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Biomedical subjects

H Lehman

Publications and source records attributed to H Lehman.

9 recordsLinked to original sources
PubMed1998

Polymerase chain reaction used to detect candidemia in patients with candiduria.

OBJECTIVES: Candiduria has been shown to be an early marker of disseminated fungal infection in critically ill patients who have undergone surgery. The management of candidemia and disseminated candidiasis depends on rapid and definitive identification of Candida. Routine or fungus-specific blood cultures are unreliable and require a large quantity of blood for incubation. We describe the importance of the polymerase chain reaction (PCR) procedure in the early detection of candidemia in critically ill patients who develop candiduria and the favorable outcome in treating these patients with systemic antifungal therapy. METHODS: We compared the results of cultures and PCR to detect the presence of C. albicans in the blood of two critically ill patients with clinical candidiasis and candiduria. RESULTS: PCR detected the presence of C. albicans deoxyribonucleic acid (DNA) in urine and blood specimens of both patients in spite of negative blood cultures and did not detect fungal DNA after systemic antifungal therapy. CONCLUSIONS: Candiduria manifests as an early sign of candidemia, and systemic antifungal therapy timed appropriately based on the clinical condition and onset of candiduria will improve outcome. Detection of fungal DNA in blood by PCR is of value in establishing the diagnosis. Additional studies with a larger sample size are required to evaluate the specificity and sensitivity of PCR as a routine diagnostic test for candidemia.

Aged↗
PubMed1997

Effect of ethnicity on adherence to diabetic regimen.

OBJECTIVE: Evaluating the effectiveness of treatment of diabetic patients in our institution led us to seek the relationship between adherence to diabetic regimens and several demographic variables. Of primary importance was ethnicity, which the practitioners believed affected adherence. Other variables researched were: marital status, gender, weight, age, type and duration of diabetes, socioeconomic status, occupation and education. PATIENTS: Adult diabetic patients (215) seen in the diabetic clinic of a large health maintenance organization who had their diabetes for at least 6 months. METHODS: Data were collected from interviews and medical records over a two-year period. RESULTS: Ethnicity, the major test variable, did not show a relationship to adherence. Two variables, gender and weight, showed a trend to significant relationship to adherence. Chi square and t tests were used, depending on the type of data. CONCLUSIONS: Since there is no difference in adherence between ethnic groups, standardized care protocols are warranted, since they are cost-efficient.

Adult↗
PubMed1992

First time experiences in infancy: when they appear to be pleasant, do they activate the adrenocortical stress response?

The effect of a positive first-time experience on adrenocortical activity was examined in 48 6- to 13-month-old infants who took part in two sessions of a YMCA-like mother-infant swim class. Experience was manipulated by comparing Novice swimmers with infants who previously had taken a swim class, and by examining responses to first versus second class session. In addition, the effects of temperamental fear of novelty were examined by maternal report prior to the first session. Preswim and Postswim cortisol levels were compared to measures obtained at the same time of day in two comparison groups, one tested at home and one tested in a playroom at the University. The results yielded no evidence of an adrenocortical stress response (elevated cortisol) to the swim sessions for either the Novice or Experienced swimmers. Infant temperamental fearfulness predicted behavioral but not adrenocortical responses during swimming. Postswim cortisol levels were significantly lower than posttest levels in the two baseline comparison groups, and lower postswim cortisol levels were associated with less negative and more positive emotional behavior and engagement of the swimming experience. These results are consistent with the hypothesis that emotions serve as a major pathway influencing adrenocortical activity, and provide no support for the uncertainty hypothesis of adrenocortical activation.

Adaptation, Psychological↗
PubMed1981

Detection by immunofluorescence of a new "core-like" Ag/Ab system in liver and serum of patients with NANB hepatitis.

Using direct immunofluorescence, a nuclear antigen was found in liver of chronic hepatitis patients with circulating NANBe Ag or anti-NANBe, and selected sera from either group were used as source of conjugates. The new Ag/Ab system was designated NANBc Ag and anti-NANBc since it behaved like the core Ag of HBV . NANBc Ag was detected in coded frozen liver biopsies from patients with chronic persistent 15/25 (60%) or active 27/50 (54%) hepatitis and cryptogenic cirrhosis 16/30 (53.3%) devoid of HBV markers. Only 2/30 alcoholic cirrhosis cases (7%) used as controls were positive (p less than or equal to 0.001). The homologous anti-NANBc antibody was always detectable by indirect immunofluorescence in the patients' serum when NANBc Ag was found in the liver. It was also found in 11/135 (8%) additional cases without any other NANB marker. A correlation was observed between coded detection of the NANBc Ag/Ab system by immunofluorescence and demonstration of NANBe Ag or anti-NANBe by immunodiffusion. In acute post-transfusion NANB hepatitis, anti-NANBc was first detectable 14 days after transfusion and persisted as long as ALT remained elevated, or longer. IgM anti-NANBc present at onset became associated with an increasing proportion of IgG after the 28th day. The prevalence of anti-NANBc in sporadic NANB hepatitis (11/50 = 22%) was significantly lower (p less than or equal to 0.001) than in cases with parenteral exposure such as post-transfusion, occupational or drug addict hepatitis (47/72 = 65%). Immunofluorescent tests for NANBc Ag and Ab are promising assays for the serological diagnosis of NANB hepatitis.

Antibodies, Viral↗