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Biomedical subjects

S Levine

Publications and source records attributed to S Levine.

At least 307 records · Page 17Linked to original sources
PubMed1987

Impact of antihypertensive therapy on quality of life: effect of hydrochlorothiazide.

Six hundred and twenty-six male patients with mild to moderate hypertension were enrolled in a multicentre randomized double-blind clinical trial to determine the effect of methyldopa, captopril and propranolol on the quality of life of these patients. During the 6-month trial hydrochlorothiazide was added to the treatment programme of those patients whose blood pressure was not normalized. More individuals in the captopril group (33%) required hydrochlorothiazide than in the propranolol group (22%). As a group, those individuals who required a diuretic were heavier and had higher basal and end-of-study blood pressure than those individuals requiring only monotherapy. However, the basal quality-of-life indices were similar in the six treatment subgroups. The withdrawal rate from the study was twice as high for those patients treated with propranolol and methyldopa as for those treated with captopril, whether a diuretic was added or not. More individuals requiring a diuretic experienced sexual dysfunction and a substantial worsening of their general well-being and of physical symptom indices over the 24 weeks of the study (P less than 0.01), particularly in the captopril and propranolol treatment subgroups. In summary, the present results suggest that diuretic therapy may have a greater negative impact on the quality of life of hypertensive patients than captopril, propranolol or methyldopa alone.

Adult↗
PubMed1987

Work performance, absenteeism and antihypertensive medications.

Relationships between antihypertensive medications and selected aspects of work performance and absenteeism were explored in a multicentre, randomized, double-blind, clinical trial with 626 male hypertensive patients assigned to regimens of captopril, methyldopa or propranolol, either alone or supplemented as needed by a diuretic for blood pressure control. Patients previously on antihypertensive therapy did not differ from new patients in work absenteeism, both before and throughout the clinical trial. After a 24-week treatment period patients on captopril alone improved significantly over baseline in work-performance measures of mental acuity and job satisfaction-morale, while significant worsening in the methyldopa group and no change in the propranolol group occurred among patients given these drugs alone. When 24-week changes between groups not on diuretic were compared, significant differences in the measures appeared in favour of captopril. However, patients also taking a diuretic did not differ from baseline either within or between the three groups. Withdrawal from the trial because of lethargy and fatigue was significantly greater among patients on methyldopa and propranolol than among those receiving captopril. Absenteeism did not differ between the drug groups. The study shows that there are measurable differences in the impact of the antihypertensive drugs on aspects of work performance, and it underlines the importance of considering this factor in assigning patients to therapy.

Absenteeism↗
PubMed1986

Percutaneous inoculation of lymph nodes.

Injections into rat lymph nodes are easily performed percutaneously, without the need for a skin incision, if the nodes are enlarged in advance. The requisite enlargement of the popliteal lymph node can be obtained in 2 or 3 weeks by a single injection of tin powder or other particulate material into the foot. This method may be especially useful when multiple intranodal inoculations are contemplated.

Animals↗
PubMed1986

The effects of antihypertensive therapy on the quality of life.

We conducted a multicenter randomized double-blind clinical trial among 626 men with mild to moderate hypertension to determine the effects of captopril, methyldopa, and propranolol on their quality of life. Hydrochlorothiazide was added if needed to control blood pressure. After a 24-week treatment period, all three groups had similar blood-pressure control, although fewer patients taking propranolol required hydrochlorothiazide. Patients taking captopril alone or in combination with a diuretic were least likely to withdraw from treatment because of adverse effects (8 percent vs. 20 percent for methyldopa and 13 percent for propranolol). The treatment groups were similar in scores for sleep dysfunction, visual memory, and social participation. However, patients taking captopril, as compared with patients taking methyldopa, scored significantly higher (P less than 0.05 to less than 0.01) on measures of general well-being, had fewer side effects, and had better scores for work performance, visual-motor functioning, and measures of life satisfaction. Patients taking propranolol also reported better work performance than patients taking methyldopa. Patients taking captopril reported fewer side effects and less sexual dysfunction than those taking propranolol and had greater improvement (P less than 0.05 to less than 0.01) on measures of general well-being. Our findings show that antihypertensive agents have different effects on the quality of life and that these can be meaningfully assessed with available psychosocial measures.

Adult↗
PubMed1986

Facial electromyography in depression. Subgroup differences.

To study whether facial electromyographic (EMG) activity during affective imagery differed between normal subjects and depressive subtypes, we evaluated EMG responses in 29 normal controls, 37 endogenously depressed patients, and 26 nonendogenously depressed patients. Different imagery states produced more distinctive EMG patterns in normal controls than in depressed patients. Patients with endogenous depression had EMG levels that differentiated them from normal subjects and had significantly greater absolute values than the nonendogenous group in corrugator happy and corrugator sad imagery trials. Intensity of sad and happy imagery, age, and severity of depression did not systematically correlate with EMG activity among depressive subtypes.

Adult↗
PubMed1986

Regional suppression, therapy after onset and prevention of relapses in experimental allergic encephalomyelitis by mitoxantrone.

Mitoxantrone, a new antineoplastic anthracenedione drug, suppressed the development of experimental allergic encephalomyelitis (EAE) in rats when administered during the incubation period. One dose of mitoxantrone had a favorable effect on EAE even when withheld until after the onset of clinical signs. In a model of relapsing EAE, a single dose during a remission prevented the expected relapse. Mitoxantrone had a particularly favorable effect when administered at the site of inoculation of the encephalitogenic antigen and adjuvant, indicating the importance of its interaction with the regional draining lymph nodes. These results support the possible clinical use of mitoxantrone for immunosuppression.

Animals↗
PubMed1986

Morphologic effects of mitoxantrone and a related anthracenedione on lymphoid tissues.

A single non-toxic dose of mitoxantrone or a related anthraquinone derivative caused extensive destruction of splenic marginal zone cells in rats and mice. This was followed by phagocytosis of cell debris and long-lasting atrophy. Germinal centers of splenic follicles were also affected. Small doses gave a cumulative effect and tolerance did not develop. Regional draining (but not distant) lymph nodes also had lymphocytic necrosis. The localization of the lymphocytolysis in the spleen may be related to the open circulation of blood in the marginal zone, and to the distribution of B-lymphocytes or B-lymphocyte subsets.

Animals↗
PubMed1986

Spinal cord syndromes in the acquired immune deficiency syndrome.

Two patients with AIDS developed paraparesis. Neuropathological post mortem examination in one revealed cytomegalovirus polyradiculopathy, and in the second, vacuolar myelopathy which occurred in association with brain lesions resembling Marchiafava-Bignami Syndrome.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Critique on application of diaphragmatic time-tension index to spontaneously breathing humans.

Bellemare and Grassino (J. Appl. Physiol. 53: 1196-1206, 1982) have reported that the diphragmatic time-tension index (TTdi) (i.e., the product of mean transdiaphragmatic pressure/maximum transdiaphragmatic pressure and the inspiratory duty cycle) can be used as a predictor of diaphragmatic fatigue in humans. However, the publications of these authors do not directly address the question of whether inspiratory flow or transdiaphragmatic pressure should be used to calculate the inspiratory duty cycle. To gather data on this point, we computed TTdi by both methods in spontaneously breathing normal adult males (AMN) and age-matched males with chronic obstructive pulmonary disease (COPD) at rest and during treadmill exercise. During rest and exercise in both AMN and COPD, the fraction of the breathing cycle over which diaphragmatic tension was maintained (Tdi/TT) exceeded the fraction of the breathing cycle over which inspiratory airflow was maintained (TI/TT). Therefore, TTdi calculations using Tdi/TT were greater (P less than 0.05) than TTdi computations using TI/TT. However, this difference in TTdi values was relatively small (approximately 15%).

Diaphragm↗
PubMed1986

Description and validation of an ECG removal procedure for EMGdi power spectrum analysis.

We describe a cross-correlation procedure for removing contaminating electrocardiogram (ECG) complexes from the diaphragmatic electromyogram (EMGdi). First, the operator selects ECG templates from the EMGdi signal during expiratory intervals. Second, these templates are used to locate ECG complexes occurring during inspiratory EMGdi activity. Third, at the point of maximum correlation between the template and these ECG complexes, the template is adjusted in size and offset to "match" the ECG complex, and adjustments are determined by the linear regression coefficients. Finally, the modified template is subtracted from the EMGdi signal. To evaluate our method, we compared the power spectral density (PSD) obtained from processing EMGdi signals by our method with those obtained from the EMGdi signal in which ECG complexes had been removed by gating. Our results indicate that PSD obtained by these two different methods shows no statistically significant differences with respect to the following features: centroid frequency, median frequency, total power, standard deviation, skewness, and kurtosis.

Analysis of Variance↗
PubMed1986

Evaluation of a ventilatory muscle endurance training program in the rehabilitation of patients with chronic obstructive pulmonary disease.

To evaluate the role of ventilatory muscle endurance training (VMET) in the rehabilitation of outpatients with chronic obstructive pulmonary disease, we carried out a prospective random allocation trial of VMET versus IPPB. Data were obtained from 15 men allocated to VMET and from 17 men assigned to IPPB. The mean age of our experimental cohort was 61 +/- SEM 1 yr, and the FEV1 was 1.2 +/- 0.1 L. Prior to and after 6 wk of daily therapy, the following data were obtained on each subject: (1) vital statistics, (2) standard pulmonary function tests, (3) activities of daily living (ADL), (4) maximal sustainable ventilatory capacity (MSVC), (5) psychologic status (PS), and (6) exercise tolerance (ET). Prior to therapy, the VMET and IPPB groups showed no significant differences with respect to these parameters. After therapy, VMET subjects exhibited a greater increase (p less than 0.05) in MSVC than did IPPB subjects. However, VMET and IPPB groups did not differ with respect to improvements noted in ADL, PS, and ET. These results from our controlled study raise the possibility that some aspect of the experimental protocol, other than VMET, accounted for the improvements noted in ADL, PS, and ET.

Adult↗
PubMed1986

Rapid cortisol and corticosteroid-binding globulin responses during pregnancy and after estrogen administration in the squirrel monkey.

Plasma cortisol and corticosteroid-binding globulin (CBG) levels were assessed in pregnant squirrel monkeys and in intact and castrated males after estrogen administration. Pregnant females showed a rapid and dramatic rise in cortisol and CBG during the first 8 weeks after conception. Estrogen treatment also caused marked elevations in cortisol and CBG. Cortisol levels increased significantly by 24 h after estrogen injection and remained elevated for 6 weeks of treatment, but a relatively greater rise in CBG resulted in a higher CBG/cortisol ratio. The data support prior research indicating that estrogen can simultaneously stimulate adrenal output and the compensatory binding of circulating cortisol by increased CBG synthesis. In addition, it appears that even in the absence of exogenous treatment, the pituitary-adrenal axis of male squirrel monkeys is stimulated by estrogen derived either from the testes or by the peripheral conversion of testosterone to estrogen.

Adrenal Glands↗
PubMed1986

Combined rotary door flap and epiglottic laryngoplasty for reconstruction of large laryngotracheal defects in dogs.

Reconstruction of large laryngotracheal defects may require simultaneous application of more than one surgical technique. This paper reports the advantages gained by combining epiglottic laryngoplasty with the myocutaneous sternohyoid muscle rotary door flap. The two procedures complement each other in achieving structural and functional rehabilitation of extensive defects in the larynx and trachea. Avoidance of intraluminal stents and use of a tracheostomy procedure that does not require an indwelling cannula have yielded improved results.

Animals↗
PubMed1986

Adoptive transfer of allergic encephalomyelitis by inoculation of cells into lymph nodes.

Experimental allergic encephalomyelitis can be transferred passively by lymph node cells from actively immunized donor rats to immunologically naive syngeneic recipients. In the present work, passive transfer was accomplished by direct inoculation of donor cells into the recipient's lymph node, and this route was more effective than the conventional intravenous or intraperitoneal routes.

Animals↗