Biomedical subjects

R Behal

Publications and source records attributed to R Behal.

8 recordsLinked to original sources

PubMed1991

A comparison of single-level fusions with and without hardware.

During a 47-month period, 68 patients were studied prospectively to compare single-level lumbar fusion with and without adjunctive pedicular fixation. Fusion indications were disabling back pain for a minimum of 6 months, inability to work, and failed conservative care. Twenty-nine patients fused without hardware and 39 fused with VSP fixation in identical procedures. All patients were evaluated according to fusion success, perceived pain, and return to work. Pseudarthrosis was demonstrated in 58.6% of the noninstrumented group. No pseudarthroses were noted in instrumented patients. Pain improvement in the nonhardware group was 41.4%, and in the hardware group, 76.9%. Return to work was 31% and 72% in each group, respectively. The fusion rate for patients exhibiting single-level disc disease improves with spinal fixation.

Adult↗

PubMed1989

Factors influencing the penetration of wires into the neural canal during segmental wiring.

We evaluated the influence of the penetration of wires into the neural canal during segmental wiring in a three-part study. First we examined the anatomy of the thoracic spine, specifically the laminar and interlaminar dimensions, as well as the epidural space. In the second part, we evaluated the depth of penetration of wires into the spinal canal at the time of their passage during spinal segmental instrumentation, using direct laboratory measurements for three configurations of the wire: first with a straight wire, and then with two wires of varying curvature. The measurements were repeated after removal of a portion of the lamina. In the third and final part of the study, we assessed the relationship between the observed penetration of the wires and the depth of penetration as calculated using mathematical models for the three wire configurations. When a wire with the largest possible diameter of curvature was passed under the lamina, there was significantly less penetration using the curved-wire configuration. This was seen in calculated models, as well as in normal specimens of the thoracic spine that were obtained from cadavera. Little epidural space was found to be available for passage of the wire. In most instances, passage of the wire must result in contact with and displacement of the dural sac and its contents. To minimize the depth of penetration at any given spinal level, it is recommended that the wire be curved to the maximum degree that will allow it to pass under the lamina.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1987

Percutaneous transhepatic cholangiography and biliary drainage after liver transplantation: a five-year experience.

Evaluation of the biliary tract by percutaneous transhepatic cholangiography (PTC) is often required in liver transplant patients with an abnormal postoperative course. Indications for PTC include failure of liver enzyme levels to return to normal postoperatively, an elevation of serum bilirubin or liver enzyme levels, suspected bile leak, biliary obstructive symptoms, cholangitis, and sepsis. Over a 5-year period 625 liver transplants in 477 patients were performed at the University Health Center of Pittsburgh. Fifty-three patients (56 transplants) underwent 70 PTCs. Complications diagnosed by PTC included biliary strictures, bile leaks, bilomas, liver abscesses, stones, and problems associated with internal biliary stents. Thirty-two percutaneous transhepatic biliary drainage procedures were performed. Ten transplantation patients underwent balloon dilatation of postoperative biliary strictures. Interventional radiologic techniques were important in treating other complications and avoiding additional surgery in many of these patients.

Adolescent↗

PubMed1983

Incomplete renal duplication obscuring ipsilateral complete duplication.

Renal duplication is not an uncommon anomaly of the urinary tract. However, we report a case in which the occurrence of incomplete duplication of a large lower pole, with an unusual side-by-side orientation of the lower pole segments, delayed recognition of the clinically troublesome ipsilateral upper pole duplication.

Child, Preschool↗

PubMed1977

Effect of glucocorticoids on liver and blood cholinesterases.

The effects of oral prednisone on plasma and red blood cell cholinesterases have been studied in human volunteers. While the activity of plasma pseudocholinesterase is depressed by glucocorticoid administration, the activity of red blood cell true cholinesterase is not affected. Cortisol administration to rats, intraperitoneal or subcutaneous, inhibited liver pseudocholinesterase activity, indicating a possible depression of the enzyme protein synthesis.

Acetylcholinesterase↗

PubMed1976

Protein-calorie malnutrition: a study of red blood cell and serum enzymes during and after crisis.

This paper reports a study of changes in red blood cell enzymes and some serum parameters during and after treatment of protein-calorie malnutrition. The red cell GSH levels were low during the crisis, together with the levels of GSSG:NADPH reductase, GSH:H2O2 peroxidase, aspartate aminotransferase and alanine aminotransferase. After treatment the levels of all these enzymes increased significantly to normal values. Of the serum parameters investigated, significant reduction in the activity of the enzymes cholinesterase, catecholamine oxidase, total proteins, albumin, urea and electrolytes were obvious, and returned to normal values after treatment. Ceruloplasmin activity remained low even after three weeks' treatment and could not be related to copper levels. The results are discussed in relation to anemia and liver damage that may accompany the syndrome.

Acetylcholinesterase↗

PubMedDate not supplied

Man to Man prostate cancer support groups.

PURPOSE: In this report, the authors describe Man to Man prostate cancer support group characteristics and functioning to identify ways to strengthen the program as it expands nationally and internationally. DESCRIPTION OF STUDY: A mail survey of 38 groups in Florida collected data on group meeting practices, facilitator background, training, and perceived needs, and on participant characteristics and satisfaction with the group. Descriptive statistics and bivariate analyses of survey data were performed. RESULTS: Typical groups included both survivors and significant others, met on a monthly basis, and followed a format that combined educational content with sharing of personal experiences. Facilitators and participants alike were typically retired white men in their 60s and 70s from well-educated professional backgrounds, who joined the groups after undergoing treatment for prostate cancer. High levels of satisfaction with the program's organization and functioning were reported. Perceived needs were in the areas of increasing access to support services, achieving a more diverse membership, and better outreach to newly diagnosed patients. CLINICAL IMPLICATIONS: Healthcare professionals can play a key role in informing newly diagnosed prostate cancer patients about the availability of support groups in their communities. Earlier referral to support groups would enhance patients' access to shared experiences and resources for guidance in treatment decisions. Greater attention to psychosocial issues in Man to Man support groups might better meet the emotional needs of patients and families.

Adult↗

PubMedDate not supplied

Ceftazidime dosing in the elderly: economic implications.

OBJECTIVE: This study evaluated the prevalence and resulting costs of ceftazidime dosing in excess of product labeling recommendations in elderly hospitalized patients. Ceftazidime is a beta-lactam antibiotic excreted via glomerular filtration. According to product labeling, ceftazidime dosing can frequently be decreased in the elderly because glomerular filtration declines with age. METHODOLOGY: A multicenter, retrospective utilization audit involving 11 US academic medical centers examined 221 medical records of patients 65 years of age or older receiving ceftazidime (any brand, any indication). The creatinine clearance of each patient was estimated using the Cockcroft-Gault formula. RESULTS: Renal insufficiency, defined as an estimated creatinine clearance of less than 50 mL/min, was present in 111 of the patients (50 percent). Ceftazidime dosing in excess of product labeling recommendations was noted in 75 of those 111 (68 percent). The cost of excess ceftazidime dosing for those 75 patients (i.e., extra drug acquisition, preparation, administration) was $13,822.50. CONCLUSIONS: Although the dosage of ceftazidime required in a specific patient is based on many factors, ceftazidime is frequently overdosed in the elderly because renal function is not considered. Ceftazidime dose-adjustment in the elderly, based on the estimated creatinine clearance, can lead to cost savings. In the US, where hospital reimbursement by Medicare is based on diagnosis, institutions can realize direct cost savings.

Academic Medical Centers↗