHDA), these effects were prevented. This would suggest that the blockage in the release of ME CRF-41 into the portal plasma following neural stimuli in rats with hypothalamic NE depletion, is responsible for the inhibition of the pituitary-adrenocortical response.
Acoustic Stimulation↗
Serum antipyrine concentrations determined by micellar electrokinetic capillary chromatography.
We developed an assay for antipyrine in serum using micellar electrokinetic capillary chromatography. A capillary electrophoresis system with a 70-cm fused-silica capillary and pH 8.2 borate-sodium dodecyl sulfate buffer was used. Standard curves ranging from 0.5 microgram/ml to 25 micrograms/ml were analyzed. The resulting electropherograms showed no interfering endogenous peaks and the assay was linear in the range of concentrations analyzed. The intra-day and inter-day relative standard deviations ranged from 0.7 to 5.2% and 1.7 to 8.1%, respectively. Analytical recovery of antipyrine ranged from 78.2 to 105.0%. The theoretical plate number for antipyrine was calculated to be 561,000 +/- 79,000 plates/m.
Acetaminophen↗
[Syndrome of resistance to thyroid hormones].
Although rare, thyroid hormone resistance syndrome should be suspected on a biological profile combining high thyroid hormone and non-suppressed TSH plasma levels. Resistance to thyroid hormone can be classified into 3 forms: generalized, pituitary and peripheral, all three showing tissue resistance heterogeneity from one person to another, and from one tissue to another in the same subject. In the generalized and pituitary forms, thyroid hormone levels are high with paradoxically normal or increased TSH levels. The TRH test still stimulates TSH secretion, and only the highest doses of T3 successfully suppress TSH secretion. In the generalized form, euthyroidism is usual, whereas in the pituitary form hyperthyroidism requires treatment in order to lower TSH secretion. In the peripheral form, various symptoms of thyroid hormone deficiency may be observed, contrasting with normal T3, T4 and TSH serum levels, and requiring supraphysiological doses of T3 for correction. In most cases, familial occurrence can be evidenced, with an autosomal dominant or sometimes recessive mode of inheritance. Genetic analysis has identified, in the generalized form, more than 10 mutations of the thyroid hormone receptor beta gene, all resulting in an alteration in the T3 binding domain of the receptor. In the autosomal dominant form, tissue resistance may result from a "dominant inhibitory effect" of the normal receptor function by the mutant receptor. All these thyroid hormone resistance syndromes constitute exceptional models for studying the mechanisms of action of thyroid hormones. Simultaneous observations of the mutated receptors with various clinical and biological phenotypes should further our understanding of thyroid hormone receptor function.
Drug Resistance↗
[Nephropathy of massive obesity].
Glomerular proteinuria without significant functional disorders or histological lesions can be found in massively obese patients. Nephrotic syndrome, segmental hyalinization of the glomeruli and altered filtration are exceptional. In most cases, therefore, glomerular proteinuria requires only supervision without treatment. The physiopathogenesis of this nephropathy (renal vein hyperpressure?) has not yet been fully elucidated.
Humans↗
The dorsal hippocampus modifies the negative feedback effect of glucocorticoids on the adrenocortical and median eminence CRF-41 responses to photic stimulation.
In the present study we have evaluated the role of the dorsal hippocampus on the negative feedback effect of glucocorticoids (GC) following photic stimulation. In hippocampectomized rats the recovery of serum corticosterone (CS) to basal levels following photic stimulation, was significantly attenuated in relation to sham hippocampectomized rats. The inhibitory effect of either systemic dexamethasone administration or CS implanted in the paraventricular nucleus (PVN), on the adrenocortical responses to photic stimulation, was completely prevented in hippocampectomized rats in comparison to sham operated animals. In rats with sham operation, the depletion of median eminence CRF-41 induced by photic stimulation, was prevented by pretreatment with CS PVN implants or systemic dexamethasone. These effects were reversed in rats with dorsal hippocampectomy. The results suggest that the dorsal hippocampus modulates the negative feedback of GC on the adrenocortical response following photic stimulation at the PVN level and this effect is mediated by median eminence CRF-41.
Adrenal Cortex↗
[Radiofrequency ablation of idiopathic ventricular tachycardia].
Ablation by radiofrequency has recently come into use to treat cardiac arrhythmias, mostly supraventricular tachycardia. We describe 2 males aged 14 and 24, respectively, with idiopathic ventricular tachycardia. They underwent endocardial mapping and the exit points of the tachycardia were identified. In 1 of them tachycardia originated in the left ventricle, and the other in the outflow tract of the right ventricle. Radiofrequency ablation of the arrhythmia was successful in both.
Adolescent↗
Immunogenicity of Haemophilus influenzae type b polysaccharide-tetanus toxoid conjugate vaccine in infants.
OBJECTIVE: To compare the safety and immunogenicity of three investigational lots of Haemophilus influenzae type b polysaccharide-tetanus toxoid (PRP-T) conjugate vaccine in infants. DESIGN: A multicenter, randomized immunogenicity trial. Infants were vaccinated at 2, 4, and 6 months of age with one of three lots of PRP-T. A control group received H influenzae type b oligomers conjugated to CRM197 (HbOC). Serum was obtained before each injection and 1 month after the third dose, and assayed blindly for antibody in one laboratory. SUBJECTS: Four hundred eighty-four infants from private pediatric practices located in five geographic areas. MEASUREMENTS AND RESULTS: There were no significant differences in the number of adverse events reported for infants receiving PRP-T or HbOC, and the rates did not exceed those observed previously in infants given diphtheria-tetanus-pertussis vaccine alone. Total serum anti-PRP antibody responses were analyzed in 336 infants who met strict inclusion criteria. After one, two, or three doses, the respective antibody responses to each of the three lots of PRP-T and to HbOC vaccine were similar. The only exception was one lot of PRP-T, which after one or two injections elicited significantly higher geometric mean antibody responses than the other two lots or the HbOC vaccine. After a third injection, there were no significant lot differences. Combining the data from the different lots, there were no significant differences in the geometric mean antibody concentration after three doses of PRP-T or HbOC (8.3 vs 7.7 micrograms/mL), and 95% and 91%, respectively, of infants had greater than 1.0 microgram/mL of antibody. There were no significant differences in the magnitudes of the respective IgG1-, IgG2-, and IgM-specific antibody concentrations between infants given PRP-T or HbOC. CONCLUSIONS: The three investigational lots of PRP-T tested were safe and were as immunogenic as or more so than the licensed HbOC conjugate vaccine.
Age Factors↗
Acyclovir therapy for varicella in otherwise healthy children and adolescents.
Acyclovir has been approved in the United States and elsewhere as antiviral therapy for otherwise healthy children and adolescents with varicella. This development arose from multicentre placebo-controlled trials of acyclovir in normal patients, 2-18 years of age, which showed that the drug accelerated cutaneous healing, and reduced fever and related constitutional symptoms without harmful side effects. Acyclovir did not, however, decrease transmission of chickenpox within the household, nor was there any demonstrable effect of antiviral therapy on varicella complications. In this article, the background and rationale for the multicentre studies of acyclovir in normal paediatric patients with chickenpox is reviewed. The evidence for and against its routine administration within 24 hours of the eruption of skin rash is also discussed.
Acyclovir↗
Varicella zoster infections in bone marrow transplants.
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Acyclovir↗
Medial posterior hypothalamic input is involved in adrenocortical activation following forebrain limbic stimulation.
Previous experiments have demonstrated that posterior hypothalamic deafferentation, which involved also the medial forebrain bundle, has prevented the rise in serum corticosterone following limbic stimuli. Consequently, the effects of a small medial posterior hypothalamic deafferentation, excluding the medial forebrain bundle, on corticosterone responses following electrical stimulation of the hippocampus, amygdala, septum and reticular formation in the rat were studied. Posterior hypothalamic deafferentation did not change basal corticosterone levels but significantly inhibited the adrenocortical responses following stimulation of the above structures when compared to intact or sham-stimulated rats. Posterior hypothalamic deafferentation did not affect median eminence corticotropin releasing factor-41 content. It is concluded that a medial posterior hypothalamic input is involved in adrenocortical activation following limbic stimulation.
Adrenal Cortex↗
Interference with endogenous ras function inhibits cellular responses to wounding.
Wounding of tissue induces cellular responses that ultimately result in wound repair. Studies in tissue culture model systems indicate that these responses include induction of AP-1 regulated genes, cell migration and mitogenesis which are also characteristic of cellular responses to growth factors. Investigations have identified cellular ras proteins as critical components of growth factor-stimulated signal transduction pathways, however their role in the wounding response is less clear. Investigation of the potential involvement of c-Ras in this process utilized quiescent living bovine corneal endothelium cells (BCE) which were microinjected with ras dominant interfering mutant protein (N17) and subsequently stimulated by mechanical wounding. Analysis of these cells demonstrated that microinjection of dominant-interfering ras protein, but not control proteins, inhibited the wounding response as evidenced by diminished Fos expression, lack of cell migration and a block in DNA synthesis.
Animals↗
Recovery of atracurium and vecuronium neuromuscular block in the isolated forearm.
The duration of recovery from neuromuscular block after a 3 x ED90 dose of atracurium or vecuronium is similar in spite of a three-fold difference in their elimination half-lives. We have investigated simultaneous spontaneous recovery from equipotent doses of atracurium and vecuronium in the isolated forearms of volunteers in order to attempt to explain this paradox. Simultaneous administration of the two drugs, one in each of the subject's forearms, allowed direct comparison of recovery to be made against the same plasma concentration of drug. The recovery index of atracurium was found to be significantly longer than that of vecuronium. We suggest that this observation, when considered with the different plasma concentrations after a 3 x ED90 dose, helps to explain the similar duration of action of the two drugs during the recovery phase after a large systemic bolus.
Adult↗
Pre-reconstruction tattooing eliminates the need for skin grafting in nipple areolar reconstruction.
Tattooing the skin of the reconstructed breast as a prelude to reconstruction of the nipple provides a nipple areolar reconstruction that has a uniform color. There is no requirement for a skin graft donor site. Tedious tattooing of the nipple papule is avoided. It is much easier to tattoo a flat surface than a projecting papule, and this technique gives a more uniform color. We believe that this approach to nipple areolar reconstruction provides a simpler, dependable technique.
Female↗