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Biomedical subjects

B Ginsberg

Publications and source records attributed to B Ginsberg.

At least 55 records · Page 3Linked to original sources
PubMed1990

Life events and relapse in schizophrenia. A one year prospective study.

Results from a one year prospective study of a relationship between major and minor life events (all other events), and relapse in twenty-two schizophrenic (DSM III-R) patients are reported. Seven (33%) patients relapsed during the one year of follow-up. Relapsed patients had experienced significantly more independent major and minor life events during the one year compared to non-relapsed patients. The independent events experienced by the relapsed patients occurred twice as often in the three month period prior to the relapse as compared to any other period among the relapsed, or the non-relapsed patients. These findings are discussed in the context of the prospective design of this study and the inclusion of minor as well as major events.

Humans↗
PubMed1990

Pharmacokinetic model-driven infusion of fentanyl: assessment of accuracy.

Computer-assisted continuous infusion (CACI) is a pharmacokinetic model-driven infusion device that enables physicians to administer intravenous (iv) drugs in a quantitative fashion, specifying a theoretical blood or plasma concentration. This study evaluated the accuracy of CACI administration of fentanyl using a newly developed CACI device programmed with a well-known set of pharmacokinetic parameters for fentanyl. Patients received diazepam 1 or 2 h before surgery. Anesthesia was induced by a combination of 70% N2O and fentanyl administered by CACI to a predicted concentration of 15-25 ng.ml-1. After neuromuscular blockade and tracheal intubation, the desired plasma fentanyl concentration (setpoint) entered into CACI was 3-6 ng.ml-1, and then the setpoint fentanyl concentration was titrated according to strict criteria of adequate or inadequate anesthesia. Plasma samples for subsequent assay of fentanyl concentration then were taken: at predefined stimuli, when inadequate anesthesia occurred, or 5 min before an anticipated decrease in the fentanyl setpoint. The predictive accuracy of CACI was assessed by calculating for each patient the tenth, 50th, and 90th percentile of the performance error and absolute performance error from each measured and predicted plasma sample pair. Cumulative probability functions for each of these were then plotted. Precision was defined as the dispersion of the tenth to 90th percentile of the median percent performance error for the population and was found to be -31-26%. The median population performance error was -4%, and the median population absolute performance error was 21%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Patient-controlled analgesia in postoperative pain: the relation of psychological factors to pain and analgesic use.

The surgical experience is often characterized by fear, stress, and pain. Whenever an individual has to confront a painful or stressful event such as surgery, the individual's opportunity to control some aspect of the situation may actually influence the degree of pain experienced. Patient-controlled analgesia (PCA) is a relatively new method of analgesic administration that allows the postoperative patient to self-administer analgesic drug. The present study examined the relationship of psychological variables, including anxiety, depression, coping strategies, and social support, to pain and PCA use in a sample of 80 adults who underwent orthopaedic surgeries. Regression analyses controlling for age and type of opioid revealed that the psychological measures were important predictors of pain and PCA use. Patients with higher anxiety levels and less social support had higher postoperative pain and made more frequent PCA demands.

Age Factors↗
PubMed1989

Onset and duration of neuromuscular blockade following high-dose vecuronium administration.

To determine the onset time and duration of high doses of vecuronium, 40 ASA Physical Status 1 and 2 patients were randomly assigned to receive either 100, 200, 300, or 400 micrograms/kg of vecuronium bromide for muscle relaxation during elective general surgery. Neuromuscular blockade was continuously quantitated by recording the electromyographic response to stimulation of the ulnar nerve train-of-four. The rate of onset of neuromuscular blockade, endotracheal intubating conditions, duration of neuromuscular blockade, and hemodynamic effects of vecuronium at each dose were evaluated and compared. The time from vecuronium administration to complete abolition of twitch tension (T1 = 0%) decreased from 208 +/- 41 to 106 +/- 35 s as the vecuronium dose was increased from 100 to 400 micrograms/kg (P less than 0.01). Corresponding times to endotracheal intubation (T1 less than 20%) also decreased from 183 +/- 24 to 96 +/- 31 s with increasing doses (P less than 0.01). Recovery time (T1 = 25%) increased from 37 +/- 13 to 138 +/- 24 min with increasing doses (P less than 0.01). No significant hemodynamic differences between the four groups were observed. Endotracheal intubating conditions were good or excellent in all patients. High doses of vecuronium may, therefore, be a useful alternative to succinylcholine when a rapid onset of neuromuscular blockade is required.

Anesthesia, General↗
PubMed1989

Effect of fatty acid composition on insulin and IGF-I binding in retinoblastoma cells.

Receptors for insulin and other hormones are often influenced by their environment, including fatty acid content and membrane fluidity. Y79 retinoblastoma cells enriched with arachidonic or docosahexaenoic acid show an increase in membrane fluidity determined by fluorescence polarization using the plasma membrane-specific probe, trimethylammonium-diphenylhexatriene. Unlike cells enriched with polyunsaturated fatty acids, cells cultured in media containing palmitic or oleic acid showed no changes in membrane fluidity or fatty acid composition. Cells enriched with docosahexaenoic acid show an increase in insulin binding at 15 degrees C that is due to an increase in the number of available insulin receptor sites on the plasma membrane. In contrast, insulin binding is not altered in cells enriched with arachidonic, palmitic or oleic acid. Furthermore, the binding of insulin-like growth factor-I (IGF-I) in Y79 cells is not changed by the fatty acid unsaturation of the cell membrane. Because docosahexaenoic acid is naturally present in high concentrations in the retina these studies suggest it may have a role in modulating insulin binding and function.

Eye Neoplasms↗
PubMed1988

Screening devices for diminished cognitive capacity.

This study compares three commonly used tests to detect organic mental disorders: the Mini-Mental State (MMS), Cognitive Capacity Screening Examination (CCSE), and Tachistoscope (T-Scope). Ninety-seven medical-surgical inpatients at the Mount Sinai Hospital referred for psychiatric consultation had a Missouri Mental Status Examination performed by a psychiatrist who also rated the patients' organic mental disorder as "none," "mild," "moderate," or "severe." The CCSE, MMS, and T-Scope, respectively, showed: sensitivity--0.54, 0.52, 0.68; specificity--0.85, 0.76, 0.79; and positive predictive value--0.83, 0.74, 0.79. False negatives occurred more often among those patients with mild organic mental disorders with all instruments (p = 0.05), while the T-Scope could not be administered in 27% of the patients. Screening instruments with increased acceptability, sensitivity, and specificity need to be developed to identify a potentially life-threatening disorder.

Adult↗
PubMed1986

Morphometric analysis of chondrocyte hypertrophy.

In the hypertrophic zone of the cartilaginous growth plate, chondrocytes enlarge, assume a more spherical shape, and form a population of cells called the hypertrophic chondrocytes. The mechanisms that are involved in the formation of hypertrophic chondrocytes are poorly understood. Cell hypertrophy usually refers to an increase in cell size and volume associated with an increase in organelles. In this study, we sought to determine whether the formation of hypertrophic chondrocytes represents true cell hypertrophy associated with an increase in organelles or whether it is due to swelling and fluid accumulation. Morphometric analyses of electron micrographs were carried out to determine changes in cell number, cell volume, cell organelle volumes, and matrix volumes in the reserve zone, upper proliferative zone, lower proliferative zone, upper hypertrophic zone, and lower hypertrophic zone. Between the upper proliferative zone and the lower hypertrophic zone, the cells increased their mean volume more than 500 per cent. As they enlarged, their matrices altered; territorial matrix volume increased as its collagen content decreased, and interterritorial matrix volume decreased as its collagen content increased between the lower proliferative zone and the lower hypertrophic zone. Between the upper proliferative zone and the lower hypertrophic zone, the absolute volume per cell of endoplasmic reticulum, Golgi membranes, and mitochondria increased 126 per cent, while the volume of cytoplasm and nucleoplasm increased 779 per cent, apparently by accumulation of water. Cell organelles of the lower hypertrophic zone did not show the changes that are associated with cell injury or death. Thus, the synthesis of organelles contributed to chondrocyte enlargement, but the primary mechanism of cell enlargement was cytoplasmic and nuclear swelling.

Animals↗
PubMed1985

Growth-plate-chondrocyte profiles and their orientation.

We studied the proximal tibial physes of mice, seven, fifteen, twenty-two, and twenty-eight days old, to define in mathematical terms the changes in cell profile and profile orientation among growth-plate zones and to determine if cell profile and profile orientation change with changes in the rate of growth. Using electron microscopy, we identified five growth-plate zones: the reserve zone, the upper proliferative zone, the lower proliferative zone, the upper hypertrophic zone, and the lower hypertrophic zone. In transverse sections, cell profiles did not change among growth-plate zones and the degree of cell-profile orientation approached zero in all zones. In longitudinal sections, cell profiles and profile orientations differed significantly among zones. Cell profiles in the upper and lower proliferative zones were eccentric and highly oriented. They became more rounded and the degree of cell orientation decreased between the proliferative and hypertrophic zones. As the rate of longitudinal bone growth decreased, cell profiles and cell-profile orientation changed. The cell profiles in the reserve zone became flatter and in the other zones the cell profiles became more rounded. The degree of cell-profile orientation decreased quadratically in the upper and lower proliferative zones, decreased linearly in the reserve and upper hypertrophic zones, and remained unchanged in the lower hypertrophic zone.

Aging↗