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Biomedical subjects

A Rubin

Publications and source records attributed to A Rubin.

At least 73 records · Page 4Linked to original sources
PubMed1994

Ovulation and follicular development associated with three low-dose oral contraceptives: a randomized controlled trial.

OBJECTIVE: To address the hypothesis that multiphasic oral contraceptives (OCs) increase rather than decrease the risk of functional ovarian cysts. METHODS: In this single-center, randomized controlled study, women were assigned to a multiphasic pill, a lower-dose monophasic pill, a higher-dose monophasic pill, or nonsteroidal contraception. Forty volunteers were randomized (ten each) to three different pill regimens or to nonsteroidal contraception. During 6 months of treatment, follicular development was measured by vaginal ultrasonography and ovulation was indicated by serum progesterone levels. RESULTS: The relative risk (RR) of developing a follicular structure greater than 30 mm in diameter during a cycle with the higher-dose monophasic pill was 0.5 (95% confidence interval [CI] 0.1-1.9; P = .49) compared with the multiphasic pill. The risk with the lower-dose monophasic pill was comparable to that with the multiphasic pill (RR 1.3, 95% CI 0.5-3.6; P = .56). With the multiphasic pill, the maximum ovulation rate over 60 cycles was 1.7 per 100 cycles (95% CI 0.0-8.9). CONCLUSION: This multiphasic pill more closely resembled the lower-dose monophasic pill than the higher-dose monophasic pill in its suppression of follicular development.

Adult↗
PubMed1993

The effects of illness on sleep behaviour in infants.

For the purpose of evaluating the association between health problems and sleep disturbances as part of a community survey of sleep patterns in childhood, a questionnaire was administered to 752 mothers of children between the ages of 4 months and 4 years, and to the nurses at their regular baby clinics. The questionnaire covered the areas of past and present sleep and settling behaviour, as well as health history and demographic data. The study group consisted of 66 (8.9%) children who had either chronic medical problems, or history of an illness requiring hospitalisation. Regular night waking was reported in 35% and 34% of the group with and without history of illness, respectively. The mean number of interrupted nights per week was similar in both groups and so were the sleep problems perceived by the mothers. We conclude that in this age group the results do not support an association between health problems and prolonged sleep disturbances.

Case-Control Studies↗
PubMed1993

Calcium homeostasis of an elderly population upon admission to a nursing home.

OBJECTIVE: To evaluate the skeletal health, calcium, and vitamin D homeostasis of patients upon their entry to a long-term-care facility. Factors that could contribute to the risk of future osteoporotic fractures were also evaluated. DESIGN: Cross-sectional study. PATIENTS: Two hundred eighty-seven consecutive admissions were invited to participate; 109 patients were recruited into the study. MEASUREMENTS: A high prevalence of low to low-normal circulating levels of 25(OH)D was found in nursing home residents upon their admission to the nursing home, with 86% of the patients having circulating 25(OH)D levels of less than 50 nmol/L and 41% having levels below 25 nmol/L. Frankly elevated parathyroid hormone levels were found in 16% of the patients. Additionally, alkaline phosphatase and osteocalcin levels were elevated in 23% and 13% of the patients, respectively. Bone mineral measurements were in the osteoporotic range for 85% of the nursing home residents. Bone density results for females with a history of any classic osteoporotic fracture were significantly lower than for those with no fracture history (68.5 arbitrary units (AU) for those with no fracture history, 58.8 AU in those with history of hip fracture; P < 0.05). The bone mineral measurements were higher in women with adequate 25(OH)D compared with women with deficient or borderline 25(OH)D with and without fracture history. Levels of 25(OH)D were positively correlated with urine calcium/creatinine (r = .24; P = 0.03) and 1,25(OH)2D (r = .28; P = 0.01) and were negatively correlated with 1-84 PTH (r = -.24; P = 0.02). CONCLUSION: Hypovitaminosis D is prevalent among elderly patients entering a nursing home with secondary hyperparathyroidism and apparently increased bone turnover present in patients with circulating 25(OH)D levels below 50 nmol/L. Bone density measurements showed that a majority of the individuals entering a nursing home are osteoporotic. There is a positive association between 25(OH)D levels and bone mass and a negative association between 25(OH)D levels and a history of fracture.

Activities of Daily Living↗
PubMed1992

[Intestinal tuberculosis presenting as Crohn's disease].

A 24-year-old woman who had immigrated from India 3 years before was referred because of diarrhea, abdominal pain and weight loss. Crohn's disease was suspected, but investigation revealed active pulmonary tuberculosis and tuberculosis of the small and large intestine. She was treated with rifampicin, 600 mg/day, INH 300 mg/day, and ethambutol, 400 mg/day, and recovered fully within 6 months.

Adult↗
PubMed1992

Is case management effective for people with serious mental illness? A research review.

Recent literature on caring for people with serious mental illnesses reflects a growing belief in the effectiveness of case management services for this population. This article reviews recent outcome studies on case management to assess the extent to which prevailing claims that it is effective are supported empirically. Based on this review, the author concludes that the hypothesis that case management is effective remains plausible, but conclusive claims that its efficacy has been empirically demonstrated are premature. The outcome studies reflect diversity and ambiguity in the ways case management is conceptualized and implemented, problems in the research methodologies employed, and inconsistencies in outcomes. Consequently, implications for further research are drawn.

Deinstitutionalization↗
PubMed1992

Ranitidine for erosive oesophagitis: a double-blind, placebo-controlled study. Glaxo Erosive Esophagitis Study Group.

A multicentre, randomized, double-blind, placebo-controlled study was conducted to evaluate the efficacy and safety of ranitidine 150 mg and 300 mg in 342 patients with erosive oesophagitis. Treatment was given four times daily, and continued for 12 weeks or until healing (that is, normal or only erythematous mucosa). Erosive oesophagitis healing rates, as determined by endoscopy, were significantly greater in ranitidine-treated patients by 4 weeks compared with those of placebo-treated patients. By 12 weeks, erosive oesophagitis healing rates were 83 and 81% for ranitidine-treated patients (150 and 300 mg, respectively) and 58% for placebo-treated patients (P less than or equal to 0.001, ranitidine vs. placebo). Symptomatic relief was achieved within 24 hours after starting either dosage of ranitidine. Heartburn frequency (P less than 0.001) and severity (P less than 0.001), as well as antacid consumed per week (P less than 0.001), were reduced in both ranitidine groups in comparison with placebo. Healing rates and symptom relief were similar in the two ranitidine groups. Both dosages of ranitidine were well tolerated. Ranitidine (150 mg) given four times daily appears to be as effective as 300 mg ranitidine given four times daily in patients with moderate to severe oesophageal erosions.

Adult↗
PubMed1992

Familial tufted angioma.

Tufted angioma is a rare slowly progressive vascular lesion found typically in children and young adults. Cases appear sporadically and clinically have been confused with low grade angiosarcoma, Kaposi's sarcoma, and multiple glomus tumours. We report a case of a patient with tufted angioma in whom a strong family history of similar lesions is apparent, transmitted in an autosomal-dominant mode of inheritance.

Adult↗
PubMed1992

Design of an expert system and its application to dermatopathology.

Expert systems are computer programs which use inference and knowledge to solve problems which usually require the expertise of a human specialist. This paper examines the application of expert systems to histopathology and explains their construction by describing the design of an expert system 'dermdx', intended to aid in the interpretation and diagnosis of biopsies of inflammatory diseases of the skin. The system consists of an expert shell, which performs the inference, and a rule-base, which contains the knowledge with which the system operates. The system can be easily updated or adapted to other tasks.

Computer Systems↗
PubMed1991

Ellipsoidal confidence regions for mean refractive status.

Confidence regions for mean dioptric power can be represented by ellipsoids in a three-dimensional space called h-space. A convenient graphical representation is provided by stereo-pair drawings that, at a glance, show the estimated accuracy with which the mean power is known. As an example, a sample of autorefractor measurements made on one eye were used to construct a 95% confidence ellipsoid for the mean objective refractive status of that eye. Key dimensions of the ellipsoid are compared with those of another eye. The analysis is of fundamental importance for scientific studies of variation and change of refractive status. Its potential clinical importance is also discussed.

Adult↗
PubMed1991

The distribution of dioptric power: ellipsoids of constant probability density.

A sample from a population of dioptric powers may be used to estimate the distribution of dioptric powers in the population itself. This paper describes the method and shows further how one can obtain a graphical representation of the distribution. The graphical representation takes the form of ellipsoids of constant probability density. The centroid of each ellipsoid estimates the mean of the population while the size, shape and orientation show the extent and nature of the spread of the population. For illustrative purposes the theory is applied to measurements of refractive status before and after radial keratotomy. The ellipsoids are presented as stereo-pairs. They are useful for comparative and predictive purposes. Thus the ellipsoid that contains 95% of the population after surgery defines the set of refractive errors within which the refractive error of a particular eye can be expected to fall with a probability of 95%.

Humans↗
PubMed1990

Psychological effects of breast-conserving cancer treatment and mastectomy.

Patients in the early stages of breast cancer were studied one year after treatment to ascertain the psychological effects of mastectomy and a breast-conserving alternative, lumpectomy plus radiation therapy. Patients who had had a mastectomy felt less attractive, less sexually desirable, and more ashamed of their breasts. They also experienced less enjoyment in their sexual relationships than they had before treatment. Patients who had radiation therapy experienced no changes in these areas. For these reasons, half of the mastectomy patients regretted not having chosen the breast-conserving alternative.

Body Image↗
PubMed1990

Secretion of nizatidine into human breast milk after single and multiple doses.

Disposition of the H2-receptor antagonist nizatidine was studied in serum, urine, and breast milk. Five lactating women and five nonlactating women participated; the disposition of nizatidine was studied in three of the lactating women. Single and multiple doses of 150 mg nizatidine were administered orally. The disposition of nizatidine (half-life, 1 1/2 hours; apparent serum clearance, 40 L/hr; renal clearance, 27 L/hr; and apparent volume of distribution, 1.4 L/kg) was similar in lactating and nonlactating women. These pharmacokinetic results were analogous to observations for men in other studies. Nizatidine breast milk concentrations were directly proportional to corresponding serum concentrations. On average, 96 micrograms nizatidine, less than 0.1% of the maternal dose, was secreted into milk during a 12-hour interval after either single or multiple doses.

Adult↗
PubMed1990

Vitamin D supplementation in elderly nursing home residents increases 25(OH)D but not 1,25(OH)2D.

Vitamin D metabolism in elderly individuals can be compromised by several mechanisms. We previously described reduced concentrations of 1,25-dihydroxyvitamin D [1,25(OH)2D] in 30% of elderly nursing home residents. The present study assesses the effect of vitamin D supplementation on 25-hydroxyvitamin D [25(OH)D] and 1,25(OH)2D. We performed a double-blind study in which 30 elderly nursing home residents were randomly given either 50 micrograms vitamin D or a placebo daily for 6 wk. Vitamin D metabolites, immunometrically assayed parathyroid hormone (IRMA-PTH), ionized calcium, and bone Gla hormone (BGP) were measured in serum at baseline and biweekly for 6 wk. Serum 25(OH)D concentrations increased significantly (P less than 0.0001) over the 6 wk in the treatment group but were unchanged in the placebo group. Serum 1,25(OH)2D, ionized calcium, BGP, and PTH were not significantly altered by the supplement. We conclude that vitamin D supplementation results in an increase in circulating 25(OH)D but not 1,25(OH)2D; however, the long-term effect on bone mineral metabolism remains unclear.

Aged↗
PubMed1990

Florid reactive lymphoid hyperplasia of the terminal ileum in adults: a condition bearing a close resemblance to low-grade malignant lymphoma.

Five cases of florid lymphoid hyperplasia of the ileocaecal region are described. This condition is characterized by large reactive germinal centres and a diffuse infiltrate of lymphoid cells and eosinophils which extends through the muscularis propria. There is a close resemblance to low-grade malignant lymphoma from which it can be distinguished only by the use of immunocytochemistry for light-chains. Using this technique it should be possible to classify all such lymphoid proliferations as either reactive or neoplastic and to eliminate ambiguous labels like pseudolymphoma.

Adult↗
PubMed1990

Multicystic structures appearing in mature cystic teratomas of the ovary: an immunohistochemical and ultrastructural study.

Multicystic or sieve-like areas are frequently present in the walls of mature cystic ovarian teratomas. This histological, immunohistochemical and ultrastructural study supports the contention that such cysts arise from oleous material which has been extravasated through the cyst wall and become lodged within fibrous tissue and small blood vessels. Some cysts may also arise from degenerate sebaceous glands.

Adolescent↗