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Biomedical subjects

L L Levy

Publications and source records attributed to L L Levy.

16 recordsLinked to original sources

Severe self-mutilation of hands in a nonpsychotic, nonretarded patient.

A case report of a young female teenager with a long history of self-destruction of her hands by chewing, scratching, and gnawing is presented. This habit was related to her successfully repaired cervical meningomyelocele in infancy. Not only did she first present with ulcerations and osteomyelitis, but also with distal autoamputation and severe iron deficiency anemia. A team approach with a pediatrician, neurologist, psychiatrist, and plastic surgeon was employed for her treatment. Behavior modification was moderately successful. Her hands and forearms were reconstructed with arthrodesis, local and distant flaps, and skin grafting without incident. She has been followed now for 4 years.

Adolescent↗

Blood pressure after stroke.

In 334 consecutive admissions for acute stroke, the blood pressure was elevated in 84% on the day of admission. The blood pressure decreased spontaneously an average of 20 mm Hg systolic and 10 mm Hg diastolic in the ten days following the acute event without specific antihypertensive therapy and was elevated in only one third of the cases on the tenth hospital day. The early elevation in blood pressure is likely a physiological response to brain ischemia, and blood pressure falls as recovery of brain function occurs.

Acute Disease↗

Comparison of lactulose and neomycin in the treatment of chronic portal-systemic encephalopathy. A double blind controlled trial.

A randomized double blind clinical comparison of neomycin and lactulose was performed in 33 cirrhotic patients with chronic portal-systemic encephalopathy (PSE) at seven cooperating hospitals. In order to maintain double blindness, sorbitol syrup was used as a control solution along with neomycin and was compared with lactulose syrup and placebo tablets in a double drug protocol. Twenty-nine patients were studied in a crossover investigation in which each received both therapeutic regimens preceded and followed by control periods. Four additional patients received one or the other agent, but did not receive both. Serial, semiquantitative assessments were made in all patients of mental status, asterixis, and the trailmaking test (TMT) and electroencephalograms (EEG) and arterial ammonia levels. Both neomycin-sorbitol and lactulose were effective in the majority of patients (83 and 90%, respectively). Each of these parameters (mental state, asterixis, TMT, EEG, and NH3) was improved significantly by neomycin-sorbitol and lactulose. The post-treatment levels for each of these measures were similar in the neomycin and lactulose-treated groups. Mean stool pH was reduced by neomycinsorbitol to 6.1 and by lactulose to 5.5. This difference was highly significant statistically. Bowel activity was similar in the two groups. Both drugs were free of toxicity. These investigations demonstrate that both lactulose and neomycin-sorbitol are effective in the treatment of chronic portal-systemic encephalopathy.

Aged↗

Cerebral blood flow regulation: vascular resistance adjustments in the circle of Willis.

Continuous measurements of systemic blood pressure (BP), cerebral perfusion pressure and CBF were accomplished in the cat during transient hypertension, hypercapnia and bilateral carotid artery occlusion. From these measurements resistance values in the circle of Willis and in the cerebral arteries distal to the circle were calculated. The results indicate that the arteries of the circle of Willis and the arteries distal to the circle of Willis dilate and contract independently.

Angiotensin II↗

Cerebral blood flow regulation. II. Vasodilator mechanisms.

Rapid vasicular resistance adjustments in the brain and in the circle of Willis have been continuously measured and enhanced by signal averaging methods. Naftidrofuryl, a drug chemically similar to local anesthetics and to beta adrenergic blocking agents, increases local CBF by reducing resistance in brain and in extracerebral supply arteries. It has also been reported to affect brain metabolism. Other similar drugs merit study for potential effects on CBF and brain metabolism which may be useful in treatment.

Animals↗