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Biomedical subjects

S Berney

Publications and source records attributed to S Berney.

At least 19 recordsLinked to original sources

The use of positive pressure devices by physiotherapists.

The aim of this paper is to review the indications for use by physiotherapists, such as physiological rationale and the comparative efficacy of intermittent positive pressure breathing (IPPB) and continuous positive airway pressure (CPAP). A brief discussion of nasal intermittent positive airway pressure is also included. The use of IPPB for post operative prophylaxis has not been supported in the literature. In patients with low lung volumes resulting from neuromuscular disease or spinal injury, IPPB may be useful in the acute phase to improve tidal volume and cough effectiveness. The physiological benefits of CPAP to improve lung volumes are well documented in the literature. Physiotherapists use CPAP as an intermittent application in patients with low lung volumes following surgery. It is predominantly used as a second line intervention in the presence of refractory atelectasis and poor gas exchange. It may also be indicated in other patient groups with similar physiological problems. Nasal intermittent positive airway pressure combines the beneficial effects of intermittent positive pressure breathing and continuous positive airway pressure. There have been many studies evaluating its effectiveness. These have been supportive for patients with neuromuscular disease and sleep disordered breathing, but more research is needed in patients with acute respiratory failure.

Intermittent Positive-Pressure Breathing↗

Increased levels of alternatively spliced interleukin 4 (IL-4delta2) transcripts in peripheral blood mononuclear cells from patients with systemic sclerosis.

Recent in vitro studies have shown that interleukin 4 (IL-4) induces and gamma interferon (IFN-gamma) inhibits collagen production. To define the TH1(IFN-gamma) and TH2(IL-4) cytokine profiles in systemic sclerosis (Sscl), a disease characterized by widespread fibrosis, we investigated IL-4 and IFN-gamma transcripts in peripheral blood mononuclear cells and plasma protein levels in 13 patients with Sscl. Two previously identified IL-4 transcripts, a full-length transcript and an alternatively spliced (truncated) transcript (designated IL-4delta2), were identified in patients and normal controls. Significantly increased levels of total IL-4 transcripts (full-length plus IL-4delta2 transcripts) were found in patients with Sscl in comparison to those found in healthy controls (P = 0.003), and this increase was primarily due to an increase in the level of the alternatively spliced IL-4delta2 form. The IL-4delta2/full-length-IL-4 transcript ratio was significantly increased in Sscl patients (P < 0.0001, versus healthy controls). Sequencing analysis revealed that the frequency of IL-4 clones carrying the IL-4delta2 transcript was also substantially increased in patients with Sscl. Plasma IL-4 protein levels were increased in Sscl patients compared to those in healthy controls (P = 0.001) and correlated with total IL-4 transcript levels. The up-regulation of the fibrogenic IL-4 (a TH2 cytokine) in Sscl suggests a pathogenic role for IL-4 in this disease.

Adult↗

Clonal hematopoiesis and acquired thalassemia in common variable immunodeficiency.

BACKGROUND: Common variable immunodeficiency (CVID) is defined by hypogammaglobulinemia and increased susceptibility to infections. The gene defect responsible for CVID remains unknown. METHODS: During the course of their CVID disease, a female and three male patients developed microcytic anemia. The investigation of this anemia forms the basis for this report. RESULTS: Reticulocyte globin chain synthesis studies revealed the abnormal alpha/beta ratios that are pathognomonic of thalassemia. Through transcriptional analysis of the glucose-6-phosphate-dehydrogenase (G6PD) locus of the active X-chromosome in blood cells, we determined that the female patient has clonal reticulocytes, platelets, granulocytes, and B and T lymphocytes. CONCLUSIONS: The simultaneous presence of globin synthesis abnormalities and panhypogammaglobulinemia suggests that a common insult at the stem cell level could contribute to the development of CVID and acquired thalassemia.

Adolescent↗

Patellar tendon rupture in systemic lupus erythematosus.

We investigated the frequency of patellar tendon rupture in our patients with systemic lupus erythematosus (SLE) in order to characterize the features that might predict rupture and compared our experience to that described in the literature. Four of 180 patients with lupus seen in the last 10 years had patellar tendon rupture. Duration of disease ranged between 7-20 years. Each patient was in clinical remission at the time of rupture. Each patient also had deforming arthritis of the hands. All had been taking prednisone from 7 to 15 years and all had side effects associated with prednisone therapy, such as moon facies, compression fractures and osteonecrosis. Review of the literature reveals 17 patients with tendon rupture. All had disease of long duration, had been taking corticosteroids for prolonged periods and had minimal or no disease activity at the time of rupture. Deforming hand arthropathy was present in all patients, when mentioned. No cases of tendon rupture had been reported in patients not taking chronic corticosteroid therapy. Therefore, tendon rupture in SLE appears to be associated with extended disease duration, chronic corticosteroid therapy, evidence of steroid induced musculoskeletal complications, minimal disease activity and deforming hand arthropathy.

Adult↗

Distal sensory nerves of the lower extremity in peripheral neuropathy: comparison of medial dorsal cutaneous and sural nerve abnormalities.

This study investigates the sensitivity and usefulness of medial dorsal cutaneous nerve (MDCN) conduction studies in patients with peripheral neuropathy. Two hundred twenty-three patients with clinical signs and symptoms of peripheral neuropathy in their lower extremities were evaluated. Nerve conduction velocity studies of the MDCN were compared to those of the sural and peroneal motor nerves. Fifty-eight percent of the patients had no measurable sensory nerve action potential (SNAP) from either the MDCN or sural nerve or both, indicating moderate to severe neuropathy. Of the remaining patients with mild neuropathy, 12% had a normal sural nerve and an abnormal MDCN, whereas 7% had a normal MDCN and an abnormal sural nerve. Fifty-one percent of the mild cases had normal peroneal motor nerve studies. It is concluded that the MDCN is equal to the sural nerve as a sensitive indicator in all stages of peripheral neuropathy; in mild or early neuropathy approximately 12% of patients will have normal sural nerve studies; and it is important to examine both distal sensory nerves of the leg. Addition of the MDCN study to the standard sural study increases diagnostic accuracy in mild peripheral neuropathy from 88% to nearly 100%.

Action Potentials↗

Bromperidol maintenance in schizophrenia.

Twenty-three patients who completed a four-week, double-blind, clinical trial of bromperidol versus haloperidol were treated with bromperidol for eight additional weeks in a continuation study. Over 87 percent of patients maintained their improved status or showed further improvement. Extrapyramidal signs were frequent, but required discontinuation of treatment in only two patients.

Double-Blind Method↗

Viloxazine HCl in the treatment of endogenous depression: a standard (imipramine) controlled clinical study.

In a four week, double-blind clinical trial, 20 patients with endogenous depression were randomly assigned to treatment with either viloxazine or imipramine. Statistically significant improvement was observed on the Hamilton Psychiatric Rating Scales for Depression and Anxiety for both treatment groups. There were no differences between the two treatment groups in the type, incidence, or severity of treatment emergent symptoms. No medication-related abnormalities in clinical laboratory values occurred in either treatment group.

Adult↗

Naltrexone in chronic schizophrenia. Results of a clinical trial.

A 4-week clinical trial, including a 1-week placebo washout period, assessed the antipsychotic activity of naltrexone in 'newly admitted', actively hallucinating, chronic schizophrenics. Chronic naltrexone administration was found to benefit 2 patients and to be of no value in 3 patients. Responsive patients differed from non-responders by the presence of hallucinations despite adequate neuroleptic maintenance therapy and an appropriate response to pathological hallucinatory experience. On the basis of these findings, the possibility of a naltrexone-responsive schizophrenic subgroup was considered.

Adult↗

A double-blind comparison of three dosages of flutroline (CP-36,584) in the treatment of schizophrenia.

Therapeutic and adverse effects of three dosages (1, 20 and 100 mg daily) of flutroline, a new gamma-carboline with a preclinical pharmacological profile similar to active neuroleptic agents, were compared in a double-blind clinical trial in 25 newly-admitted schizophrenic patients. Therapeutic effects and extrapyramidal signs were seen at the 20 and 100-mg daily dosages, but not at the 1-mg dosage. Serum prolactin levels were significantly elevated only at the 100-mg daily dosage.

Adolescent↗

Effect of splenectomy on the immune response of BALB/c mice bearing an immunoglobulin M plasmacytoma (TEPC-183).

Mice bearing TEPC-183, an immunoglobulin M(kappa)-secreting plasmacytoma, exhibit severe suppression of their immune responses to both thymus-dependent and thymus-independent antigens, 2,4-dinitrophenyl, and the type 3 pneumococcal polysaccharide SSS-III. This immunosuppression is not lifted by splenectomy of the tumor-bearing mice or prevented by removal of the spleen prior to tumor injection. On the contrary, splenectomy either before or after tumor implantation further accentuates the immunosuppressed state of tumor bearers and even depresses the immune response of normal mice. A secondary immune response of normal mice 34 to 51 days after splenectomy is still reduced. Thus, spleen cells may play a dual role. While splenectomy may remove a source of suppressor cells in tumor-bearing mice, it also eliminates a major source of antibody-producing cells and results in reduced immune responses of normal and TEPC-183-bearing mice. These findings have clinical relevance since splenectomy is used as a therapeutic and diagnostic procedure in neoplastic lymphoproliferative disorders.

Animals↗

The role of the corpus striatum in neuroleptic- and narcotic-induced catalepsy.

Lesion experiments (in the rat) were designed to elucidate the function of the corpus striatum in neuroleptic- and narcotic-induced catalepsy, respectively. Bilateral lesions of the corpus striatum were observed to attenuate neuroleptic (CPZ)-induced catalepsy. However, analogous lesions of the corpus striatum potentiated narcotic (morphine)-induced catalepsy. These results suggests that (a) the corpus striatum may be a primary site of action of neuroleptic drugs (such as CPZ) in the production of catalepsy, and (b) narcotic (morphine)-induced catalepsy may not be exclusively mediated by the corpus striatum.

Animals↗

Electron microscope study of surface immunoglobulin-bearing human tonsil cells.

Surface immunoglobulin-bearing cells were selected from suspensions of human tonsil cells by the reverse immune cytoadherence technique. The method employed a hybrid antibody directed against Ig on lymphoid cells and against ferritin bound to sheep red blood cells (SRBC). Only 6% of the cells formed rosettes. When subjected to electron microscopy they were shown to consist of a morphologically heterogeneous population of cells. However, most cells in the center of rosettes showed ribosome-associated endoplasmic reticulum (RER) and polyribosomes. Usually these organelles were located in close proximity to membrane sites where a 400-600 A bridge was resolved between the lymphocyte and the ferritin particle on the SRBC. The bridge is postulated to consist at least in part of Ig. Only 50% of the plasma cells formed rosettes and bridges could not be resolved. The surface of the plasma cells within rosettes differed from that of plasma cells which had not reacted with ferritin-coated sheep erythrocytes. The incidence of plasma cells and gamma-globulin-bearing lymphoid cells was corroborated with the help of fluorescent antibody techniques.

Animals↗