Search PubMed⌕ Search

Biomedical subjects

B Raphael

Publications and source records attributed to B Raphael.

At least 55 records · Page 3Linked to original sources
PubMed1995

Psychological responses to malignant melanoma. An investigation of traumatic stress reactions to life-threatening illness.

A cross-sectional study of 95 individuals with malignant melanoma was conducted to investigate posttraumatic stress responses to a diagnosis of melanoma and to validate the use of the Impact of Event Scale (IES) as a measure of the response to the trauma of life-threatening disease. The diagnosis and progression of malignant disease are likely to present a range of acute and chronic trauma to the individual and the individual's family. The findings suggest that the IES is a reliable and valid measure of this distress, with scores varying according to disease progression and prognostic status of nonmetastatic disease patients. This indicates the importance of clinical attention to the specific symptoms that may best reflect the traumatic impact of life-threatening illness and its progression, and the applicability of posttraumatic stress syndromes in understanding the psychological distress of this clinical population.

Adult↗
PubMed1994

Rearrangement and expression of MDM2 oncogene in chronic lymphocytic leukemia.

Since trisomy 12 is the most common chromosome abnormality found in CLL and MDM2 has been mapped to this chromosome, we examined the possible association of MDM2 in the pathogenesis of CLL. A rearrangement of the MDM2 gene was observed in 4 of 11 peripheral blood mononuclear cells (PBMC) from patients with CLL by Southern blot hybridization. Expression of MDM2 was detected in all of the CLL samples examined by Northern blot. However, neither gross amplification nor overexpression of the MDM2 gene was found in CLL. The data suggest that MDM2 may play a role in the pathogenesis of CLL and may help to explain how abnormalities of chromosome 12 are related to CLL.

Blotting, Northern↗
PubMed1994

Coraco-clavicular joint: normal variant in humans. A radiographic demonstration in the human and non-human primate.

The coraco-clavicular joint is a true synovial joint that may become painful in some patients after trauma. Among the descriptions of this entity is the assertion that the coraco-clavicular joint is routinely seen in gorillas and gibbons. We undertook to assess the incidence of this variant among gorillas, gibbons, and other non-human primates. All available radiographs of large primates performed at the International Wildlife Conservation Park/Bronx Zoo (IWCP) over the past 10 years were reviewed by a musculoskeletal radiologist (human radiology). All radiographs were taken during the normal clinical care of the non-human primate population of the IWCP and are a part of each animal's clinical record. Eighty-one non-human primate radiographs were suitable for study as they contained the region of interest. The 81 radiographic examinations included 14 different species of non-human primates. The coraco-clavicular joint was seen in 4 out of 9 silver-leaf langur, 2 out of 8 lowland gorilla, and in 1 out of 6 white-handed gibbon. In all non-human primate cases where the coraco-clavicular joint occurred, it was bilateral. In 1 out of 8 mandrill, there were very wide distal clavicular ends that articulated both with the coracoid and with the acromion. The coraco-clavicular joint differs from an ossified coraco-clavicular ligament. The radiographic appearance is characteristic and is found in both humans and some non-human primate species. It may rarely become painful following trauma. When symptomatic in humans, resection of this anomalous articulation is curative.

Acromioclavicular Joint↗
PubMed1994

Concepts of normal bereavement.

This study used a 25-item questionnaire to examine the perceptions of 128 people with a close interest in bereavement and its literature. The study is part of a project to identify key aspects and the bereavement process. Subjects were asked to rate their perceptions of key bereavement phenomena with regards their frequency in the acute and later stages of bereavement. Descriptive results are presented and discussed, and a profile of phenomena perceived to be common to both stages is outlined.

Adaptation, Psychological↗
PubMed1994

Determinants of condom use by Australian secondary school students.

PURPOSE: To identify factors that are associated with condom use to aid in the understanding of how to change the behavior of those young people who have sex without using condoms. METHODS: The article reports data from 932 sexually active grade 10-12 students from a sample of 72 public secondary schools in seven Australian states and territories. The data were collected using a cross-sectional, self-report questionnaire. RESULTS: Boys were more likely than girls to report that a condom was used the last time they had sex. For boys and girls, communication with a partner about avoiding infection with HIV/STDs, the belief that more peers use condoms, and a higher perceived risk of becoming infected with HIV/STDs were associated with using a condom, as was lower knowledge of STDs. The use of oral contraception and the unavailability of condoms were reported by the students as prominent reasons for non-use of condoms. Number of sexual partners in the past year and type of relationship with partner on the most recent occasion were not associated with condom use. CONCLUSIONS: Adolescents are more concerned with unwanted pregnancy than with disease prevention. School students more at risk are not more likely to take the necessary precautions to protect themselves from HIV/STDs.

Adolescent↗
PubMed1994

A longitudinal study of bereavement phenomena in recently widowed elderly men.

A three-phase longitudinal design was used to study bereavement phenomena in a cohort (N = 78) of recently widowed elderly Australian men. One group of 57 widowers was compared with a second group of 21 widowers on a waiting list. A brief, interviewer-administered, structured questionnaire was used to rate the frequency of 22 self-reported bereavement phenomena. The prevalence and temporal evolution of these phenomena are described. Half of a subgroup of elderly widowers reporting high levels of bereavement phenomena at 6 weeks post-bereavement went on to exhibit persistent or chronic grief at 13 months post-bereavement. The prevalence of persistent or chronic grief throughout the first 13 months post-bereavement was 8.8%. Income, education and expectedness of the death were all negatively correlated with frequency of self-reported bereavement phenomena at 6 weeks post-bereavement. In a multiple regression analysis only expectedness of the death contributed significantly to prediction of the frequency of bereavement phenomena at 6 weeks post-bereavement. Widowers who were unable to anticipate their wife's death, even when their wife had suffered a long final illness, had a more severe bereavement reaction.

Aged↗
PubMed1994

Are there two depressive syndromes after stroke?

The objective of this study was to describe the clinical characteristics of minor depression after stroke and to compare this disorder with poststroke major depression and the nondepressed state. Ninety-four stroke inpatients were examined 8 weeks after stroke and reexamined 15 months later. Twenty-one (22%) of the 94 patients suffered from minor depression, 14 (15%) suffered from major depression, and 59 (63%) were not depressed. Minor depressed patients were twice as symptomatic as nondepressed patients but were only half as symptomatic as major depressed patients. Minor depressed patients were more likely than nondepressed patients to have a previous history of stroke and were more physically disabled. They were less likely than major depressed patients to have a family history of affective disorder. Depression symptom severity was associated with greater physical disability among minor but not major depressed patients. Fewer minor than major depressed patients were depressed at 15 months. These findings suggest that poststroke major and minor depression may be different depressive syndromes. Some cases of minor depression may be construed as an adjustment reaction to stroke disability.

Aged↗
PubMed1994

Religiosity, sexual intercourse and condom use among university students.

There is strong evidence that religiosity among adolescents is associated with delayed onset of sexual activity. However, research on relationships between religiosity and contraceptive practices is limited and inconsistent. This paper provides data from a survey of 374 students aged between 16 and 21 at two Brisbane universities (72.4 per cent response rate). Those who perceived religion to be important in their lives were less likely to have had intercourse. Among the sexually active sample, religious youth did not differ from their peers in recent condom use, the age at which they first used condoms or the rate of partner change. Contrary to several recent assertions in review articles, this and other empirical studies do not show that religious youth are less likely than nonreligious youth to take precautions during sex.

Adolescent↗
PubMed1994

Phase I trial of low-dose continuous topotecan infusion in patients with cancer: an active and well-tolerated regimen.

PURPOSE: The objective of this trial was to define the maximum-tolerated dose (MTD) of topotecan for a 21-day infusion schedule, repeated every 28 days, in patients with cancer. PATIENTS AND METHODS: Cohorts of four patients received continuous ambulatory infusions of topotecan in escalated duration with doses beginning at 0.20 mg/m2/d for 7 days. Forty-four patients with a histologic diagnosis of cancer refractory to standard therapy were treated with infusions of topotecan for a total of 115 cycles and 1,780 patient-days of infusion. The median number of treatment cycles per patient was two (range, one to eight). All patients were heavily pretreated with chemotherapy and/or radiation. RESULTS: The dose-limiting toxicity (DLT) was myelo-suppression, with thrombocytopenia greater than neutropenia seen at the dose level of 0.70 mg/m2/d for 21 days. At the MTD of 0.53 mg/m2, ten patients were treated for a total of 20 courses, resulting in one episode of grade 4 thrombocytopenia and leukopenia, one grade 3 thrombocytopenia, and two grade 3 leukopenias. This dose regimen was well tolerated, with minimal nonhematologic toxicity. Local infusion port complications developed in two patients and two had bacteremia, including one patient with repeated local skin infections. Objective responses were observed in this heavily pretreated population for patients with ovarian cancer (two partial responses and one mixed response in six patients), breast cancer (one partial response and one mixed response in two patients), and for one patient each with renal and non-small-cell lung cancer (two partial remissions). CONCLUSION: Twenty-one-day topotecan infusion is well tolerated at 0.53 mg/m2, with dose-intensity exceeding other schedules for administration of topotecan. The DLT is hematologic, with thrombocytopenia somewhat exceeding leukopenia. Objective responses were observed in seven patients with breast, ovarian, renal, and non-small-cell lung cancer.

Adult↗
PubMed1994

Women in medicine--socialization, stereotypes and self perceptions.

Eleven women in various specialities, including the academic and administrative spheres, were interviewed with regard to their experiences throughout their career. These women all held senior positions in Medicine and represent a broad age range (35-69 years). Information gathered during the interviews was analysed thematically in an attempt to develop a basis for further research examining predictors of success for women in medicine.

Adult↗
PubMed1994

[Retinal vasculitis and antiphospholipid antibodies].

Antiphospholipid antibodies (APAb) are often found in systemic lupus erythematosus (LE) (secondary antiphospholipid syndrome), leading to arterial or venous thrombosis. In primary antiphospholipid syndrome other LE-associated symptoms are not detectable. We present the clinical course and therapy of three patients with this rarely reported disease, discussing immunopathology and therapy. Three young patients (28, 29 and 31 years) were seen at the university eye clinic, presenting severe occlusive vasculitis with vitreal haemorrhages and/or thrombosis. The first patient did not respond to any therapy (various immunosuppressives, plasma-pheresis, laser coagulation) and ended up with defective light perception in both eyes. The second patient also had light perception as final outcome in spite of acetylsalicylic acid, steroids and immunosuppression. The third patient established complete reperfusion on an arteriovenous occlusion after haemodilution and acetylsalicylic acid. Antibodies directed against phospholipids interfere with the blood clotting system in many ways (activation and aggregation of thrombocytes, endothelial function, coagulation cascade). The optimal therapy of this severe disease is unclear, suggesting that acetylsalicylic acid seems to be important, while the effect of immunosuppression or steroids is uncertain.

Adult↗
PubMed1994

Elevation of transforming growth factor alpha in cat aqueous humor after corneal endothelial injury.

PURPOSE: To determine if a scrape injury to cat corneal endothelial cells increases the level of mitogenic proteins such as transforming growth factor alpha (TGF alpha) in aqueous humor. METHODS: Aqueous humor of cats was collected at 0, 2, 6, and 24 hours after wounding the endothelium by contact with a cannula tip. Aqueous humor samples collected from sham-wounded cats served as controls. Aqueous humor samples were analyzed for levels of protein, for mitogenic activity using incorporation of tritiated thymidine by cultures of bovine corneal endothelial cells, and for immunoreactive TGF alpha protein using a specific radioimmunoassay. RESULTS: The average protein level in aqueous humor obtained before wounding was low (0.5 mg/ml), increased 26-fold at 2 hours after injury (13 mg/ml), then progressively decreased at 6 hours (8 mg/ml) and 24 hours (2 mg/ml). Levels of mitogenic activity of aqueous humor samples collected 2, 6, and 24 hours after wounding were 2-fold, 2.5-fold, and 0.6-fold higher, respectively, compared to the level of mitogenic activity measured in aqueous humor collected before wounding (0 hours) or in aqueous humor collected from sham-wounded eyes. TGF alpha concentration in aqueous humor collected before endothelial wounding was low (6.8 ng/ml), increased 14-fold 2 hours after wounding (97.4 ng/ml), then progressively decreased at 6 hours (63.3 ng/ml) and 24 hours (35.5 ng/ml) after wounding. TGF alpha concentrations in aqueous humor collected from sham-wounded eyes at 2 hours (9.5 ng/ml) and 6 hours (5.3 ng/ml) were not significantly different from prewound levels. Detergent extracts of bovine corneal endothelial cells contained substantial levels of TGF alpha immunoreactive protein (20 ng/mg protein). CONCLUSIONS: Wounding of cat endothelium causes a rapid increase in mitogenic proteins in aqueous humor including TGF alpha, which may act by an autocrine mechanism to stimulate endothelial wound healing.

Animals↗
PubMed1993

Domestic violence victims in a hospital emergency department.

OBJECTIVE: To determine the prevalence and predictors of domestic violence victims among attenders at the emergency department at Royal Brisbane Hospital in 1991. DESIGN: Cross-sectional study in which randomly selected nursing shifts were used to screen attenders. RESULTS: Of all attenders at the emergency department, 14.1% disclosed a history of domestic violence. Women were more likely than men to disclose domestic violence ("raw" relative risk, 2.31; 95% confidence interval [CI], 1.83-2.91; relative risk adjusted for age and history of child abuse, 4.50; 95% CI, 3.02-6.71). The greatest risks for being an adult victim of domestic violence were being female and having experienced abuse as a child. Most of those who had experienced domestic violence within the last 24 hours (1.1% of attenders) came to the department after-hours when social work staff were unavailable for referral. CONCLUSIONS: The prevalence and risk factors have implications for the training of doctors and nurses in domestic violence problems and for the provision of adequate resources to deal with the psychosocial aspects of domestic violence.

Adolescent↗
PubMed1993

Adolescent resilience: the potential impact of personal development in schools.

The challenges and stresses faced by adolescents include entry into secondary school, the development of adolescent sexuality, family conflicts, parental mental illness, socio-cultural factors, substance use and abuse, work and career abuse, social and antisocial behaviour, and the carry-over of problems from childhood. The ways in which programmes through schools can address these issues, enhance resilience and promote adolescent mental health are discussed. The potential of personal development programmes could be utilized to this end, with targeted educational and group initiatives and evaluation of outcomes.

Adolescent↗
PubMed1993

An international perspective on bereavement related concepts.

This paper reports on part of a study which was aimed at assessing the views of leading researchers, theorists or clinicians working in the field of bereavement on key issues including, as reported here, concepts of different forms of grief as well as favoured theoretical orientations. Of a range of conceptual models the most favoured, by a large margin, were attachment theory and the psychodynamic model. The views of the "experts" were canvassed with respect to the use of seven selected terms used to denote some variant of the grieving process. There was, on the part of the respondents, reasonable support for the syndromes of "delayed", "chronic", "anticipatory" and "absent" grief. "Inhibited" and "unresolved" grief tended to be described using one of the four terms already supported, while the use of the term "distorted grief" attracted little support.

Adaptation, Psychological↗
PubMed1993

Emotional lability after stroke.

The aims of this study were (i) to determine the frequency of emotional lability following first ever stroke, and (ii) to identify factors associated with this condition. Sixty-six consecutive inpatients with first ever stroke were surveyed two months post stroke for the presence of emotional lability. Demographic, clinical, psychiatric and stroke lesion characteristics were also assessed. Emotional lability was present in 12 of the 66 patients (prevalence: 18%). Emotional lability occurred independently of post stroke depression. Single lesions located in anterior regions of the cerebral hemispheres had four times the odds of emotional lability than lesions located anywhere else (p < 0.05). Emotional lability is a common emotional-behavioural syndrome following stroke and is probably a separate condition from post stroke depression. The aetiology of this condition is possibly related to the consequences of injury to anterior regions of the cerebral hemispheres.

Affective Symptoms↗