Biomedical subjects
Publications and source records attributed to Y Melamed.
The pulmonary manifestations of decompression sickness have been attributed to various mechanisms, all of which invoke bubble formation and presence in the lung as the cause of symptoms. A case of persistent "chokes" syndrome, which responded to recompression of 72 h after presentation, is described. The possible physiological mechanisms and the late response to therapy is discussed.
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The extent of hypercapnia in oxygen-breathing subjects was investigated during rest and exercise (650 kpm/min). Divers, ex-divers, and non-divers were studied. Carbon dioxide retention was judged by end-tidal Pco2 values achieved after a few minutes at each state. End-breath-hold (EBH) PAco2 was also measured in the two states to assess the contribution of breathing pattern to CO2 retention. Findings indicated a pronounced hypoventilation and hypercapnia in the divers during exercise, and a mean exercise EBH PAco2 value 15 mmHg greater than that in non-divers. Ex-divers had group mean values not significantly different from those of active divers. Superimposed inspired CO2 load caused similar elevations in PAco2 values in divers and non-divers. We concluded that CO2 retention in exercising oxygen-breathing divers cannot be accounted for solely as a conditioned breathing behavior, may be due partly to a reduced central responsiveness of CO2, and is not dependent on current diving activity.
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Collecting is a normal phenomenon, in contrast with pathological collecting, or hoarding. Is hoarding a different phenomenon, or an extreme aspect existing on the same spectrum of behavior? How may these phenomena be understood when they are part of everyone's repertoire on one hand, but may be symptomatic of a grave disturbance on the other hand. An overview and a discussion of hoarding are presented.
In the mental health clinic, the psychotherapist must cope with a multitude of diagnostic and therapeutic challenges. Extensive efforts are expended in reaching a diagnosis and a decision regarding treatment. Despite these efforts, the patient may fail to comply with the recommendations for treatment. Noncompliance has a wide variety of manifestations. One of the major reasons for noncompliance concerns the relationship between the patient and the physician, forcing the therapist to take an active part. Manifestations of noncompliance usually arouse countertransference reactions in therapists, who feel that this behavior exemplifies a lack of trust in them and in the corpus of knowledge they represent. Unique to the therapist's work in the mental health clinic is the need that sometimes arises to begin intervention before a basis for treatment has been established or an initial treatment contract achieved. In certain cases, observation is the only psychotherapeutic intervention possible. Much time may elapse until a therapeutic contract is established, and sometimes it is not established at all.
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During the recent Persian Gulf war, the civilian population in Israel was frequently instructed to stay in sealed rooms in preparation for a possible chemical missile attack. The war broke out in mid-winter, and in many instances it was necessary to heat the rooms. The use of open fires or malfunctioning heating appliances inside sealed rooms could create ideal conditions for carbon monoxide (CO) poisoning. Six patients with CO intoxication resulting from confinement inside sealed rooms were referred for hyperbaric oxygen (HBO) treatment. Indications for HBO therapy were loss of consciousness and metabolic acidosis. The treatment protocol consisted of 90-min exposure to 100% oxygen at 2.5 atmospheres absolute (ATA), with repeated exposures when required. All patients made a full recovery. The risk of CO poisoning should be taken into consideration and should determine the selection of heating devices for future use in similar circumstances.
In a double-blind, placebo controlled, crossover study, we evaluated the effects of cinnarizine on the VOR of 55 healthy young subjects. VOR was evaluated by the Sinusoidal Harmonic Acceleration (SHA) test at frequencies of 0.01, 0.02, 0.04, 0.08 and 0.16 Hz. There was a reduction in VOR gain in 16 of the 20 SHA trials performed under the influence of cinnarizine alone (25 mg and 50 mg) and cinnarizine 25 mg in combination with 10 mg domperidone or 1 transdermal scopolamine patch. This decrease in VOR gain was significant in only a few SHA trials. Phase lead was not consistently affected by cinnarizine. No notable side effects were found for any of the drug groups. Our findings are in accord with the contention that increased resistance to seasickness produced either by drugs, or by the natural process of habituation to sea conditions, may be reflected by a decrease in VOR gain.
An unusual case of odontodysplasia is presented, involving both primary and permanent dentition, with oligodontia of permanent teeth and hypoplasia, taurodontism and incomplete eruption of a first permanent molar. In order to improve the patient's appearance, occlusion and function, his intra- and inter-arch relationships were altered. To accomplish this, a multidisciplinary treatment approach was adopted, involving restorative and prosthetic treatments by a pediatric dentist, accompanied by periodontal surgery, endodontics and orthodontics.
A survey conducted among 116 crew members of seagoing vessels confirmed that mal de debarquement (M-D) is a transient feeling of swinging, swaying, unsteadiness, and disequilibrium. None of the subjects requested medical attention, although there were isolated cases in which a strong sensation of swinging and unsteadiness caused transient postural instability and impaired the ability to drive. In most cases, the sensation of M-D appeared immediately on disembarking and generally lasted a few hours. In addition, subjects usually described bouts or attacks of M-D associated with changes in body posture, head position, or with closing of the eyes. M-D was reported by 72% of our subjects. Sixty-six percent of subjects reported a high incidence following their first voyages. A significant positive correlation was found between M-D and seasickness susceptibility. The nature of M-D may be explained within the framework of multisensorimotor adaptation and habituation to a new or abnormal motion environment. It is suggested that M-D represents a dynamic, multisensorimotor form of CNS adaptive plasticity.