Biomedical subjects

L Neumann

Publications and source records attributed to L Neumann.

At least 109 records · Page 6Linked to original sources

PubMed1994

Treatment of psoriatic arthritis at the Dead Sea.

OBJECTIVE: To evaluate the effectiveness of balneotherapy (mud packs and sulfur baths) on patients with psoriasis and psoriatic arthritis (PsA). METHODS: One hundred and sixty-six patients with psoriasis and PsA were treated at the Dead Sea for a period of 3 weeks. The patients were divided into 2 groups. Both groups had the regular regimen of bathing in Dead Sea water and exposure to the sun's ultraviolet rays. The study group, which consisted of 146 patients also was treated with mud packs and sulfur baths. The control group, which had no additional therapy, consisted of 20 patients. The main clinical variables assessed were duration of morning stiffness, grip strength, activities of daily living, subjective patient assessment of disease severity, number of active joints, number of effluent joints. Ritchie index, psoriasis area and severity index score, cervical, thoracic, and lumbar spine pain and limitations of movement. RESULTS: Statistically significant improvement was found in most variables in both groups. However, better results were observed in the study group. In 2 variables, reduction of spinal pain and range of movement in the lumbar spine, significant improvement (p < 0.001 and p = 0.022, respectively) was observed in the study group only. CONCLUSION: Treatment of psoriasis and PsA at the Dead Sea area is very efficacious and the addition of balneotherapy can have additional beneficial effects on patients with PsA. Other controlled studies with longer followup periods are needed to verify our results.

Adult↗

PubMed1994

Long-term results of Charnley total hip replacement. Review of 92 patients at 15 to 20 years.

We made a prospective study of 241 Charnley total hip replacements performed between 1968 and 1974. In 1990, we reviewed 92 patients with 103 hips (96.3% of surviving hips) at a mean follow-up of 17.6 years (15 to 20.6) The clinical results were excellent, with Charnley scores of 4 or more for pain in 95% of the patients, for function in 73% and for movement in 93%. Of the whole series, 8.3% had been revised, and Kaplan-Meier survival analysis showed a probability of revision at 20 years of 10.7%. These results are similar to those from the few other series with extended follow-up, and make it difficult to justify the present widespread use of uncemented hip prostheses. It would seem that some aspects of the design of the first-generation Charnley stem were beneficial for long-term survival of the arthroplasty. We found no correlation between the clinical results and radiological loosening on the Harris scale.

Adult↗

PubMed1993

Gender differences in health perceptions and their predictors.

This study explored the degree to which risks embedded in the social construction of gender roles and personality traits explained gender differences in health perceptions and reporting among mild hypertensive patients (134 women and 104 men) under the same treatment regime. Compared with men, women were less educated, less likely to be employed, less happy, more distressed, less satisfied with family functioning, and had a weaker sense of coherence. Twice as many women as men evaluated their health as 'poor', and on average reported 2.6 more symptoms than men. These gender differences largely disappeared when unhappiness, distress, and sense of coherence were controlled. While education attainment, employment, and satisfaction with family functioning decreased gender differences in some half of the symptoms, multivariate analysis suggested that unhappiness, distress, and the sense of coherence are far better predictors of gender differential health perceptions. It is suggested that beyond biological predispositions, women's health is in double jeopardy by gender role related risks, which affect morbidity both directly through immunology system and indirectly through health perceptions.

Adult↗

PubMed1993

Assessment of nonarticular tenderness and prevalence of fibromyalgia in hyperprolactinemic women.

OBJECTIVE: To assess nonarticular tenderness and prevalence of fibromyalgia syndrome (FMS) in hyperprolactinemic subjects. METHODS: Twenty-one consecutive women with hyperprolactinemia (HPRL) and 44 consecutive women with normal prolactin levels (PRL) were examined in the fertility unit by one observer during a 24-month period. Mean age was 31 years, range 22-46 years. Hyperprolactinemia was defined as PRL levels > 24.5 ng/ml (immunoradiometric assay). In all women, a count of 18 tender points (TP) was conducted by thumb palpation. Tenderness of some of the TP sites (9 points) as well as control point sites (4 points) was further assessed using a Chatillon dolorimeter. All women were questioned about the presence of widespread pain or aching. Women were considered to have FMS if they met the American College of Rheumatology (ACR) criteria for diagnosis. RESULTS: Of the 21 women with HPRL, 15 (71%) had FMS vs only 2 of 44 (4.5%) normoprolactinemic women (p < 0.0001). Thresholds of tenderness of 9 fibrositic points were 2.7 (1.5) kg [mean (standard deviation)] for HPRL women vs 5.0 (1.4) (kg) for women with normal PRL (p < 0.0001). Thresholds of tenderness of 4 control points were 5.2 (1.5) (kg) for women with HPRL vs 6.8 (1.1) (kg) for normoprolactinemic women (p < 0.0001). The frequency of FMS was directly associated with the level of PRL. CONCLUSIONS: We suggest that FMS is very common in a subset of women with HPRL and that its frequency is directly associated with the degree of hyperprolactinemia. Women with HPRL have lower thresholds of tenderness than women with normal PRL. More studies are needed to clarify the relationships between PRL, FMS and tenderness.

Adult↗

PubMed1993

Cefuroxime prophylaxis in biliary surgery: single versus triple dose.

The standard regimen for prophylaxis in bilary surgery consists of three doses of a first- or second-generation cephalosporin (one pre- and two postoperatively). The purpose of our study was to compare a single dose of cefuroxime (1.5 gi.v. on call to surgery) with the standard regimen (1.5 gi.v. on call to surgery followed by two additional doses of 750 mg i.v. each, 8 and 16 h after surgery). One hundred patients participated in the study, 44 in the single-dose group and 56 in the triple-dose group. These two groups did not differ with regard to sex, risk factors, duration of surgery, etc. The incidence of infection was 9% in the single-dose group and 7% in the triple-dose group. We conclude that one dose of cefuroxime is as effective as three for biliary surgery. This regimen would reduce the risk of side effects and/or suprainfections and the emergence of resistant strains of bacteria. It is also more convenient for the nursing staff and reduces the cost by one-half.

Cefuroxime↗

PubMed1993

Assessment of nonarticular tenderness and prevalence of fibromyalgia in children.

Fibromyalgia syndrome (FS) is most common in midlife, but may be seen at any age. Its prevalence and assessment of tenderness in healthy children is not known. We assessed 338 healthy schoolchildren for tenderness thresholds and prevalence of FS. In all children a point count of 18 tender points (TP) was conducted by thumb palpation and tenderness of some of the TP sites as well as control point sites was further assessed using a Chatillon dolorimeter. All children and their parents were questioned about the presence of widespread pain or aching. Children were considered to have FS if they met the American College of Rheumatology (ACR) criteria for diagnosis of FS. Of the 338 children, 21 (6.2%) had FS. Thresholds of tenderness of 9 TP were 5.0 (1.2) (kg) [mean (standard deviation)] for boys vs 3.6 (0.8) (kg) for girls (p < 0.001). Thresholds of tenderness of the control point sites were 7.1 (1.4) (kg) for boys vs 5.5 (1.1) (kg) for girls (p < 0.001). Thresholds of tenderness of TP and control points in the children with FS were 2.5 (0.4) (kg) and 4.2 (0.5) (kg) vs 4.5 (1.2) (kg) and 6.6 (1.4) (kg) respectively in the children without FS (p < 0.001). We suggest that FS is common in the pediatric age group. Boys have lower tenderness than girls; children with FS have lower thresholds for tenderness both at control and TP compared to the subjects without FS.

Adolescent↗

PubMed1992

Mud pack therapy in rheumatoid arthritis.

Twenty-eight patients with classical or definite rheumatoid arthritis were randomly divided into two groups of fourteen patients each. All patients were treated once a day with mud packs derived from the Dead Sea heated to 40 degrees C and applied over the four extremities, neck and back for 20 minutes. Group 1 was treated with the true mud packs and Group 2 with washed out and less concentrated mud packs. The study was double blind and of two weeks duration. All patients were evaluated by one rheumatologist both before treatment and two weeks later at the end of the treatment period. Follow-up evaluations were made one and three months after conclusion of the treatment. The clinical indices evaluated included duration of morning stiffness, hand-grip strength, activities of daily living, patient's own assessment of disease activity, number of active joints and the Ritchie index. A statistically significant improvement (p less than 0.01 or p less than 0.05) was observed in Group 1 only in most of the clinical indices, lasting between 1 to 3 months.

Arthritis, Rheumatoid↗

PubMed1992

Effects of mental and physical stress on plasma catecholamine levels before and after beta-adrenoceptor blocker treatment.

In a study in mild hypertensives, the impact of mental and physical stress on plasma epinephrine (E), norepinephrine (NE), and on their ratio (NE/E) was evaluated. The effect of two beta-adrenoceptor blocking drugs, atenolol and bopindolol, on plasma catecholamine levels was also examined. Each stressful stimulus significantly increased the NE and E levels compared to rest. The increase was progressive from mental stress, through the handgrip test to the treadmill test. A slight decrease in the NE/E ratio was observed following mental stress and the handgrip test, while this ratio increased during the treadmill test. No significant impact of beta blocking treatment on catecholamine levels was observed under any test condition.

Adrenergic beta-Antagonists↗

PubMed1991

Response to mental and physical stress before and during adrenoreceptor blocker and angiotensin-converting enzyme inhibitor treatment in essential hypertension.

The effects of mental, static and dynamic stresses on physiologic parameters before and after beta-blocker (n = 24) and angiotensin-converting enzyme inhibitor (n = 29) treatment were examined. Mental stress induced similar elevation in systolic and diastolic blood pressures (BPs) with and without beta-blocker treatment. During angiotensin-converting enzyme inhibitor treatment, the change in systolic BP was significantly greater (p less than 0.05). Heart rate response was attenuated by beta blockers and unchanged by the angiotensin-converting enzyme inhibitor. Skin temperature and galvanic skin resistance significantly decreased (p less than 0.05) with mental stress. Beta blockers did not change the response pattern, whereas the angiotensin-converting enzyme inhibitor attenuated the stress-induced reduction of both skin temperature and galvanic skin response. After handgrip exercise, increases in systolic and diastolic BPs and heart rate were similar before and after beta-blocker treatment, whereas the angiotensin-converting enzyme inhibitor induced small but significantly fewer (p less than 0.05) changes in diastolic BP and heart rate. Treadmill exercise induced similar changes in systolic and diastolic BPs with both treatments compared with no treatment. The angiotensin-converting enzyme inhibitor appears to provide additional protection to that seen with beta blockers during mental and static stressors by blunted changes in skin temperature and galvanic skin resistance.

Adrenergic beta-Antagonists↗

PubMed1991

[Prognostic factors in pigmented villonodular synovitis].

By means of the diagnostic register, all of the patients in the County of Funn with the diagnosis pigmented villonodular synovitis (PVS) during the years 1973 to 1987 were localized. Out of 22 patients, 19 were followed-up clinically and radiologically. Fifteen patients had PVS in a knee, 63% were women. The diagnosis was established late. Repeated punctures of the knee with dark aspirate without relevant trauma should raise the suspicion of PVS. The clinical course of the disease could not be related to the radiographic findings or the histology but depended rather on the localization. In some patients, PVS ran a more aggressive course and arthroses were observed electively in patients treated early. The prognosis in cases diagnosed early was not better but, as treatment yielded considerable relief of symptoms, early treatment was considered to be of value. This consists of local resection of the nodular PVS elements and as radical synovectomy as possible in the diffuse cases. Treatment of recurrences should depend on the symptoms and the degree of possible arthrosis. One patient who had had three recurrences received irradiation with good results. Restricted joint mobility after synovectomy is treated effectively with brisement.

Adolescent↗

PubMed1991

Self-esteem, internal-external locus of control, and their relationship to weight reduction.

One hundred sixteen women participated in a 10-week weight reduction program and lost on the average of 7 kg. Family-related variables and two personality constructs, self-esteem and Internal-External Locus of Control (I-E Loc), were examined as predictors for success in weight loss. Principal findings were: (a) Subjects with low self-esteem scores lost significantly less weight than subjects with medium and high scores (4.3 kg vs. 8.7 and 6.4, respectively); (b) No significant differences were recorded between Internals and Externals with regard to weight reduction; and (c) Family-related variables, marriage and number of children, did not directly affect weight loss, but their effect was observed within the three self-esteem and the two I-E Loc groups.

Adult↗

PubMed1991

Student characteristics as predictors of drop-out from medical school: admissions to Beer-Sheva over a decade.

The study sought to identify variables from the demographic, socio-economic, academic and personal background of medical students in order to reveal possible predictors of drop-out from medical school. The research included 443 students who were admitted to Ben Gurion University (BGU) Medical School during its first 10 years, 1974-1983. It was found that the permanent drop-out rate in BGU Medical School (12.6%) is relatively high and mainly due to academic failures. Of all admitted students 11.3% do not graduate on time due to academic reasons. The findings are discussed and suggestions for changes in admissions policy are provided.

Adult↗

PubMed1991

Cellular B-2 microglobulin expression as a prognostic indicator in renal cell carcinoma.

The expression of B-2 microglobulin (B-2M) on tumor cells and their normal cell counterparts in 39 patients with renal cell carcinoma was studied and correlated to tumor stage and survival. The median survival time of patients with localized disease (stage I) whose tumors expressed B-2M was 10.2 years while the median survival time for patients whose tumors did not express B-2M was only 3.6 years (p less than 0.001). For patients with more advanced disease (stages II, III, IV) whose tumors expressed B-2M, median survival time was 3.6 years compared to 2.0 years in patients whose tumors did not express B-2M, a non-significant difference. It is suggested that the tumor cell membrane expression of B-2M may serve as an indicator of good prognosis in early renal cell carcinoma.

Adolescent↗

PubMed1990

[Prevalence of type 2 diabetes in the Negev].

10,578 medical records of patients 30 years and older, registered in 3 representative primary care clinics, were reviewed in 1984. 705 diabetics were identified. The prevalence rate was 6.7%: 5.9% among men and 7.1% among women. The male/female ratio was 46/54. In both sexes rates increased with age. The highest age-adjusted rate was among Jews of North African origin (7.5%).

Adult↗

PubMed1990

[Preventive antibiotic treatment in cases of complicated injuries of the extremities. A questionnaire study].

A questionnaire about prophylactic antibiotic treatment of open bone, tendon or joint lesions in the extremities was sent to the 83 casualty departments in Denmark. The questionnaire was answered by 56 casualty departments which treated 72% of the orthopaedic surgical injuries in Denmark. In cases of lesions of the hands and feet, 23% of the patients were treated in casualty departments where prophylactic antibiotic therapy was rarely employed while 24% were treated in casualty departments where prophylactic antibiotic therapy was always employed. In cases of lesions proximal to the wrist or ankle joints, the figures were 26% and 38%, respectively. Penicillin was nearly always employed and treatment was commenced before or during operation. The majority of departments continued treatment for four days or longer. Considerable scatter was reported in the dosage of penicillin employed. The literature about prophylactic antibiotic treatment in cases of complicated lesions of the extremities is insufficient and controlled investigations are necessary to elucidate a series of conditions.

Arm Injuries↗

PubMed1990

Acute plastic bowing fractures of both the tibia and the fibula in a child.

A case of acute plastic bowing fractures of both the fibula and tibia in a child is presented. This type of fracture has never been reported in the tibia, but has now been reported in all the major bones of the limbs. The clinical picture is described, and the indications for treatment discussed. In case of doubt, radiographs should be taken of the opposite limb, if the clinical picture suggests a bowing fracture.

Bone Development↗

PubMed1990

Subtrochanteric fractures following Gouffon pinning of subcapital femoral fractures.

Of the first 158 patients in a series of 292 consecutive patients treated for a femoral neck fracture with multiple pinning according to Gouffon's method (Howmedica Inc.), four (2.5 per cent) subsequently suffered a subtrochanteric fracture at the site of the distal pins. The configuration of the fractures was identical. These fractures occurred spontaneously while walking, and one occurred after slight direct trauma. Re-osteosynthesis was required in all four cases using a screw-plate device. If necessary, one or two pins were left in place to secure rotational stability. After a review of these cases and the literature, various modifications to Gouffon's method were introduced, and none of the following 134 patients suffered secondary fractures.

Aged↗

PubMed1990

Motivation patterns, self-esteem, and depression of patients after first myocardial infarction.

This study explored the relationship between dominance-achievement motivation and psychological adjustment of 53 patients after their first myocardial infarction. These two motivations are perceived as expressions of general tendency to "agency," or assertiveness. The following findings were observed: (1) High-agency subjects reported less depressive moods than low-agency subjects; there was no time effect on this difference between groups nor within each group separately. (2) the self-esteem of high-agency patients was high and stable, whereas that of low-agency subjects was lower and got lower with time. It may be concluded that patients with a high-agency level might be more efficiently equipped to cope with stressful events.

Achievement↗