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Biomedical subjects

D Jacobs

Publications and source records attributed to D Jacobs.

At least 145 records · Page 8Linked to original sources
PubMed1986

Population strategies to enhance physical activity: the Minnesota Heart Health Program.

A population-wide, community-based program in cardiovascular disease prevention, the Minnesota Heart Health Program (MHHP), has been designed to promote more frequent and vigorous physical activity in North American communities, along with improved eating and smoking patterns. The physical activity component of this broad-based education strategy is based on the facilitation which physical activity provides to lowering of other risk characteristics for heart disease and its enhancement of other healthy behaviors and on the potential for prevention of elevated risk in the first place. The rationale for a population strategy to complement medical approaches to prevention is that exercise patterns are largely socially learned and culturally determined. The MHHP Physical Activity Program is implemented through three major education strategies: direct education, community organization, and mass communications. Early results from this 10-year project indicate that it is feasible to enter U.S. communities and to involve their leadership actively in MHHP activities of health promotion. Moreover, attitudes, knowledge, awareness, participation, and behaviors related to exercise and eating patterns appear to be changed by the program. Nevertheless, there are problems in the design, implementation, analysis and interpretation of population changes in physical activity and other health behaviors in community demonstration programs. These issues, along with their solutions, should provide useful information for medical science and for the public health about population strategies of disease prevention and health promotion.

Adolescent↗
PubMed1984

The relationship of dopamine receptor blockade to clinical response in schizophrenic patients treated with pimozide or haloperidol.

Pimozide and haloperidol were found to be equally effective in the treatment of acute schizophrenia in a double-blind clinical trial involving 22 patients. Drug plasma levels measured by radioimmunoassay (RIA) did not correlate with clinical response following either drug. Nor was there any correlation between clinical response and the dopamine receptor blocking activity of either drug as measured by radio receptor assay (RRA). Following pimozide plasma prolactin (PRL) levels correlated with clinical change, although the time courses of response of PRL and clinical response were dissimilar. There was no correlation between PRL and clinical response to haloperidol. RRA and RIA values correlated highly following pimozide but not haloperidol. Our findings lead us to conclude that the RRA technique reflects the plasma level of a drug rather than its central dopamine blocking activity. We also consider that the clinical response to antipsychotic drugs in schizophrenia may be less directly linked to dopamine receptor blockade than has previously been supposed.

Acute Disease↗
PubMed1984

Psychopharmacologic management of the psychiatric emergency patient.

The general hospital emergency room has become the locus of care for many psychiatric patients. It has become essential for emergency department personnel to be able to manage the behavioral emergency. Critical to this management is the rational use of psychotropic drugs. The author offers guidelines for the use of antipsychotic drugs and minor tranquilizers. The importance of differential diagnosis and the correlation of drug use with patient variables are stressed. The section on anti-depressants addresses the issues of when, and under what conditions the treatment of a depressive disorder can be initiated in an emergency setting. An approach to the toxic-behavioral-confusional state is offered. The final section reviews the approach to the patient who is a diagnostic dilemma and/or mute.

Amobarbital↗
PubMed1984

Oral acyclovir to suppress recurring herpes simplex virus infections in immunodeficient patients.

Thirty-two episodes of herpes simplex virus infection in four immunodeficient patients with frequent recurrences were successfully treated with oral acyclovir, one capsule five times a day for 5 days. In 23 of these episodes, the treatments were extended for 1 to 6 months using two to five capsules a day with the aim of suppressing expected recurrences. In these patients, who routinely had more than one recurrence per month before treatment, there were only six outbreaks during more than 60 patient-months of suppressive therapy. Infection always recurred after treatments were completed, but the time to recurrence was shorter after treatments with two acyclovir capsules per day than after treatments with five capsules per day (p less than 0.001).

Acyclovir↗
PubMed1984

Support of an anephric dog for 54 days with ambulatory peritoneal dialysis and a newly designed peritoneal catheter.

A bilaterally nephrectomized dog was successfully supported with peritoneal dialysis for 54 days, using a radically new design of access catheter and a human dialysis schedule designated as continuous ambulatory peritoneal dialysis. The dog remained active and alert with a stabilized blood urea nitrogen of 30 to 40 mg/dl and a serum creatinine concentration of 4 to 6.5 mg/dl. Problems encountered with the peritoneal dialysis included the propensity for developing peritonitis, anorexia, and a significant plasma protein loss in the dialysate fluid as result of leakage across the peritoneum. Protein loss coupled with anorexia produced a catabolic state, and the animal was euthanatized because of this, at postnephrectomy day 54. The development of a new catheter design alleviated the drainage problems of the straight tube Tenckhoff catheter. Its use coupled with the continuous ambulatory peritoneal dialysis schedule and detailed management techniques allowed using the anephric dog as a model of uremia. In addition, peritoneal dialysis could be a viable treatment for animals presenting with acute reversible anuric or oliguric renal failure where conservative medical management with fluids and diuretics has failed to give clinical improvement.

Animals↗
PubMed1983

The effect of alcohol on serum high density lipoprotein (HDL). A controlled experiment.

A cross-over study using 11 male subjects and a closely controlled diet, investigated the effect of alcohol on serum high density lipoprotein (HDL) components. Smoking status and body weight remained essentially constant and exercise changes were adjusted for in the analysis. As compared to sucrose, alcohol consumption was associated with a significant elevation in serum apolipoprotein A-I (0.37 mg/dl/g/day of alcohol) with similar effects for serum HDL cholesterol (0.14 mg/dl/g/day of alcohol) and serum apolipoprotein A-II (0.11 mg/dl/g/day of alcohol) achieving borderline levels of statistical significance.

Adult↗
PubMed1983

Quality of Korotkoff sounds: bell vs diaphragm, cubital fossa vs brachial artery.

Comparison of clarity of Korotkoff sounds was made between those heard with the bell or diaphragm of the stethoscope and between those heard over the cubital fossa or more proximally and medially over the maximal brachial artery pulse--during indirect sphygmomanometry. Multiple measurements were made by two trained technicians on 48 supine adults. The measurements were balanced as to stethoscope-head/arm-placement combinations, stethoscope used, control of the pressure bulb, and use of right or left arm. The Korotkoff sounds were heard better with the bell of the stethoscope placed over the brachial artery pulse (BB) than with the diaphragm placed over the cubital fossa (DC). The former combination (BB) gave significantly higher blood pressure estimates for systolic blood pressure and fourth phase diastolic blood pressure than the latter combination (DC).

Adult↗
PubMed1983

The treatment capabilities of psychiatric emergency services.

The author describes the treatment capabilities of a psychiatric emergency service. Psychiatric emergency facilities have become an integral part of general hospitals and the mental health system, and are used increasingly by patients. The author defines the treatment goals of psychiatric emergency care as, (1) symptomatic relief, (2) maintenance of ongoing treatment, and (3) referral and facilitation for entering treatment. The treatment techniques include an integration of psychologic, pharmacologic, and physical management principles. The qualities needed by an emergency service clinician to work in such a setting are described. Implications for training and research are discussed.

Crisis Intervention↗
PubMed1983

Weight and sodium reduction for the prevention of hypertension: a comparison of group treatment and individual counseling.

Ninety-three overweight adult males with labile blood pressure elevation participated in a 20-week dietary intervention program to achieve a 10 per cent reduction in body weight and a reduction in dietary sodium intake to 70 milliequivalents per day. By random assignment, half were treated with intensive group treatment procedures and half with individual counseling. Written handouts and assignments were identical, as was the schedule of treatment visits. Both techniques produced significant decreases in weight, sodium intake, calorie intake, and blood pressure. Calorie and sodium knowledge also increased significantly with both intervention approaches. The two treatment modalities did not differ in effectiveness.

Counseling↗
PubMed1983

Evaluation and management of the violent patient in emergency settings.

The evaluation and management of the violent patient in emergency settings is a complicated task for emergency psychiatric specialists. Etiologic considerations must be carefully weighed. The interplay of biologic, psychologic, and social factors has to be clearly recognized. Psychiatrists and physicians staffing emergency departments must be facile with the application of psychopharmacologic treatment. In addition, a familiarity and comfort with physical restraint must be developed. Interview styles and stances that diverge from traditional psychiatric "examining" should be employed. There is no sure-fire way to prevent violence, but adhering to the above principles should help to minimize violence as well as allow staff to comfort this most difficult aspect of emergency psychiatry.

Antipsychotic Agents↗
PubMed1982

Rabbit antisera to cell lines RC2a and U937: antigens expressed on human leukaemic cells of myeloid, monocyte and T-lymphocyte lineage.

Rabbit antisera have been produced to an acute myelomonocytic leukaemia (AMML)-derived cell line (RC2a) and a histiocytic lymphoma derived cell line (U937) having macrophage characteristics. The antisera were screened by complement-mediated cytotoxicity and immunofluorescence (cytofluorograph analysis) against separated leukaemic (122 patients plus 13 cell lines) and normal haematologic cell populations (60 preparations from 20 donors plus 10 B-lymphoblastoid cell lines). The sera were absorbed with pooled B-lymphoblastoid cell lines including the autologous B-lymphoblastoid cell line to RC2a (CESS-B) or alternatively with B-CLL and T-CLL cells. All leukaemic cell populations were confirmed using the markers SIg, E-rosette receptor, cALL antigen, alpha-naphthyl butyrate esterase and myeloperoxidase. Rabbit anti-RC2a (Adherent cells) (RARC2a(Ad) ) and rabbit anti-U937 (RAU937) recognised antigens common to immature myeloid monocyte and T-lymphocyte lineage but did not react by cytotoxicity, absorption or cytofluorographic analysis with cells of B-lymphocyte lineage (B-lymphoblastoid or B-CLL) and reacted only occasionally with cALL patients' cells (includes pre B phenotype). These sera reacted with peripheral blood monocytes but not with other mature blood leucocytes. RAU937 reacted with a major mononuclear population from normal marrow and with more differentiated myeloid leukaemia cells. RARC2a(Ad) and RAU937 detected overlapping subgroups of myeloid leukaemia (AMoL, AMML, AML and CML) patients and Null-ALL and T-ALL patients. These subgroups are now being examined for prognostic significance.

Animals↗
PubMed1982

Overview: clinical applications of the Amytal interview in psychiatric emergency settings.

The authors review the evidence for the efficacy of the sodium amytal interview with particular reference to psychiatric emergencies and rapid assessment and treatment. Amytal interviews have a valid role in the assessment and initial management of catatonia, hysterical stupor, and unexplained muteness as well as in distinguishing between depressive, schizophrenic, and organic stuporous states. Valid therapeutic indications include the abreaction of traumatic neurosis, recovery of memory in amnesic and fugue states, and recovery of function in conversion disorders. The authors offer a protocol for application of the amytal interview in emergency settings.

Adult↗