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Biomedical subjects

L Berlin

Publications and source records attributed to L Berlin.

12 recordsLinked to original sources
PubMed1991

Cardiac changes from beta-blocker, diuretic and minoxidil combination in hypertension.

The open, long-term antihypertensive, hemodynamic and metabolic effects of betaxolol in combination with furosemide and minoxidil were investigated on 30 male patients with moderate to severe essential hypertension. Twenty-three patients were observed for 104 weeks, and 7 patients for 128 weeks. The patients were seen in the clinic every 4 weeks. Blood chemistries, electrocardiograms, chest x-rays and echocardiograms were done at set intervals during the study. This drug combination caused a significant and sustained decrease in arterial pressure and heart rate (p less than 0.001), a significant increase in the cardiothoracic ratio (p less than 0.05), left and right ventricular diameter in end diastole and in left ventricular mass (p less than 0.001), and had no effect on left ventricular wall thickness, interventricular septal thickness, left ventricular ejection fraction, myocardial fiber shortening or metabolic functions. Clinical side effects included hypertrichosis, weight gain and edema. We conclude: (1) Single daily administration of betaxolol, furosemide and minoxidil produced a significant and sustained antihypertensive effect. (2) It caused cardiac enlargement and increased left ventricular mass without deterioration of myocardial function. (3) The clinical significance of the latter findings is not known at present time.

Betaxolol↗
PubMed1989

Cryptococcal meningitis. False-negative antigen test results and cultures in nonimmunosuppressed patients.

All cases of cryptococcal meningitis at Yale-New Haven (Conn) Hospital seen during a 4 1/2-year period were reviewed to calculate the rate of false-negative antigen test results and cultures preceding diagnosis. Of 13 patients, 9 were immunosuppressed and were diagnosed following the initial lumbar puncture, with both antigen test results and cultures positive in all cases. Among 4 nonimmunosuppressed patients, the rate of false-negative antigen test results was 77%, and of cultures, 89%. The diagnosis was consequently delayed in 3, 2 of whom died despite treatment. Cryptococcal meningitis may be underdiagnosed and undertreated to a significant degree in nonimmunosuppressed patients.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Reproducibility of the diagnosis of cervicitis in pregnancy.

Cervicitis has been associated with several infections of the female genital tract. Criteria have been established for making the diagnosis of cervicitis in gynecologic populations but there are no well-established criteria for diagnosing cervicitis in obstetrical populations. Because of the association of the cervicitis and sexually transmitted diseases, and because of the association of sexually transmitted diseases and adverse pregnancy outcome, the present study was undertaken in an attempt to establish criteria for the diagnosis of cervicitis in pregnancy. We also attempted to determine the reproducibility of that diagnosis with respect to intra- and interobserver variability. We concluded that intraobserver variability is improved after specific training has been completed and that interobserver variability may be reduced to an acceptable level. On a public health scale, this may allow for identification of a population at high risk for adverse pregnancy outcome when sophisticated microbiologic techniques are unavailable.

Adolescent↗
PubMed1986

Malpractice and radiologists, update 1986: an 11.5-year perspective.

All medical malpractice lawsuits filed in Cook County, IL, from January 1, 1980, through June 30, 1986, were reviewed and compared with similar data for the period of January 1, 1975, through December 30, 1979. A total of 11,203 suits were filed during the 11.5-year period; of these, 1391 (12%) were radiology related. The latter were categorized into six groups. The largest was missed radiologic diagnoses, which accounted for 40% of the total. The remaining groups included complications, 19%; failure to order, 17%; radiation therapy, 11%; slip and fall, 5%; and miscellaneous, 8%. Over the 1975-1986 period, the rise in the number of suits alleging radiologic misses outpaced all other groups. Although the most common type of miss continues to involve fractures, the frequency of missed carcinomas has grown at a disproportionately faster rate. Misses specifically involving CT, nuclear medicine, and sonography also are becoming more prevalent. Radiographic misses continue to occur at an average rate of 30%, with little hope of improvement. Methods to combat the rising number of malpractice suits are discussed. It is concluded that although programs to educate radiologists on risk management should continue, the ultimate solution may be a more enlightened public attitude as to what actually constitutes malpractice, and institution of tort reform measures by federal and state legislatures.

Accidents↗
PubMed1985

Linkage analysis of a DNA marker localized to 20p12 and multiple endocrine neoplasia type 2A.

A DNA segment D20S5 isolated from a chromosome 19/20 flow-sorted library was shown to identify two restriction fragment length polymorphisms (RFLPs) with MspI and PvuII. The probe was localized by hybridization in situ to 20p12, the putative site of an interstitial deletion in some MEN 2A and 2B patients. Linkage of the D20S5 and MEN 2A loci was excluded at theta less than or equal to .13 using two large MEN 2A kindreds. These data suggest that the MEN 2A locus may not lie within 20p12 as previously suggested.

Chromosome Mapping↗
PubMed1977

Does the "missed" radiographic diagnosis constitute malpractice?

Recent studies confirm that radiologists disagree as often as 50% of the time and that as many as 30% of pathological findings are "missed." Legally, "simple" errors are not considered to constitute malpractice, but "negligent" errors are; yet there are no practical guidelines to help the courts or the medical profession distinguish between the two. A practical "standard of radiological practice" must be developed, possibly by the various radiological societies, so that the courts may more easily distinguish true negligence from "simple" errors. It is also suggested that review panels be organized to render a medical opinion as to whether or not they conform to standard radiological practice.

Diagnostic Errors↗