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Biomedical subjects

B Friedman

Publications and source records attributed to B Friedman.

At least 127 records · Page 7Linked to original sources
PubMed1987

The Longitudinal Interval Follow-up Evaluation. A comprehensive method for assessing outcome in prospective longitudinal studies.

The Longitudinal Interval Follow-up Evaluation (LIFE) is an integrated system for assessing the longitudinal course of psychiatric disorders. It consists of a semistructured interview, an Instruction booklet, a coding sheet, and a set of training materials. An interviewer uses the LIFE to collect detailed psychosocial, psychopathologic, and treatment information for a six-month follow-up interval. The weekly psychopathology measures ("psychiatric status ratings") are ordinal symptom-based scales with categories defined to match the levels of symptoms used in the Research Diagnostic Criteria. The ratings provide a separate, concurrent record of the course of each disorder initially diagnosed in patients or developing during the follow-up. Any DSM-III or Research Diagnostic Criteria disorder can be rated with the LIFE, and any length or number of follow-up intervals can be accommodated. The psychosocial and treatment information is recorded so that these data can be linked temporally to the psychiatric status ratings.

Data Collection↗
PubMed1987

Factitious lymphedema of the hand: a diagnostic challenge.

A case of factitious lymphedema of the hand is presented. Attention is drawn to this entity and its differential diagnosis. Delayed detection in our case resulted in prolonged and costly hospitalization with some loss of hand function. Treatment should be left to those skilled in psychotherapy.

Adult↗
PubMed1986

Plasticity in the olfactory cortex: age-dependent effects of deafferentation.

In order to assess the role of input-target interactions in the development of olfactory cortex, the primary afferent fibers from the olfactory bulb to the superficial part of layer I of the cortex (layer Ia) were removed in developing and mature rats. After survival periods that vary from a few days to 2-6 months, changes were assessed in (1) the radial thickness of layer I, (2) the laminar distribution of intracortical associational fibers, which normally terminate in a deep part of layer I (layer Ib), and (3) the distribution of glia in layer I. The findings indicate that the lamination of fibers within layer I is not intrinsically prespecified, but gradually becomes "set" during the first month after birth. If the fibers from the olfactory bulb are removed, the dendrites of cortical cells are capable of accepting inputs from other fiber systems, depending on the maturational state of the dendrites and the ingrowing axons. Development of the abnormal inputs is associated with relatively normal dendritic growth, whereas lack of adequate input results in dendritic atrophy. Thus, after neonatal bulb ablation, the intracortical fibers occupy both superficial and deep parts of layer I, and a normal synaptic density is established throughout the layer. Layer I also develops to nearly its normal adult thickness, although the high density of glia that normally characterizes layer Ia is not apparent. With bulb ablation at progressively older ages (from postnatal day (P-) 3 to 21), the cortical associational fibers show progressively less extension into the denervated layer Ia. Layer I continues to grow, but not to the same extent as after P-1 ablations. In these experiments the glia distribution resembles the pattern present at the time of denervation. After adult olfactory bulb ablation, the long intracortical fibers extend very little into layer Ia, which undergoes pronounced shrinkage and becomes filled with a high concentration of glia. However, partial reinnervation of layer Ia is accomplished by the proliferation of a normally sparse native fiber system, which has been identified only with the Timm method. These results are interpreted as evidence that the normal development of lamination of afferent fibers to the olfactory cortex depends on axodendritic interaction during development.

Age Factors↗
PubMed1986

Age-dependent cell death in the olfactory cortex: lack of transneuronal degeneration in neonates.

Adult olfactory cortical neurons in layer IIa undergo fulminant transneuronal degeneration after removal of afferent olfactory bulb fibers (Price, '76, Neurosci Abst. 2:161; Heimer and Kalil, '78, J. Comp. Neurol. 178:559-609). This provides an unusual example of dependence of a mature population of neurons on axonal input. In order to investigate whether similar transneuronal degeneration occurs in immature animals, a series of rats were subjected to unilateral olfactory bulb removal at various ages during the first 3 postnatal weeks. The brains were examined for degeneration after short survivals by use of the de Olmos cupric silver method, which selectively stains degenerating neurons. In addition, animals with long survivals were examined with the HRP retrograde tracing method, in order to determine if cells that survive the acute effects of deafferentation develop normal patterns of connections. Young neurons are more resistant to the effects of olfactory bulb removal than more mature neurons. There was little degeneration of cortical neurons after bulb ablation during the first 2 postnatal weeks. Although layer IIa does not become distinct from layer IIb in these experimental animals, cells that have connections normally characteristic of the cells of layer IIa, and are situated at the superficial edge of layer II, were identified with the HRP method. The severity of transneuronal degeneration increases and becomes adultlike between the second and third postnatal weeks. This increase in transneuronal degeneration is temporally associated with a progressive reduction in axonal sprouting following deafferentation during the first 3 postnatal weeks, as described in the companion paper (Friedman and Price, '86). Thus, axon sprouting may "protect" the immature IIa neurons from the effects of removal of the fibers from the olfactory bulb. A period of normal cell death has also been identified in olfactory cortex by the use of the de Olmos cupric silver method. This cellular degeneration is much less severe and has a different time course and laminar distribution than the transneuronal degeneration produced by olfactory bulb ablation in adults. Although normal cell death appears to be potentiated by removal of the olfactory bulb on postnatal day 1, it is clearly a different process from the transneuronal reaction.

Age Factors↗
PubMed1986

Calcinosis cutis--a rare late complication of burns.

Pillars of calcification are rarely found in the skin. An interesting case is described where rows of new bone developed in the skin which had been grafted 31 years previously to cover partial skin thickness burns of the shin. The problems of heterotropic ossification are discussed.

Adult↗
PubMed1986

Rupture of extensor digitorum communis after distal ulnar styloidectomy.

Attrition ruptures of tendons in the hand, other than those caused by rheumatoid arthritis, are rare. We report a case in which high styloidectomy of the distal ulna caused the rupture of the extensor digitorum communis tendon to the long finger. This complication can be avoided by resection of the smallest segment of the distal ulna that is compatible with relief of the problem. Soft tissue closure over the resected end of the ulna should also be carried out.

Adult↗
PubMed1986

Intrathoracic abnormalities demonstrated by technetium-99m sulfur colloid imaging.

Since the scintillation camera enables us to include lower thorax in the views obtained during Tc-99m colloid imaging of the liver and spleen, intrathoracic pathology may be identified as relatively cold or hot areas in the thoracic cavity. Eighteen patients who underwent Tc-99m sulfur colloid imaging during a one-year period were found to have intrathoracic pathology demonstrated either as photopenic areas or as areas of increased radioactivity. These patients' clinical data and the results of other diagnostic modalities, including autopsy, were correlated with the Tc-99m images. The intrathoracic disease processes recognized were bacteremia, two cases; pleural effusion, two cases; lung pathology, one case; and cardiomegaly, 13 cases. With the Exception of two patients with bacteremia who had substantial radiocolloid sequestration by the lung, all the other patients had hepatic dysfunction. The presence of compromised hepatic function allows the visualization of intrathoracic abnormalities: photopenia suggesting pleural fluid collection or an enlarged cardiac silhouette (either photopenia or increased radioactivity occupying a large space in the anterior view to yield cardiothoracic ratio of greater than 50%). Therefore, Tc-99m sulfur during colloid liver-spleen imaging, patients with hepatic dysfunction may incidentally demonstrate intrathoracic pathology, especially cardiomegaly.

Aged↗
PubMed1986

Medicare beneficiary decision making about health insurance. Implications for a voucher system.

A two-phase study involving focus group interviews and a survey of 2,016 Medicare beneficiaries was conducted to examine beneficiary decision making about health insurance under a hypothetical Medicare voucher program. Some of the major findings were that: beneficiaries lack important information about Medicare and health insurance in general; plans with physician restrictions, no restrictions on hospitals, and benefits for custodial long-term care at home or in nursing homes are most preferred when prices are roughly equal to actuarial costs; plan features often interact rather than combined additively to affect choices; price sensitivity is small in comparison with sensitivity to other plan features; price sensitivity is particularly small for plans with custodial long-term care benefits; Medicare would not experience substantial selection bias in a voluntary system containing a wide range of plans preferred by beneficiaries; physician-restricted plans would experience favorable selection; plans with long-term custodial care benefits would experience some adverse selection which might be handled by modest price adjustments in view of the relatively low price elasticity of preferences.

Community Participation↗
PubMed1986

The sensation of facial swelling in temporal arteritis: a predictor for the development of visual disturbance.

The sensation of facial swelling in temporal arteritis may be an important predictor of the development of visual disturbance. A clinical report of two patients who developed a sensation of puffiness of the face without altered facial appearance, as a presenting symptom of temporal arteritis with visual disturbance is presented. This symptom, though documented previously by us, has not been identified before as a predictor of visual disturbance.

Aged↗
PubMed1986

Septic arthritis of the sternoclavicular joint.

An adult patient with isolated septic arthritis of the sternoclavicular joint (SCJ) caused by Staphylococcus aureus is described. The patient had no underlying diseases other than paronychia, which might have served as the portal of entry. Antibiotic therapy resulted in clinical cure but x-ray revealed progression of the destructive process.

Adult↗
PubMed1986

Atropine and glycopyrrolate as ECT preanesthesia.

Twenty-four patients receiving ECT were systematically studied to compare the effects of two dosages of atropine and two dosages of glycopyrrolate as preanesthetic agents. Glycopyrrolate resulted in more cardiac arrhythmias, nausea and vomiting, and episodes of bradycardia than atropine (p = .4). More patients receiving atropine showed post-ECT confusion, but the clinical impact of this was minimal. Atropine appears to be preferable to glycopyrrolate for use in ECT preanesthesia.

Adolescent↗
PubMed1985

Thallium-201 scintigraphic visualization at rest of a dilated and hypertrophied right ventricle in a patient with sarcoidosis complicated by cor pulmonale.

Visualization, by resting TI-201 scintigraphy, of a markedly enlarged right ventricle (RV) in a 48-year-old black man with a 20-year history of pulmonary sarcoidosis is presented. The RV was three to four times larger than the left ventricle. Sarcoidosis resulted in marked distortion of the thoracic contents, as shown by the radiograph. This distortion possibly accounts for optimal scintigraphic visualization of the enlarged RV in the left lateral projection rather than in the left anterior projection. Because of the distortion, the chest radiograph could not be used to evaluate the cardiac contour; TI-201 scintigraphy demonstrated the RV enlargement.

Cardiomegaly↗