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P A Levy

Publications and source records attributed to P A Levy.

8 recordsLinked to original sources
PubMed1998

Amniotic bands.

Explore the source record for details and available documents.

Amniotic Band Syndrome↗
PubMed1995

The awareness of chromosomal disarrangements in the evaluation of child psychiatry patients.

This case report reviews genetics consultations on psychiatrically hospitalized school-age children. Six of 100 patients were noted to have positive genetic findings: four with congenital anomalies and/or biochemical/metabolic abnormalities and two with chromosomal abnormalities. Three of these patients are used to illustrate the occurrence of genetic abnormalities in psychiatrically hospitalized children. The indications for chromosomal analysis are discussed.

Child↗
PubMed1991

Effects of captopril combined with oxygen therapy at rest and on exercise in patients with chronic bronchitis and pulmonary hypertension.

The aim of this study was to determine the effects of captopril combined with oxygen therapy on pulmonary hemodynamics and gas exchange in chronic obstructive pulmonary disease (COPD) patients with pulmonary hypertension. Eleven subjects, with severe airflow obstruction (FEV1/FVC: 42 +/- 11%) and chronic respiratory failure (PaO2: 54 +/- 6 mm Hg, PaCO2: 46 +/- 8 mm Hg) treated with long-term oxygen, underwent two successive hemodynamic and arterial gas studies, at rest and during exercise. All the studies were performed whilst the patients were breathing oxygen, at rest and during exercise and 1 h after intake of 12.5 mg of captopril. The second study was performed in 9 out of the 11 patients after 8 weeks of treatment with 12.5 mg captopril 3 times daily. At rest, there was no significant effect of captopril. Mean pulmonary arterial pressure (PAP) showed a trend towards decrease after 8 weeks treatment. During exercise, there was a statistically significant decrease of mean PAP, pulmonary capillary wedge pressure and total pulmonary vascular resistance, without any deleterious effect on blood gases. However, the clinical significance of these variations during exercise is poor. We conclude that a low dose of captopril associated with oxygen therapy has no significant clinical effect on pulmonary hemodynamics at rest and during exercise in COPD.

Aged↗
PubMed1991

Changes in left ventricular ejection fraction during REM sleep and exercise in chronic obstructive pulmonary disease and sleep apnoea syndrome.

Nine patients, 4 with chronic obstructive pulmonary disease (COPD) and 5 with obstructive sleep apnoea syndrome (OSAS) were monitored during sleep, rest and exercise. Left ventricular ejection fraction (LVEF) was investigated using gated equilibrium 99mtechnetium ventricular scintigraphy during rapid eye movement (REM) sleep, during exercise, and during wakeful rest. Control wakeful rest periods used for comparison with a study state (either REM sleep or exercise) were always selected during the same circadian segment as that state. Myocardial stress thallium-201 scintigraphy was performed during, and 4 h after, exercise, and results were compared to a daytime rest period. Several patients had myocardial hypoperfusion despite a normal electrocardiographic (ECG) treadmill test. During REM sleep, all patients exhibited a significant change in LVEF (greater than 5%) compared to wakefulness. During exercise, 5 subjects increased their LVEF normally (greater than 5%) and 4 (1 COPD, 3 OSAS) decreased it. All patients had a similar change (increase or decrease) during REM and at maximal exercise. Our results suggest that REM sleep in COPD and in OSAS can produce a myocardial stress as great as that produced by exercise. We conclude that REM sleep, like exercise, is a state in which morbidity may become higher and that it may account for mortality in COPD and OSAS patients with compromised myocardial circulation.

Adult↗
PubMed1979

Usefulness of preoperative screening tests in perioperative respiratory therapy.

The incidence of postoperative pulmonary morbidity was studied in 910 surgical patients who had received preoperative screening by routine history-physical examinations, chest x-ray, and spirometry. Retrospective data were correlated with results of the preoperative screening procedures to calculate accuracy and efficiency of each test and test-combination. Use of the data to predict total cost of therapy, and cost per patient benefited, is described for a protocol of perioperative respiratory therapy when it is administered to all patients with positive screening tests. The optimum screening procedure is identified by comparison. It was shown that when an optimum screening procedure is used, with therapy administered only to patients with positive screening tests, about 80% of at-risk patients can be identified preoperatively and the cose of therapy can be reduced by up to 50%, or, in a selected population, by up to 75%. A screening procedure using all three of the tests studied, in combination, was shown to provide maximum economy of therapy with minimum loss of efficiency. The routine history-physical examination alone, for identification of at-risk patients, was shown to be inaccurate and inefficient. Spirometry was shown to be equally as useful as chest x-ray in improving the accuracy and efficiency of screening procedures.

California↗