The social scientist's view of the neighborhood health center as a new social institution.
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Biomedical subjects
Publications and source records attributed to S Levine.
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PURPOSE: Although cardiac and pulmonary rehabilitation are frequently considered together, differences in the two populations have not been evaluated adequately. METHODS: This study compared patients who were referred to outpatient cardiac and pulmonary rehabilitation over a 1-year period at the authors' institution. Fifty-five cardiac rehabilitation patients (CR) and 47 pulmonary rehabilitation patients (PR) were studied with respect to age, gender, weight, smoking history, functional status, employment status, numbers and types of diagnoses and medications, and number of recent hospitalizations and hospital days. RESULTS: Cardiac rehabilitation patients were approximately 7 years younger, smoked less, were somewhat heavier, had a markedly better functional status, and were more likely employed than their counterparts in pulmonary rehabilitation. In addition, this group had fewer diagnoses and used fewer medications than PR patients. The number of hospitalizations and hospital days in the year preceding rehabilitation, however, were greater in CR patients than in PR patients. CONCLUSIONS: CR patients and PR patients are quite distinct with respect to demographics, functional status, comorbidity, and hospital resource consumption.
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Intraperitoneal injection of rats with two doses of pertussis vaccine produces a small amount of ascitic fluid. Much larger amounts of fluid are produced when two spaced injections of the vaccine are preceded by a small amount of liquid petrolatum. A similar result is obtained by a single injection of pertussis vaccine emulsified in liquid petrolatum and Arlacel A. Ascites produced without tubercle bacilli or tumor cells may increase the use of rats for antibody production.
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Between 10 and 30% of depressed patients, mostly bipolar, develop a therapy-resistant illness. The known causes of such chronic evolutions are discussed: misdiagnosis (underlying schizophrenia, personality disorder or dementia), drug-induced depression (neuroleptics), systemic disease (hypothyroidism, multiple sclerosis, cardiovascular or neoplastic disease etc.), or lack of efficacy (drug compliance, insufficient dosage). Remedies are suggested: adequate dosage, drug combination (Newcastle cocktail. tricyclic antidepressant + MAOI, imipramine + T3), carbamazepine in lithium-resistant cases, alprazolam, reduction in vanadium intake, sleep deprivation, psychosurgery.
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BACKGROUND AND OBJECTIVES: A case of delayed respiratory arrest in the combined spinal-epidural anesthesia (CSEA) is described. This event was likely due to morphine injected through the epidural catheter, unintentionally entering into the subarachnoid space through the hole in the dura that was made previously by the spinal needle in the needle-through-needle technique. METHODS: The CSEA is a popular new regional anesthesia that combines the benefits of the spinal and epidural injections. The needle-through-needle technique, which is only one of the various techniques to accomplish CSEA, may increase the risk of unintentionally allowing the entry of the epidural catheter into the subarachnoid space because the spinal needle and epidural catheter have the same pathway. RESULTS: This is the second case report of this event with the needle-through-needle technique. The FDA has recently approved this needle-through-needle technique. CONCLUSIONS: Careful attention to technique is necessary with utilization of CSEA.
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OBJECTIVE: The purpose of this work was to develop an animal model of sclerosing encapsulating peritonitis, a complication of continuous ambulatory peritoneal dialysis in which the intestines are conglomerated into an ovoid cocoonlike structure. DESIGN: Toward this end, rats were injected with a chemical irritant (household bleach) intraperitoneally. One week later, before the resultant peritonitis could cause adhesions, 10 or 25 mL of fresh whole rat blood was injected into the peritoneal cavity. Two weeks later, the effect of the treatments was evaluated by macroscopic and microscopic study. RESULTS: The irritant caused a chemical peritonitis. The subsequently injected blood clotted on the surfaces of the inflamed intestines, and contraction of the clot (syneresis) was responsible for bringing the intestinal loops together. This conglomeration was made permanent by the fibrosis evoked by the chemical peritonitis. The end result was an ovoid encapsulated mass of intestines and other viscera. CONCLUSION: An animal model for an abdominal cocoon has been produced. It can be used for studies of the pathogenesis and prevention of this complication of peritoneal dialysis.