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Biomedical subjects

J M Levy

Publications and source records attributed to J M Levy.

At least 55 records · Page 3Linked to original sources
PubMed1989

Intermediate-term follow-up results of balloon aortic valvuloplasty in infants and children with special reference to causes of restenosis.

Sixteen infants and children with valvular aortic stenosis underwent percutaneous balloon aortic valvuloplasty over a 36-month period ending August 1988. The mean systolic pressure gradient across the aortic valve decreased from 72 +/- 21 (mean +/- standard deviation) to 28 +/- 13 mm Hg (p less than 0.001) immediately after valvuloplasty; the degree of aortic insufficiency did not significantly increase. Follow-up catheterization (in 10 patients) and Doppler data (in all 16 patients) were available 3 to 32 months (mean 12 months) after valvuloplasty and revealed a residual aortic valvular gradient of 37 +/- 23 mm Hg, which continues to be significantly lower (p less than 0.001) than that before valvuloplasty. There was no increase in aortic insufficiency. On the basis of follow-up data, the 16 children were divided into 2 groups: group I with good results (gradients less than or equal to 49 mm Hg), 12 patients; and group II with poor results (gradients greater than or equal to 50 mm Hg), 4 patients. All 4 patients in group II required repeat balloon valvuloplasty or surgical valvotomy; none from group I required these procedures. Seventeen general, anatomic, physiologic and technical variables were examined by a multivariate logistic regression analysis to identify factors associated with restenosis; these risk factors were: age less than or equal to 3 years; and immediate aortic valvular gradient after valvuloplasty greater than or equal to 30 mm Hg. The immediate and intermediate-term follow-up results of balloon aortic valvuloplasty are encouraging. Recognition of the risk factors may help identify potential candidates for recurrence.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Who benefits most from respite care?

This study examines the effect of five measures of utilization of respite care services (desire to use respite care services, actual use, accessibility, scheduling and helpfulness) upon mothers' coping resources. Using the analysis of variance between utilization measures and coping resources with the following intervening variables as covariates--mothers' self-esteem, family cohesion and adaptation, and clients' and mothers' characteristics--it was found that respite care acts as a differential service that can enhance coping resources (i.e., stress reduction skills) and is of most benefit to high self-esteem mothers of young developmentally disabled children. A home-based model was found to be the most beneficial to mothers in terms of enhanced coping resources. Findings are interpreted with respect to their implications for research, program model, planning and intervention.

Adaptation, Psychological↗
PubMed1989

Value of laser-assisted angioplasty in the community hospital.

The experience with laser-assisted angioplasty at a community hospital was reviewed. One hundred twenty patients required angioplasty during a 7-month period, and in only 17-13 of whom had superficial femoral artery occlusions--was the use of lasers deemed appropriate. The success rate was 65% for laser-assisted angioplasty and 98% for balloon angioplasty. Laser-assisted angioplasty was the initial intervention in eight of the 13 superficial femoral artery occlusions. In two cases, a wire had been first advanced across the lesion, and in three cases, attempts to cross the lesion with a wire had been unsuccessful. The availability of the laser did not significantly increase the number of cases amenable to angioplasty, and at present laser angioplasty, does not seem to be cost-effective for community hospitals.

Aged↗
PubMed1989

Developing an AIDS prevention education program for persons with developmental disabilities.

The AIDS epidemic poses a serious threat to people with developmental disabilities, the magnitude of which has not yet been fully realized by many professionals working with this population. Models for effective AIDS prevention education have been developed, however, within other populations. Key principles utilized in existing models were discussed and recommendations presented on how to adapt these models when designing programs for people who have developmental disabilities, most specifically, those in the mild/moderate range of mental retardation.

Acquired Immunodeficiency Syndrome↗
PubMed1988

[Neonatal carcinoma. Review of the literature apropos of a case].

A cortical adrenal carcinoma arising during the neonatal period and associated with virilization recurred after an initial excision and is in complete remission after a follow-up period of 10 years. The authors have performed a review of the medical literature which has yielded 56 neonatal carcinomas including this one. More than half of these cases concerned the thyroid gland (15 cases) and the adrenal cortex (14 cases). These were followed by malignant melanomas (12 cases), carcinomas of the parotid gland (6 cases), oropharyngeal region (3 cases), adrenal medulla (2 cases) and stomach, liver, breast and cutaneous sweat gland (one case each). Six tumors were associated with congenital malformations which included Beckwith-Wiedeman's syndrome; 4 tumors arose from preexisting tissue lesions; in one case, oral contraceptives were taken during pregnancy. The main treatment of neonatal carcinomas is surgery. Local recurrences (7 cases) do not markedly affect the outcome, whereas metastases (12 cases) have a very unfavorable prognosis. Superficial tumors are diagnosed earlier and more frequently cured. Out of 44 cases for which the outcome is known, only 18 children survived.

Abnormalities, Multiple↗
PubMed1987

The causes and underlying developmental mechanisms of congenital cardiovascular malformations: a critical review.

Cardiovascular malformations are the second most common type of birth defect, occurring in 5-8/1,000 livebirths with a still higher prevalence among stillborn infants and spontaneously aborted embryos and fetuses. Dealing effectively with the high frequency of heart defects means reducing the incidence of cardiac malformations in the world. In this paper we cite some of the genetic and environmental risk factors associated with congenital cardiovascular malformations, describe the putative biochemical nature of the genetic predisposition relative to environmentally induced teratogenesis, and either support or discourage the use of available methods as strategies in preventing cardiovascular anomalies.

Chromosome Aberrations↗
PubMed1987

Direct catheter redirection of a symptomatic errant intracranial Silastic sphere embolus.

A patient with an arteriovenous malformation experienced a severe neurologic deficit during preoperative particulate embolization with Silastic spheres. Angiography and radiography showed that one sphere had become lodged in a normal branch of the middle cerebral artery. After several unsuccessful attempts at dislodgment, a Tracker catheter system was advanced directly to the site of the sphere, and the sphere was successfully dislodged. The neurologic deficit cleared immediately, and the sphere was redirected to an artery feeding the malformation.

Adult↗
PubMed1986

Aortico-left ventricular tunnel: diagnosis based on two-dimensional echocardiography, color flow Doppler imaging, and magnetic resonance imaging.

Aortico-left ventricular tunnel is a rare congenital cardiac lesion that often results in severe aortic insufficiency in infancy. In previously reported cases, the diagnosis has often been missed initially despite use of cardiac catheterization and angiography. We describe a patient who underwent successful surgical correction of this malformation at 10 months of age after the diagnosis had been established by use of two-dimensional echocardiography, color flow Doppler imaging, and magnetic resonance imaging. Aortico-left ventricular tunnel can be diagnosed by use of these noninvasive means without cardiac catheterization.

Echocardiography↗
PubMed1986

Neonatal primary hyperparathyroidism: total parathyroidectomy with autotransplantation of cryopreserved parathyroid tissue.

Primary neonatal hyperparathyroidism is a life threatening disease because of severe hypercalcemia. The best therapy is early total parathyroidectomy which requires permanent replacement therapy. We describe the first case treated by total parathyroidectomy and late autotransplantation of cryopreserved parathyroid tissue. Twenty months after transplantation, serum calcium and phosphate levels are normal in the absence of any supplementary treatment.

Female↗