351
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Demmler GJ, Levy ML, Cole CL, Mishaw CO, Benson AB, Thaller RM, Feingold M. Brown recluse spider bites. AMERICAN JOURNAL OF DISEASES OF CHILDREN (1960) 1989; 143:843. [PMID: 2741858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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352
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Weldt E, Valenzuela B, Angulo G, Muñoz E, Gómez S, Levy ML, Rosselot S, Norambuena N. [Follow-up of infants with birth weight under 1,500 g]. REVISTA CHILENA DE PEDIATRIA 1989; 60:129-34. [PMID: 2484667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A prospective study of 199 children with birth weight less than 1,500 g was done. 86 boys and 113 girls, 141 (71%) adequate for gestational age and 58 (29%) small for gestational age. At follow-up 43 (21.6%) infants were lost to control, 17 (7%) moved to other places and 7 (3.5%) died in the first year of life. In the first year of life, infants whose birthweights were adequate for gestational age had been hospitalized more frequently and the small for dates showed higher percentage of undernutrition. After the second year of life, it was possible to know the impairment. It was found 7.4% of cerebral palsy, 2.9% of hipoacusia and 2.2% of retinopathy of prematurity, these diagnosis were most frequent in children that were adequate for gestational age. We concluded that small for dates infants are at risk of undernutrition and that those adequate for gestational age are at risk of permanent sequelae.
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353
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Duvic M, Lowe L, Rapini RP, Rodriguez S, Levy ML. Eruptive dysplastic nevi associated with human immunodeficiency virus infection. ARCHIVES OF DERMATOLOGY 1989; 125:397-401. [PMID: 2923449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The cutaneous manifestations of the acquired immunodeficiency syndrome include infections and neoplasms resulting from the immunodeficient state. Seven patients presenting with the symptom of new eruptive nevi with dysplastic histologic findings are described. These patients noted multiple new moles, which occurred in crops and in individuals without the dysplastic nevus syndrome (familial melanomas). This symptom occurred as the patients became symptomatic from their human immunodeficiency virus infection, developing acquired immunodeficiency syndrome or its related complex. Further confirmation and study of this phenomenon could lead to a better understanding of the pathogenesis of melanocytic dysplasia and its relationship to the immune system.
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354
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Cabral A, Portela R, Tasso T, Eusébio F, Guilherme A, Lorga L, De Almeida IT, Silveira C, Levy ML. [Phenylketonuria--physical and mental development of phenylketonuric children subjected to early treatment]. ACTA MEDICA PORT 1989; 2:1-5. [PMID: 2773674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The Authors present the first clinical and laboratory assessment of 6 children with PKU, diagnosed and treated early, as a result of the application of the Early Diagnosis Programme in the southern part of the country, from April 1984 to November 1986. The main protein source used in the feeding of these patients was a phenylalanine-free mixture of amino-acids, with an excellent tolerance.
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355
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Abstract
A 13-year-old girl receiving multiple agent chemotherapy for osteosarcoma was found to have neutrophilic eccrine hidradenitis (NEH). This dermatosis is marked histopathologically by necrosis of the eccrine structures with a neutrophilic infiltrate. Clinically, the presentation is variable and the differential diagnosis is extensive. Our patient's clinical picture was unique in that she had hyperpigmented plaques instead of purpuric nodules or erythematous plaques as described previously. Currently, NEH is felt to be a complication of chemotherapy. The most likely causative agent in our patient was bleomycin. Physicians should be aware of this entity and its variable clinical presentation.
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356
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Fine JD, Eady RA, Levy ML, Hejtmancik JF, Courtney KB, Carpenter RJ, Holbrook KA, Hawkins HK. Prenatal diagnosis of dominant and recessive dystrophic epidermolysis bullosa: application and limitations in the use of KF-1 and LH 7:2 monoclonal antibodies and immunofluorescence mapping technique. J Invest Dermatol 1988; 91:465-71. [PMID: 3049834 DOI: 10.1111/1523-1747.ep12476604] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Prenatal diagnosis is now possible for junctional and recessive dystrophic forms of epidermolysis bullosa (EB); however, there is no similar published experience for dominant dystrophic EB, although data with KF-1 monoclonal antibody suggests that both forms of dystrophic EB can be identified at least postnatally with this unique probe. We now report our experience with light microscopy, electron microscopy, immunofluorescence mapping, and KF-1 and LH 7:2 monoclonal antibodies, in both a mother with dominant dystrophic EB and her fetus at risk, and in a fetus previously shown to be affected with recessive dystrophic EB. KF-1 and LH 7:2 antigens were absent in recessive dystrophic EB fetal skin, identical to findings observed postnatally. LH 7:2 was normally expressed in a mother with dominant dystrophic EB and in her fetus at risk for this disease. In contrast, while KF-1 antigen was abnormally expressed in the affected mother, it was normally expressed in only 1/7 fetal biopsies despite the fact that this fetus was shown by light and electron microscopy and immunofluorescence mapping to be unaffected with dominant dystrophic EB. We conclude that 1) transmission electron microscopy can be used to prenatally exclude the diagnosis of dominant dystrophic EB (Cockayne-Touraine variety), 2) immunofluorescence mapping is an accurate technique for prenatal as well as postnatal diagnosis of EB, and 3) KF-1 cannot by itself be used as an accurate probe for the prenatal diagnosis of dominant dystrophic EB, due to the apparent variability in the time for the normal expression of KF-1 in fetal skin during the second trimester.
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357
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Andrews BT, Levy ML, Pitts LH. Implications of systemic hypotension for the neurological examination in patients with severe head injury. SURGICAL NEUROLOGY 1987; 28:419-22. [PMID: 3686321 DOI: 10.1016/0090-3019(87)90223-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Thirty-six patients admitted with severe head injury and various degrees of systemic hypotension were studied to determine the effect of hypotension on the validity of the neurological examination in reflecting mechanical brain compression. All patients had clinical signs of transtentorial herniation or upper brainstem compression and underwent immediate bilateral placement of exploratory burr holes for the diagnosis and removal of intracranial hematomas. All patients were initially hypotensive: 10 were in cardiac arrest, 7 had a systolic blood pressure (SBP) less than 60 torr, and 19 had SBP of 60-90 torr. The median score on the Glascow coma scale was 3 (range 3-8). Although 4 of the 10 cardiac arrest patients had anisocoria, only one (10%) had an intracranial hematoma. Among the seven patients with severe hypotension, only two had anisocoria and neither had and intracranial hematoma; one patient in this group (14%) had a hematoma that was diagnosed at autopsy. In contrast, intracranial hematomas were discovered by burr-hole placement and evacuated in 13 (68%) of 19 patients with initially moderate hypotension, including seven (78%) of nine patients with anisocoria. Anisocoria was associated with mechanical brain compression from an intracranial hematoma significantly more often in patients with an initial SBP of 60-90 torr than in those with initial cardiac arrest or SBP less than 60 torr (chi-square p less than 0.05). Intracranial hematomas were significantly more frequent among patients with SBP of 60-90 torr than among those with a lower SBP or initial cardiac arrest (P less than 0.01). Thirty-three of 36 patients died; each of the three survivors had an initial SBP of 60-90 torr, and hematomas were removed in two. In head-injured patients with SBP greater than 60 torr, clinical signs of tentorial herniation or upper brainstem dysfunction remain valid indicators of possible mechanical compression; the high percentage of patients with acute intracranial hematomas in this group warrants immediate diagnostic burr-hole exploration. In patients with severe initial hypotension (SBP less than 60 torr) or cardiac arrest, clinical findings of brainstem dysfunction cannot be relied upon to indicate mechanical compression, and computed tomography scanning should be done immediately after resuscitation to determine the need for surgical exploration.
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358
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Altman A, Rosen T, Tschen JA, Hoffmann T, Bruce S, Siegel DM, Levy ML, Schaefer D, Goldberg LH. Basal cell epithelioma in black patients. J Am Acad Dermatol 1987; 17:741-5. [PMID: 3680652 DOI: 10.1016/s0190-9622(87)70256-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The occurrence of cutaneous carcinoma in black patients is an unusual phenomenon, with basal cell carcinoma being particularly uncommon. We present five cases of basal cell epithelioma in black patients collected from the Texas Medical Center to graphically illustrate the varied and often atypical clinical presentations of such tumors. This report supports recent series of basal cell epithelioma in black patients derived from retrospective chart reviews.
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359
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Andrews BT, Levy ML, Dillon W, Weinstein PR. Unilateral normal perfusion pressure breakthrough after carotid endarterectomy: case report. Neurosurgery 1987; 21:568-71. [PMID: 3683796 DOI: 10.1227/00006123-198710000-00025] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The authors report a case of unilateral malignant cerebral edema that occurred after the removal of a high grade atheromatous lesion of the ipsilateral internal carotid artery. A form of unilateral normal perfusion pressure breakthrough caused by postischemic impairment of cerebrovascular autoregulation and exacerbated by systemic hypertension is thought to have contributed to this complication. Control of the hypertension and treatment of the cerebral edema with mannitol and dexamethasone led to a complete neurological recovery.
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360
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Orengo IF, Kettler AH, Bruce S, Levy ML, Rosen T, Tschen J. Cutaneous Waldenström's macroglobulinemia. A report of a case successfully treated with radiotherapy. Cancer 1987; 60:1341-5. [PMID: 3113711 DOI: 10.1002/1097-0142(19870915)60:6<1341::aid-cncr2820600630>3.0.co;2-i] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Waldenström's macroglobulinemia is a lymphoproliferative disorder that only rarely exhibits specific cutaneous findings. The authors present a case of Waldenström's macroglobulinemia in which the patient developed cutaneous lesions while his systemic disease seemed to be under control with chlorambucil therapy. A review of the scant literature regarding the response of cutaneous Waldenström's to treatment suggests that the skin lesions do not respond well to systemic therapy. This case was successfully treated with radiotherapy.
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361
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Levy ML. Bronchial asthma. BMJ : BRITISH MEDICAL JOURNAL 1987; 294:974. [PMID: 3107683 PMCID: PMC1246036 DOI: 10.1136/bmj.294.6577.974-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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362
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Abstract
We report two instances of Hansen's disease as a complication of lymphoma. Although patients with leprosy may be at risk for the development of neoplasia, the converse has only rarely been reported. Nonetheless, granulomatous lesions in patients with lymphoreticular malignancy should suggest appropriate studies to rule out Hansen's disease, as illustrated by the cases detailed herein.
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363
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Abstract
Cutaneous bacterial infections, most commonly caused by Pseudomonas aeruginosa, have been clearly linked to use of hot tubs. A 10-year-old female with atopic eczema developed eczema herpeticum after hot tub use with a friend who had "fever blisters"; herpes simplex virus was recovered from cutaneous vesicles. Since herpesvirus has been shown to survive in the hot tub environment, herpes simplex should be considered as another potential cause of disease in the spa setting.
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364
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Levy ML. [Infant mortality throughout the world]. ARCHIVES FRANCAISES DE PEDIATRIE 1983; 40:515-7. [PMID: 6625852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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365
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366
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Levy ML, Jaffe N. Osteosarcoma in early childhood. Pediatrics 1982; 70:302-3. [PMID: 6954451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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367
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Block CS, Levy ML, Fritz VU. Bacillus cereus endocarditis. A case report. S Afr Med J 1978; 53:556-7. [PMID: 97794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Bacillus cereus may cause infective problems in compromised patients. No previous record of infective endocarditis due to this organism could be found. A 51-year-old White woman with B. cereus endocarditis after prosthetic mitral valve replacement is described. The problems of interpreting the significance of B. cereus bacteraemia, delayed diagnosis, and the inherent resistance of the organism are discussed.
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368
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Berk JL, Hagen JF, Tong RK, Levy ML, Martin PJ. The role of adrenergic stimulation in the pathogenesis of pulmonary insufficiency. Surgery 1977; 82:366-72. [PMID: 18806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Recent studies have shown that epinephrine (E), norepinephrine (NE), and isoproterenol (I) caus'e substantial pulmonary shunting. This study was undertaken to determine the role of alpha (pulmonary vasconconstriction) and beta (pulmonary vasodilatation) adrenergic stimulation in the pathogenesis of pulmonary insufficiency. Forty-three mechanically ventilated, anesthetized dogs received infusions of E, alpha and beta stimulant; NE, a relatively pure alpha stimulant; I, a relatively pure beta stimulant; and dextran (D), a drug with no known adrenergic activity. The cardiac output and shunt measurements were determined simultaneously in the control period and four times during a 1 hour infusion. The quadratic equation of best fit was determined for each group for the relationship between the cardiac output and the shunt over a wide range of cardiac outputs, and statistical comparisons were made between all groups of the shunt at the same cardiac output. In all groups an increase in cardiac output was associated with an increase in the shunt, but the magnitude of the increase in the shunt differed significantly with each drug over the entire range, being smallest with D and becoming progressively larger with I, E, and NE, respectively. It is concluded that an increase in the pulmonary blood flow causes an increase in the pulmonary shunt, but that the magnitude of the increase is dependent on the specific pulmonary microcirculatory effects of each drug.
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369
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Levy ML, Coakley CS. Organization and experience with outpatient anesthesia in a large university hospital. Int Anesthesiol Clin 1976; 14:131-42. [PMID: 950251 DOI: 10.1097/00004311-197614020-00008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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370
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Greenberg SD, Harness MK, Levy ML, Fechner RE. Diagnosing brochial carcinoid tumors by electron microscopy. Tex Med 1975; 71:50-4. [PMID: 49936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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371
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Coakley CS, Levy ML. Anesthesia for ambulatory surgery. THE JOURNAL OF THE ARKANSAS MEDICAL SOCIETY 1971; 68:101-4. [PMID: 4254658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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372
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373
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Pedro JC, Cordeiro M, Levy ML. [Threshold values of tryptophan in the pediatric clinic]. REVISTA PORTUGUESA DE PEDIATRIA E PUERICULTURA 1967; 30:361-7. [PMID: 5603026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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374
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Levy ML. A trip with Medico to Santa Rosa de Copan. JOURNAL OF THE AMERICAN MEDICAL WOMEN'S ASSOCIATION 1967; 22:475-7. [PMID: 4227408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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