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Biomedical subjects

S Levin

Publications and source records attributed to S Levin.

At least 163 records · Page 9Linked to original sources
PubMed1990

Arthrodesis of the metacarpophalangeal joint of the thumb in children and adults. Adjunctive treatment of thumb-in-palm deformity in cerebral palsy.

A hypermobile hyperextension or hyperflexion deformity of the metacarpophalangeal (MCP) joint associated with thumb-in-palm deformity in 90 patients affected by cerebral palsy was treated by arthrodesis with or without soft-tissue procedures. Twenty-two of these patients were adults with closed physes, and 68 were children or adolescents with open growth plates. The MCP joint fusion was usually accompanied by intrinsic muscle lengthening and/or extrinsic tendon transfer, but occasionally it was the only procedure performed to diminish the thumb-in-palm position. Even in four-year-olds, joint fusion was a predictable procedure to establish stability of that joint without disturbing longitudinal or circumferential growth. Measurable function was improved to a mild or moderate degree in 44 of the 50 children who were followed to maturity. Eighteen of the 68 children were unavailable for follow-up evaluation. Six of the 50 followed patients showed no functional improvement, although arthrodesis of the MCP joint occurred in four of the six. The other two patients were operated on when they were 12 years of age and developed a fibrous union that was painless and stable when they were adults. Even those patients who had no functional improvement did have improved appearance and easier control of the affected hand when it was manipulated by the opposite hand. The children were followed to maturity with age-matched cerebral palsy control patients. There was no significant disturbance in growth of those thumbs that had MCP joint fusion when the physes were open.

Adolescent↗
PubMed1989

Randomized study of intravenous/oral ciprofloxacin versus ceftazidime in the treatment of hospital and nursing home patients with lower respiratory tract infections.

This study determined the efficacy of intravenous ciprofloxacin in the treatment of institutionalized patients with lower respiratory tract infections. Hospitalized adults with hospital/nursing home-acquired pneumonia were randomly assigned to receive either intravenous ciprofloxacin or ceftazidime. When deemed feasible, therapy was changed to oral ciprofloxacin for patients who received ciprofloxacin intravenously or to any alternative oral therapy for patients who received ceftazidime. All 23 patients who received ciprofloxacin had a favorable response versus 15 of 21 patients who received ceftazidime (p less than 0.025). One patient with a favorable response to ceftazidime developed a superinfection and one patient had a relapse during subsequent alternative oral therapy. However, patients who received ceftazidime were more severely ill than those who received ciprofloxacin on the basis of APACHE II scores.

Administration, Oral↗
PubMed1989

Thiamine deficiency in utero alters response to ethanol in adulthood.

To determine whether prenatal thiamine deficiency, a frequent concomitant of alcoholism, reduces the response to ethanol during adulthood in the rat as does ethanol exposure in utero (Abel et al. 1981), pregnant Sprague-Dawley rats received either control or thiamine deficient diets together with daily injections of the thiamine antagonist pyrithiamine. At 7 months of age, male offspring were exposed to precisely regulated ethanol vapor concentrations in an inhalation chamber for 24 h and blood ethanol concentrations (BECs) and ethanol-induced intoxication were determined. Prenatally thiamine deficient rats and controls were indistinguishable in terms of appearance, body and liver weights, and the ratios of liver to body weight and brain to liver weight. However, total body water was significantly greater, and BECs and behavioral impairment were decreased, in the experimental rats. These findings indicate that prenatal thiamine deprivation is associated with reduced pharmacologic effect of ethanol as a result of increases in its volume of distribution and rate of metabolism.

Animals↗
PubMed1989

The effect of leukotriene-B4 receptor antagonist, SC-41930, on acetic acid-induced colonic inflammation.

SC-41930, 7-[3-(4-acetyl-3-methoxy-2-propylphenoxy)-propoxy]-3,4-dihydro-8-p ropyl- 2H-1-benzopyran-2-carboxylic acid, is a potent in vitro leukotriene-B4 (LTB4) receptor antagonist. LTB4 levels are elevated in colonic tissue of inflammatory bowel disease (IBD) patients which may account for the high degree of neutrophil (PMN) infiltration. The guinea pig acetic acid-induced colonic inflammation model has characteristics of IBD including PMN infiltration, edema, ulceration and necrosis. The model was used to evaluate the effect of SC-41930. SC-41930 was given orally, 30 min before and after intrarectal administration of 3% acetic acid. The PMN marker enzyme, myeloperoxidase, was measured along with histological evaluation to assess inflammation. Both parameters showed significantly less inflammation in SC-41930 treated animals with an oral ED50 of 20 mg/kg. These study results with an LTB4 receptor antagonist indicate a role for LTB4 in colonic inflammation and that an LTB4 receptor antagonist may be beneficial for treatment of IBD.

Acetates↗
PubMed1989

Possible role of natural cytotoxic activity in the pathogenesis of AIDS.

In an attempt to assess the role of immune cytotoxic activity in the sequence of events leading to the acquired immunodeficiency syndrome (AIDS), natural cytotoxic activity was studied in 17 asymptomatic homosexual males, seropositive for anti-human immunodeficiency virus (HIV) antibodies, as compared to 16 of their seronegative counterparts and to 14 control healthy heterosexual individuals. Cell (contact)-mediated cytotoxicity (CMC) as well as cytotoxin (CTX) production by lipopolysaccharide (LPS)-stimulated, phytohemagglutinin (PHA)-stimulated, HeLa tumor cell-stimulated, and unstimulated peripheral blood mononuclear cells (PBMC) were determined using HeLa cell monolayer cultures, sensitized with cycloheximide, as targets. The CMC was markedly enhanced in the seropositive group (28 +/- 21 (mean +/- SD) lytic units/10(6) PBMC) as compared to the seronegative group (17 +/- 7; P less than 0.005) and to the heterosexual group (13 +/- 6; P less than 0.05). Likewise, CTX production by unstimulated PBMC from seropositive homosexuals (19 +/- 26 units/ml) was higher than that observed in the other groups (both 4 +/- 4 units/ml; P less than 0.05). CTX production by PHA-stimulated, LPS-stimulated, and HeLa cell-stimulated PBMC was significantly enhanced in both the seropositive and seronegative groups in comparison to the normal heterosexual controls. These results suggest that increased cytotoxic activity may be present in homosexuals prior to their exposure to HIV, and may be further enhanced after HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1989

The interferon system in subacute sclerosing panencephalitis and its response to isoprinosine.

Plasma interferon activity (IFN) and its spontaneous and stimulated production by peripheral blood mononuclear cells (PBMC) was studied in 11 patients with subacute sclerosing panencephalitis (SSPE) and age-matched healthy controls. The patients, similar to the healthy controls, had no detectable plasma IFN activity. However, their PBMC failed to produce IFN in response to stimulation with poly I:C and PHA. After isoprinosine administration to 7 patients for several days a significant increase in plasma IFN activity was observed and their PBMC responded to stimulation by producing IFN. The long-term effect of isoprinosine on the IFN response was evaluated in 3 patients who had been treated for 57-88 days. Induction of the abolished IFN production was observed with initiation of therapy. However, discontinuation of isoprinosine for 10 days resulted in recurrence of the inactivation state of the IFN system.

Adolescent↗
PubMed1989

Contributions of clinical neuropsychology to the study of schizophrenia.

Clinical neuropsychological findings are examined with respect to competing hypotheses about localized neuropathology in schizophrenia. Two general models of structural and functional impairment are described. The first addresses deficits in cortical/subcortical processes concerned with arousal, attention, and higher cortical functions. The second addresses impairments in the balance of lateralized functions consistent with left hemisphere overactivation. Empirical data provide support for both models, and suggest that the explanatory power of these models may vary when they are applied to different subtypes of schizophrenia.

Cerebral Cortex↗
PubMed1989

Clinical impact of rapid identification and susceptibility testing of bacterial blood culture isolates.

Two hundred twenty-six patients with bacteremia were prospectively enrolled in a randomized trial that was performed to determine the clinical impact of the receipt of in vitro microbiological data by the physician soon after organism detection as opposed to having the physicians wait until similar data were available by routine methods. Identification and antibiotic susceptibility patterns of 110 isolates were determined by direct inoculation of the Vitek AutoMicrobic system (Vitek Systems, Inc., Hazelwood, Mo.) with a sample from a positive blood culture vial. One hundred sixteen isolates were processed by routine methods. Microbiological results were available within an average of 8.8 h by the direct method versus an average of 48 h by the routine method. In both groups an infectious disease fellow used the information to make therapeutic recommendations to the responsible physician. When compared with that provided by the routine method, the information provided by the direct method was significantly more likely to result in an initiation of antibiotic therapy, a change to more effective therapy, or a change to less expensive therapy. Recommendations were significantly more likely to be followed in patients whose isolates were processed by the direct method versus the routine method. A projected savings of $158 per patient was estimated for the patients who were changed to less expensive therapy or in whom antibiotics were discontinued because results were available sooner. These cost savings, coupled with changes in therapy made for reasons of efficacy, support the usefulness of the earlier reporting of the identity and antibiotic susceptibility patterns of bacterial blood culture isolates.

Bacteria↗
PubMed1989

Prostaglandins and the gastric epithelium: effects of misoprostol on gastric epithelial cell proliferation in the dog.

The effects of the methyl ester analogue of prostaglandin E1, misoprostol, on gastric epithelial cell proliferation were investigated in six dogs given 300 micrograms/kg/day of misoprostol orally for 11 weeks and in six control dogs given placebo for 11 weeks. Misoprostol treatment resulted in a 36% increase in stomach weight (p less than 0.01) and a 30% increase in the length (measured as the cell column count from the base/neck junction to the surface) of the fundic gastric glands (p less than 0.01). This mucosal hyperplasia was predominantly caused by enlargement of the foveolar region of the gland, with little change occurring in the neck or in the isthmus. The hyperplasia was the result of an increased number of mitotic (p less than 0.01) and DNA synthesising cells (p less than 0.05) in each gastric gland, which resulted in a significant increase in the gland cell production rate, from 22.5 to 42.6 cells per gland per day (p less than 0.05).

Alprostadil↗
PubMed1989

Multicentric giant-cell reparative granuloma. A case in the foot.

A case of multicentric giant-cell reparative granuloma in the foot of a 17-year-old boy is reported. Initially, there was a calcaneal lesion and 6 months later, three additional lesions in the forefoot. The calcaneal lesion was treated by curettage and bone grafting, and those in the forefoot by wide excision. The patient has now been free of disease for 18 months.

Adolescent↗
PubMed1989

Interferon treatment in acute progressive and fulminant hepatitis.

A small proportion of patients with acute viral hepatitis run a progressive fulminant course ending in acute liver failure with encephalopathy, and with a mortality rate of 75-80%. In small children and pregnant women mortality is even higher. We have treated 32 patients of all ages with acute progressive and fulminant hepatitis over the last 7 years in an uncontrolled trial with human interferon-alpha (HulFN-alpha), with i.m. doses of 3 x 10(6) u/day (70,000 u/kg per day for infants) for 8 +/- 3 days (mean +/- SD.) In 17 patients hepatitis was due to hepatitis A virus, in 7 to hepatitis B virus, in 6 to non A-non B virus and in 1 case each to herpes and cytomegalovirus. Sixteen patients (50%) recovered including 9 of 22 (41%) who were in Grades III-IV coma when treatment was started. Only 1 of 8 children less than 4 years of age recovered, whereas 15 of 24 (62%) older children and adults survived. Two of three pregnant women with acute fulminant hepatitis survived. In patients who recovered, improvement was often noted on about the fifth day of IFN treatment: 9 of 16 patients died before completing 5 days of therapy. Our studies of the IFN system response to hepatitis viruses showed that the greater majority of patients produce IFN in the acute stage of the infection. However, a minority have a defective IFN response that is more severe and more common in progressive fulminant hepatitis, and in several of these patients IFN response was completely lacking. It is in these cases that IFN treatment is likely to have the greatest value. On the basis of these encouraging preliminary results, it is suggested that a well-controlled, double-blind study be done to evaluate the effectiveness of HulFN-alpha treatment when given early during the course of acute progressive viral hepatitis.

Acute Disease↗
PubMed1989

Cerebral vasculitis and hemorrhage in an adolescent taking diet pills containing phenylpropanolamine: case report and review of literature.

Phenylpropanolamine is consumed by millions of persons annually and is sold in varying dosages and combinations for different ailments. Adolescents are an especially susceptible group influenced by its action as an anorexiant. During the past 6 years, several cases have been reported of patients in whom intracerebral hemorrhage developed, with and without concomitant angiographic evidence of vasculitis, after taking phenylpropanolamine. In this report, the 11th documented case of phenylpropanolamine-associated intracerebral hemorrhage with vasculitis is described. This is the first case in an adolescent following the ingestion of an overdose of diet-aid pills. Cases of intracerebral hemorrhage with vasculitis have also been described in users and abusers of amphetamine, methamphetamine, and ephedrine, all sympathomimetics with chemical structures similar to that of phenylpropanolamine. This report should alert pediatricians to the potential use by their patients of nonprescription medications containing phenylpropanolamine whenever unexplained acute cerebral symptoms are present.

Adolescent↗
PubMed1989

The role of prophylactic antibiotics in the prevention of prosthetic device infections.

This article examines available information concerning the use of antimicrobial agents to prevent prosthetic device infection at the time of surgical implantation. Additionally, the authors comment on the dearth of information concerning prophylactic antibiotics prior to elective surgical or dental procedures to prevent contamination of prosthetic devices already in place.

Anti-Bacterial Agents↗