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Biomedical subjects

A Kaplan

Publications and source records attributed to A Kaplan.

At least 37 records · Page 2Linked to original sources
PubMed2001

What treatments patients seek after inpatient care: a follow-up of 24 patients with anorexia nervosa.

BACKGROUND: To determine the kind of treatment patients with anorexia nervosa (AN) seek for their eating disorder following hospitalization. METHOD: Twenty-four women previously treated in the Toronto General Hospital were interviewed to determine the nature and amount of treatment received following discharge. RESULTS: Mean age: 31 years (SD=9.18). Mean body mass index (BMI) at assessment: 19.97 (SD=4.00). All had seen at least one or more professionals, mainly family doctors and psychiatrists, within the first 6 months. Mean hours of treatment: 85. Eighty-eight per cent had taken psychotropic medication (most commonly antidepressants). Symptomatic and asymptomatic patients did not differ in amount of treatment received. CONCLUSIONS: Regardless of their symptom state, AN patients continue to use the health system heavily following weight restoration. Their aftercare is thus essential for ongoing maintenance treatment and to prevent relapse, and training primary-care physicians to provide it may be one way to contain health care costs.

Adult↗
PubMed2001

Is it important to perform pollen skin prick tests in the season?

BACKGROUND: Seasonal exposure to pollens causes the characteristic symptoms of respiratory allergy as well as an increase in specific IgE levels and inflammatory mediator release. However, little is known about the effect of natural allergen exposure on the skin test reactivity of patients with seasonal allergy. OBJECTIVE: The aim of this study was to investigate the monthly variation in skin test reactions with pollen allergens during pollen season and its relation to pollen counts. METHODS: Fifteen subjects with seasonal allergic rhinitis and/or asthma (4 male, 11 female) between the ages of 13 and 52 (mean 33.9 +/- 2.9) who lived in Ankara, Turkey were selected for this study. Patients were monitored from the beginning of March to the end of September 1997, and skin prick tests were performed using 5 grass, 12 tree, and 5 weed pollen allergen extracts every month. Atmospheric pollen grains were counted in the Ankara area between January and December, 1997. RESULTS: There were small but statistically significant increases in tree pollen-induced wheal sizes in May when compared with other months (P < 0.05). Skin test reactivity was correlated with tree pollen counts (r = 0.978, P < 0.05). There was not a significant difference in skin test reactivity to grass and weed pollens between months. CONCLUSIONS: Although skin test reactivity may be slightly greater to tree pollen during the tree pollen season, the timing of skin testing is not a critical determinant in patients with pollen allergy.

Adolescent↗
PubMed2001

Living under a "dormant" canopy: a molecular acclimation mechanism of the desert plant Retama raetam.

Desert plants are exposed to a combination of environmental stress conditions, including low water availability, extreme temperature fluctuations, high irradiance and nutrient deprivation. Studying desert plants within their natural habitat may therefore reveal novel mechanisms and strategies that enable plants to resist stressful conditions. We studied the acclimation of Retama raetam, an evergreen stem-assimilating desert plant, to growth within an arid dune ecosystem. Retama raetam contained two different populations of stems: those of the upper canopy, exposed to direct sunlight, and those of the lower canopy, protected from direct sunlight. During the dry season, stems of the upper canopy contained a very low level of a number of essential proteins, including the large and small subunits of rubisco, ascorbate peroxidase and the D1 subunit of the reaction centre of photosystem II. However, RNA encoding these proteins was present; cytosolic transcripts were associated with polysomes, while chloroplastic transcripts were not. Upon water application, as well as following the first rainfall of the season, these "photosynthetically suppressed" stems recovered and accumulated essential proteins within 6-24 h. In contrast, stems of the lower canopy contained the essential proteins throughout the dry season. We suggest that R. raetam uses an acclimation strategy of "partial plant dormancy" in order to survive the dry season. "Dormancy", as evident by the post-transcriptional suppression of gene expression, as well as the suppression of photosynthesis, was induced specifically in stems of the upper canopy which protect the lower canopy by shading.

Adaptation, Physiological↗
PubMed2001

Clinical features and T-cell subsets in HIV-infected children with and without lymphocytic interstitial pneumonitis.

Lymphocytic interstitial pneumonitis (LIP) is a non-infective lung condition common in untreated older children with vertically acquired HIV infection. Little is known about the prognosis in children with LIP, and diagnosis remains a problem where lung biopsy is not feasible. Our aim was to determine which clinical features aid the diagnosis of LIP in conjunction with the typical reticulonodular radiological picture, and whether the prognosis in children with LIP is different from that in HIV-infected children of the same age without LIP. We retrospectively compared the clinical features and T-cell subsets of 49 children with LIP with those of 56 children of similar age without LIP. Diagnosis of LIP was made radiologically. All children were apyrexial at the time of X-ray and acute intercurrent infections and tuberculosis had been excluded as far as possible. Ages ranged from 24 to 112 months in the non-LIP group and from 24 to 120 months in the LIP group. Digital clubbing and reticulo-endothelial hyperplasia were significantly more common in children with LIP than in those without. Children with LIP tended to have lower CD4+ counts and CD4% and higher CD8+ counts and CD8%, which resulted in significantly lower CD4/CD8 ratios in children under 5 years with LIP. It is possible in most cases to diagnose LIP using a combination of clinical and X-ray findings, as long as every effort is made to exclude tuberculosis. Lower CD4+ counts and CD4% as well as more frequent hospital admissions suggest that LIP adversely affects prognosis in children with HIV.

CD4 Lymphocyte Count↗
PubMed2001

DNA microarray analysis of cyanobacterial gene expression during acclimation to high light.

DNA microarrays bearing nearly all of the genes of the unicellular cyanobacterium Synechocystis sp PCC 6803 were used to examine the temporal program of gene expression during acclimation from low to high light intensity. A complete pattern is provided of gene expression during acclimation of a photosynthetic organism to changing light intensity. More than 160 responsive genes were identified and classified into distinct sets. Genes involved in light absorption and photochemical reactions were downregulated within 15 min of exposure to high light intensity, whereas those associated with CO(2) fixation and protection from photoinhibition were upregulated. Changes in the expression of genes involved in replication, transcription, and translation, which were induced to support cellular proliferation, occurred later. Several unidentified open reading frames were induced or repressed. The possible involvement of these genes in the acclimation to high light conditions is discussed.

Adaptation, Physiological↗
PubMed2001

IL-10 receptor dysfunction in macrophages during chronic inflammation.

The immunosuppressive activity of interleukin-10 (IL-10) makes this cytokine a potentially important clinical tool to reduce inflammatory responses in various diseases. Its efficacy as a therapeutic modality is dependent on the responsiveness of immune cells. We report that macrophages from mice chronically infected with the LP-BM5 retrovirus had a reduced capacity to respond to IL-10 in vitro. The ability of IL-10 to inhibit lipopolysaccharide-induced production of tumor necrosis factor (TNF) alpha and IL-6 was significantly reduced in both alveolar and peritoneal macrophages from infected versus uninfected mice. IL-10 hyporesponsiveness was not related to direct infection by the retrovirus, because bone marrow-derived macrophages infected in vitro with LP-BM5 were as responsive to IL-10 as were uninfected bone marrow-derived macrophages. TNF-alpha appeared to contribute to development of IL-10 hyporesponsiveness, because exposure of normal macrophages to TNF-alpha but not interferon-gamma reduced macrophage responsiveness to IL-10. Reverse transcriptase-PCR and flow cytometry demonstrated normal expression of the alpha and beta chains of the IL-10 receptor in macrophages from infected mice, suggesting that IL-10 hyporesponsiveness is not related to a change in receptor expression. The potential role of reduced IL-10 responsiveness in the chronicity of inflammation in this and other diseases is discussed.

Animals↗
PubMed2000

A search for susceptibility loci for anorexia nervosa: methods and sample description.

BACKGROUND: Eating disorders have not traditionally been viewed as heritable illnesses; however, recent family and twin studies lend credence to the potential role of genetic transmission. The Price Foundation funded an international, multisite study to identify genetic factors contributing to the pathogenesis of anorexia nervosa (AN) by recruiting affective relative pairs. This article is an overview of study methods and the clinical characteristics of the sample. METHODS: All probands met modified DSM-IV criteria for AN; all affected first, second, and third degree relatives met DSM-IV criteria for AN, bulimia nervosa (BN), or eating disorder not otherwise specified (NOS). Probands and affected relatives were assessed diagnostically with the Structured Interview for Anorexia and Bulimia. DNA was collected from probands, affected relatives and a subset of their biological parents. RESULTS: Assessments were obtained from 196 probands and 237 affected relatives, over 98% of whom are of Caucasian ancestry. Overall, there were 229 relative pairs who were informative for linkage analysis. Of the proband-relative pairs, 63% were AN-AN, 20% were AN-BN, and 16% were AN-NOS. For family-based association analyses, DNA has been collected from both biological parents of 159 eating-disordered subjects. Few significant differences in demographic characteristics were found between proband and relative groups. CONCLUSIONS: The present study represents the first large-scale molecular genetic investigation of AN. Our successful recruitment of over 500 subjects, consisting of affected probands, affected relatives, and their biological parents, will provide the basis to investigate genetic transmission of eating disorders via a genome scan and assessment of candidate genes.

Adult↗
PubMed2000

The diagnostic value of power Doppler measurements in the endometrium of women with postmenopausal bleeding.

OBJECTIVE: The objective was to evaluate the accuracy of blood flow measurements by power Doppler in endometrial vessels in women with postmenopausal bleeding (PMB). METHODS: Sixty consecutive patients with PMB participated in the study. Endometrial thickness and power Doppler measurements of small vessels in the endometrium and subendometrial tissue were performed prior to dilatation and curettage. Correlation between Doppler indices, endometrial thickness (by transvaginal sonography), and histopathologic examination was performed. A Student t test was used for statistical analysis with P < 0.05 as the level of significance. RESULTS: Fourteen positive cases were found: 11 endometrial cancers, 1 sarcoma, 1 simple hyperplasia, and 1 complex hyperplasia with atypia. Measurements of endometrial thickness using a cutoff point of 5 mm revealed a sensitivity of 78% and specificity of 45.6% (P > 0.05, NS) for detecting endometrial pathology. Power Doppler measurements (pulsatility index cutoff point = 1.0) revealed a sensitivity of 85. 7% and specificity of 89% (P = 0.001) for detecting endometrial pathology. CONCLUSIONS: The noninvasive methods for endometrial evaluation are not sensitive enough to exclude endometrial pathology. When invasive methods could not be performed, the combination of transvaginal sonography and power Doppler imaging provided the best results. When both modalities are negative, the probability of cancer is less than 5%.

Adult↗
PubMed2000

Pharmacotherapy for obsessive-compulsive disorder.

SSRIs and the tricyclic antidepressant clomipramine are the first-line therapies for patients with OCD, with the side-effect profile of SSRIs being more favorable than that of clomipramine. As many as 40% to 60% of patients with OCD may not respond to adequate trials of SRIs. Not all patients tolerate SSRIs, and delays in full therapeutic responses often occur. Thus, other pharmacologic approaches to treating patients with OCD have been investigated. Augmentation and monotherapy have been explored with serotonergic enhancers, dopamine and 5-HT antagonists, enhancers of second-messenger systems, and GABAergic agents with varying efficacy.

Antidepressive Agents, Tricyclic↗
PubMed2000

Thymidine kinase gene therapy with concomitant topotecan chemotherapy for recurrent ovarian cancer.

INTRODUCTION: Patients with recurrent ovarian cancer were treated with a replication-deficient recombinant adenovirus containing the herpes simplex virus thymidine kinase gene administered intraperitoneally (i.p.) followed by administration of an anti-herpetic prodrug and topotecan. MATERIALS AND METHODS: A total of 10 patients with stage IIIc epithelial ovarian cancer underwent secondary debulking to < or =0.5 cm residual tumor. Patients with normal i.p. flow received i.p. delivery of adenovirus. Two patients each were treated on dose level 1 (2 x 10(10) vector particles (VP)), dose level 2 (2 x 10(11) VP), and dose level 3 (2 x 10(12) VP); four patients were treated on dose level 4 (2 x 10(13) VP). Acyclovir and topotecan were started 24 hours after vector delivery. RESULTS: No patient treated at any dose level incurred unanticipated toxic effects, and all side effects resolved. The most common adverse event was myelosuppression: grade 3 or 4 thrombocytopenia with grade 2-4 anemia in three patients and grade 3 or 4 neutropenia in eight patients. Three patients developed thrombocytosis and three patients had a mild elevation of serum glutamic pyruvic transaminase/alanine aminotransferase. Temperature elevations that were not associated with detectable infection occurred in two patients. DISCUSSION: I.p. delivery of adenoviral vector with concomitant topotecan chemotherapy was well tolerated without significant lasting toxicities. Side effects were independent of the dose of adenoviral vector.

Acyclovir↗
PubMed2000

Fluvoxamine augmentation of antipsychotics improves negative symptoms in psychotic chronic schizophrenic patients: a placebo-controlled study.

The efficacy and safety of adding fluvoxamine to antipsychotic treatment in schizophrenic patients with mixed positive and negative symptoms was examined. Fifty-three patients selected for persistent negative and positive symptoms who were receiving antipsychotic treatment were randomly allocated to additional fluvoxamine (50-100 mg/day) or placebo in a double-blind manner. Fluvoxamine was associated with significant improvement in negative symptoms (Scale for the Assessment of Negative Symptoms) compared to placebo. The combination was well tolerated. Fluvoxamine augmentation of antipsychotics is safe in chronic schizophrenic patients with mixed positive and negative symptoms and may ameliorate negative symptoms in such patients.

Adult↗
PubMed2000

Temperament and character in women with anorexia nervosa.

The present study examined temperament differences among anorexia nervosa (AN) subtypes and community controls, as well as the effect of body weight on personality traits in women with AN. Temperament and Character Inventory (TCI) scores were compared between 146 women with restrictor-type AN (RAN), 117 women with purging-type AN (PAN), 60 women with binge/purge-type AN (BAN), and 827 community control women (CW) obtained from an archival normative database. Women with AN scored significantly higher on harm avoidance and significantly lower on cooperativeness than CW. Subtype analyses revealed that women with RAN and PAN reported the lowest novelty seeking, RAN women the highest persistence and self-directedness, and PAN women the highest harm avoidance. Body mass index had a nominal effect on subgroup differences, suggesting that personality disturbances are independent of body weight. Findings suggest that certain facets of temperament differ markedly between women with AN, regardless of diagnostic subtype, and controls. More subtle temperament and character differences that were independent of body weight emerged that distinguish among subtypes of AN.

Adult↗
PubMed2000

Pneumococcal and influenza immunization and human immunodeficiency virus load in children.

OBJECTIVE: HIV-infected children receiving influenza vaccine, pneumococcal vaccine and both vaccines concurrently were studied to examine the effect of immunization on plasma HIV viral load. METHODS: Thirteen children received immunizations: pneumococcal vaccine, 5; pneumococcal and influenza vaccines, 7; and influenza vaccine, 1. Most patients (12 of 13) were receiving combination reverse transcriptase inhibitor antiretroviral therapy without protease inhibitors at the time of immunization. Baseline plasma HIV RNA was determined 1 month prior (11 of 13), 2 weeks prior (12 of 13) and on the day of immunization (12 of 13). Plasma HIV RNA was assayed at 2 weeks (11 of 13), 4 weeks (12 of 13) and 3 months (5 of 13) after immunization. T cell activation markers (HLA-DR+, CD38+ and CD45RO+, CD28+) were examined for both CD4+ and CD8+ lymphocytes on the day of immunization and 2 weeks after immunization for 11 children. RESULTS: Only one child developed a >0.5-log increase in viral load at any time after immunization. There was no correlation between an increase in viral load and antibody response to pneumococcal vaccine. At least one activation marker increased (> 10%) for two children receiving pneumococcal vaccine and two children receiving pneumococcal and influenza vaccines. One of these children experienced an increase in viral load. CONCLUSION: Immunization with pneumococcal and influenza vaccines, alone or in combination, is rarely associated with a significant increase in HIV plasma RNA in children receiving combination antiretroviral therapy.

Anti-HIV Agents↗
PubMed2000

Spontaneous symmetry breaking and switching in planar nonlinear optical antiwaveguides

We consider guided light beams in a nonlinear planar structure described by the nonlinear Schrodinger equation with a symmetric potential hill. Such an "antiwaveguide" (AWG) structure induces a transition from symmetric to asymmetric modes via a transcritical pitchfork bifurcation, provided that the beam's power exceeds a certain critical value. It is shown analytically that the asymmetric modes always satisfy the Vakhitov-Kolokolov (necessary) stability criterion; nevertheless, the application of a general Jones' theorem shows that the AWG modes are always unstable. To realize the actual character of the instability, we perform direct numerical simulations, which reveal that a deflecting instability, which drives the asymmetric beam into the cladding without giving rise to fanning or stripping of the beam, sets in after a propagation distance of approximately 16 transverse widths of the AWG's core. The symmetry-breaking bifurcation, in combination with the deflecting instability, may be used to design an all-optical switch. The switching can easily be controlled by means of a symmetry-breaking "hot spot" that acts upon an initial symmetric beam launched with a power exceeding the bifurcation value.

Journal Article↗
PubMed2000

Perfectionism in anorexia nervosa: variation by clinical subtype, obsessionality, and pathological eating behavior.

OBJECTIVE: The purpose of this study was to examine the role of perfectionism as a phenotypic trait in anorexia nervosa and its relevance across clinical subtypes of this illness. METHOD: The Multidimensional Perfectionism Scale and the perfectionism subscale of the Eating Disorder Inventory were administered to 322 women with a history of anorexia nervosa who were participating in an international, multicenter genetic study of anorexia nervosa. All participants were additionally interviewed with the Yale-Brown Obsessive Compulsive Scale and the Yale-Brown-Cornell Eating Disorder Scale. Mean differences on dependent measures among women with anorexia nervosa and comparison subjects were examined by using generalized estimating equations. RESULTS: Persons who had had anorexia nervosa had significantly higher total scores on the Multidimensional Perfectionism Scale than did the healthy comparison subjects. In addition, scores of the anorexia subjects on the Eating Disorder Inventory-2 perfectionism subscale exceeded Eating Disorder Inventory-2 normative data. For the anorexia nervosa participants, the total score on the Multidimensional Perfectionism Scale and the Eating Disorder Inventory-2 perfectionism subscale score were highly correlated. Total score on the Multidimensional Perfectionism Scale was also significantly related to the total score and the motivation-for-change subscale score of the Yale-Brown-Cornell Eating Disorder Scale. CONCLUSIONS: These data show that perfectionism is a robust, discriminating characteristic of anorexia nervosa. Perfectionism is likely to be one of a cluster of phenotypic trait variables associated with a genetic diathesis for anorexia nervosa.

Adolescent↗