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Biomedical subjects

S Isenberg

Publications and source records attributed to S Isenberg.

At least 19 recordsLinked to original sources
PubMed1997

Defensiveness and perception of external inspiratory resistive loads in asthma.

This study examined the relationship between defensiveness, as measured by the Marlowe-Crowne Social Desirability Scale (MCSDS), and the perception of an externally applied respiratory resistance among people with asthma. Thirty asthmatic adults breathed through nine levels of inspiratory resistive load. Participants higher on the MCSDS were less accurate than others in psychophysical magnitude estimates of resistive load, and showed a reduced relationship between the physical load and the quality of respiratory sensations associated with exposure to the resistors. Defensive subjects also showed a differentially high increase in correlation between unpleasantness of respiratory sensations and resistance levels after receiving parenteral naloxone. These findings are consistent with the hypothesis that defensiveness may increase risk of asthma morbidity, due to inaccuracy in detecting sensations of dyspnea during asthma exacerbations. The inaccuracy may be caused by elevated endogenous opioids among defensive individuals.

Adult↗
PubMed1997

Relationship between changes in EMG and respiratory sinus arrhythmia in a study of relaxation therapy for asthma.

This paper reports the relationships among changes in cardiovagal activity, surface EMG, and measures of pulmonary function in a study of relaxation therapy for asthma. Changes in FEV1/FVC were negatively correlated with those in cardiac interbeat interval, consistent with the hypothesis that relaxation-induced changes in airway function are mediated autonomically, with increased vagal tone and/or decreased sympathetic arousal producing bronchoconstriction. Contrary to Kotses's theory of a vagal-trigeminal reflex as mediator for relaxation-induced improvement in asthma, decreases in pulmonary function occurred during relaxation sessions, accompanied by increases in cardiovagal activity, and within-session changes in frontal EMG in the first session of training were positively associated with changes in a measure of pulmonary function (FEV1/FVC). However, consistent with this hypothesis, first-session frontalis EMG changes were positively associated with changes in respiratory sinus arrhythmia, and last-session changes in cardiac interbeat interval were positively associated with changes in FEV1/FVC. The results suggest that the immediate effects of generalized relaxation instruction can be associated with a parasympathetic rebound, which, in tum, may induce countertherapeutic changes in asthma. However, the effects of specific facial muscle relaxation remain unclear.

Adult↗
PubMed1994

Relaxation and music therapies for asthma among patients prestabilized on asthma medication.

One hundred six asthmatic subjects were medically prestabilized, then assigned to eight sessions of progressive relaxation, music, or a waiting-list. Seventy-two subjects completed treatment, of which 37 were evaluated in the laboratory with measures of forced expiratory flow. Relaxation-group subjects reported feeling the most deeply relaxed and produced the greatest improvement in forced expiratory flow during the last presession assessment period. All groups evidenced decreases in asthma symptoms. All groups showed decreases in pulmonary function immediately after relaxation sessions. None of the changes in pulmonary function reached levels that are accepted in drug trials to be of clinical significance, and the therapeutic changes occurred only in the situation where training was rendered. Listening to music produced greater decreases in peaks of tension than progressive relaxation, and it produced greater compliance with relaxation practice, but it did not produce any specific therapeutic effects on asthma.

Adolescent↗
PubMed1993

The Asthma Symptom Profile: a psychophysically based scale for assessment of asthma symptoms.

The Asthma Symptom Profile (ASP) assesses phasic changes in three dimensions of asthma symptoms: intensity, unpleasantness, and quality of sensations. Quantification data on verbal descriptors were gathered from 46 adult asthmatics for each of these scales, using bimodality scaling: i.e., with numerical estimates and drawing lines varying length. Close agreement was obtained between these two modalities. The ASP was analyzed before and after a bronchodilator in 44 asthmatics using ipratropium bromide (IB). Forty of these subjects were also tested in a placebo condition. Although ASP changes produced by IB were no greater than those produced by the placebo, correlations with changes in spirometry variables were significant. There were no significant differences in correlations with line drawings vs. numerical ratings. The ASP appears to be useful measure of phasic changes in asthma symptoms. Asthmatics with mild airway obstruction do not appear to be able to discriminate small changes in airway function.

Adolescent↗
PubMed1993

Asthma and emotion: a review.

This review of the empirical literature on the relationship between asthma and emotion presents an explanatory model of the connection between them. Asthmatics tend to report and display a high level of negative emotion, and asthma exacerbations have been linked temporally to periods of heightened emotionality. Causality may be bidirectional. Hypothesized mediators for the relationship between asthma and emotionality include vagal and alpha-sympathetic hyperreactivity, predominant obstruction in the larger airways, individual response stereotypy, direct effects of emotion-related facial muscle tension on the airways, the emotional effects of asthma medications, heightened respiratory drive, and hyperventilation. Predictions are presented for research on this model of asthma and emotion, and for the psychological treatment of asthma.

Asthma↗
PubMed1984

Chemical preparation of the eye in ophthalmic surgery. III. Effect of povidone-iodine on the conjunctiva.

A half-strength povidone-iodine (Betadine) solution was used topically as part of the preoperative chemical preparation of the eye. Aerobic and anaerobic bacterial cultures of the conjunctiva were taken before and after the chemical preparation in 30 consecutive patients; the second eye served as a control. In the control eyes, no significant change in the number of colonies or species of bacteria was found. In the povidone-iodine-treated eyes, the numbers of colonies decreased 91% and the number of species decreased 50% (statistically significant). We therefore recommend that a half-strength povidone-iodine solution be used as part of the chemical preparation of the eye for surgery.

Administration, Topical↗
PubMed1984

A comparison of mydriatic eyedrops in low-weight infants.

The pupils of neonates often need to be dilated to examine the retina for retinopathy of prematurity and other disorders. It is known that low-weight infants (less than 1600 grams) are susceptible to systemic hypertension when 10% or 2.5% phenylephrine eye drops are used. To find the safest and best commercially available mydriatic agent in neonates, 30 low-weight infants were divided evenly into three groups. The drops tested were cyclopentolate 0.5% alone, cyclopentolate 0.5% plus mydriacyl 0.5%, and a combination drop of phenylephrine 1% and cyclopentolate 0.2%. There was no clinically significant effect of any of the drops on systolic blood pressure or pulse rate. The cyclopentolate and phenylephrine combination dilated the pupils by a mean of 2.8 mm which was statistically greater than the other groups (P less than 0.01) and had a longer duration of maximal dilation than the other drops (P less than 0.05).

Blood Pressure↗
PubMed1984

Infantile leukocoria caused by posterior lenticonus.

Posterior lenticonus--a bulging of the posterior capsule and cortex--is an acquired lens abnormality, which becomes increasingly opaque. We report an unusual case of bilateral posterior lenticonus in an infant, who initially presented with leukocoria and was referred with a diagnosis of retinoblastoma. Careful physical examination and ultrasound analysis were important in the diagnosis. Ultrasound also aids the surgeon in planning therapy. Posterior lenticonus should be considered in the differential diagnosis of retinoblastoma.

Diagnosis, Differential↗
PubMed1984

The eye as a peripheral sensor.

The eye is no longer an organ onto itself, but is now being used as a sensor for the rest of the body. The development, clinical uses, and future applications of conjunctival capillary monitoring are presented.

Adult↗
PubMed1984

An anatomical etiology of congenital eyelid eversion.

Congenital eversion of the eyelids is a rare condition which has never had a proven anatomic etiology. A one-day-old male presented with severe congenital eversion of both upper eyelids. Medical therapy was unsuccessful. At surgery, adipose tissue was found beneath the tendon of the levator palpebrae and extended anterior to the tarsus because the orbital septum was not attached inferiorly. The defect was repaired. In this case, non-attachment of the orbital septum may have induced eversion of the upper eyelids.

Ectropion↗
PubMed1983

Chemical preparation of the eye in ophthalmic surgery. I. Effect of conjunctival irrigation.

We investigated the effect on bacterial flora of conjunctival irrigation as part of the chemical preparation of the eye before surgery. Forty consecutive patients underwent conjunctival irrigation with a saline solution in one randomly selected eye. Aerobic and anaerobic bacterial conjunctival cultures were taken in masked fashion before and after the preparation. In nonirrigated eyes, the colony counts before and after the preparation were virtually identical; the species count increased 23%. In irrigated eyes, the colony count increased 18% and the species count increased 46%. The increase in the species count was significant. Our findings suggest irrigation with a saline solution does not reduce the bacterial flora of the conjunctiva.

Conjunctiva↗
PubMed1983

Chemical preparation of the eye in ophthalmic surgery. II. Effectiveness of mild silver protein solution.

Although a mild silver protein solution (Argyrol) has been used for a number of years and is still used by many ophthalmic surgeons, its efficiency as an antibacterial agent on the conjunctiva has not been scientifically evaluated as part of the preoperative chemical preparation of the eye. We studied the effectiveness of a mild silver protein solution on the conjunctival flora of 32 patients in a masked fashion. By bacteriologic analysis, the mild silver protein solution was found to be no more effective in reducing the number of species and colonies in the treated eye than in the untreated eye. While the mild silver protein solution does stain mucus and other debris on the eye to facilitate irrigation, this study did not demonstrate a significant bactericidal effect.

Conjunctiva↗
PubMed1983

Double-masked trial of fenoprofen sodium: treatment of chronic aphakic cystoid macular edema.

Aphakic cystoid macular edema is a serious eye disease. Its etiology is unknown, but a widely held theory attributes it to an inflammatory response to surgical trauma. In a double-masked study, a 1% solution of fenoprofen sodium, a topically applied antiprostaglandin agent, was evaluated against placebo in determining the effectiveness of fenoprofen in the treatment of chronic aphakic cystoid macular edema. Fourteen patients, five women and nine men, participated in the study. Fenoprofen sodium was found to have no effect on the course of chronic aphakic cystoid macular edema. We believe that the lack of effect may have been due to the duration of edema at the time of treatment or to the small sample size. Larger studies in the immediate postoperative period are suggested. The importance of iris angiography as a possible predicting technique of macular leakage is emphasized.

Aged↗
PubMed1982

Chemical preparation of skin and eye in ophthalmic surgery: an international survey.

We surveyed 214 ophthalmologists worldwide to learn their methods of preoperative chemical preparation of eye and skin. A 96.8% return rate was achieved. While a wide diversity of agents was reported, povidone-iodine was the most popular agent applied to the skin. The conjunctiva usually was either ignored or rinsed with a saline solution by the respondents. Almost a quarter used mild silver protein (Argyrol) on the conjunctiva. Most of the preparation is performed by the physician rather than the nurse. Review of the advantages and pitfalls of the agents reported should cause the ophthalmologist to reconsider these agents for their effectiveness, spectrum, and duration of action.

Anti-Infective Agents, Local↗
PubMed1977

Eye position of strabismus patients under general anesthesia.

We studied the change in eye position under general anesthesia in 317 patients undergoing strabismus surgery. We used the prism cover test to measure preoperative eye position, and the prism reflex test (Krimsky's method) to measure the eye position under general anesthesia. Almost all patients had divergence under anesthesia. We calculated a linear equation and curve to relate the eye position under anesthesia to the preoperative eye position. Patients with a normal amount of divergence (within one standard deviation of the mean) had a higher rate of successful surgical results than those with an abnormal amount of divergence under anesthesia (greater than one standard deviation from the mean).

Adolescent↗
PubMed1977

Clinical observations in 101 consecutive patients with Duane's retraction syndrome.

We retrospectively studied 101 consecutive patients with Duane's retraction syndrome. Eighty-five percent were unilaterally affected and 15% were bilaterally affected. More patients had straight eyes in primary position than esotropia or exotropia. On lateral version reflex testing the amount of underaction of the lateral and medial rectus muscles could be determined, and could be used to predict whether the patients' eyes were esotropic, exotropic, or straight in primary position. Almost all the patients showed an esotropia when looking to one side and either an exotropia or no deviation to the other side. The degree of the exotropia and the esotropia on opposite sides determined whether a head turn would be present and in what direction. On adduction, the palpebral fissure in the affected eye narrowed in one half the patients because of motion of both upper and lower eyelids, and in 40% because of motion of only one eyelid. When the lower eyelid elevated, it usually assumed a straight horizontal contour with peaking of the punctum lacrimalis (appearing as a small pyramid). The statistical predominance of females and left eyes was more significant among patients whose eyes were straight in primary position. All patients tested demonstrated stereopsis. Most of the amblyopic patients had anisometropia.

Amblyopia↗