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Biomedical subjects

Y Melamed

Publications and source records attributed to Y Melamed.

At least 73 records · Page 4Linked to original sources
PubMed1994

Seasickness susceptibility, personality factors, and salivation.

The present study investigates the possible relationship between motion sickness susceptibility, personality factors and salivation. Personality factors, as evaluated by the Eysenck Personality Questionnaire, and salivary composition and flow were measured in a group of 29 subjects highly susceptible to seasickness and in a group of 25 non-susceptible subjects. The non-susceptible group had significantly higher psychoticism scores and significantly lower salivary amylase levels compared to the highly susceptible group. A significant positive correlation was found between psychoticism scores and the amount of the increase in salivary flow in response to gustatory stimulation. These results provide more data in support of a connection between motion sickness susceptibility, personality, and the autonomic nervous system.

Adolescent↗
PubMed1993

[Treatment of the diabetic foot by hyperbaric oxygen].

Diabetic foot wounds are consequences of the neuropathy and the small and large vessel disease that complicate diabetes. At the cellular level, the result is hypoxia which impairs wound healing. Hyperbaric oxygenation (HBO) may be a useful adjuvant to wound care. It leads to enhanced oxygenation of the affected tissues, has an antiseptic effect, reduces edema, and accelerates collagen production and angiogenesis, thus enhancing tissue repair. 14 diabetics with chronic nonhealing wounds which did not respond to treatment for at least 3 months were treated by HBO. All had palpable pedal pulses. Transcutaneous measurements of tissue pO2 showed elevation from 20 +/- 10 mm Hg during air breathing to 643 +/- 242 mm Hg while breathing pure oxygen at 2.5 ATA. They were treated with HBO in 56 +/- 10 consecutive HBO sessions. In 11 there was complete wound healing, while in 1 there was partial response, in 1 minimal response, and in 1 a transient response. HBO is useful in chronic nonhealing wounds of the diabetic foot and of the diabetic foot with impending amputation. It is a safe mode of therapy, but further studies are required to establish its efficacy and to ascertain which diabetic patients and wounds will benefit the most from it.

Diabetes Complications↗
PubMed1993

Spinal cord decompression sickness in sport diving.

OBJECTIVE: To summarize 16 years' experience in the diagnosis and treatment of spinal cord decompression sickness in Israel. DESIGN: The survey data were collected firsthand by physicians trained in underwater diving medicine. SETTING: The Israeli Naval Medical Institute, Israel's national hyperbaric referral center. PATIENTS: Sixty-eight sport divers diagnosed as having spinal cord decompression sickness. INTERVENTIONS: Hydration and 100% oxygen breathing until the patient reached the hyperbaric chamber. All patients received recompression therapy on US Navy treatment tables using oxygen, except for six who were treated by Comex Treatment Table CX-30, which uses helium in addition to oxygen. MAIN OUTCOME MEASURES: Neurological examination after the completion of recompression therapy. RESULTS: Forty-one percent of the dives were performed within the decompression limits of the US Navy standard decompression tables. Risk factors were fatigue, circumstances suggesting dehydration, and extreme physical effort. The most common presenting symptoms were paresthesias, weakness of the legs, lower back pain, or abdominal pain. Full recovery was achieved in 79% of the patients. Spinal symptoms appeared immediately on surfacing in six of the eight patients who continued to have multiple neurological sequelae. CONCLUSIONS: United States Navy air decompression tables appear not to be completely safe for sport divers. Even mild spinal symptoms identified on surfacing should be treated vigorously. High-pressure oxygen-helium therapy seems to be a promising alternative in cases of severe spinal cord decompression sickness.

Adult↗
PubMed1993

Hyperbaric oxygenation for arterial air embolism during cardiopulmonary bypass.

The incidence of systemic air embolism during cardiopulmonary bypass is estimated to be 0.1%. However, the vast majority of instances are unreported and quietly ignored. The result may be disability or death. The control of air embolism obviously lies in prevention. The definite and specific treatment of this complication is hyperbaric oxygen. We report 6 patients referred to our institute because of air embolism during cardiopulmonary bypass. Of the 4 patients in whom hyperbaric oxygen therapy was delayed for 17 to 20 hours, 2 showed partial neurological improvement, as opposed to the success of hyperbaric oxygen therapy in the 2 patients in whom the delay was minimal. We conclude that as soon as the proposed open heart operation has been completed and there is an indication that air embolism has occurred, the patient should be treated with hyperbaric oxygen as quickly as possible, even before neurologic manifestations of cerebral ischemia appear.

Aged↗
PubMed1993

Treatment of necrobiosis lipoidica diabeticorum by hyperbaric oxygen.

Necrobiosis lipoidica diabeticorum is a chronic cutaneous complication of diabetes mellitus with microangiopathy as an important pathophysiologic factor. Because of the known success of hyperbaric oxygen in the treatment of chronic non-healing wounds, we used this mode of therapy to treat a diabetic patient with ulcerated necrobiosis lipoidica of 7 years' duration, refractory to medical and surgical treatment. The patient received daily sessions of hyperbaric oxygen therapy. There was considerable improvement during the course of the treatment, with complete closure of all the ulcerations after 98 sessions. The success of this treatment emphasizes the role of hypoxia in the pathogenesis of the lesion. This simple and safe treatment method may be a good solution for patients with chronic nonhealing necrobiosis lipoidica which fails to respond to other therapeutic approaches.

Adult↗
PubMed1993

Oxy-helium treatment of severe spinal decompression sickness after air diving.

Spinal cord injury in DCS after air diving is relatively frequent and often has late sequelae. U.S. Navy oxygen tables are sometimes not satisfactory. The advantage of using helium in these cases is based theoretically on its physical properties and has been demonstrated in animal models. We have introduced the Comex-30 (CX-30) oxy-helium table as an integral part of our treatment protocol for severe spinal DCS. We summarize here our clinical experience with seven cases. A case was considered severe if clinical assessment suggested progressive neurologic injury to the spinal cord or roots. Except for one case, the initial treatment was CX-30 followed by HBO sessions as indicated. Of the seven patients treated, five made a full recovery and the remaining two were left with mild neurologic sequelae.

Adult↗
PubMed1993

Effect of a single exposure to hyperbaric oxygen on blood mononuclear cells in human subjects.

We studied the effect of a single exposure to a therapeutic profile of hyperbaric oxygen on blood mononuclear cell subset. Twenty healthy volunteers were exposed to 0.28 MPa for 90 min. Thirteen breathed pure oxygen and seven were control subjects exposed to compressed air at the same pressure. Venous blood samples were drawn before HBO exposure, immediately on exit from the chamber, and 24 h later. Immediately after the exposure, a significant increase was observed in the percentage and absolute number of CD8 (suppressor/cytotoxic) T cells, with a concomitant decrease in the CD4 (helper/inducer) T cells. These changes resulted in a decreased CD4:CD8 ratio. A rise was also observed in the number of HLA-DR antigen-bearing cells, with a transient increase in monocytes. There was no change in the total count and percentage of T cells (CD3), B cells, and NK cells. Twenty-four hours after HBO exposure there was a partial reversal of the decrease in the mean CD4:CD8 ratio, but it was still significantly lower than preexposure values. The fast reversibility of the change in the CD4:CD8 ratio suggests specific HBO-induced shifts and sequestration of T-cell subpopulations.

Adult↗
PubMed1993

Pulmonary barotrauma after a free dive--a possible mechanism.

Pulmonary barotrauma during scuba diving is a life-threatening event. In a skin diver, who does not use compressed air, this complication is rare and its pathophysiology is not readily understood. We present a young, healthy skin diver who suffered pneumomediastinum and subcutaneous emphysema after a sequence of free dives to 5 m, and suggest a possible mechanism.

Adult↗
PubMed1993

Delayed hyperbaric treatment of cerebral air embolism.

Urgent exposure to hyperbaric oxygen (HBO) is currently accepted as an effective therapy for cerebral air embolism. The diagnosis of air embolism in the critically ill post-surgical patient is frequently difficult and therefore the initiation of specific therapy is often delayed. Only limited information is currently available on the effects of delayed HBO treatment in these patients. We recently used HBO to treat five patients with cerebral air embolism resulting from invasive medical procedures; hyperbaric treatment was begun 15-60 h after the embolic event. The causes of air embolism were: cardiopulmonary bypass accidents, pulmonary barotrauma induced by mechanical ventilation, and central vein catheterization. All patients received initial treatment according to U.S. Navy Compression Table 6A in a multiplace chamber, followed by subsequent treatments with 100% O2 at 2.5 to 2.8 ATA for 90 min as indicated. Significant, partial or complete recovery was observed in three patients, one patient did not respond, and one died. The salutary effects of HBO in our subgroup of patients suggest that this treatment should be used in cerebral air embolism even when referral to a hyperbaric facility is delayed.

Adult↗
PubMed1992

[Hyperbaric oxygen for neuropsychiatric sequelae of carbon monoxide poisoning].

A broad range of neuropsychiatric abnormalities, including dementia, psychosis, and parkinsonism, as well as almost every known neurologic syndrome, can occur following carbon monoxide (CO) poisoning. These symptoms develop 2-40 days (usually 2-3 weeks), after initial exposure. There is an incidence of recurrence of up to 40%. However, in recent years the neuropsychiatric sequelae appear to have been occurring less frequently, perhaps as a direct result of the use of hyperbaric oxygen (HBO) therapy. There is no specific therapy for this complication, but up to 75% recover within 12-18 months. Myers et al. (Ann Emerg Med, 14: 1163, 1985) found HBO to be effective for the neuropsychiatric sequelae. We report a 19-year-old man who developed late psychiatric disturbances despite the use of HBO for acute CO intoxication. The neuropsychiatric symptoms, which developed 3 days after full recovery of consciousness, resolved completely when HBO therapy was reinstituted. 6 months later he was functioning normally with no neuropsychiatric symptoms.

Adult↗
PubMed1992

Massive air embolism--a possible cause of death after operative hysteroscopy using a 32% dextran-70 pump.

Although considered a safe procedure, operative hysteroscopy has been reported to result in serious and even fatal complications. A fatal outcome is described after operative hysteroscopy. The attending team made a diagnosis of massive air embolism. However, HBO therapy, which is the specific treatment for air embolism, yielded only transient improvement. The pathologist's diagnosis on autopsy was anaphylaxis. These two complications must be borne in mind during the procedure, and a contingency plan developed for dealing with them should they arise.

Adult↗
PubMed1992

Anaerobic osteomyelitis in patients with Gaucher's disease.

Bone involvement in patients with Gaucher's disease is common, and some of its clinical manifestations may resemble acute osteomyelitis. In addition, many studies have emphasized the high risk of secondary infection when surgical procedures are performed at the site of the involved bone. Nevertheless, these infections have never been well documented in the literature. Presentation of a patient with Gaucher's disease and osteomyelitis due to Prevotella (Bacteroides) melaninogenica provided us the opportunity to review 10 other similar case reports documented in the literature since 1966. This review suggests that acute hematogenic osteomyelitis is an uncommon complication of Gaucher's disease, but it is of interest that in most cases it is due to unusual organisms, particularly anaerobes.

Adult↗