PubMed Health⌕ Search

Biomedical subjects

A Lefkowitz

Publications and source records attributed to A Lefkowitz.

12 recordsLinked to original sources

Effect of antihypertensive therapy on renal injury in type 2 diabetic rats with hypertension.

In a previous study, we demonstrated that doxazosin (DZN), an alpha(1)-adrenergic blocker, prevented proteinuria in streptozotocin diabetic rats. In this study, we investigated whether DZN would lower established proteinuria by improving glomerular sclerosis in spontaneously hypertensive corpulent rats with type 2 diabetes mellitus. DZN treatment was compared with treatment with angiotensin-converting enzyme inhibitor, lisinopril (LIS) alone, and DZN in combination with LIS. Combination therapy was used to examine any additive effect of either drug alone in the reduction of proteinuria and glomerular sclerosis. Both male and female rats age 6 months with established proteinuria were used. The rats were allocated randomly to 1 of 4 groups: untreated, DZN treated, LIS treated, or a combination of DZN and LIS treatment. Drug treatment was continued for 16 weeks. The results show that (1) either drug alone or in combination significantly lowered systolic blood pressure; (2) DZN, LIS, or combination therapy reduced albuminuria at 16 weeks of treatment from baseline by 38.61+/-5.77%, 30.70+/-4. 21%, and 42.17+/-4.77% (mean+/-SE), respectively. No difference in albuminuria was observed among the 3 groups of rats; (3) the fractional mesangial area, which was 20.55+/-3.77% in untreated rats, was significantly reduced to 11.18+/-1.32% in DZN-treated rats, with a further reduction to 8.72+/-0.64% in LIS-treated rats and to 3.48+/-0.35% in rats treated with DZN+LIS; and (4) DZN but not LIS significantly improved plasma glucose levels in spontaneously hypertensive corpulent rats (untreated 21.06+/-0.97 mmol/L versus DZN treated 15.81+/-0.93 mmol/L or DZN+LIS treated 17.38+/-1.10 mmol/L; P<0.025 to 0.005). Thus, the data suggest that 16-week treatment with either DZN or LIS improves established proteinuria and glomerular sclerosis, but combination therapy is superior to either DZN or LIS alone in preventing glomerular sclerosis in type 2 diabetic rats with hypertension.

Albuminuria↗

Nevus comedonicus.

The nevus comedonicus (NC) is an uncommon variant of adnexal hamartoma which appears clinically as linear groups of open comedones. Its name may be a misnomer since, according to some, true comedones are not present. NC usually occurs by itself but may be linked with a variety of systemic findings such as skeletal or ocular anomalies. Although the nevus comedonicus is viewed by many as a hamartoma arising from a defective mesoderm, others consider this lesion to be an epidermal nevus involving the hair follicle or an appendageal nevus of sweat ducts.

Diagnosis, Differential↗

Decreased seroprevalence for Toxoplasma gondii in Seventh Day Adventists in Maryland.

Despite its widespread prevalence, uncertainties remain about the relative contribution of various routes of transmission to the overall rate of infection with Toxoplasma gondii, particularly in developed countries. To explore the hypothesis that meat consumption is an important risk factor for infection, a cross-sectional seroprevalence study was performed on healthy adults in one region in the state of Maryland. The population included Seventh Day Adventists who as a group follow a diet containing no meat, and control community volunteers who were not Seventh Day Adventists. Thirty-one percent of the population had serologic evidence of T. gondii infection. People with T. gondii infection were older (49 versus 42 years old; P < 0.01, by t-test) and less likely to be Seventh Day Adventists (24% versus 50%; P < 0.01, by chi-square test) than people without T. gondii infection. When adjustments were made for age and gender through multiple logistic regression, Seventh Day Adventists had a significantly decreased risk of T. gondii infection (odds ratio = 0.21, 95% confidence interval = 0.09-0.46, P = 0.0001) compared with the controls. While the basis for this effect remains to be determined, one possible protective factor is the general adherence of Seventh Day Adventists to a diet that does not contain meat.

Adult↗

A serosurvey of pathogens associated with shellfish: prevalence of antibodies to Vibrio species and Norwalk virus in the Chesapeake Bay region.

Recent concerns regarding the safety of shellfish consumption have focused on the risk posed by naturally occurring marine bacteria such as Vibrio species and by viruses such as Norwalk and related agents. Despite the widespread environmental presence of Vibrio species in the Chesapeake Bay, the rate of reported infections remains low; there have also been no reports of major Norwalk outbreaks associated with shellfish in this area. As infections with these agents may not always be recognized because of difficulties in making the diagnosis and/or their mild or subclinical presentation, a serosurvey was conducted among healthy volunteers living in the Chesapeake Bay region. Serum and questionnaire data were collected during the fall of 1987 from 267 persons with varying levels of exposure to shellfish: shellfish industry workers, persons attending a local seafood festival, and Seventh-day Adventists (who traditionally abstain from eating shellfish). In comparisons among groups, a significant association could not be demonstrated between shellfish consumption or contact and antibody response to Vibrio cholerae O1 or Norwalk virus. Rates of seropositivity were high for both agents (up to 22% seropositive with a V. cholerae O1 Inaba vibriocidal assay, 14% with an enzyme-linked immunosorbent assay for cholera toxin, and up to 70% seropositive with an enzyme-linked immunosorbent assay for antibodies to Norwalk virus); the basis for these responses in population-based studies remains to be determined. Shellfish industry workers did have a significantly elevated antibody response to the unencapsulated phase variant of Vibrio vulnificus as compared with the other groups studied. Infection with V. vulnificus may be relatively common among persons with high levels of exposure to shellfish.

Adult↗

Preventive care in a Veterans Administration continuity clinic.

Low levels of compliance with established guidelines for preventive care have been documented in a variety of settings. Although the Veterans Administration (VA) is the largest health care provider in the United States, data concerning preventive care to veterans is lacking. A study was conducted to examine preventive care in a university affiliated VA continuity care clinic staffed by resident physicians. Recognized guidelines were used to generate criteria specifying appropriate periodic health examinations and preventive procedures. A random sample of patients followed in the Baltimore VA Primary Care Clinic was reviewed. Compliance was highest for the traditional elements of the periodic health examination. Over 85% of patients had received histories and physical examinations, complete blood counts, electrolytes, chest radiographs, urinalyses, weight measurements, blood pressure determinations and electrocardiograms. Compliance was lower for cholesterol determination (51%) and for cancer screening procedures. Of appropriately selected patients, 19% had sigmoidoscopies, 44% rectal examinations, 50% PAP smears, and 17% mammograms. Lowest compliance was seen for influenza immunization. Only 12.5% of high risk males and 0% of high risk females had received the vaccine. Compliance did not consistently vary by duration of clinic enrollment, age, race, or sex. Efforts must be made to improve compliance with established guidelines for preventive care.

Baltimore↗

Seroprevalence of Helicobacter pylori in Seventh-Day Adventists and other groups in Maryland. Lack of association with diet.

To evaluate the possible role of diet in the transmission of Helicobacter pylori, we compared H pylori seroprevalence among Seventh-Day Adventists (who are vegetarian and abstain from alcohol, caffeine, and meat; n = 94) and two non-Seventh-Day Adventist control groups (n = 168). With the use of an enzyme-linked immunosorbent assay H pylori antigen prepared in a French pressure cell, we found no difference in seroprevalence among these groups; however, seropositivity strongly correlated with age and black race.

Adult↗

Predictors of rehabilitation outcome among patients with SCI.

Because rehabilitation medicine has undergone major changes with respect to patient management and case mix since 1980, it is important to determine whether the factors predictive of rehabilitation outcomes also have changed over time.

Activities of Daily Living↗

Dollars & scents.

Explore the source record for details and available documents.

Holidays↗

Wrap sessions.

Explore the source record for details and available documents.

Hospital Administration↗