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Biomedical subjects

D Reich

Publications and source records attributed to D Reich.

35 records · Page 2Linked to original sources
PubMed1996

Decreased ferritin levels, despite iron supplementation, during erythropoietin therapy in anaemia of prematurity.

Erythropoietin (rHuEPO) therapy has been shown to be beneficial in preventing and treating anaemia of prematurity and to decrease the need for blood transfusions. There is, however, only scanty data on the effect of rHuEPO therapy on iron metabolism. We studied 29 preterm infants (age 34 +/- 14 days) who were randomly assigned to receive either rHuEPO 900 U kg-1 week-1 with 6 mg kg-1 day-1 of iron for 4 weeks (n = 15) or no therapy. The following parameters were evaluated and compared between and within groups at the beginning, during and at the end of the study: Haematocrit (SI), reticulocytes (10(9) micrograms l-1), serum ferritin (microgram 1-1) and iron (mumol l-1). The results were as follows. At the baseline, erythropoietin levels were similar in both groups: 7.2 +/- 5.6 versus 6.2 +/- 3.2 mU ml-1 (NS). In the treated infants the haematocrit remained stable during the study and was significantly higher than in the control group by the end of the study: 0.34 +/- 0.03 versus 0.28 +/- 0.05 (p = 0.001). rHuEPO therapy increased the reticulocyte count from 130 +/- 70 to 430 +/- 200 (p = 0.0002). However, rHuEPO therapy depleted both serum ferritin and iron levels from 321 +/- 191 to 76 +/- 58 micrograms l-1 (p = 0.04) and from 18 +/- 5 to 13 +/- 4 mumol l-1 (p = 0.03), respectively. We conclude that rHuEPO therapy prevented anaemia and its sequelae; however, serum ferritin and iron levels were depleted. We suggest that the effect of rHuEPO may be further increased by higher iron supplementation.

Anemia, Neonatal↗
PubMed1996

Failure of early postnatal dexamethasone to prevent chronic lung disease in infants with respiratory distress syndrome.

OBJECTIVE: To study the effect of early postnatal dexamethasone (days 1-3) on the incidence and severity of chronic lung disease in preterm infants with respiratory distress syndrome. METHODS: A multicentre, randomised, placebo controlled, blinded study was carried out in 18 neonatal intensive care units in Israel. The primary outcome measure was survival to discharge without requirement for supplemental oxygen therapy beyond 28 days of life. The secondary outcome measures were requirement for mechanical ventilation at 3 and 7 days, duration of ventilation or oxygen therapy, need for subsequent steroids for established chronic lung disease and incidence of major morbidities. RESULTS: The study consisted of 248 infants (dexamethasone n = 132; placebo n = 116). No differences were found in the outcome variables except for a reduction in requirement for mechanical ventilation at age 3 days in treated infants (dexamethasone 44%, placebo 67%; P = 0.001). Gastrointestinal haemorrhage, hypertension, and hyperglycaemia were more common in treated infants, but no life threatening complications, such as gastrointestinal perforation, were encountered. CONCLUSIONS: These data do no support the routine use of early postnatal steroids, but may justify further study in a selected, high risk group of infants.

Birth Weight↗
PubMed1996

Delivery of the very low birthweight breech: what is the best way for the baby?

A retrospective analysis was done to determine whether vaginally vs. cesarean section-born breech infants in the very low birthweight range are at increased risk for morbidity and mortality. Eighty-three viable singleton breech infants weighing 700-1,600 g, who were delivered in our medical center during the period 1980 through 1993, were followed for up to 5 years of age. Analysis of data after correction for weight, gestational age and other confounding variables such as antepartum complications revealed that survival rates in the 700-1,000 g group were similar in both routes of delivery. In the 1,001-1,600 g group, survival rate was 60.9% after vaginal delivery, as compared to 100% after cesarean section (P < 0.01). No difference was demonstrated in long-term outcome between the vaginal and cesarean groups, although the population was too small to draw statistical conclusions. Considering the limitation of such a retrospective analysis, our data identified a trend that supports prophylactic cesarean section in cases of pre-term breech infants weighing 1,000-1,600 g.

Adult↗
PubMed1994

Sonographic presentation of Hirschsprung's disease. A case of an entirely aganglionic colon and ileum.

Prenatal sonographic presentation of Hirschsprung's disease has been considered non-specific and uncommon. This report presents a second-trimester fetus with an aganglionic colon and ileum diagnosed by the sonographic presentation of dilated fetal bowel loops, increased abdominal circumference, and mild polyhydramnios. The prenatal sonographic diagnosis of Hirschsprung's disease helped to expedite early neonatal treatment.

Adult↗
PubMed1994

The persisting mesonephric duct syndrome in a neonate with agenesis of the corpus callosum.

Agenesis of the corpus callosum is a rare condition, often associated with craniofacial, skeletal and genitourinary abnormalities. We report on a male newborn in whom all of these organ systems were affected. The genitourinary anomaly consisted of vaso-ureteral fusion accompanied by renal, ureteral, vesical, ductal and genital malformations. The diagnostic approach and management of this unusual case are described and the literature is reviewed.

Abnormalities, Multiple↗
PubMed1993

Transoesophageal echocardiography and the intraoperative diagnosis of left atrial invasion by carcinoid tumour.

A 41-yr-old woman with pulmonary carcinoid tumour presented for thoracotomy and lung resection. However, intraoperative transoesophageal echocardiography (TEE) revealed that the tumour had invaded the left atrium, and the planned resection was aborted to allow resection under cardiopulmonary bypass at a later date. Although the incidence of cardiac involvement by lung cancer at the time of pulmonary resection is unknown, transoesophageal echocardiography can be useful in identifying the extension of hilar lung tumours. This should preferentially be done preoperatively, but can be done intraoperatively as described in this case report.

Adult↗
PubMed1992

Presynaptic A1-purinoceptor-mediated inhibitory effects of adenosine and its stable analogues on the mouse hemidiaphragm preparation.

1. The effect of adenosine or its stable analogues (2-chloroadenosine, CADO; 5'-N-ethylcarboxamidoadenosine, NECA; and N6-cyclopentyladenosine, CPA) on the release of [3H]-acetylcholine ([3H]-ACh), and on the development of force of contraction evoked by electrical stimulation of the nerve, were studied in the mouse phrenic nerve-hemidiaphragm preparation. Evidence was obtained that the release of ACh is subject to presynaptic modulation through presynaptic A1(P1)-purinoceptors. 2. Adenosine or its stable analogues (CADO, NECA, CPA) inhibited, in a concentration-dependent manner, both the release of ACh and the force of the indirectly elicited contraction of hemidiaphragm preparation, provided in the latter case that the margin of safety was reduced by (+)-tubocurarine or magnesium. The order of potency in reducing ACh release was CPA greater than NECA greater than CADO greater than adenosine with IC50 values of 0.08 +/- 0.01, 0.74 +/- 0.05, 9.05 +/- 0.20, and 410.2 +/- 42.5 mumol/l, respectively. The order of potency in reducing twitch tension was CPA greater than NECA greater than CADO greater than adenosine with IC50 values of 0.11 +/- 0.02, 0.48 +/- 0.03, 2.07 +/- 0.49, and 240.4 +/- 20.0 mumol/l, respectively. 3. 8-Phenyltheophylline (8-PT) antagonized the inhibitory effects of the adenosine receptor agonists on ACh release and twitch tension.(ABSTRACT TRUNCATED AT 250 WORDS)

2-Chloroadenosine↗
PubMed1992

Reusables win a battle over disposables.

The time is right to market the environmental benefits of reusable textiles. Take it from Stan Wiener, director of sales for Unitex Textile Rental Services, Mount Vernon, N.Y. Wearing one of his company's reusable cloth examination gowns, Wiener made a sales call to a leading New York health services center. Persuaded by the environmental friendliness of reusables, the health center made the switch from paper gowns and has realized a 5,000-lb. reduction in disposable trash.

Ambulatory Care Facilities↗
PubMed1989

Human milk immunoglobulin A antibodies to Shigella virulence determinants.

Because human milk is thought to protect infants from shigellosis, we evaluated milk for immunoglobulin A to Shigella virulence determinants. Milk was preincubated to remove antibodies unrelated to each locus of interest, using defined Shigella and E. coli hybrids containing known Shigella genetic segments prior to immunoblotting. The milk could not be shown to contain antibodies to chromosomally encoded virulence loci except for the expected antibodies to the products of the histidine locus. However, all the milk samples contained antibodies to antigens encoded by the large virulence plasmid. The finding of these antibodies suggests a possible mechanism by which human milk might protect infants.

Adsorption↗
PubMed1989

Soft-tissue effects of biliary extracorporeal shockwave lithotripsy in swine.

This study investigates the soft-tissue effects of biliary extracorporeal shockwave lithotripsy (BESWL) using a recently developed lithotripter, which consists of an electromagnetic shockwave generator and an integrated ultrasonic targeting system. Sixteen swine, evenly divided into four groups, underwent BESWL. One group had one BESWL session targeted on the gallbladder and another group had two BESWL sessions targeted on the gallbladder. The third group had one BESWL session targeted on implanted gallbladder stones and the fourth group had one BESWL session targeted on the region of the common bile duct (CBD). Half of each group were sacrificed on the day of lithotripsy and half 1 week later. Post-mortem examinations were performed. Each implanted gallstone had fragmented. There were no findings attributable to BESWL in 11 animals. Three animals had pulmonary haemorrhagic spots (the largest was 10 mm in diameter) and one had a submucosal CBD petechia; these findings were attributable to BESWL. In two animals, microscopic haemorrhage associated with bronchopneumonia (usually present in our pig population) was more prominent than usual. This was possibly attributable to BESWL. The swine's deep posterior costophrenic sulcus makes it difficult to avoid the lung base during BESWL in swine. We conclude that this BESWL device can fragment gallstones without causing clinically significant soft-tissue damage.

Animals↗
PubMed1986

Chronic mesenteric vascular insufficiency with gastric ulceration.

Four middle-aged women presented with long histories of severe progressive weight loss and chronic abdominal pain. Endoscopically atypical gastric ulcers were identified in all; the ulcers were multiple and antral in location, with irregular shapes, sloping edges, and whitish sclerotic bases, and were surrounded by mottled and erythematous mucosa containing numerous superficial erosions. They did not heal with conservative therapy. All 4 patients were found to be suffering from chronic mesenteric vascular insufficiency. Balloon dilatation of the superior mesenteric artery in one and surgical revascularization in the others resulted in progressive clinical improvement and healing of the ulcers. The striking feature in these patients with mesenteric ischemia was the finding of gastric ulcers with a morphology different from the ordinary gastric ulcer, which healed only with revascularization. Future observation of similar lesions should suggest the possible diagnosis and expedite early treatment of mesenteric insufficiency in patients with this disorder.

Dilatation↗
PubMed1979

Clinical and biochemical study of a child with the non-neuronopathic-Type B form of Niemann-Pick disease.

A child with Niemann-Pick disease type B, diagnosed at the age of two years and followed up for three years is described. Despite extensive visceral involvement--as deduced from marked hepatosplenomegaly and pulmonary infiltration--the child is in general good health and has no apparent neurologic abnormality. Biochemical studies revealed a tenfold increase of sphingomyelin content in his liver biopsy specimen and a markedly reduced sphingomyelinase activity in peripheral blood leukocytes. His parents were found to be heterozygous carriers of the disease, showing sphingomyelinase activity values intermediate between those of patient and healthy subjects. The relevant literature, concerning patients with the non-neuronopathic type B form, is reviewed.

Biopsy↗
PubMedDate not supplied

Symptom clusters in a community with chronic exposure to chemicals in two superfund sites.

Sikes and French, Ltd., two National Priority List sites that are proximal to one another, are located approximately 20 mi (32 km) east of Houston, Texas. Dumping at Sikes occurred during the early 1960s and continued until 1967. Benzene, 1,2-dichloroethane, toluene, 1,1,2-trichloroethane, naphthalene, lead, fluorene, and pyrene are chemicals that pose a particular public health concern. French, Ltd., commenced operations in 1966, and dumping ceased in 1973. Chemicals of potential public health impact at the French, Ltd., site are benzene, benzo(a)anthracene, benzo(a)pyrene, copper, chrysene, chromium, dichlorodiphenyltrichloroethane, heptachlor, lead, nickel, polychlorinated biphenyls, tetrachloroethylene, trichloroethylene, and zinc. During the 1980s, both sites were placed on the National Priority List. Barrett Station is a stable black community located near the two sites. The question of whether levels of exposure to dumpsite chemicals were related to health complaints in the Barrett Station population was examined. The prevalence of 29 symptoms reported by 321 individuals who had been highly exposed was compared with symptoms reported by a group of 351 persons from the same community who had limited exposure. A meaningful difference between the two groups emerged for some of the symptoms, the most notable of which symptoms were neurologic. Almost twice as many subjects in the high-exposure group reported five or more neurologic symptoms, compared with the low-exposure group. This excess of neurological symptoms is consistent with the known toxic properties of the chemicals at the sites.

Cardiovascular Diseases↗
PubMedDate not supplied

Molecular karyotyping of multiple yeast species isolated from nine patients with AIDS during prolonged fluconazole therapy.

Variations in molecular karyotype and fluconazole susceptibility of serial yeast isolates from the oral cavities of nine patients with AIDS receiving fluconazole for single or multiple episodes of oropharyngeal candidiasis were monitored. Multiple yeast species were isolated from the initial oral specimens in six patients. Molecular karyotyping identified at least eight different DNA subtypes of C. albicans, at least eight of T. glabrata and only one DNA subtype each of C. krusei, C. tropicalis and C. parapsilosis. Among isolates of T. glabrata, fluconazole MICs in each patient were consistently within one or two dilutions, regardless of strain variations. Similarly, among five patients monitored during one course of therapy, the MICs of fluconazole of C. albicans isolates of either the same or different DNA subtypes remained within two dilutions. However, increases in MICs of fluconazole of C. albicans were observed in four patients who received two or more courses of fluconazole, three of whom had the same DNA subtype and one of whom changed from one DNA subtype to another.

Acquired Immunodeficiency Syndrome↗