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Biomedical subjects

B Raphael

Publications and source records attributed to B Raphael.

At least 91 records · Page 5Linked to original sources

Relationships between mental adjustment to HIV diagnosis, psychological morbidity and sexual behaviour.

This paper examines patterns of psychological adjustment in a small sample of asymptomatic HIV antibody positive men. Comparison is made with data available on male cancer patients. HIV positive men reported greater degrees of anxious preoccupation and hopelessness, and lower levels of the more adaptive 'fighting spirit' response. In HIV-infected men, depression correlated positively with frequency of high risk sexual practices.

Adaptation, Psychological↗

Comparison of chlorambucil and prednisone versus cyclophosphamide, vincristine, and prednisone as initial treatment for chronic lymphocytic leukemia: long-term follow-up of an Eastern Cooperative Oncology Group randomized clinical trial.

The Eastern Cooperative Oncology Group (ECOG) conducted a study in which patients with advanced chronic lymphocytic leukemia (CLL) were randomized between a regimen consisting of chlorambucil (30 mg/m2 orally day 1) and prednisone (80 mg orally days 1 to 5) (C + P) administered every 2 weeks and a more intensive regimen of cyclosphosphamide (300 mg/m2 orally days 1 to 5), vincristine (1.4 mg/m2 intravenously [IV] day 1), and prednisone (100 mg/m2 orally days 1 to 5) (CVP) given every 3 weeks. Treatment was continued for up to 18 months to maximal response. Of the 122 eligible patients, 60 received C + P, while 62 received CVP. With a median follow-up of 7 years, there were no significant differences in survival (4.8 v 3.9 years, P = .12), complete remission (CR) rate (25% v 23%; P = .83), or duration of response (2.0 v 1.9 years; P = .78) between C + P and CVP. Toxicity was modest despite the prolonged treatment. The long median survival of 4.1 years for stage III and IV patients is superior to that usually reported. This could stem from continuing treatment to maximal response rather than an increase in intensity of therapy. These results are comparable to those reported with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) therapy by other investigators. The data suggest that intermittent C + P administered to maximal response continues to be the standard treatment approach for advanced CLL.

Adult↗

The evaluation of teaching in undergraduate psychiatric education: students' attitudes to psychiatry and the evaluation of clinical competency.

There is an increasing demand for improved skills by medical graduates in the psychosocial aspects of medical care. Psychiatrists as educators need to play an important role in the development and evaluation of education in many areas of the undergraduate curriculum in addition to the continuing education of graduates. In this review approaches to the evaluation of undergraduate psychiatric education are discussed with particular emphasis on students' attitudes to psychiatry. Key issues that remain to be addressed include the clarification of the most appropriate goals for undergraduate education in psychiatry, the most valid means of evaluating such educational programmes, particularly clinical competency and, finally, the many tasks in improving the status of the psychosocial aspects of medical care for students and their clinical teachers.

Attitude of Health Personnel↗

[PDGF-induced calcium increase in cultivated epithelial cells in the cattle lens].

Platelet-derived growth factor (PDGF) is one of numerous growth factors regulating development of the ocular lens and its component parts. Although little is known about its site of action on the cell and the mechanisms of this confirmed mitogenic action, a close connection has been assumed between the influence of PDGF on both the lens epithelium and intracellular calcium homeostasis. The present study therefore examined the influence of PDGF on the concentration of intracellular free calcium [( Ca2+]i) in primary cultivated bovine epithelial cells. A dose-dependent [Ca2+]i increase of up to 300% followed stimulation with PDGF (5-50 ng/ml) in a medium containing Ca2+. [Ca2+]i also rose significantly in Ca(2+)-free medium, indicating mobilization from intracellular storage.

Animals↗

Three-dimensional reconstruction in routine computerized tomography of the skull and spine. Experience based on 161 cases.

Three-dimensional (3D) reconstruction in routine computerized tomography (CT) presupposes that the referring clinicians are motivated, software programs are of good quality, a second working console is available and manipulations are made by experienced persons. Maxillofacial surgery is the main, conventional indication, but the method is also used to plan the surgical treatment of craniofacial malformations and that of injuries and tumours. 3D reconstruction cannot replace a thorough analysis of the acquisition sections since its spatial definition is not as good as theirs. Without competing with pure research-work, a number of applications remain in the realm of speculative imaging, but it cannot be denied that 3D reconstruction has an interesting potential for teaching.

Adult↗

The health effects of chemical waste in an urban community.

This paper presents the results of a community health survey of people living near a hazardous chemical waste site in Kingston, Queensland. In comparison with a matched control group, people near the site were no more likely to report serious diseases, and reports of cancer and mortality rates did not differ in the two groups. Kingston residents reported higher rates of symptoms of general poor health, high levels of stress and anxiety and a higher incidence of miscarriages. The reports of poor physical health appear to be independent of proximity to the hazardous waste site and duration of residence in the area. Symptom prevalence and perceived recent decline in health correlate most strongly with the stress and anxiety measures. While long-term investigation is necessary, it appears at this stage that the chemical waste is not associated with an increase in major diseases as reported by those who were interviewed. When health in a broader sense is considered, however, it is clear that the situation has had a negative impact.

Abortion, Spontaneous↗

Burns.

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Adult↗

Prevalence and course of depressive disorders in hospitalized stroke patients.

In a sample of ninety-nine patients seen two months post-stroke, 18 percent were diagnosed as having minor depression and 14 percent major depression. At follow-up, fifteen months later, the prevalence of depressive disorder had declined substantially, to 12 percent overall. Major depression was characterized by an average duration of thirty-nine weeks, a mortality rate of 23 percent and was associated with positive family history of affective or anxiety disorder. Among patients with left hemisphere lesions, major depression was associated with cognitive impairment. Minor depression had a shorter average duration (twelve weeks) and was more common in males. These two syndromes may define distinct types of post-stroke depression with implications for treatment interventions.

Activities of Daily Living↗

A research seminar programme for doctoral candidates in psychiatry.

A worldwide trend towards fewer clinician-researchers in the medical specialties has been identified. The ratio of clinicians to non-clinicians in academic departments is declining. Possible responses to these trends are briefly surveyed and an innovative research seminar programme for doctoral students in psychiatry is described.

Curriculum↗

Adsorptive and fluid phase endocytosis by cultured rabbit corneal endothelium.

In addition to maintaining corneal transparency via a pump-leak mechanism, the corneal endothelium plays an active role in the transport of certain proteins to supply nutrients for the stroma and to remove metabolites. In order to investigate transcellular transport mechanisms across the endothelium, we exposed cultured rabbit corneal endothelial cells to tracers that are commonly used to describe various forms of endocytosis. The cells were incubated on their apical surfaces in solutions containing different HRP conjugated lectins (concanavalin A and lens culinaris = alpha-D-mannose, alpha-D-glucose; peanut agglutinin = alpha-D-galactose), cationized ferritin (CF), native ferritin (NF), and HRP alone for 5-60 min and processed for EM cytochemistry. At early times, the lectins and CF were seen bound to the apical plasma membrane, thus indicating adsorptive endocytosis. The NF and the lectins in the presence of their competing sugar as well as HRP showed little or no surface binding, thus being markers for fluid phase endocytosis. At later times, large amounts of lectins and CF were located in round, tubular, or U-shaped vesicles of various sizes, large vacuoles, multivesicular bodies, and in other cytoplasmic compartments. Very little or no uptake was observed with NF, or when the lectins were used in presence of their competing sugars. HRP was seen in moderate amounts only in round or oval shaped vesicles. This study suggests that adsorptive endocytic pathways play a major role in transcellular transport through the corneal endothelium, whereas the transport of macro-molecules via fluid phase endocytosis is more limited. In addition, our observations suggest that adsorptive endocytic tracers undergo various intracellular fates and also appear to be transported through the cells at different rates.

Adsorption↗

Radiation osteitis of the clavicle following radiotherapy and radical neck dissection of head and neck cancer.

The bone alterations in the region of the clavicle (3 cases) are similar to those we have observed and described elsewhere in the skeleton i.e., the mandible, maxillary and ethmoid bones. Rarefaction is the result of three different types of bone destruction: osteoclasia, a kind of osteocytic osteolysis only observed after irradiation and obviously related with infection, and a pure demineralization of the osseous tissue by contact with pus. Reconstruction processes, although unable to prevent spontaneous fracture, are also present and correspond to islets of chondroid tissue surrounded by lamellar bone. However, these recently deposited calcified tissues are already necrotic since most of their lacunae are empty.

Clavicle↗

The impact of parental loss on adolescents' psychosocial characteristics.

This study examined ten measures of personality, self-image, and emotional and family problems in a sample of 2,158 Australian adolescents, some of whom had suffered parental loss. The data reveal a pattern of poorer adjustment in adolescents who have lost a parent, but clearly demonstrate that type of loss and family reconstitution have no differential effects on psychosocial development. Implications for future research are discussed.

Achievement↗

A research method for the study of psychological and psychiatric aspects of disaster.

This paper attempts to draw together some of the current questions related to the methodology of exploring the psychological and psychiatric aspects of human response to disaster. It sets out some of the key areas in which research questions might be mounted. A range of relevant instruments are suggested. The value of a structured interview which can explore issues of relevance to disaster victims is demonstrated. Early screening measures and proposals regarding these, as well as the particular instruments for longer term follow-up and assessment of outcome, are discussed in considerable detail. The article concludes with an overview of the principal issues to be addressed in methodology research, and emphasises the need for a collaborative approach using core items so that studies embracing different disasters and different countries can have some comparative basis.

Adaptation, Psychological↗