Biomedical subjects

A Berman

Publications and source records attributed to A Berman.

At least 19 recordsLinked to original sources

PubMed2001

Favorable histologic findings and tensile strength at 14 years in knitted polyester aortofemoral and femoropopliteal grafts in the same patient.

Patent right and left limbs of an aortobifemoral knitted polyester graft and a patent left femoropopliteal graft, both implanted for 14 years, were removed 40 hr postmortem from a 63-year-old man. Healing studies were performed, using routine and immunocytochemistry staining scanning electron microscopy (SEM), and transmission electron microscopy (TEM) on multiple samples taken from sites sufficiently far from the anastomoses to avoid pannus healing. Evaluation by weight-elongation comparison with a fresh graft demonstrated that structural stability and strength were well preserved. Anastomoses were patent with no remarkable intimal hyperplasia. There was no thrombus on the flow surface of either graft. Histologic studies of these grafts revealed uniform through-wall tissue ingrowth and extensive patches of endothelial cells scattered over the flow surface, confirmed by factor VIII, SEM, and TEM. These findings document that long-term stable tensile strength and healing with flow surface endothelialization can be attained with knitted polyester grafts in the human.

Aorta↗

PubMed2000

Mammary infection with Staphylococcus aureus in cows: progress from inoculation to chronic infection and its detection.

The progress of Staphylococcus aureus infection from inoculation to the early chronic stage was examined in 12 Israeli-Holstein cows (four primiparous and eight multiparous) for up to 48 d after inoculation. Before inoculation, the primiparous cows were free from any infection and the multiparous cows were infected by coagulase-negative staphylococci. Two quarters in each cow were inoculated intracisternally following milking with 2000 cfu of a local prevailing Staph. aureus strain, VL-8407. Infection was established in 21 out of 24 quarters. The control quarters remained free from infection during the study, with no significant change in function. No statistically significant differences were found between primiparous and multiparous cows in the responses examined. Somatic cell count (SCC) increased within 24 h of inoculation and remained high for the duration of the study. In the infected quarters mean ln (SCC) increased within 24 h from 9.9 +/- 0.5 before inoculation to 13.0 +/- 0.2 after inoculation; most of the cells were neutrophils. N-acetyl-beta-glucosaminidase activity, expressed as ln (nnmol/min per l), was increased from 0.9 +/- 0.6 to 2.4 +/- 0.2 by inoculation, and was highly correlated with SCC. The Staph. aureus count fluctuated with no particular relationship with SCC. The phagocytic activity of neutrophils was significantly lower in the inoculated than in the control quarters and this difference increased with time after inoculation. CD8+ T lymphocytes were the main subpopulation of lymphocytes found in inoculated quarters. After inoculation, maximum but not minimum electrical conductivity (EC) recorded during milking increased significantly. The rises in maximum EC varied significantly among cows. The rises in SCC were associated with a persistent increase in EC in only one of the eight cows examined. No clinical signs were observed, and milk yield and composition were not affected during the study period. The results suggest that some strains of Staph. aureus may induce a relatively mild response in mammary glands of cows in mid lactation, and that the concomitant development of such chronic Staph. aureus infections in two quarters may not be detected by changes in the EC of composite milk and in the yield of the cow.

Acetylglucosaminidase↗

PubMed2000

Relation of familial schizophrenia to negative symptoms but not to the deficit syndrome.

OBJECTIVE: Although a family history of schizophrenia has been associated with negative symptoms, family history is inconsistently related to the presence of the deficit syndrome. METHOD: The authors assessed family history and the deficit syndrome in 99 patients with DSM-III-R-diagnosed schizophrenia who were assessed during clinical treatment. Of these 99 patients, 45 were assessed both while antipsychotic free and during antipsychotic treatment to index their treatment response. RESULTS: Patients with (N=39) and without (N=60) a family history of schizophrenia had similar proportions of the deficit syndrome. Yet family history and deficit syndrome categorizations identified a group with greater negative symptoms on the Positive and Negative Syndrome Scale. Those with a family history had greater emotional withdrawal, poor rapport, and lack of spontaneity. Groups with and without the deficit syndrome similarly differed in these symptoms but also in affective blunting, motor retardation, and passive or apathetic social withdrawal. The study involving antipsychotic-free and antipsychotic treatment phases showed main medication effects explaining positive, psychopathology, depression, and activation symptoms but not negative symptoms. Only patients without a family history had improved negative symptoms with antipsychotic treatment. CONCLUSIONS: Patients with a family history of schizophrenia had greater and more treatment-resistant negative symptoms than those without a family history. They were not more likely to have the deficit syndrome. The group with a family history had more pathology only in negative symptoms related to psychosocial function. The stable negative symptoms specifically related to the genetic vulnerability to inherit schizophrenia might be those associated with psychosocial functioning.

Adaptation, Psychological↗

PubMed2000

Schizophrenia subgroups differing in dichotic listening laterality also differ in neurometabolism and symptomatology.

Schizophrenia patients vary in right ear advantage (REA) on dichotic listening tests for assessing left hemispheric dominance for language processing. The authors examined if patients with low REA differed from other patients in symptoms and in resting brain metabolism. SPECT was conducted during visual fixation for 9 healthy control subjects and 16 schizophrenia patients: 8 with normal and 8 with diminished REA. REA-diminished patients had greater positive symptoms and lower mental status scores (all P<0.05) and had right middle temporal gyrus hypermetabolism. Both schizophrenia groups had decreased right frontal and increased medial temporal lobe metabolism vs. control subjects. REA-diminished patients had right temporal lobe hypermetabolism under a resting condition (eyes open, visual fixation). Results suggest reduced right ear (left hemisphere) advantage for dichotic word perception in schizophrenia is related to a predisposition to overactivate right temporal lobe regions and to positive symptoms. In contrast, the prefrontal-medial temporal imbalance present in both patient groups may typify the schizophrenia syndrome.

Adult↗

PubMed2000

Systemic lupus erythematosus: mortality and survival in Argentina. A multicenter study.

OBJECTIVE: To analyze the factors associated with mortality, survival and causes of death in patients with systemic lupus erythematosus (SLE) in Argentina. PATIENTS AND METHOD: A series of 366 patients with SLE (45 men and 321 women), mean age 29 y (range 11-70 y) and mean disease duration 6 y, was evaluated from 1990 to 1998. A total of 57 clinical, serological and therapeutic variables were studied. RESULTS: Five- and 10-year survival was 91% and 85% respectively. Forty four patients died (12%): 54% due to sepsis and 32% due to active SLE. Mortality risk factors included heart involvement CRR 3.82), hyperlipidemia (RR 2.72), renal damage (RR 2. 62), infections (RR 2.44), lung disease (RR 2.20) and myositis (RR 2. 07). High-dose prednisone (RR 3.4) or cyclophosphamide (RR 9.19) treatments increased the risk of sepsis (P=0.003) as a cause of death. However, corticosteroids, antimalarial agents and accumulated cyclophosphamide doses proved to be protective factors in overall mortality figures (RR <1). CONCLUSIONS: The main risk factors of death in SLE were heart involvement, hyperlipidemia and renal damage. Treatment with steroids, antimalarial agents and cyclophosphamide improved survival. High-dose corticosteroids and cyclophosphamide were associated with sepsis as a cause of death.

Adolescent↗

PubMed1999

SPECT study of visual fixation in schizophrenia and comparison subjects.

BACKGROUND: The consistent association of impaired eye movements and schizophrenia suggests a relationship between the neurobiology of the illness and visual pursuit systems. Visual fixation (VF), an eye "movement" task at zero velocity, is the simplest such abnormality in schizophrenia patients and their relatives. METHODS: We used a VF task for a functional imaging study. Six neuroleptic-free schizophrenia patients and eight gender and mean age matched comparison subjects had SPECT scans with 20 mCi of Tc99-HMPAO, during VF on a simple blue line intersection. MEDX data saved in ANALYZE format for SPM 95 was used to generate paired t-test statistical data for display in Talairach space, with rCBF changes given as Z-scores. RESULTS: Patients, compared to controls, had increased rCBF in both the parahippocampal gyrus (bilaterally) and in the right fusiform gyrus. They had decreased rCBF in the left frontal cortex, including medial and superior frontal gyri and anterior cingulate. Overall, compared to controls, patients had medial temporal lobe hyperperfusion along with left prefrontal hypoperfusion. CONCLUSIONS: These findings are consistent with the hypothesized imbalance between the medial temporal and frontal lobes that is postulated for schizophrenia. It was of interest that the relative rCBF differences between schizophrenia patients and controls in this small sample were observable with this cognitively non-demanding visual fixation task.

Adult↗

PubMed1999

A homologue of Sar1p localises to a novel trafficking pathway in malaria-infected erythrocytes.

We have identified a homologue of the GTP-binding protein, Sar1p, in Plasmodium falciparum. Sar1p is a small GTPase that is thought to play a crucial role in trafficking of proteins between the endoplasmic reticulum and the Golgi. The P.falciparum SAR1 gene is located on chromosome 4 and comprises two exons separated by a 508 bp intron. The deduced amino acid sequence of PfSar1p (GenBank accession number AF104306) shows 71% similarity (58% identity) to Sar1p from Saccharomyces cerevisiae. Expression of PfSar1p in erythrocytic stages of P. falciparum was confirmed by sequencing of a tryptic peptide derived from a polypeptide excised from an SDS-polyacrylamide gel. A recombinant protein corresponding to approximately 70% of the PfSar1p sequence was used to raise antibodies. The affinity-purified antiserum recognised a protein with an apparent molecular weight of 23 K in Western blots of malaria-infected erythrocytes but not in uninfected erythrocytes. PfSar1p was shown to be largely insoluble in non-ionic detergent and a low ionic strength buffer. Confocal immunofluorescence microscopy of malaria-infected erythrocytes was used to show that PfSar1p is located near the periphery of the parasite in discrete compartments, which appear to be distinct from the parasite endoplasmic reticulum. In addition, PfSar1p appears to be exported to structures outside the parasite in the erythrocyte cytoplasm. The export of PfSar1p to the erythrocyte cytosol is inhibited by treatment with brefeldin A. This provides the first evidence that the malaria parasite is capable of elaborating components of the classical vesicle-mediated trafficking machinery outside the boundaries of its own plasma membrane.

Amino Acid Sequence↗

PubMed1999

Soft tissues and osteo-articular infections in HIV-infected patients and other immunodeficient states.

Soft tissue and osteo-articular infections are rarely seen in patients with HIV infection and other immunodeficiency states. When present in HIV-infected patients, they tend to occur in the presence of low CD4(+)cell counts, intravascular indwelling catheters, extra-articular infection and trauma, and in intravenous drug users and haemophiliacs. A wide spectrum of clinical manifestations is seen, ranging from cellulitis and soft tissue abscesses to septic arthritis and pyomyositis. In general, the clinical picture and response to therapy is similar to that of patients without HIV infection. Causal micro-organisms are also similar to those in non-HIV populations, Staphylococcus aureus being the most common aetiological agent.

AIDS-Related Opportunistic Infections↗

PubMed1999

Obstetrical complications and childhood-onset schizophrenia.

OBJECTIVE: Increased obstetrical complications have been reported in individuals with adult-onset schizophrenia, with several studies finding an association between such complications and an earlier age at onset. Consequently, obstetrical records were examined for individuals with childhood-onset schizophrenia to determine if birth complications were more prevalent. METHOD: The birth records of 36 patients with childhood-onset schizophrenia and 35 sibling comparison subjects were rated for birth complications by two psychiatrists who were unaware of group membership. RESULTS: There were no significant differences between the groups in rates of obstetrical complications. Patients with such complications did not have a relatively earlier age at onset of schizophrenia. CONCLUSIONS: A very early age at onset of schizophrenia is probably not due to birth complications.

Age of Onset↗

PubMed1999

Human immunodeficiency virus infection associated arthritis: clinical characteristics.

OBJECTIVE: To define the frequency and characteristics of human immunodeficiency virus (HIV) associated arthritis. METHODS: A total of 270 patients with HIV infection were prospectively evaluated for the presence of rheumatic complaints. Diagnosis of HIV infection was performed by ELISA and confirmed by Western blot, and all HIV patients were classified according to the US Centers for Disease Control criteria. RESULTS: Twenty-one (7.8%) patients presented with HIV associated arthritis. Other arthritides including HLA-B27 related, such as Reiter's syndrome, psoriatic arthritis, and rheumatoid arthritis, were excluded. Seventeen were men and 4 women, with a mean age of 34.8 years (SD 11.1). Fourteen (66%) were homosexuals, 4 (19%) intravenous drug users, and 3 (14%) heterosexuals. Twelve (57%) were in stage IV, 5 (23%) in stage III, and 4 (9%) in stage II. Ten (47%) patients had oligoarticular involvement, 8 (38%) monoarticular, 2 (9%) asymmetric polyarthritis, and one (4%) symmetric polyarthritis. Rheumatoid factor and HLA-B27 antigen were negative in all (15) patients studied. The mean duration of arthritis was 2 weeks (1-24). No differences in duration of arthritis were found among the different risk factors (p = 0.811), HIV stages (p = 0.205), and type of articular involvement (p = 0.252). There was, however, a trend between the number of involved joints and stages of HIV infection (p = 0.13). CONCLUSION: The pattern of joint involvement of HIV associated arthritis is similar to that of other viral disorders: acute onset, short duration, no recurrences, and no erosive changes.

Adolescent↗

PubMed1999

Self-envy and the concealment of inner resources.

Self-envy refers to envy of one's own inner resources. This term is an adjunct to the psychodynamic understanding of developmental self-arrest, defined as deliberate and defensive impairment of one's own abilities and accomplishments and the concealment of inner resources. The article suggests possible explanations for the formation of self-envy, emphasizing the formation of envious object representations and the construction of a part of the personality based on these introjections. The effects of self-envy on patient therapist relations are also described, focusing on two particular manifestations: attachment to the therapist as a defense against self-envy and attacking the therapeutic contract as one of the patient's assets. Excerpts from a case study are included.

Countertransference↗

PubMed1998

Subclinical mastitis assessed by deviations in milk yield and electrical resistance.

Concurrent falls in milk production and electrical resistance of composite milk were examined in Israeli Holstein cows. The cows were milked three times a day by a system that recorded yield and the lowest electrical resistance in the composite milk from the four glands. The study included two groups: cows that experienced on day 0 a decline in resistance and milk production > or = 20% from the mean of the previous 9 d (62 cows, case group) and cows that experienced no such episodes over 9 d before and after a fixed day (118 cows, control group). Bacteriological status and somatic cell count (SCC) or California mastitis test scores were assessed on the fixed day in the control group, and on days 0, 1 and 2 in the case group. California mastitis test scores greater than 2 and SCC thresholds of 5 x 10(5) cells/ml were used to create two classes of leucocytosis. There was no statistically significant difference between the two groups in frequency distributions of pathogens and their types: in 30% of cows infection was not detected, 33% were infected by major pathogens (95% of which were Staphylococcus aureus), and 53.5% by minor pathogens (80% Micrococcus spp.). Cows in the case group had lower milk production during the 8 d following day 0. Mean electrical resistance was lower in infected cows and particularly in cows infected by Staph. aureus. High leucocytosis was associated with reduced electrical resistance in both groups, and was found in 93% of cows in the case group v. 25% in the control group. The results suggest that falls in electrical resistance of milk and in milk production were not linked to a specific pathogen, and were followed by 3-8 d of reduced milk production and electrical resistance. The study suggests that there are episodic aggravations in mammary health that do not evolve into clinical mastitis but may induce significant losses in milk yield and quality.

Animals↗

PubMed1998

The advanced-stage therapy group.

Many authors describe a stage of maturity in the development of groups, but each highlights a different dimension. This article describes the characteristics of the advanced stage and the main axes along which it develops (internalization and containment, symbolization, self and self-other development, differentiation and individuation). It also offers a conceptual explanation for these developments and attempts to identify the conditions necessary for the emergence of this stage of maturity. An understanding of this stage and the conditions required for its development can be used by the group leader as a compass to help him or her navigate the group toward this objective.

Adult↗

PubMed1998

Clinical predictors of acute response with olanzapine in psychotic mood disorders.

BACKGROUND: In controlled studies of patients with schizophrenia, the atypical antipsychotic olanzapine has been shown to be more effective in the treatment of positive and negative symptoms compared with haloperidol at doses of 10 mg/day. However, little is known about the efficacy of olanzapine in patients with psychotic mood disorders. The purpose of this study was to assess the efficacy of olanzapine in the treatment of these psychotic mood disorders in comparison with nonaffective psychotic disorders and to identify clinical factors associated with olanzapine response. METHOD: In a naturalistic setting, by reviewing medical records, we assessed response to olanzapine and factors associated with response to olanzapine in 150 consecutive patients newly treated with the drug at a nonprofit academic psychiatric hospital. RESULTS: Patients displaying a moderate-to-marked response to olanzapine were more likely to be younger; be female; receive a diagnosis of bipolar disorder; and have a shorter duration of illness, shorter length of stay prior to olanzapine, and longer duration of trial. CONCLUSION: Olanzapine may be a useful alternative or adjunctive treatment for patients with bipolar disorder.

Adolescent↗

PubMed1998

Extracorporeal shock wave treatment for chronic calcific tendinitis of the shoulder.

OBJECTIVE: To study the clinical and radiological response of chronic calcific tendinitis of the shoulder to extracorporeal shock wave treatment (ESWT). METHODS: The study included 3 female patients, 42, 48, and 50 years of age, all with calcified tendinitis of the rotator cuff. All had severe shoulder pain and limitation of motion. ESWT was done in one session with an extracorporeal shock wave lithotripter. RESULTS: After 24 hours, a fragmentation of calcification was achieved, and the patients had no pain and had entirely regained their joint movement. After 2 years of followup they were clinically and radiologically asymptomatic, and there were no adverse effects or other complications. CONCLUSION: With its good tolerance, safety, and clinical and radiologic response, ESWT should be considered as an alternative therapy in the treatment of chronic calcific tendinitis of the shoulder refractory to other therapies.

Adult↗

PubMed1998

Musculoskeletal rehabilitation.

Musculoskeletal problems are common, disabling, and cause great suffering in older adults. Rehabilitation services are frequently indicated and can usually be offered in an outpatient setting. The role of the physician is to make an accurate diagnosis, recognize disability, and refer for rehabilitation services when indicated. There are many diagnostic tests available to assist the physician, but none is as useful and practical as the office examination, including the functional history. Treatment goals with musculoskeletal conditions often are modest and include reduced pain and improved function. Frequently, conditions can flare up or persist in smoldering forms, requiring recurrent interactions with the rehabilitation team. The primary care physician can make use of many of the following resources available to treat musculoskeletal pain and limitations: exercise, medication, physical modalities, adaptive equipment, and arthritis education, including self-help and support groups. Used in combination, these treatments can contribute to increased well-being. The key for the physician is knowing that these options exist and being familiar with their use.

Aged↗

PubMed1997

Effect of continuous quality improvement analysis on the delivery of primary percutaneous transluminal coronary angioplasty for acute myocardial infarction.

A successful primary percutaneous transluminal coronary angioplasty (PTCA) program requires a learning process whereby the efficiency of the cardiac catheterization laboratory to deliver prompt intervention can be refined. The purpose of this study was to (1) quantify this learning process in terms of shortening the time to reperfusion, (2) examine the changes in strategy that allowed for this, and (3) determine if expedited reperfusion by primary PTCA improved patient outcomes. A database of all primary PTCA procedures was established in February 1, 1994. Continuous quality assurance analysis was performed, and program modifications introduced as needed. Patients were separated into early (group A = February 1, 1994 through January 31, 1995) and late (group B1 = February 1, 1995 through June 31, 1995, and group B2 = July 1, 1995 through December 31, 1995) cohorts. Time intervals to certain treatment landmarks were compared among groups. In-hospital outcomes were tabulated. Fifty-two consecutive patients were included (group A = 19, group B1 = 17, group B2 = 16). Time intervals shortened significantly (group A vs group B1 vs group B2) with the time from hospital presentation to first balloon inflation decreasing progressively (from 205 to 119 to 97 minutes; p <0.001). Most of this decrease was obtained by shortening the time from hospital presentation to xylocaine administration (158 to 85 to 72 minutes; p <0.005), although the time from xylocaine to first balloon inflation also decreased (from 47 to 33 to 24 minutes; p <0.005). Parallel decreases for in-hospital mortality (26% vs 0%; p = 0.004), adverse events (47% vs 18%; p = 0.05), and length of hospital stay (13.3 +/- 13.7 vs 8.4 +/- 4.4 days; p = NS) were demonstrated for groups A versus B1 and B2. A learning effect following initiation of a primary PTCA program is demonstrated in which reperfusion was more rapidly achieved as the result of procedural changes directed by quality improvement analysis with a concurrent improvement in in-hospital outcomes.

Adrenergic beta-Antagonists↗

PubMed1997

Muscular strength and bone mineral density in haemodialysis patients.

PURPOSE: The objective of this study was to determine the relationship between muscular strength and bone mineral density (BMD) in patients undergoing regular haemodialysis. METHODS: The BMD was measured in the lumbar spine (L2-L4) and in the proximal femur (femoral neck and trochanter) with dual-energy X-ray absorptiometry DEXA (Lunar DPX). Muscular strength of the extensors, flexors and abductors muscles of the femur (proximal muscles) and the extensors muscles of the back was measured with an isometric dynamometer. Thirty patients, 15 women with a mean age of 33.7 years (18-43) and 15 men with a mean age of 45.5 years (18-65) were included in the study. RESULTS: There was a positive and significant correlation between the BMD of the femoral neck and muscular strength of the flexors (r = 0.490, P < 0.005), the extensors (r = 0.658, P < 0.01) and the abductors muscles of the femur (r = 0.671, P < 0.0008), as well as between the muscular strength of the flexors (r = 0.413, P < 0.02) and extensors muscles of the femur (r = 0.433, P < 0.01) with BMD of the trochanter. There was no correlation between the muscular strength of the back extensor muscles and the BMD of the lumbar spine (r = -0.119, P NS). There was no correlation between the BMD and the number of years of haemodialysis therapy (r = -0.032, P NS), the patient's age (r = -159, P NS), or the value of serum PTH (r = 0.369, P NS) respectively. However, there was a significant correlation between the BMD of the femoral neck with muscular strength (r = 0.602, P < 0.05). CONCLUSION: This study reveals the close relationship that exists between muscular strength of the proximal muscles and the BMD of proximal femur in patients undergoing haemodialysis.

Adolescent↗