Biomedical subjects
Publications and source records attributed to C Rosenthal.
Clinical experience with continuous ambulatory peritoneal dialysis (CAPD) is described in 12 patients. A survey over 8 months shows satisfactory results. Besides the numerous advantages of this treatment, peritonitis represents the main problem. Technical developments in the future will aim at a reduction of this risk.
Improvement in mortality and perinatal morbidity in rural areas is the result of: The appointment of qualified obstetricians. The provision of modern methods of obstetrical monitoring. The fact that "'avoidable" mortality and morbidity persist in these same rural districts is related to: Premature deliveries and the difficulties of transporting the premature babies. The survival of "country deliveries". We propose three solutions to improve perinatal care in these regions: Transformation of rural maternity units which are under-equipped into Centres where pregnancy can be monitored properly. Avoidance of transfer of the newborn by making it easier to transport the mother to Centres that have a good obstetric and paediatric unit. Provision of a real liaison between the unit that has the obstetrician and paediatrician in it and the district rural maternity services.
Due to its high sensitivity, radioimmunoassay has become of great importance in the detection and measurement of levels of proteins and steroids in body fluids. However, this method involves the use of expensive equipment and radioactive material. Herein is described an alternate method to radioimmunoassay, which uses an enzyme-labeled rather than a radioactively-labeled antibody. An enzyme immunoassay procedure, the Cordia HAA-enzyme Immunoassay, for the detection of hepatitis-associated antigen has been evaluated. With this technique a sandwich type immunoassay with an alkaline phosphatase tagged second antibody is used. The presence of antigen is detected by the p-nitrophenyl phosphotase activity of the bound enzyme. In 1083 clinical samples from patients of Jackson Memorial Hospital, only 19 discrepant results were found when tested by both the Cordia and the Ausria II methods. Eight had sufficient sera for retesting, yielding two positive Cordia, negative Austia; one negative Cordia, positive Ausria; one borderline positive; and four unconfirmed false positives by Cordia.
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Ultrasound echocardiography is automatic easy to carry out even in children in a precarious condition. The authors show the value of echocardiography in the neonatal period in a preliminary study involving 50 normal newborn infants. They discuss the cardiac abnormalities which may be diagnosed using this technique.
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The authors have studied the action of nicotinate of xantinol on the placental, myometrial and cervical circulations using an isotope technique (Indium 113) and anemometric thermometry. They show that this product in every case increases the flow through the cervix and has little action on the flow through the placenta, except that in rare cases it lessens it. The action on the myometrial circulation varies from woman to woman. There is a significant negative statistical correlation between variation in the circulation through the cervix and the placenta.
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PROBLEM: The assessment of hospital-related stressors experienced by child and adolescent patients on a psychiatric inpatient unit. SUBJECTS: Child and adolescent inpatients (N = 40) admitted to an acute, short-term psychiatric unit. METHODS: A newly developed stressor survey was administered to subjects to identify the most problematic stressors. Correlation analyses were used to assess associations between hospital-related stress and adjustment variables. FINDINGS: Broad domains and specific items of the most problematic hospital-related stressors were revealed. Also, higher levels of hospital-related stress were consistently associated with poorer hospital-based adjustment. CONCLUSIONS: Implications for treatment include identifying hospital-related stressors for individual patients and providing interventions to enhance coping.
BACKGROUND: Invasive fungal infections are an increasing cause of morbidity in acute leukemia (AL) patients. METHODS: In a prospective pilot trial, the safety and efficacy of antifungal prophylaxis with intravenous (i.v.) amphotericin B (AMB; 1 mg/kg every 48 h) was studied in 46 consecutive cycles. Prophylaxis with i.v. AMB was carried out in patients treated with intensive chemotherapy for AL and compared with a control of 49 cycles without prophylaxis. RESULTS: Pulmonary infiltrates (5 vs. 23; p < 0.001) and fungal microabscesses in the liver or spleen (0 vs. 6; p = 0.014) occurred significantly less frequently in the prophylaxis group. While there were 3 deaths related to systemic fungal infections in the control group, there were none in the prophylaxis group. Escalation to conventional AMB (1.0 mg/kg/day) was significantly less frequent in the prophylaxis group (9 out of 46 cycles) compared with the control arm (29 out of 49 cycles; p = 0.001). A total of 695 mg of AMB per cycle was administered in the prophylaxis arm, compared with 634 mg/cycle for empirical treatment in the control group (p = 0.6). Infusion-related toxicity was documented in 29% of the cycles of prophylaxis compared with 55% of the cycles of empirical treatment with i.v. AMB in the control group. The nephrotoxicity of AMB prophylaxis was moderate, with >/= WHO degree II reported in 1 out of 46 cycles only. CONCLUSION: Intensive i.v. AMB prophylaxis reduced invasive fungal infections and led to a reduction in fungal microabscesses in the liver or spleen, as well as pulmonary infiltrates, in patients treated for AL. The need for escalation to empirical i.v. AMB treatment was significantly reduced. Intensive AMB prophylaxis was feasible, with moderate adverse effects.
The objective of the present study was to determine the prevalence of certain mycoplasma species, i.e., Mycoplasma hominis, Ureaplasma urealyticum and Mycoplasma penetrans, in urethral swabs from HIV-1 infected patients compared to swabs from a control group. Mycoplasmas were detected by routine culture techniques and by the Polymerase Chain Reaction (PCR) technique, using 16SrRNA generic primers of conserved region and Mycoplasma penetrans specific primers. The positivity rates obtained with the two methods were comparable. Nevertheless, PCR was more sensitive, while the culture techniques allowed the quantification of the isolates. The results showed no significant difference (p < 0.05) in positivity rates between the methods used for mycoplasma detection.
Two patients with concomitant leptospirosis and the acquired immunodeficiency syndrome (AIDS) are reported. In these cases different clinical aspects that can be attributed to simultaneity of these pathologies was not observed.
Very few case reports evaluate clinical and laboratory parameters of acute HIV infection. This paper describes seven such cases, four being mononucleosis like disease and one lymphocytic meningitis. Clinical manifestations were fever (7/7), lymphadenopathy (7/7), enlarged liver size (7/7) pharyngitis (6/7), malaise (4/7) and anorexia (4/7). Inversion of the normal T4/T8 ratio was present in 3/5 patients, all with normal absolute values for T4 cells. Moderate transaminase increases were found in 5/6; 5/7 had atypical lymphocytes in blood smear and 5/5 had abnormal mucoprotein levels. All patients had a total remission of clinical symptoms within two weeks. However, the abnormal lymph nodes and the enlarged liver persisted. Follow-up for ten months showed 4/7 patients with all abnormalities resolved and 3/7 still with persistent enlarged lymph nodes.
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