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Biomedical subjects

S Melamed

Publications and source records attributed to S Melamed.

At least 127 records · Page 7Linked to original sources
PubMed1985

Prediction of functional outcome in hemiplegic patients.

A follow-up study of 40 hemiplegic patients two years after discharge from hospital was aimed at (a) identifying variables capable of predicting general functional ability in everyday life (work, home, family and social life) and (b) examining the relationship between levels of functioning and subjective evaluation of their rehabilitation state. The results showed that a composite measure of functioning ability was closely related to self-reports of satisfaction in significant areas of life: physical well-being, emotional security, satisfaction of family and social needs and vocational self-actualization. The best objective predictor of overall domestic and outdoor functioning was the primary ADL (eating, dressing, bathing, etc.). Other significant variables were ambulation (walking freely for 300 meters), sustaining mental load and emotional acceptance of disability. Predisposing and concurrent diseases (such as congestive heart failure, diabetes mellitus, hypertension and others) were not found to be of predictive value. The findings thus obtained could provide the physician with a good prognostic tool to evaluate the rehabilitation outcome of hemiplegic patients. They also suggested that intervention aimed at emotional acceptance of disability could facilitate the rehabilitation process.

Activities of Daily Living↗
PubMed1985

Divided attention in brain-injured patients.

Clinical observations have shown that brain-injured patients perform poorly in tasks requiring attention. While selective and sustained attention has been extensively investigated, there is little systematic information on how brain-injured patients perform on divided attention tasks requiring simultaneous handling of and responding to two sources of information. This study was designed to analyse the behavior of hospitalized brain-injured patients as compared with matched normal controls in performing a dual task consisting of pursuit motor tracking coupled with delayed digit recall (DDR). Four two-minute trials were given. Time on target (TOT) and number of recall errors were recorded. It was assumed that the brain-injured group would (a) have lower TOT and more recall errors; and (b) show less learning effect. Results confirmed both expectations: (1) for the brain-injured group, TOT was lower and did not improve across trials; moreover, the number of recall errors was higher, increasing across trials; (2) for the control group, the number of recall errors was negligible across trials and TOT improved with time; (3) the normal trade-off between two simultaneous difficult tasks was not observed in the brain-injured group as they failed in both tasks; (4) the number of recall errors of the brain-injured subjects markedly increased towards the end of each trial, suggesting rapidly increasing fatigue. Thus, brain-injured patients appeared limited not only in their attention capacity but also in the variety of strategies they employ in processing information.

Adult↗
PubMed1985

Attention capacity limitation, psychiatric parameters and their impact on work involvement following brain injury.

A follow-up study conducted among brain-injured patients explored the correlation between attention capacity limitation and psychiatric parameters as well as their impact on work involvement, two years after hospitalization. Capacity limitation was identified as difficulties in dual-task performance which requires simultaneous attention and response to two sources of stimulation. Poor performance on one or both tasks included in the dual-task paradigm (pursuit motor tracking task and a verbal task) was correlated with psychiatric parameters of behavior, personality and thought. This also correlated with the inability reported by the patients to concentrate for long periods of time and to the feeling of fatigue after physical and mental effort. In addition, it was found that dual-task performance correlated with work involvement. It was concluded that there is a reciprocal relationship between the variables studied. Attention capacity limitations are manifested in various psychiatric parameters; conversely, some psychiatric parameters affect the performance on the dual-task. This highlights the difficulty such patients have in coping with work demands and their consequent inability to maintain steady employment.

Adult↗
PubMed1985

Behavioral disturbances as an expression of severity of cerebral damage.

The present study was designed to validate our ongoing clinical observations, which reveal that distinct clusters of psychiatric symptoms tend to develop following mild or severe brain injury, independently of injury location. These clusters are termed "Extroversion" and "Introversion" syndromes respectively. The symptoms constituting each syndrome manifest themselves along four domains: behavior, personality, affect and cognition. The study sample included 85 brain-injured patients recalled for a follow-up examination 2-3 years after discharge from hospital. Classification into Extroversion and Introversion was done on the basis of a structured psychiatric interview. Severity of brain damage was independently assessed by combinations of five parameters: unconsciousness and PTA duration, cognitive deficiencies, communication and locomotor disorders. The results supported our clinical observations, suggesting that severity of brain damage could also be assessed by the nature of psychiatric symptomatology exhibited following the injury.

Adolescent↗
PubMed1981

Bilateral maculopathy simulating 'cherry-red spot' in a patient with Crohn's disease.

A 23-year-old man suffering from Crohn's disease developed a bilateral maculopathy simulating 'cherry-red spot' with vision impairment and normal electroretinogram during total parenteral hyperalimentation, when copper and zinc serum levels were considerably decreased. The maculopathy rapidly subsided after cessation of the parenteral hyperalimentation and the addition of cooper and zinc. The cause of this maculopathy may be ocular involvement as part of the systemic disease owing to storage of the supplementary free amines and intravenous lipids, and the deficiency of zinc and copper.

Adult↗
PubMed1980

Corneal endothelial changes under induced intraocular pressure elevation: a scanning and transmission electron microscopic study in rabbits.

Intraocular pressure was artificially raised to 60--70 mmHg in 7 albino rabbits for periods of 15 minutes to 4 hours. The corneal endothelium of these eyes was studied by transmission and scanning electron microscopy. A correlation between exposure time to elevated IOP, clinical signs observed by slit-lamp examination, and extent of morphological damage is clearly shown. In eyes exposed to high pressure for 15 and 30 minutes corneas remained transparent and only minimal changes could be detected by SEM, which consisted of small areas of cell with unevenness of their surface, occasional cellular ruptures, and diminution of cilia and microvilli. After 1--2 hours of exposure small, solitary corneal opacifications appeared. In these eyes more severe morphological changes affecting larger areas were observed, with additional cellular blebbing, excariocytosis, cellular rupture, disintegration, and disappearance seen in SEM. Thin sections revealed swelling of mitochondria, disorganisation of endoplasmic reticulum, and the existence of myelin bodies. In eyes exposed for 3 and 4 hours to high IOP corneal haziness, implying stromal oedema, appeared. In these eyes the areas affected were larger, the extent of damage being more severe. Many areas were bare of endothelium, surrounded by scattered cellular debris, and showed cells with ballooning surfaces and multiple ruptures. Even in severe cellular damage cellular junctions appeared intact. It is assumed that endothelial cells are more sensitive to IOP elevation than the cellular junctions and that injury to the active pump system due to morphological damage is responsible for the resultant corneal oedema.

Albinism↗
PubMed1979

Laser iridotomy in closed-angle glaucoma.

An argon laser iridotomy was performed on 53 eyes of 34 patients with closed-angle glaucoma. Technically, all of the iridotomies were successful. Blue irides were more resistant to treatment than brown irides. The iridotomies were performed with high energy of 2 W and a very short exposure time of 0.01 to 0.04 s, thus minimizing thermal damage to adjacent tissues. Patients with narrow angles who underwent preventive laser irodotomy benefited most from the procedure, and all the eyes of this group maintained a normal intraocular pressure (IOP) after the iridotomy. Of the 20 eyes with acute angle-closure glaucoma, 17 maintained a normal IOP after iridotomy, and only three were resistant to this treatment, calling for filtering operations later. The IOP of eyes with chronic closed-angle glaucoma did not change after the procedure, and the iridocorneal angles remained practically the same. Argon laser iridotomy by this technique is highly recommended as the procedure of choice for eyes with acute angle-closure glaucoma and for preventive iridotomy in the fellow eye. The procedure is simple, is performed in the outpatient clinic, and engenders no major complications.

Follow-Up Studies↗
PubMed1979

The recurrence of intracranial meningiomas.

A series of 126 patients with meningioma, operated upon 7-17 years ago, is reviewed as to the recurrence of the tumour. The overall rate of recurrence of the histologically benign lesions was 29 per cent. The most important factors influencing the prognosis were the site of the tumour and the degree of radicality of excision. Both factors were illustrated best in the parasagittal meningiomas, which carry the highest rate of recurrence. Infiltration of tumour into adjacent bone does not necessarily carry a higher risk of a clinically relevant recurrence. There seems to be a great variation in the rate of growth of different meningiomas.

Adolescent↗
PubMed1978

Fuch's heterochromic iridocyclitis: an electron microscopic study of the iris.

The irides of two patients with Fuch's heterochromic iridocyclitis were investigated by electron microscopy. The main findings were abnormal melanocytes with relatively few, small, and at times immature melanin granules, abundance of plasma cells, and membranous degeneration of nerve fibers. The defective melanin production may be due to abnormal adrenergic innervation, either primary or secondary to the inflammatory process. The cause for this inflammatory reaction was not evident in this study.

Cataract↗
PubMed1977

GI pharmacology of polyethyleneimine I: effects on gastric emptying in rats.

Experiments were conducted to determine the effect of ingested polyethyleneimine upon gastric emptying of the fasted rat. Emptying was evaluated by the phenolsulfonphthalein and resin bead methods. The two techniques gave comparable results; both showed that this agent inhibited gastric emptying. A delay in gastric emptying could be detected within 15 min of intubation. The effect was dose related, quite long lasting (approximately 4 hr), and reversible. Commercially available, branched polyethyleneimines were highly active, but the linear polyethyleneimine was without observable effect. A branched polyethyleneimine derivative with all primary amine sites selectively acetylated also was inactive.

Animals↗
PubMed1977

GI pharmacology of polyethyleneimine II: motor activity in anesthetized dogs.

The effects of orally and intravenously administered doses of polyethyleneimine were observed in 18 chloralose-urethan-anesthetized dogs. Polyethyleneimine produced an initial augmentation of rhythmic segmenting gastric antral contractions, a copious flow of gastric mucus, increased segmenting and propulsive activities of the small and large intestines, and occasional micturition and defecation. The gastric corpus and fundic regions became relaxed and enlarged. These events were associated with the prompt appearance of retching. The retching response to oral administration could only be abolished by bilateral vagotomy or bilateral sympathectomy. The skeletal muscle component of retching was blocked by tubocurarine. Intravenous administration of chlorpromazine blocked the retching response and gastric corporal atonia to either intravenous or oral doses of polyethyleneimine. Either oral or intravenous administration of polyethyleneimine produced no detectable changes in the lead II ECG but was associated with marked transient reductions in both mean and pulsatile arterial blood pressures. These depressor effects showed clear tachyphylaxis. In all cases where GI effects were noted, respiration was augmented and erratic in a manner associated with the retching responses.

Animals↗
PubMed1977

A comparative study of hepatitis B and non-B in hospitalized adults in an endemic area.

The epidemiologic, clinical and laboratory features of 40 adults with acute viral hepatitis type B were compared with those of 40 adults with hepatitis non-B. Overall, the clinical presentations were remarkably similar and the etiology could not be determined in individual cases. An exception to this was that all post-transfusion cases in this series were affected by hepatitis B. Men predominated in both the hepatitis B and non-B groups. There was a tendency to seasonal clustering in summer/autumn in both groups. Hepatitis B patients were significantly older and 59% of them had a history of possible parenteral exposure during the six months preceding admission. On the other hand 76% of patients with hepatitis non-B had no apparent parenteral exposure. Dental treatment, injections and contact with jaundiced patients were recorded in both groups and were therefore of no value in determining the exact etiology in individual cases. Fever was more common in hepatitis non-B, while the onset of the disease was insidious and afebrile in 80% of patients with hepatitis B. As a group, patients with hepatitis B had more extensive liver injury and a more prolonged clinical course, and the only fatality was in this group. Cholestatic features were rare and extrahepatic immune complex disease was extremely uncommon in both hepatitis B and non-B.

Adult↗