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Biomedical subjects

M H Levy

Publications and source records attributed to M H Levy.

At least 55 records · Page 3Linked to original sources
PubMed1991

Effective integration of pain management into comprehensive cancer care.

Pain management is an integral component of comprehensive cancer care. The combined goals of optimal comfort and optimal function require a working understanding of how pain therapy interacts with cancer and cancer therapy. The two main aspects of cancer which affect pain management are the cancer's treatability and its non-pain pathophysiology. Cancer treatability determines the importance of pain management and the appropriateness of invasive pain-blocking procedures. Cancer non-pain pathophysiology often hinders pain control by preventing oral administration of medications, narrowing a patient's therapeutic window for opioid analgesics, limiting psychological therapies, and interfering with invasive pain relieving procedures. Cancer therapy can impair or enhance pain therapy and vice versa. Cancer therapy can impair pain therapy by its production of adverse effects or by its direct causation of pain. Cancer therapy can enhance pain therapy by reducing the amount of cancer, by including drugs which act as coanalgesics, and by providing intravenous access devices for parenteral opioid administration. Pain therapy can impair cancer therapy by augmenting or complicating cancer therapy's adverse effects. Pain therapy can enhance cancer therapy by improving organ function and patient performance status permitting previously limited or contraindicated cancer therapies to be given. Five case studies are presented to illustrate how effective integration of pain management into comprehensive cancer care is mandatory for optimal care of cancer patients and their families.

Female↗
PubMed1990

"Just one shot" is not enough--measles control and eradication.

The epidemiology of measles in Australia has changed in the last decade due to control of the disease by increased immunization rates. Elimination of endemic measles is possible, but has still to be attempted. A partially immunized population results in disease in an older population, with the possibility of contracting measles in the childbearing years. For elimination of measles to occur, a second dose of measles-mumps-rubella vaccine should be introduced. Changes in the immunization protocol would need to be monitored with reliable population-based data on seroconversion rates and disease incidence. Reliable documentation of immunization is a prerequisite for any legislative initiative in the field of immunization. In order to maximize the impact of immunization programmes, the social and cultural contexts within which immunization occurs should receive greater consideration.

Adolescent↗
PubMed1989

Integration of pain management into comprehensive cancer care.

Pain management is an integral component of comprehensive cancer care. Designing an effective pain control strategy for the individual patient requires knowledge of the ways in which a patient's cancer, cancer therapy, and pain therapy can interact. Two important aspects of cancer that affect the way in which pain is managed are the cancer's treatability and components of its pathophysiology that themselves do not cause pain (the cancer's "nonpain" pathophysiology). Cancer treatability modifies the need for pain management and the appropriateness of invasive pain procedures. Cancer nonpain pathophysiology can interfere with the oral administration of medications, narrow the patient's therapeutic window for analgesic drugs, limit the effectiveness of psychologic pain therapies, and complicate or preclude invasive pain-relieving procedures. In addition, cancer therapy can interfere with or enhance pain therapy and vice versa. Cancer therapy can interfere with pain therapy by causing pain or by producing other adverse effects. Cancer therapy can enhance pain therapy by reducing the extent of cancer, by acting as a coanalgesic, and by providing intravenous access for parenteral drug administration to patients who require it. Pain therapy can interfere with cancer therapy by increasing or complicating the adverse effects of cancer therapy. Pain therapy can enhance cancer therapy by improving patient performance, and certain palliative surgical procedures may have the ancillary effect of improving organ function. Five case descriptions are presented as illustrations of effective integration of pain management into comprehensive cancer care.

Adenocarcinoma↗
PubMed1989

Pain control in breast cancer. A panel discussion.

Pain can be a prominent finding in breast cancer patients. It may occur in the setting of the postmastectomy period, related to the disruption of normal neural pathways or the development of lymphedema. In advanced disease, the management of pain from nerve compression or bone metastases requires special approaches. In this panel discussion, the participating physicians will discuss these topics and provide an up-to-date approach to pain control in breast cancer patients.

Analgesics, Opioid↗
PubMed1989

Bilateral idiopathic inflammation of the optic nerve sheaths. Light and electron microscopic findings.

Idiopathic perioptic neuritis is a term used to describe noninfectious inflammatory disorders of the optic nerve sheaths, the causes of which are unknown. In the following report, a 68-year-old woman with bilateral visual loss was found to have chronic inflammation with necrobiotic granulomas of her optic nerve sheaths. The patient, who had no systemic condition known to be associated with necrobiotic granuloma, lost vision from infarction of the optic nerve parenchyma and from compression due to thickened meninges. Although there are similarities between the inflammatory reaction in this case to the necrobiotic dermatoses, the pathogenesis of this condition remains obscure.

Aged↗
PubMed1987

Enhancing cancer pain control regimens through patient education.

The problem of cancer-related pain afflicts millions of people annually. The study described here was aimed at improving cancer patients' pain control through a planned patient education program. A randomized clinical trial with a Solomon Four-Group design was used to assess the effectiveness of a patient education intervention consisting of nurse counseling and printed materials. The sample included 230 cancer patients. One month later, patients in the experimental group were more likely to have taken their pain medicine on the correct schedule and to have taken the correct dosage. The experimental group also was significantly less likely to report stopping the medicine when they felt better. In addition, they were significantly less worried about tolerance and addiction to pain medicines. Forty-four percent of the experimental group compared to 24% of the control group reported no or mild pain at the posttest.

Aged↗
PubMed1984

Cancer patients' knowledge, beliefs, and behavior regarding pain control regimens: implications for education programs.

The inadequate control of cancer-related pain is a matter of great concern. Misconceptions about pain medications on the part of professionals and the public have been implicated as causes of this problem. Another cause may be noncompliance with prescribed regimens. A study of 82 cancer patients who were prescribed pain medications was conducted to further investigate the problem of pain control in this population. Patients were interviewed twice: on the day after they received pain prescriptions (T1) and again two weeks later (T2). There was a significant decrease in patients' reported pain between T1 and T2 (P = 0.0001). By their own report, the level of patients' compliance with prescribed pain control regimens was very high. At T2 77% of the patients recalled the correct names of their pain medications and 88% had been taking them. However, an important gap in patients' knowledge was revealed by their general inability to recall any of the common side effects of pain medications (constipation, nausea, and sedation). None of the measures of pain--pain level at T1 and T2 and change in pain between T1 and T2--was related to the patients' education, age, attending physician, prescribed medication schedule, or medication strength. More women than men reported increased pain during the study period (P = 0.04). In general, the patients' concern about possible addiction or tolerance to prescribed medications were low. However, there was a positive relationship between intensity of pain and concern about tolerance to drugs (P = 0.0003).(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1981

Effect of population density upon life expectancy and wing retention in the common house fly, Musca domestica L.

In adult caged house flies, maintained on a complete diet of powdered whole milk, cane sugar and water, the median longevity, maximal longevity, and percentage that exhibit complete wing retention at death are increased as the number of individuals per cage is correspondingly decreased from 240 to 10 flies per cage. These effects are more marked for the shorter-lived males than for the females. Female longevities at all population densities are more significantly reduced by a restricted diet of sugar and water only. Under conditions of individual confinement, the life expectancy of the female house fly is no greater than that of the male. These results are in agreement with earlier suggestions that increased physical activity including interaction among individuals in a restricted population decreases longevity.

Animals↗
PubMed1976

Use of silica to identify host mechanisms involved in suppression of established Friend virus leukemia.

Silica, an agent predominantly toxic for macrophages, inoculated i.v. to Friend leukemia virus (FLV)-infected mice, blocks the FLV-leukemosuppressive effects of chlorite-oxidized oxyamylose (COAM)-statolon treatment. FLV-infected, COAM-statolon-treated mice that have received silica and have failed to suppress FLV leukemia produced normal amounts of interferon, but did not make antibodies cytotoxic for FLV leukemic cells. Transfer of untreated spleen cells, splenic T cells, or thymocytes from mice with suppressed FLV erythroleukemia to FLV-infected mice treated with silica and COAM-statolon restores the humoral immune response to FLV antigens and results in leukemosuppression. Thus, T lymphocytes from mice with suppressed erythroleukemia participate in FLV leukemosuppression either directly as effector cells, or indirectly as helper cell in the production of antibodies to FLV antigens.

Amylose↗
PubMed1975

Impaired macrophage function in Friend virus leukemia: restoration by statolon.

Phagocytic and migratory functions of peritoneal macrophages from Friend virus (FV) leukemic mice are significantly depressed as compared with normal controls. Leukemic macrophages exposed in vivo and in vitro to statolon, an extract of the mold Penicillium stoloniferum, shown previously to suppress FV erythroleukemia, regain normal function and release reduced amounts of FV. Statolon's in vivo restoration of leukemic macrophage function is paralleled by restoration of humoral immune competence. Statolon induces interferon in vitro but its effects on leukemic macrophages are probably direct, since restoration of macrophage function occurs at dosage levels far below those that induce interferon. These studies suggest that macrophages play an integral role in both the pathogenesis and the statolon-induced suppression of FV disease.

Animals↗