Search PubMed⌕ Search

Biomedical subjects

A Goldberg

Publications and source records attributed to A Goldberg.

At least 91 records · Page 5Linked to original sources
PubMed1994

[Diagnosis and misdiagnosis in familial dysautonomia].

The method of diagnosis in 122 patients with familial dysautonomia (FD) was reviewed. In all cases the diagnosis was based on the clinical history, physical examination and results of the histamine test (concentrations of 1:1,000 and 1:10,000). In 8 patients the diagnosis was also supported by a meiotic response to pilocarpine (0.0625 mg/dl). 69 (56%) were diagnosed in the first year of life (19 of them relatives of known FD patients), 16 (13%) in the second year, 31 (25%) from 25 months to 10 years, 3 (2%) from 10.1-20 years, and 3 from 20.1-44 years. At diagnosis the mean age was 2.9 years (SD 5.84) and the median age 11 months. In 17 diagnosis was delayed by an average of 18.5 months (SD 16.9) from the time FD was initially suspected, mainly because of false interpretation of the histamine test. Early correct diagnosis is essential to prevent unnecessary morbidity and mortality from FD.

Adolescent↗
PubMed1994

[Allergic responses to date palm and pecan pollen in Israel].

Date palm (Phoenix dactylifera) and pecan (Carya illinoensis) trees are commonly planted in Israel for fruit, for shade, or as ornamental plants. Pollen grains of both species are allergenic; however, the extent of exposure to such pollen and the incidence of allergic response have not been studied here. We therefore investigated skin-test responses to pollen extracts of 12 varieties of palm and 9 of pecan in 705 allergic patients living in 3 cities and 19 rural settlements. Sensitivity to the pollen extracts of both species was much higher among residents of rural than of urban communities. Moreover, there was a definite relationship between the abundance of these trees in a region and the incidence of skin responders to their pollen. Sensitivity was frequent in settlements rich in these 2 species, such as those with nearby commercial date or pecan plantations. In general, sensitivity to date pollen extracts was lower than to pecan. However, differences in skin responses to pollen extracts of various clones were substantiated. Air sampling revealed that pollen pollution decreased considerably with distance from the trees. At approximately 100 m from a source concentrations of airborne pollen were low. Since planting of male palm and pecan trees in population centers would increase pollen pollution, it should be avoided.

Demography↗
PubMed1994

The relationship between receptor-effector unit heterogeneity and the shape of the concentration-effect profile: pharmacodynamic implications.

The apparent concentration-effect relationship is the ensemble of many effector units (such as individual cells or channels) that do not always exhibit a uniform stimulus-effect relationship. This concept is substantiated by many observations of heterogeneity in receptor-effector populations including hormone secreting cells, response to hormonal stimuli, activity pattern of second messengers, stimulus-evoked synaptic currents, and single ion channels. The relationship between drug concentration and magnitude of pharmacologic response is commonly described by the sigmoidal Emax model which was derived from the Hill equation. The sigmoidicity factor (N) in this model is assumed to be a pure mathematical parameter without physiological connotations. This work demonstrates that the numerical value of N (measured empirically) is the product of two factors: (i) the degree of heterogeneity of the effector subunits, i.e., the elemental component that upon drug stimulus contributes its pharmacological effect independently and does not interact with other subunits (it could range from a single receptor up to a whole tissue), and (ii) value of N*--the shape factor of the subunits' concentration-effect relationship. A special case of this approach occurs when N* > 5, which is an on-off case. Here N is determined by the distribution (density equation) of the subunit values. In case of heterogeneity of the microparameters of the effector subunits the apparent N will always have a lower value than N*. According to this theory it can be concluded that without knowledge of the distribution of the microparameters no mechanistic interpretation can be deduced from the apparent N value. If in the future N* can be determined by theoretical or experimental methods, the distribution function relating N* to N can be calculated. The relevance of this theory is increased in view of the progress being made in advanced research techniques which may enable us to determine the concentration-effect relationship at the level of the individual effector unit.

Hormones↗
PubMed1994

Deliberate bee sting challenge of patients receiving maintenance venom immunotherapy at 3-month intervals.

BACKGROUND: A large part of the cost and inconvenience associated with venom immunotherapy (VIT) is related to the need for monthly treatments. Since VIT is advocated for at least 3 to 5 years, and occasionally longer, reducing the number of venom injections may cut down significantly on both cost and inconvenience. OBJECTIVE: We evaluated whether maintenance VIT given every 3 months is both safe and effective regarding reactions to treatment injections or field re-stings and lack of systemic reaction (SR) to deliberate challenge sting. METHODS: The standard 1-month interval was gradually extended to 3 months in 28 patients (mean age 26 years, range 7 to 76) allergic to bee venom (BV), yellow jacket venom, or both venoms. Nineteen patients allergic to BV were deliberately challenged by a live bee sting. In 15 patients the original SR in the field was moderate; in one patient it was mild; and in three patients it was severe. RESULTS: Mean duration receiving standard maintenance VIT before extending the 1-month interval was 17 months. No patient had an SR while receiving the 3-month VIT therapy. Two patients experienced four field re-stings while receiving the 3-month therapy with no reaction. After the live challenge, there was mild urticaria in a single patient; no SR developed in the rest of the patients. CONCLUSION: For young patients allergic to BV whose initial SR is mild to moderate and who have already received 1-month VIT for longer than 17 months, the maintenance interval may safely be extended to 3 months while preserving its protective activity against re-stings.

Adolescent↗
PubMed1994

Strength training increases resting metabolic rate and norepinephrine levels in healthy 50- to 65-yr-old men.

Resting metabolic rate (RMR) decreases with age, largely because of an age-related decline in fat-free mass (FFM). We hypothesized that a strength-training program capable of eliciting increases in FFM would also increase RMR in older individuals. To test this hypothesis, RMR, body composition, and plasma concentrations of certain hormones known to affect RMR were measured before and after a 16-wk heavy-resistance strength-training program in 13 healthy men 50-65 yr of age. Average strength levels, assessed by the three-repetition maximum test, increased 40% with training (P < 0.001). Body weight did not change, but body fat decreased (25.6 +/- 1.5 vs. 23.7 +/- 1.7%; P < 0.001) and FFM increased (60.6 +/- 2.2 vs. 62.2 +/- 2.1 kg; P < 0.01). RMR, measured by indirect calorimetry, increased 7.7% with strength training (6,449 +/- 217 vs. 6,998 +/- 226 kJ/24 h; P < 0.01). This increase remained significant even when RMR was expressed per kilogram of FFM. Strength training increased arterialized plasma norepinephrine levels 36% (1.1 +/- 0.1 vs. 1.5 +/- 0.1 nmol/l; P < 0.01) but did not change fasting glucose, insulin, or thyroid hormone levels. These results indicate that a heavy-resistance strength-training program increases RMR in healthy older men, perhaps by increasing FFM and sympathetic nervous system activity.

Aged↗
PubMed1994

Anaphylaxis to cisplatin: diagnosis and value of pretreatment in prevention of recurrent allergic reactions.

Two patients, who developed anaphylaxis to cisplatin, are described. This phenomenon was preceded by mild allergic symptoms, which were overlooked, in previous treatment courses. Intradermal skin tests were both sensitive and specific in the diagnosis of cisplatin allergy. Pretreatment with antihistamines and corticosteroids was ineffective in preventing recurrent anaphylaxis. Thus, a trial of desensitization is mandatory among those patients whose disease responds to the administration of this agent.

Adenocarcinoma↗
PubMed1994

Farewell to the objective analyst.

The objective analyst is one who can stand outside of any given situation and make neutral observations, providing his or her countertransference feelings are in hand. The argument against such objectivity offered in this paper is that the activity of analysis involves both prejudice, i.e. one's pre-set ideas, and participation, i.e. a necessary and inevitable change in oneself. Therefore we all see things a bit differently, and we are all effected differently by what we see. Such a view of analysis forces us to insist upon limiting its practice to the analytic setting as well as calling for a recognition of our own subjective states which go beyond countertransference and encompass our whole selves. Since we are never context-free we must recognise that our interpretations are never able to be limited to one fixed reading and so the exchange between patient and analyst is always open and continuous.

Adult↗
PubMed1993

Once-daily, extended-release gemfibrozil in patients with dyslipidemia. The Lopid SR Work Group I.

This randomized, parallel-group, multicenter clinical trial compared a newly developed, once-daily, extended-release formulation of gemfibrozil (Lopid SR) and gemfibrozil twice daily (Lopid) in terms of lipid-regulating effects and toxicity. Patients were men and women with elevations of low-density lipoprotein cholesterol and low levels of high-density lipoprotein cholesterol. The trial consisted of a 1-week screening period, an 8-week diet baseline period (Step One Diet), and a 24-week double-blind treatment period (extended-release gemfibrozil 1,200 mg once daily vs gemfibrozil 600 mg twice daily). At the end of the trial, the 2 treatment groups showed comparable improvements in all primary lipid factors: mean percent changes in triglyceride, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol were -32, +10 and -10% for extended release (n = 325) and -36, +11 and -10% for twice daily (n = 330). The 90% confidence interval for the relative difference between the treatment means fell within the equivalence bounds of +/- 35% for all 3 factors, demonstrating equivalence of efficacy. Adverse events were reported at low rates and were similarly distributed in frequency and intensity between treatment groups; they were preponderantly mild or moderate, and gastrointestinal effects were the most frequent. The once-daily formulation of gemfibrozil may afford better control of dyslipidemia through improved compliance by patients who have this asymptomatic disease.

Adolescent↗
PubMed1993

Nedocromil sodium inhibits T-cell function in vitro and in vivo.

Nedocromil sodium, a topical antiinflammatory agent recommended as a prophylactic regimen for asthma, is known to inhibit both allergic and nonallergic inflammatory processes in which an essential role for T cells has been implicated. Therefore the direct effects of this drug on several aspects of T-cell activity were analyzed in the present study. By using murine lymphocytes we found that NS at concentrations of 10(-8) to 10(-6) mol/L inhibited the mitogen- or antigen-induced proliferative responses of these cells. It is interesting to note that higher concentrations were ineffective. Preincubation of immune lymph node cells from contact sensitized mice with the drug abrogated their ability to transfer contact sensitivity to naive recipients, an effect that was found to be specific for the treated cells. Nedocromil sodium also interfered with the mitogen-induced interleukin-2 and tumor necrosis factor production by T cells and with their ability to adhere to the bound protein components of the extracellular matrix laminin and fibronectin. All these effects may be attributed to the inhibition of the increase of cytosolic calcium, which accompanies the early phase of T-cell activation and which is an essential step in inducing the aforementioned phenomena.

Animals↗
PubMed1993

Establishment of cell lines from B-cell precursor acute lymphoblastic leukemia.

In an attempt to establish permanent cell lines from children with B-cell precursor acute lymphoblastic leukemia (BCP-ALL), 123 clinical samples from 117 patients were cultured in vitro. Using a method which was successful for the growth of ALL with T-cell phenotype, 3% (2/74) of BCP-ALL samples from patients at diagnosis and 31% (9/29) of BCP-ALL samples from patients at relapse were established as cell lines. However, in most cultures, leukemic cells survived for only a few weeks and the majority of viable cells present after 28 days of culture were esterase-positive mononuclear cells. Based on the hypothesis that mononuclear cells inhibited leukemic cell growth, we evaluated the effect of a monocyte toxin, L-leucine methyl ester (Leu-OMe), on the growth of four frozen BCP-ALL samples. Thawed leukemic cells treated with Leu-OMe, but not untreated control cells, proliferated in three samples and one new cell line was established. Subsequently, when Leu-OMe was added to fresh leukemia cells in culture, leukemic cell lines were grown from 29% (4/14) of samples at diagnosis and 66% (4/6) of relapse samples. Overall, 20 BCP-ALL cell lines were established, all were Epstein-Barr virus (EBV)-negative, and authenticity of each cell line was verified by a direct comparison of the immunophenotype, karyotype, and genotype with the patient's tumor cells. This improved method of cell culture permits a higher success rate of cell line establishment from patients with BCP-ALL thereby aiding in analysis of B-lymphocyte transformation and neoplasia.

Adolescent↗
PubMed1993

Sexualization and desexualization.

This paper is a reconsideration of the role of sexualization in psychoanalysis. After a review of the accepted definitions of sexualization as defense and/or part of normal sexuality, a new explanation is offered. This posits sexualization as a psychological manifestation of a structural deficit and suggests analytic treatment as a process of structuralization. These terms are defined and illustrated. A case example demonstrates the thesis, and some implications of this concept are discussed.

Adult↗
PubMed1992

The Missouri Cardiovascular Health Plan: a focus on prevention.

The authors describe a framework for planning, implementing, and evaluating cardiovascular health programs in Missouri. Populations targeted for intervention are identified, and the role of the physician in supporting community-based cardiovascular health promotion is explored.

Black or African American↗