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Biomedical subjects

B Silverstein

Publications and source records attributed to B Silverstein.

At least 37 records · Page 2Linked to original sources
PubMed1994

Occupational lead poisoning: can it be eliminated?

The continued occurrence of occupational lead poisoning and overexposure in the United States represents a serious challenge to the occupational health community. We outline a proposed action strategy which integrates case-based surveillance, hazard surveillance, increased requirements for biological monitoring, and targeted educational activities, with a goal of eliminating occupational lead poisoning. The system provides a simple mechanism for monitoring compliance in lead-using employers, in order to identify employers for enforcement action. Lead poisoning should be viewed as an eradicable condition; successfully solving the persistent lead overexposure problem can serve as a model for approaching other occupational diseases.

Case-Control Studies↗
PubMed1992

Applying psychometric criteria to functional assessment in medical rehabilitation: III. Construct validity and predicting level of care.

A discriminant analysis was performed using Rasch ability estimates derived from four Patient Evaluation and Conference System (PECS) subscales, to distinguish among the functional independence and impairment profiles exhibited by patients admitted into any of three levels of medical rehabilitation delineated by the National Association of Rehabilitation Facilities (NARF): (1) inpatient hospital, (2) atypical nursing home (intermediate), or (3) day program. Two discriminant functions accounted for 91% and 9% of the between-group variance, respectively. Cross-validated classification of patients into one of the three levels of care, based on discriminant function scores, produced 75% correct classification; a 66% improvement over the percentage of correct classification likely by chance alone. Results support the construct validity of the PECS subscales and indicate they may be useful in validating clinically-based admission decisions among three of the levels of care promulgated by NARF.

Activities of Daily Living↗
PubMed1992

Applying psychometric criteria to functional assessment in medical rehabilitation: II. Defining interval measures.

The use of functional assessment total scores in arithmetic operations has proliferated despite the lack of evidence supporting their use as interval measures of patient ability. Such evidence is minimally necessary to assure the validity of functional assessment total scores for clinical and management decision-making. Two requirements of interval measurement are explained and a set of Rasch analyses of 5,500 assessments using the Patient Evaluation and Conference System (PECS) are presented. The analyses were performed to determine the extent to which four item subsets identified in a previously reported factor analysis of the PECS comprise interval measures of functional independence status. Results indicate that the PECS scales meet these requirements to varying degrees. The analyses also identify areas in which measurement quality can be improved.

Activities of Daily Living↗
PubMed1991

Gender differences in depression: historical changes.

Depression has been widely reported to be more prevalent among females than among males. In this study we demonstrate that gender differences in depression occur only among individuals born during particular historical periods, and test the utility of a model focusing on changes in women's opportunities for academic and professional achievement in predicting periods of significant gender differences in depression. Based on reanalysis of data reported by Klerman et al., we find gender differences in depression among people 40 years of age and older to be high among cohorts that reach adolescence during periods of increasing opportunities for female achievement. Among cohorts that reach adolescence during periods of stable or decreasing opportunities for women, gender differences in depression are not significant at any age.

Achievement↗
PubMed1991

Applying psychometric criteria to functional assessment in medical rehabilitation: I. Exploring unidimensionality.

While rehabilitation providers are facing increasing pressure to document treatment outcomes, critics have warned against the inappropriate use of ordinal functional assessment data in arithmetic operations. Two salient criticisms concern the combination of items representing multidimensional abilities into a single total score, and the indeterminate distances between hierarchical functional assessment scale categories. In this initial study, the factor structure of the Patient Evaluation and Conference System (PECS) was studied to assess the potential for unidimensional measurement. Factor analysis of a multidiagnostic dataset (n = 3,564) yielded eight factors accounting for 60% of the variance among 68 PECS items. The factors indicate that several unidimensional measures may underlie the PECS. These factors are delineated, and further studies of unidimensionality and additivity are recommended.

Activities of Daily Living↗
PubMed1989

Don't abandon FAS.

Explore the source record for details and available documents.

Activities of Daily Living↗
PubMed1987

Laser irradiation and balloon dilatation in experimental transluminal angioplasty.

Percutaneous transluminal balloon angioplasty (PTA) is being currently used in patients with coronary artery disease. Laser irradiation (LI) has been effective in vaporizing atherosclerotic plaques. The purpose of this work was twofold: to compare PTA and LI techniques in the recanalization of experimental obstructive arterial lesions, and to evaluate the possibility of reducing the failures and local complications and increasing the success rate of PTA by the combined use of LI. Atherosclerotic iliac stenoses were induced in 27 rabbits; lesions were evaluated angiographically before and after intervention and were studied histologically and by electron microscopy. Argon-ion LI delivered through microlens-tip optic fibers reduced the stenotic area from 64.2 +/- 21.8% to 40.3 +/- 10.7% (n = 10, P less than .01) and PTA from 60.7 +/- 15.9% to 30.4 +/- 7.7% (n = 9, P less than .01). However, percentage reduction was higher in PTA-treated stenoses (48.4 +/- 10.1% vs 34.5 +/- 13.5%, P less than .0125). In eight more rabbits, low power LI (4.55 +/- 1.25 J) was delivered after PTA in dilated segments. Post-PTA LI further decreased stenoses (from 31.2 +/- 7.8% to 29.1 +/- 8.1%, P less than .0125); laser-irradiated segments showed diffuse carbonization of the disrupted intimal layer. The normalized transtenotic pressure gradient decreased significantly in all groups: LI reduced the gradient from .40 +/- .25 to .17 +/- .07 (P = .005); PTA from .37 +/- .14 to .11 +/- .04 (P = .001); LI after PTA from .40 +/- .16 to .12 +/- .06 (P = .001). Thus, LI is effective (less than PTA) in relieving experimental atherosclerotic stenoses and seems useful when combined with PTA.

Angioplasty, Balloon↗
PubMed1987

Hand-wrist disorders among investment casting plant workers.

A survey of the prevalence of chronic soft tissue disorders of the hand and wrist was conducted 3 years after an initial survey of workers in a midwestern investment casting plant. The second survey of 136 (90%) of the original participants disclosed that (1) approximately 25% had different jobs in 1986, (2) 35% of those who had different jobs in 1986 reported transfers because of disorders, and (3) of those workers with the same job during both surveys, 11% reported temporary job changes due to disorders in the preceding 3 years. Workers with hand-wrist disorders in high-force and high-repetitive jobs tended to transfer out of these jobs more frequently than those in low-force-low-repetitive jobs. We failed to detect a relationship between ergonomic changes and change in prevalence of chronic hand-wrist disorders. This may be because the changes did not substantially alter the force and repetitiveness characteristics of the jobs.

Accidents, Occupational↗
PubMed1986

Mortality among ferrous foundry workers.

Mortality analyses were carried out for 278 male hourly workers who were employed for at least 10 years at a gray iron foundry and who died between January 1, 1970 and December 31, 1981. Statistically significant excess proportional mortality due to non-malignant respiratory disease (SPMR = 177), lung cancer (SPMR = 148), and leukemia (SPMR = 284) was found among the 221 white males. Among nonwhite males there was a significant excess in proportional mortality due to circulatory diseases (SPMR = 143). White males in the Finishing classification experienced a significant excess of proportional mortality due to nonmalignant respiratory disease (SPMR = 279) and lung cancer (SPMR = 179). White males in the Core Room classification experienced an excess of proportional mortality due to nonmalignant respiratory disease (SPMR = 321). Case-control studies demonstrated a significant association between nonmalignant respiratory disease and the Finishing classification after controlling for the effects of age, prior occupations in coal mining or foundries, and smoking. A positive but nonsignificant association between lung cancer and Finishing was also found after controlling for age, prior work history, and smoking in case control studies.

Adult↗
PubMed1985

Freud's psychology and its organic foundation: sexuality and mind-body interactionism.

Although Freud's neurological education had a great impact on his thinking, a review of Freud's early writings reveals that: (1) Freud adhered to a mind-body interactionist position that was not in accord with the mechanistic neurology of his medical school education; (2) Freud saw psychical processes as intentional, not completely determined by mechanical brain processes--but interactive with them; (3) Freud made functional and psychological interpretations freely without accepting a need to "neurologize" his psychological insights by providing specific neuroanatomical or neurophysiological correlates for such interpretations; and (4) Freud sought the organic base for his evolving psychology in sexual physiology, not neuroanatomy or neurophysiology.

Austria↗
PubMed1982

Fluorometric studies on the blood-retinal barrier in experimental animals.

Fluorophotometry was used to evaluate the blood-ocular barrier in rats following streptozocin-induced diabetes, experimental systemic hypertension, sodium iodate treatment, diet-induced galactosemia, and aldose reductase inhibitors. After administration of intravenous (IV) fluorescein sodium, diabetes, hypertension, or sodium iodate treatment resulted in an increased vitreous accumulation of IV fluorescein. Accumulation of dextran-labeled fluorescein (3,000 and 19,000 molecular weight [mol wt]) was not increased in diabetic or sodium iodate-treated animals. However, 3,000-mol wt dextran-labeled dye accumulated in the vitreous of hypertensive rats. The disappearance of fluorescein injected into the vitreous was significantly delayed in diabetic and sodium iodate-treated rats, whereas this rate was normal in hypertension animals. Galactosemia did not alter vitreous fluorophotometric measurements. Pretreatment for systemic effects with aldose reductase inhibitors did not correct the vitreous fluorophotometric measurements of diabetic rats.

Aldehyde Reductase↗
PubMed1982

Physiological predisposition toward becoming a cigarette smoker: experimental evidence for a sex difference.

In two experiments, nonsmoking females whose urine was acidified were more willing after smoking one cigarette to volunteer to smoke additional cigarettes than were females whose urine was made alkaline. Males did not exhibit this effect. The results indicate that physiological factors that influence nicotine intake during the early smoking experiences of nonsmokers help determine who becomes a cigarette smoker, at least for females. These results may help us interpret recent increases in smoking among teenage females.

Female↗
PubMed1982

Cigarette smoking, nicotine addiction, and relaxation.

In an attempt to explain the self-report of smokers that cigarette smoking is relaxing, shock endurance was used to measure the amount of anxiety experienced in a stressful situation by nonsmokers, smokers who were allowed to smoke cigarettes containing either low levels or moderately high levels of nicotine, and smokers who were not allowed to smoke a cigarette. Smokers who were deprived of cigarettes and those who smoked cigarettes containing low levels of nicotine behaved more anxiously than nonsmokers and than smokers who smoked cigarettes containing moderately high levels of nicotine, but the high-nicotine smokers behaved no less anxiously than nonsmokers. These results supported the hypothesis that the calming effect attributed to smoking a cigarette is due to the action of nicotine in ending withdrawal symptoms in addicted smokers rather than to a sedative property of cigarette smoking.

Adolescent↗
PubMed1981

Mortality among workers in a die-casting and electroplating plant.

A proportional mortality and case-referent analysis of 238 deaths among hourly employees in an automobile hardware manufacturing plant was conducted. The major operations of the plant were zinc die casting and electroplating. Chemical exposure included die-casting emissions and mists from chrome and nickel plating. The chief proportional mortality finding was a significant excess of lung cancer among both white men and women. A case-referent analysis indicated a possible association between lung cancer and work in certain departments. The findings support the hypothesis of a work-related carcinogenic risk. Follow-up recommendations have been made.

Adult↗