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Biomedical subjects

S M Levy

Publications and source records attributed to S M Levy.

At least 91 records · Page 5Linked to original sources
PubMed1984

Fluoride analyses of patient water supplies requested by North Carolina health professionals.

The frequencies, patterns, and results of 1,900 patient drinking water assays for fluoride content requested in a six-month period by North Carolina health professionals were determined. Twelve per cent of the samples warranted adjustment from the full dosage fluoride supplement. Less than 3 per cent of physicians and 8 per cent of dentists submitted samples. Water supplies should be tested before a systemic fluoride supplement is prescribed. Either few dentists and physicians in North Carolina test water before prescribing supplements or few prescribe them at all.

Allied Health Personnel↗
PubMed1983

Kinetic analysis of atropine-induced alterations in bullfrog ganglionic fast synaptic currents.

The concentration- and voltage-dependent effects of atropine on the fast excitatory post-synaptic current (e.p.s.c.) of bullfrog sympathetic ganglion cells have been analysed and fitted to a kinetic scheme of open-channel blockade. Atropine (1-75 microM) reduced the peak e.p.s.c. amplitude without altering the quantal content or the reversal potential. The e.p.s.c. decay was complex in the presence of atropine, being well fitted by two exponential components. With increasing concentrations of atropine the time constant of the fast component, tau 2, decreased and the time constant of the slow component, tau 1, increased. Over the voltage range -30 to -100 mV tau 2 exhibited little or no voltage dependence and tau 1 increased with hyperpolarization. The amount of charge moved during the e.p.s.c. was reduced as a function of atropine concentration. Driving functions, which represented the rate of channel opening, were derived from e.p.s.c.s both from control and atropine-treated cells. The characteristics of the driving functions did not vary with membrane voltage, but the driving functions were shorter in duration from atropine-treated than control cells. The area under the driving function decreased as a function of atropine concentration. The decay time constants and the amplitude ratio of the exponential components were used to calculate the closing, blocking, and unblocking rate constants, alpha, G, and F. alpha and F remained constant with increasing atropine concentration, but G declined significantly. The voltage dependence of the equilibrium constant, G/F, implied that the transient blocking site for atropine is halfway through the ionic channel. The sequential model does not predict the concentration-dependent decrease in the blocking rate, G, or in the charge moved during an e.p.s.c. We conclude that atropine has an action more complex than simple channel blockade in sympathetic ganglion cells.

Animals↗
PubMed1980

The adjustment of the older woman: effects of chronic ill health and attitudes toward retirement.

While the general portrayal of today's aging woman in the literature is a rather bleak one, the few studies that have been concerned with her adjustment to retirement have revealed discrepant findings. The present study investigated affect and temporal experience as indicators of adjustment through structured interviews with fifty-two female retirees. Data were analyzed by a 2x2x2 ANOVA comparing groups in terms of Health, Willingness to Retire, and Time Since Retirement. In general, it was found that both healthy and ill females who had not initially wanted to retire, did not adjust over time to the retirement state. Even above the median time since retirement, these women experienced negative affect and a constricted and discontinuous sense of time passage. Second, and in contrast with the findings of an earlier study with male retirees, chronically ill females were not uniform in terms of maladjustment. A significant portion of ill female interviewees were seemingly able to surmount the effects of bodily disease and adjust to the requirements of role transition in an adaptive manner. Differential needs of the aging male and female in this cohort were emphasized, and implications for intervention were drawn.

Aged↗
PubMed1978

Some determinants of temporal experience in the retired and its correlates.

The effects of physical health status, attitude toward retirement, and social class on temporal experience were studied in 70 male Ss, aged 52--74. A semistructured interview was utilized, and a content analysis by independent raters was performed on the resulting interview material. In general, it was found that chronic illness had a differential effect on experience, depending upon social class, for certain temporal variables. Among the healthy retirees it was also found that willingness to retire interacted with social class, and that blue collar workers who had resisted retirement resembled the chronically ill in terms of affect and temporal experience. The possibility for adjustment in retirement was linked to variations in temporal experience, and implications were drawn for preretirement intervention with specific social class target populations. Finally, psychological and behavioral consequences of variations in temporal experience were discussed, and the possibility of developing methods of altering temporal experience as a means of helping the elderly to adjust to life transitions was explored.

Aged↗
PubMed1977

Surface chemical modification of hard tissues: I. Bone.

Surfaces of bone were modified in a controlled manner by grafting or by adding interpenetrating polymeric side chains to the bone substrate. The properties of the hard tissue surface attained varied widely. The surface alteration may improve the ability of hard tissues such as bone or dentin to adhere to restorative materials.

Acrylates↗
PubMedDate not supplied

Detecting symptoms of alcohol abuse in primary care settings.

BACKGROUND: Studies on alcohol abuse are frequently based on patients who meet minimum diagnostic criteria, thus ignoring patients with individual symptoms of harmful or hazardous use. Consequently, we are unable to characterize alcohol-abusing patients with sufficient clarity to effectively focus screening for primary prevention. OBJECTIVE: To determine the prevalence of harmful and hazardous use of alcohol, assess screening instruments for detecting alcohol abuse or dependence, and assess the impact of alcohol use on other diagnoses treated in outpatient settings. DESIGN: Survey (cross-sectional study). SETTING: Hospital-based outpatient clinic. PARTICIPANTS: Three hundred randomly selected adults (aged 18 years and older). MAIN OUTCOME MEASURE: Diagnosis of alcohol abuse or dependence based on the Diagnostic Interview Schedule (DIS). RESULTS: About 18% met DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) criteria of abuse or dependence while almost 50% had at least one symptom of harmful or hazardous use. The T-ACE questionnaire, a modified version of the CAGE questionnaire, was the most effective screening instrument for both men and women. Selected diagnoses, personal characteristics such as family history of alcohol abuse, and self-reported patterns of alcohol use could identify patients likely to meet diagnostic criteria. CONCLUSIONS: Many symptoms of substance use disorders are not adequately addressed in outpatient practice. Little is known about how alcohol use in varying quantities affects health care utilization and treatment of conditions commonly seen in outpatient medicine. Consequently, we lack a full appreciation of the burden of disease borne by alcohol use and have yet to achieve a universally accepted method of approaching primary and secondary prevention of alcohol-related problems.

Adult↗
PubMedDate not supplied

Survival hazards analysis in first recurrent breast cancer patients: seven-year follow-up.

The purpose of this study was to identify predictors of survival time in first recurrent breast cancer patients, including psychologic as well as biologic factors. Beginning in 1979, 36 women being treated at the National Institutes of Health for histologically proven recurrent disease were enrolled in this prospective study. At the time of data analysis, 24 had died from their malignancy. Through the use of a Cox proportional hazards model, four factors significantly entered the equation predicting survival time in the sample: Patients with a longer disease-free interval, who expressed more joy at baseline testing, who were predicted to live longer by their physicians, and who had fewer metastatic sites tended to live longer with recurrent disease than others in the sample (X2 = 22.9, p less than 0.0001). Findings from recent clinical and animal studies suggest that regulatory systems within the organism are linked and potentially influence one another. This study has demonstrated that factors at a number of levels--behavioral, as well as biologic--need to be considered in accounting for disease outcome variance.

Adaptation, Psychological↗
PubMedDate not supplied

Perceived social support and tumor estrogen/progesterone receptor status as predictors of natural killer cell activity in breast cancer patients.

This report is concerned with the prediction of natural killer (NK) cell activity in 61 Stage I and II breast cancer patients, between the ages of 25 and 70, who were accrued to this project. All baseline interview and testing data were obtained either just before patients were discharged from the hospital, or at their first outpatient visit, within two weeks of discharge. A major interest of this project is the predictive value of perceived social support, as a potential "stress" buffer, related to NK activity. In the main model reported here, we found that a significant amount of NK activity variance could be explained by five variables. Higher NK activity could be predicted by the perception of high quality emotional support from a spouse or intimate other, perceived social support from the patient's physician, estrogen receptor-negative tumor status, having an excisional biopsy as surgical treatment, and actively seeking social support as a major coping strategy (R2 = 0.33, F(5,55) = 5.5, p less than 0.0004). Findings are discussed in terms of host interaction with tumor endocrine status, and the role that social support might play in modulating such activity.

Adult↗
PubMedDate not supplied

A clinical evaluation of the restoration of root surface caries.

Root surface caries is of growing importance because its prevalence increases with age, and the population of the United States is growing older while edentulism and tooth loss rates have declined. Few clinical studies have evaluated materials used for the restoration of active root caries lesions. This study evaluated a Type II glass ionomer cement and a microfilled composite resin, both placed in preparations without mechanical retention or acid etching of enamel, in the restoration of root caries. Fifty adult volunteers with active root caries received one or both materials with the material chosen randomly. Patients were recalled after 24 months to evaluate restorations for retention, additional caries, marginal integrity, and overall clinical acceptability. Seventy-seven restorations were available for reevaluation. Forty-five percent of the glass ionomer and 73% of the composite restorations were clinically acceptable after 24 months. Of the glass ionomers, 39% were fully retained compared with 73% of composite restorations. Among those partially or fully retained, 25% of the glass ionomer restorations had minimal loss of marginal integrity and 30% had extensive loss while 53% and 9% of composite restorations had minimal and extensive loss, respectively. Most restorations were clinically unacceptable because of restorative material loss. Substantial numbers of glass ionomer cement and composite resin restorations were lost. This may be the result of difficulties in maintaining isolation and obtaining a proper gingival seal. Thus, routine use of mechanical retention is still highly recommended to reduce the loss of restorative material.

Adult↗
PubMedDate not supplied

Medications with dental significance: usage in a nursing home population.

The institutionalized elderly use more drugs per capita than do other segments of the population and are more likely than other population groups to have adverse drug reactions. Many of these drugs could affect oral health or dental treatment. This paper provides data on the frequency with which a population of nursing home residents took medications with possible oral effects. Information regarding prescription and nonprescription drug use was obtained from nursing home records of 481 subjects. Nine medication effect categories of possible significance in dentistry were established. Dentists treating institutionalized patients must be knowledgeable about patient drug use because 94% of this institutionalized population were taking medications that could alter oral health or dental treatment.

Aged↗
PubMedDate not supplied

A comparison of medical histories reported by dental patients and their physicians.

This paper reports on the comparison of 104 patient-provided medical histories and those provided by the patients' physicians. Patient-provided histories were obtained using a written health questionnaire with verbal follow-up. At the level of specific medical conditions, patients and physicians agreed only about half of the time, whereas there was better agreement by systemic disease category (average agreement 77%). Both patients and physicians reported systemic conditions not reported by the other, indicating that neither patients nor physicians can be relied on as the sole source of medical history information. Whenever there is a complex medical history or uncertainty about the completeness of the patient's knowledge and reporting of their medical history, contacts with the patient's physician(s) are indicated.

Adult↗
PubMedDate not supplied

An evaluation of the effectiveness of four mechanical plaque-removal devices when used by a trained care-provider.

Many care-dependent elderly individuals live in nursing homes and must depend on nursing home aides for oral hygiene care. It is generally agreed that the level of oral hygiene care among care-dependent nursing home residents is less than optimal. Two reasons are time constraints and the difficulty involved in brushing other individuals' teeth. The identification of effective and efficient plaque-removal devices for use by care-providers should make it easier for nursing home aides to incorporate effective oral hygiene care into their daily routines. This pilot study was undertaken to determine the relative effectiveness of four plaque removal devices with different basic designs when used by a non-professional care-provider on 10 healthy volunteers. A brush with curved bristles on the lateral aspect of the brush head and short straight bristles in the center (Collis-curve) and an electric toothbrush with tufts that rotate reciprocally (Interplak) were the most effective, a conventional brush (Oral-B) was somewhat less effective, and a disposable foam brush (Abco) was least effective and similar to the prebrushing plaque score (baseline). All the volunteers reported that the Collis-curve was the most comfortable brush, and the care-provider reported that it was the easiest to use.

Adult↗
PubMedDate not supplied

Oral hygiene care levels in Iowa intermediate care facilities.

This study was undertaken to improve understanding of current oral hygiene care practices in intermediate care facilities. Questionnaires were sent to directors of nursing of all licensed intermediate care facilities in Iowa. Results show that an estimated 57% of residents needed direct oral hygiene assistance. In all intermediate care facilities, the majority of direct oral hygiene care was provided by aides. Oral hygiene care was often not provided at an optimal level, and the main reasons reported for this lack of care were uncooperative residents (82%), lack of perceived need by aides (68%), and inadequate time/personnel (49%). Development and promotion of oral hygiene care programs in intermediate care facilities must take into consideration the realities and problems involved. Otherwise, efforts to introduce or implement new or improved care programs will fail.

Aged↗