Altered cerebral dominance in atopy and in children of asthmatic mothers.
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Asthma↗
Biomedical subjects
D Greenberg
Publications and source records attributed to D Greenberg.
Cholecystokinin and the satiating effect of fat.
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Animals↗
The Patient Rejection Scale in an Israeli sample: correlations with relapse and physician's assessment.
The Patient Rejection Scale (PRS), which was developed to assess the feelings of rejection that relatives experience toward mental patients, was administered to a sample of 50 family members living with schizophrenic outpatients in Jerusalem, Israel. PRS response distribution was similar to that reported for a New York City sample. Total rejection scores were significantly correlated with a number of demographic variables and with the treating physician's assessment of the degree of rejection, hostility and criticism of the respective family members. Physician's rating of emotional over-involvement did not correlate with PRS scores. Both PRS and treating physician's ratings correlated significantly with course of illness parameters. The findings and their implications are discussed in the context of expressed emotion (EE) research.
Adult↗
The psychological management of depression.
This article reviews the effects of psychological treatments specifically developed for depression. Promising and durable results have been reported for cognitive and interpersonal psychotherapies but also for behavioral psychotherapy, which has generated less research interest so far. The therapeutic effects seem to be equivalent and at least comparable to pharmacotherapy in mild to moderate depression.
Antidepressive Agents↗
Mysticism and psychosis: the fate of Ben Zoma.
This paper examines the link between psychosis and mystical study through the cases of four young men who 'entered the garden' of Jewish mystical speculation and subsequently became psychotic. The role of such study as a precipitating factor is suggested, as three had no signs of disturbance prior to their mystical studies. All had suffered personal losses, and their choice of mystical texts and rites showed that their attraction to mysticism included a search for atonement for guilt they felt over their loss. The features of normative mysticism are presented with each case and it is apparent that hallucinations, grandiose and paranoid delusions, and social withdrawal, are phenomena that do not distinguish the psychotic from the mystic. Diagnosis of psychosis is made on the basis of duration of the state, ability to control entry into the state and the associated deterioration of habits, particularly the neglect of daily religious duties. These findings emphasize the need for the examining psychiatrist to be aware of the cultural background, despite the presence of seemingly florid psychopathology. Four eminent Rabbis entered the garden of mystical speculation. Ben Azzai glimpsed and died. Ben Zoma glimpsed and was damaged (lost his sanity). Elisha ben Avuyah lost his faith. Rabbi Akiva departed in peace.
Adult↗
Genetics of autoimmune thyroid disease: lack of evidence for linkage to HLA within families.
Clinical and epidemiologic observations, including the association of Graves' disease (GD) and Hashimoto's thyroiditis (HT) with the HLA gene complex, support a role for specific disease-related genes in the development of autoimmune thyroid disease (AITD). The combination of HLA and immunoglobulin heavy chain allotypes (Gm) has previously been reported to be predictive of AITD in multiply affected Japanese families. We have investigated the immunogenetics of AITD in families in the United States. Twenty-seven pedigrees including 15 with GD, 8 with HT, and 4 with both HT and GD were immunogenetically typed and analyzed for population and within family disease associations. The majority of families (63%) were multiplex for AITD. HLA-DR3 was increased in affected family members with GD and HLA-DR5 was increased in affected family members with HT. Formal linkage analysis was applied to test for coinheritance of disease with the HLA locus within families. The LIPED computer program was used to calculate the probability of linkage in terms of the lod score. Evidence from linkage analysis was consistently against linkage of either GD or HT to the HLA region under various penetrances and different modes of inheritance. The combination of HLA and Gm was not found to be predictive of disease in 7 selected multiplex families with multigenerational instances of AITD. T cell function was also examined in 3 pairs of siblings genetically identical for HLA and Gm but discordant for disease expression. We found no evidence of a global T cell defect in the small number of patients examined. We conclude that whereas there is an association of AITD with the HLA region, our linkage analysis demonstrates that alleles of the HLA region are not cosegregating with either GD or HT within these families. Thus, whereas HLA may increase susceptibility to AITD, as shown by the existence of an HLA association, the major genetic influence on the inheritance of AITD must be at another locus.
B-Lymphocytes↗
Coronary thrombolysis. Comparative effects of intracoronary administration of recombinant tissue plasminogen activator and urokinase.
We employed a canine model of coronary thrombosis, induced by injection of radioactive blood clot, via a catheter placed in the left anterior descending coronary artery, to compare effects of intracoronary administration of recombinant tissue plasminogen activator (rtPA) and urokinase (UK) on rate and extent of coronary thrombolysis. Two doses of UK, 15,000 U/kg (UK15) and 30,000 U/kg (UK30) and two doses of rtPA, 0.25 mg/kg (rtPA.25) and 0.75 mg/kg (rtPA.75) were given. Drugs were infused over 45 min. Compared with the other regimens, rate and extent of coronary thrombolysis were significantly increased with rtPA.75. Also, despite a much higher dose of UK, coronary thrombolysis was similar with UK30 and rtPA.25. Compared with UK15, rate and extent of coronary thrombolysis were increased with rtPA.25. These results indicate that intracoronary administration of rtPA is superior to intracoronary UK in inducing thrombolysis.
Animals↗
The killing of four therapists in the West Jerusalem Mental Health Center.
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Community Mental Health Centers↗
Is psychotherapy possible with unbelievers?: The care of the ultra-orthodox community.
The ultra-orthodox (haredi) community is a sizable proportion of the population of North Jerusalem. They are proportionately underrepresented among new referrals to the Community Mental Health services, tend to drop out of treatment early, and only present with severe psychopathology. Fear of stigma, contact with the irreligious world, "yihud" with opposite sex therapists, suspicion of irreligious healers of the Jewish "nefesh", and seeing such a need as a sign of weakness of faith all serve to deter the religious patient from seeking help. The therapist's anti-religious sentiments, his feelings of being belittled and used, and lack of attention to these feelings help diminish the therapist's changes of a successful outcome. Differences in communication style, language, concepts and interests affect the prospects of establishing a therapeutic alliance. The views of two Rabbis involved in the field of mental health are presented. Their views portray the structure of the ultra-orthodox society, and its expectations and misgivings concerning psychiatry, psychotherapy and therapists. Ten suggestions are proposed for improving communication between the Community Mental Health services and the ultra-orthodox community.
Humans↗
Deletion analysis of the human CD2 gene locus control region in transgenic mice.
Genomic sequences located at the 3' flanking region of the human CD2 gene confer high level tissue-specific, position-independent expression of the gene when introduced in the germ line of mice. In order to further characterize these sequences a range of deletions, from the 3' end were produced and transgenic mice were generated with the human CD2 (hCD2) gene linked to these deleted fragments. This allowed us to establish the minimum sequences necessary for the copy-dependent transgene expression. 2.1 kb or 1.5 kb of 3' flanking sequences linked to a hCD2 mini-gene is sufficient to allow T-cell specific, copy-dependent, integration-independent expression in transgenic mice. 1.1 kb of 3' sequences results in the gene being expressed in a T-cell specific manner, but copy-dependent, integration-independent expression was not observed in a small number of transgenic animals. 0.2 or 0.5 kb of 3' flanking sequences were insufficient to allow expression above the level previously found with a human CD2 gene which lacked 3' flanking sequences. We conclude that the Locus Control Region (LCR) effect is caused by 1.5 kb of flanking sequences immediately 3' to the polyadenylation signal of the gene.
Animals↗
Failure to detect increases in brain dopamine metabolism in rats sham feeding sucrose and corn oil.
In a recent study we found that when rats sham fed 6% sucrose, 10% sucrose, and 100% corn oil, the rank order of inhibitory potency for D-1 and D-2 receptor antagonists was 6% sucrose greater than 10% sucrose greater than 100% corn oil. In a complementary study, sham-feeding rats preferred 100% corn oil greater than 10% sucrose greater than 6% sucrose as measured by two-bottle preference tests. The preferences are evidence for the rank order of reward value of these solutions. In the present study we tested the hypothesis that the relative antagonist potencies were due to differential release of DA, dependent on the reward value of the sham-fed solution. Dopamine metabolism, estimated by the ratio of dihydroxphenylacetic acid (DOPAC) to DA, was measured in forebrain-DA terminal fields during sham feeding of 100% corn oil, 6% sucrose, and 10% sucrose. The results did not support our hypothesis: no increase in DA metabolism was observed after the sham feeding of any solution.
3,4-Dihydroxyphenylacetic Acid↗
Treatment of Charcot spinal arthropathy following traumatic paraplegia.
Four cases of Charcot's spinal arthropathy in patients with complete traumatic paraplegia were diagnosed an average of 12 years (range, 4-22 years) postinjury. Each patient had previous posterior spinal fusion with Harrington instrumentation. The Charcot joint occurred just below the fusion near the thoracolumbar junction and well below the level of spinal cord injury. All four patients experienced progressive kyphosis, flexion instability, and loss of height. Each underwent a treatment protocol that included anterior fusion with partial resection of the Charcot joint and staged posterior spinal fusion and stabilization with Cotrel-Dubousset (CD) rods. At follow-up evaluation 18-30 months postoperatively, three of four patients showed complete healing with kyphosis correction. One patient developed loosening of his lower hooks at 6 months postoperatively and required posterior revision with ultimate healing. Resection of the involved segments along with two-stage fusion with segmental instrumentation provides excellent management of this difficult problem.
Adult↗
Effects of flow on recombinant tissue plasminogen activator-induced pulmonary thrombolysis.
We employed a canine model of pulmonary embolism induced by injection of radioactive blood clots to investigate effects of changes in cardiac output (CO) on recombinant tissue plasminogen activator- (rtPA) induced pulmonary thrombolysis. Rate and extent of thrombolysis were assessed with a gamma camera. Eighteen dogs were studied. Emboli increased mean pulmonary arterial pressure and decreased CO from 2.6 to 1.9 l/min (P less than 0.001). Subsequently, dogs were randomly divided into three groups: group 1 received 0.5 mg/kg of rtPA over 30 min; 30 min before the same dose regimen of rtPA, in the six group 2 dogs, mean CO was increased to approximately 3.25 l/min by opening one systemic arteriovenous fistula; in the six group 3 dogs, before rtPA, mean CO was increased to approximately 4.5 l/min by opening two or three fistulas. After embolization, CO remained low in group 1; the mean 2-h time-averaged CO was 1.8 l/min. CO was much higher in groups 2 and 3 (3.3 and 4.6 l/min, respectively; both P less than 0.001 compared with group 1; and P less than 0.001, group 2 vs. group 3). Compared with group 1, corresponding to the increased flow in groups 2 and 3, rate and extent of pulmonary thrombolysis significantly increased. These results indicate that an increase in flow per se augments rtPA-induced pulmonary thrombolysis. Also, because thrombolysis was similar between groups 2 and 3, these results define an upper limit to the flow-thrombolytic relationship with rtPA.
Animals↗
Problems in the treatment of religious patients.
Members of religious groups are bound together by doctrine, ritual, and social organization. These factors also separate religious people from members of other groups or cultures. This division is apparent during interactions with other groups, and critical when members of religious groups are referred for help for psychiatric problems. In this paper we discuss four problems that therapists may encounter with strictly religious patients. Religious patients are often suspicious of secular therapists and therapy, and therapists too, may be influenced by their personal attitudes toward religion. Differentiating religious beliefs and rituals from delusions and compulsions is difficult for therapists ignorant of the basic tenets of that religion. Clinical examples of the four problems are presented from our work with patients from the ultra-orthodox Jewish community of North Jerusalem and we provide guidelines for their resolution. Therapists need a basic knowledge of the religion's doctrines and rituals, should assess patients using its terminology, and approach the patients through the social organization of their religious group. We consider that attention to these issues is vital for effective communication and assessment of strictly religious patients.
Adult↗
Improving case assignments and caseload management at a community health center.
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Ambulatory Care↗
Cryptosporidium in Bedouin and Jewish infants and children in southern Israel.
We conducted a 1-year prospective study in two clinics and a hospital in the Negev region of southern Israel to determine the epidemiological and clinical patterns of Cryptosporidium diarrhea among Jewish and Bedouin infants and children living in the same geographical area. A total of 612 episodes were studied: 398 in Bedouins and 214 in Jews, of which 449 occurred in patients with diarrhea and 164 in controls. Cryptosporidium was detected in 13 of 382 patients (3.4%) with diarrhea and in 1 of 138 controls (0.7%) (P = 0.078). In 5 of 13 Cryptosporidium-positive patients (38%) another pathogen was detected. No significant difference in Cryptosporidium detection rates was observed between Jews and Bedouins or between hospitalized or nonhospitalized patients. The frequency of Cryptosporidium detection did not differ significantly when three age-groups were compared (less than 6 months old, 7-12 and 13-36 months old). The rate of Cryptosporidium detection was similar among malnourished and well-nourished patients, as determined by weight-for-height percentiles. Cryptosporidium was detected more frequently during the summer months (8.3%) than during the rest of the year (1.2%) (P less than 0.001). Patients with Cryptosporidium diarrhea did not differ clinically from patients with other causes of diarrhea. However, they were characterized by the absence of fecal leukocytes. Cryptosporidium is not a rare cause of diarrhea in southern Israel. It is more prevalent during the hot and dry season and can be detected in a relatively high prevalence among very young infants. Its clinical features are indistinguishable from those of patients with non-cryptosporidial diarrhea.
Child, Preschool↗
Corn oil and mineral oil stimulate sham feeding in rats.
To determine the orosensory effects of oils on ingestion, we measured the 1-bottle intake of corn oil and of mineral oil during 30 minutes of sham feeding in rats that were food deprived overnight or nondeprived. Rats sham fed both oils. Food-deprived rats ingested significantly more of both oils than nondeprived rats. Rats discriminated corn oil from mineral oil and as little as 0.78% corn oil emulsion from water. When rats sham fed 8 dilutions of corn oil, intake was an inverted-U function of concentration with maximal intakes produced by 12.5%, 25% and 50% corn oil emulsions. Despite similar, sometimes equal, intakes of corn oil and mineral oil in 1-bottle tests, food-deprived and nondeprived rats showed a strong preference for corn oil in 2-bottle, sham-feeding, preference tests. The sensory mechanisms that mediate the oral effects of oil on intake and preference are not known, but the olfactory and trigeminal sensory systems are the most likely candidates. Further work is required to characterize the potency, sensitivity, and discriminability of the orosensory effects of oils, the mechanisms that mediate them, and their role in the control of fat intake.
Animals↗