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Biomedical subjects

R Silverberg

Publications and source records attributed to R Silverberg.

At least 19 recordsLinked to original sources
PubMed2001

[Acute colonic pseudo-obstruction].

Colonic Pseudo-obstruction is a poorly understood syndrome. It was first described by Ogilvie in 1948 and is characterized by signs of large bowel obstruction with a non-mechanical etiology. The suggested cause of this pathophysiology is an imbalance in the autonomic nerve supply to the colon. The syndrome affects mainly old, bedridden patients, usually hospitalised for non-colonic causes. The actual incidence of this syndrome is unknown, mainly due to the fact that spontaneous recovery may occur. When massive abdominal distention is apparent, diagnosis and treatment are usually problematic and other causes of obstruction must be ruled out. It is usually managed by water soluble contrast administered orally or rectally, or by colonic decompression. In extreme cases surgical treatment is required with significant morbidity and mortality. Pharmacologic management with parasympathomimetic drugs has been suggested recently. We describe the successful treatment of a patient with neostigmine and review the current literature.

Acute Disease↗
PubMed2000

Pluto story.

Explore the source record for details and available documents.

Exobiology↗
PubMed1995

Serial casting of the lower extremity to correct contractures during the acute phase of burn care.

Severe contractures that develop early following a burn may not improve with splinting and exercise treatment. An alternative treatment is serial casting, which has been used to promote increased range of motion, to facilitate patient compliance with positioning, and to prevent the patient from scratching the burned area. This case report describes the use of serial casting for resolution of ankle plantar-flexion contractures that occurred in the acute phase of burn injury. The child described in this case report sustained a 49% total body surface area scald burn and developed contractures within 1 week after injury. The contractures, which were not corrected with thermoplastic splints, improved with casting from 45 degrees of plantar flexion to neutral dorsiflexion over 2 months with biweekly cast changes. The patient had multiple skin grafts and progressed in functional activities. Serial casting is a conservative and effective modality in correcting contractures resulting from burns. Further documentation of the efficacy of this treatment approach is necessary to support its use in burn care throughout various stages of healing.

Acute Disease↗
PubMed1990

Direct costs of stroke for a Swedish population.

Direct costs were estimated for the treatment, rehabilitation, and nursing of 125 patients with first stroke in the Lund and Orup health districts (population of 200,191). Patients were followed from the onset of stroke in 1983 until October 31, 1985. The data were used to calculate the present value of the expected lifetime direct costs for an individual contracting his or her first stroke at various ages. For example, at the age of 72, these costs were estimated at SEK 283,000 for a man and SEK 561,000 for a woman. Hospital care was the major cost component (75% for males and 89% for females) at this age of onset. The results could be used to estimate the economic benefits of preventing new strokes, hence, forming part of a cost-effectiveness or cost-utility analysis. Together with prognoses of the expected developments in the incidence of stroke, they could also serve as the basis of forecasts of future costs of the health care and social service sectors.

Adult↗
PubMed1985

Subsidizing pharmaceutical prescriptions: the experience of Denmark, Finland, Norway and Sweden.

In 1980, drug consumption per capita was 455 Swedish crowns (SEK) in Sweden, SEK 452 in Denmark, SEK 384 in Finland and SEK 382 in Norway; actual figures for Denmark, Finland and Norway being converted into Swedish crowns using the mean 1980 exchange rates. To what extent can these differences be explained by differences in the drug reimbursement programmes of these four Nordic countries? For instance, is it the greater generosity of the Swedish system--in Sweden, the share of drug reimbursement expenditures to total drug consumption is 57%, as against 33% in Norway, 38% in Finland and 34% in Denmark--that makes drug consumption per capita so much higher in Sweden? If the demand for drugs were elastic and if all other influencing factors, besides the reimbursement system, were the same in all the four Nordic countries, then a definite conclusion would, obviously, be fairly easy to reach. However, a number of factors do differ: for instance, income per capita, physician remuneration schemes (and, hence, maybe, physician behaviour) and consumer charges for inpatient and outpatient care; and other factors such as morbidity and patterns of illness may differ. A complete analysis has to take all these factors into account. Too many factors seem to vary to make the sole use of cross-section data meaningful in this case. Time-series data are available and will be used in future analyses.

Cost Control↗
PubMed1982

Variations between and within countries in hospital care for peptic ulcer. A comparison between Denmark and Sweden.

The present study tries to examine variations in utilization rates for hospital care for ulcer disease between and within Denmark and Sweden. The focus is on how utilization rates differ but an attempt is also made to explain why regional differences occur. Hospital patient statistics from both countries show that ulcer disease accounts for 35% more bed-days per 100000 inhabitants in Denmark than in Sweden. The main source for this difference is duodenal ulcer, where the number of bed-days is 63% higher in Denmark. The differences in length of stay are negligible and the numbers of surgical operations are about the same in the two countries. The greater utilization of hospital resources in Denmark is explained mainly by the fact that more medical cases are treated as in-patients in Denmark than in Sweden. Neither mortality rates nor other data support the hypothesis that the incidence of duodenal ulcer is higher in Denmark than in Sweden. The difference between Denmark and Sweden widens when utilization rates are adjusted for differences in the age structure of the population in the two countries. There are wide variations in utilization rates between regions within both countries. The findings support the hypothesis that the intertemporal change in the technology for management of ulcer disease is one of the main reasons for variations between and within countries.

Denmark↗
PubMed1981

Asymmetrical cognitive deterioration in demented and Parkinson patients.

Patients with Parkinson's disease and patients with dementia showed greater deterioration on functions attributed to the right cerebral hemisphere, than on functions attributed to the left. Relative to matched controls, Parkinson patients were significantly impaired on right hemisphere tests, but did not differ on left hemisphere tests. Demented patients were significantly deficient on all tests, but right decline was greater than left. Ninety-six patients were tested: 32 diagnosed as senile or presenile dementia, 32 Parkinson patients, and 32 non-neurological patients matched for age, sex and education. Functional performance was assessed by a battery of validated tests for left and right hemisphere cognitive functions. Patients were defined with two scores based on the results of the test: Cognitive Laterally Quotient (CLQ) reflecting the averaged performance on the left hemisphere tests, subtracted from the average performance on right hemisphere tests, and Cognitive Performance Quotient (CPQ), reflecting the total level of performance of both hemispheres. These measures defined a characteristic cognitive profile for each group.

Aged↗
PubMed1980

Therapy improvement in two out-patient mental health clinics.

This study describes clients, therapists, treatment characteristics, and therapy outcomes for 551 consecutive, first-time clients at two out-patient mental health clinics. Significant improvement was found on target problems, global outcome ratings, and Hopkins Symptom Checklist scores for clients who mutually terminated therapy. The target problem and outcome ratings remained higher for this group than for dropouts at a six-month follow-up interview. Clients who improved most were those who were initially most uncomfortable and disturbed. Improvement was also strongly related to the number of therapy sessions. The implications of these and other results are discussed.

Adolescent↗
PubMed1979

Inosiplex in the treatment of subacute sclerosing panencephalitis.

Six patients with subacute sclerosing panencephalitis were treated with the antiviral agent inosiplex. The clinical condition of four children continued to deteriorate in spite of the treatment, the condition of one remained unchanged, and that of another improved minimally. The effect of inosiplex in these patients is not evident since this group demonstrated a pattern of progression similar to that seen in subacute sclerosing panencephalitis without specific treatment.

Adolescent↗
PubMed1979

Angina pectoris with normal coronary arteries in Shy-Drager syndrome.

A patient with Shy-Drager syndrome who presented with severe angina pectoris is described. Special investigations of his autonomic nervous system showed sympathetic and parasympathetic dysfunction with supersensitive end-organ response. Sympathetic dysfunction manifested as labile hypertension, severe postural hypotension, and inadequate heart rate response to atropine and the Valsalva manoeuvre. These changes in blood pressure were accompanied by severe disabling angina pectoris. Selective coronary angiography showed normal coronary arteries. It is suggested that angina pectoris resulted from the inadequate circulatory response and is another clinical manifestation of the Shy-Drager syndrome.

Angina Pectoris↗
PubMed1979

Differential aphasia in tow bilingual individuals.

Moderate nonfluent aphasia following a left parietotemporal lesion was found in the native language of one bilingual patient, in contrast to less severe, fluent aphasia in the patient's secondary language. Conversely, mild anomia was found in the native language of a second patient, while global aphasia was found in the secondary language. His lesion was located in the left posterior frontal area. These examples of differential aphasia were assessed by standard aphasia tests and by language inventory translated into the appropriate languages. We propose that differential aphasia resulting from a single hemispheric lesion is related to the disruption of different basic cognitive functions, which participate to varying degrees in the performance of the languages affected. In terms of neurolinguistic theory, the findings in these patients support the observation that most frequently used language is the first to recover. They refute the notion that the native language recovers first.

Adult↗
PubMed1979

The anatomic basis of visual agnosia.

In a patient with associative visual agnosia without alexia, there was bilateral infarction in the distribution of the posterior cerebral arteries, with corticosubcortical lesions in both occipitotemporal regions, sparing the corpus callosum. Bilateral loss of visual-limbic connections may underlie associative visual agnosia, and bilateral lesions of the inferior longitudinal fasciculi may be the necessary and sufficient lesions for this syndrome. Alexia was absent in this case, perhaps because the corpus callosum was intact.

Agnosia↗