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Biomedical subjects

D Perlman

Publications and source records attributed to D Perlman.

At least 19 recordsLinked to original sources
PubMed2004

Nonesterified phytosterols dissolved and recrystallized in oil reduce plasma cholesterol in gerbils and humans.

When free phytosterols are adequately heated and then cooled in fat, they recrystallize and are rendered bioavailable for blocking cholesterol absorption. To extend the application of phytosterols to fried foods, the activity of these modified crystals was assessed in 2 experiments with 26 male gerbils fed purified diets containing 0.15 g/100 g cholesterol with or without 0.75 g/100 g free phytosterols. The heat-modified soybean sterols were added directly to the diet (Expt. 1) or as phytosterol-enriched potato chips (Expt. 2). In the gerbil experiments, only the diet containing phytosterols significantly reduced plasma cholesterol (35-48%) and the total cholesterol/HDL cholesterol (HDL-C) ratio (40%), as well as hepatic cholesterol esters (80%). In a subsequent human study, subjects (n = 7) consumed two 28-g servings of tortilla chips fried in oil with or without phytosterols that provided 0 or 1.5 g/d for 4-wk periods in a crossover design (Expt. 3). During consumption of the phytosterol-enriched chips, significant reductions in plasma cholesterol (10%) and LDL cholesterol (15%) were achieved without affecting HDL-C. This novel means of delivering free phytosterols proved to be both functionally efficient and effective.

Adult↗
PubMed2002

Intra-ureteric capsaicin in loin pain haematuria syndrome: efficacy and complications.

OBJECTIVE: To evaluate the safety and efficacy of intra-ureteric capsaicin for loin pain haematuria syndrome (LPHS). PATIENTS AND METHODS: In an open prospective pilot study, four middle-aged patients (three women and one man) with LPHS resistant to therapies such as splanchnic nerve block, psychological treatment or renal autotransplantation (one) were assessed. An intra-ureteric infusion of capsaicin (30 mg/100 mL of 30% alcohol in saline) for 30 min with bladder irrigation was administered under general anaesthesia, with a subsequent intravenous patient-controlled narcotic analgesic pump for pain control. Double-concentration capsaicin was used for second infusions, if necessary when the response to the earlier infusion was inadequate or incomplete. RESULTS: The first patient had experienced reduced pain levels for the first 3 months only, with no benefit from the subsequent treatments with higher doses of capsaicin (60 mg). The second patient with recurrent pain in an autotransplanted kidney had no benefit from either a 30 or 60 mg capsaicin infusion a month apart, but developed a fibrotic stricture at the transplant pelvi-ureteric junction, requiring pyelocystoplasty. The third patient with concurrent depression had no benefit from a 30-mg infusion of capsaicin. The fourth patient experienced no pain relief from a 30 mg infusion of capsaicin but developed proteinuria secondary to mesangial proliferative glomerulonephritis, ureteric inflammation needing stenting within 7 days of treatment and subsequently nephrectomy for a nonfunctioning kidney at 3 months. CONCLUSION: Intra-ureteric capsaicin was neither effective nor safe in LPHS; the contribution of the alcohol diluent cannot be excluded.

Adult↗
PubMed2002

Malignant hyperthermia associated with exercise-induced rhabdomyolysis or congenital abnormalities and a novel RYR1 mutation in New Zealand and Australian pedigrees.

Malignant hyperthermia (MH) is rarely associated with specific myopathies or musculoskeletal abnormalities. Three clinical investigations of MH associated with either non-specific myopathies or congenital disorders in three separate families are presented. Two of these cases also show evidence of exercise-induced rhabdomyolysis. In each case MH susceptibility was confirmed by in vitro contracture testing of quadriceps muscle. DNA sequence analysis of each kindred revealed the presence of a common novel mutation that results in an arginine401-cysteine substitution in the skeletal muscle ryanodine receptor gene (RYR1). Haplotype analysis using chromosome 19q markers indicated that the three families are likely to be unrelated, providing confirmation that the MH/central core disease region 1 of RYR1 is a mutation hot spot.

Amino Acid Sequence↗
PubMed2001

Vitamin E in fortified cow milk uniquely enriches human plasma lipoproteins.

BACKGROUND: Milk fat may contribute to atherogenesis in humans. OBJECTIVE: We sought to offset the atherogenic potential of milk fat by adding polyunsaturated fat and vitamin E to milk. DESIGN: We measured plasma lipids, lipoproteins, and tocopherol and LDL oxidation in normolipemic adults. In experiment 1 (n = 48), we compared delivery of 100 mg all-rac-alpha-tocopheryl acetate/d in capsules, skim milk, and 1%-fat milks containing soybean oil, milk fat, or both (1:1). In experiment 2 (n = 24), we compared delivery of natural (RRR-alpha-tocopheryl acetate) and synthetic (all-rac-alpha-tocopheryl acetate) vitamin E in milk with delivery of all-rac-alpha-tocopheryl acetate in orange juice (200 mg/d in each group). In experiment 3 (n = 7), we compared delivery of 30 mg all-rac-alpha-tocopheryl acetate/d in milks with and without added vitamins A and D. RESULTS: Enrichment of milk fat with soybean oil did not alter plasma lipoproteins. Microdispersion of vitamin E in milks increased the molar ratio of plasma tocopherol to cholesterol by >2-fold compared with the molar ratio after consuming vitamin E capsules, whereas the molar ratios were comparable after ingestion of orange juice and capsules. Synthetic and natural vitamin E performed comparably. The enhanced plasma vitamin E:cholesterol attributed to milk increased protection of LDL against oxidation. Vitamins A and D did not affect vitamin E delivery by milk. CONCLUSIONS: Milk augments vitamin E transport by human lipoproteins at intakes of 100-200 but not 30 mg/d. This augmentation is independent of the presence and type of fat in milk, its vitamin A and D contents, and whether the vitamin E is natural or synthetic.

Adolescent↗
PubMed1999

The impact of personal problems on accessing prenatal care in low-income urban African American women.

OBJECTIVE: The purpose of this study was to investigate the nature and contribution of personal factors related to the use of prenatal care in a sample of high-risk women residing in an urban environment where care was accessible and free. STUDY DESIGN: The sample consisted of 297 African American women with low socioeconomic status and a high school education or less who were newly delivered of neonates. The level of prenatal care was classified according to the Kessner 3 Parameter Index (adequate, intermediate, inadequate). Women who received no prenatal care made up a fourth group. Subjects responded to the "Ten-Item Checklist" of Richwald. Rhodes, and Kersey and an in-person interview that queried their reasons for obtaining different levels of prenatal care. RESULTS: Both personal and structural reasons were described by women for not obtaining care earlier in pregnancy or at all. The mean number of personal and structural problems reported per subject was inversely correlated to the level of prenatal care obtained. However, personal problems were the single most important reason cited by these women. Personal problems that were statistically significant different among the groups were drug use and desire for an abortion. The structural barriers that exhibited statistically significant differences among the groups were trouble scheduling an appointment, access totransportation, dislike of health care professionals and institutions, access to child care, and not knowing where to go. CONCLUSION: Both personal and structural problems were cited as reasons for not obtaining adequate prenatal care. Structural barriers to prenatal care have been identified and extensively studied. These barriers to care continue to persist, despite innovations in program delivery and access. This study demonstrates that the significance of personal problems has not been adequately considered as a major factor associated with insufficient prenatal care.

Adult↗
PubMed1997

A case of idiopathic anaphylaxis associated with respiratory infections.

BACKGROUND: Anaphylaxis is associated with IgE-mediated reactions to foods, drugs, and other allergens. Exercise-induced anaphylaxis and food plus exercise-induced anaphylaxis have been reported. Anaphylactoid reactions with no mechanisms determined have been described with radiographic contrast media. Idiopathic anaphylaxis by definition is anaphylaxis with no identifiable external allergen or stimulus. In our series of more than 350 patients with idiopathic anaphylaxis, extensive evaluation has failed to identify a cause for the anaphylaxis. OBJECTIVE: To report a first case of idiopathic anaphylaxis associated with coryzal symptoms. METHODS: A patient was evaluated for idiopathic anaphylaxis. Appropriate therapy was initiated. RESULTS: The patient's anaphylactic episodes are related to the occurrence of coryzal symptoms but no clear IgE-mediated mechanism was identified. CONCLUSION: This is the first reported association of anaphylaxis with an inciting factor of infection.

Anaphylaxis↗
PubMed1996

Recurrent graft pain following renal autotransplantation for loin pain haematuria syndrome.

OBJECTIVE: To review retrospectively the Perth experience of autotransplantation for loin pain haematuria syndrome and identify possible factors associated with its failure. PATIENTS AND METHODS: The medical records of 11 women patients (median age 42 years, range 29-48) who had 12 autotransplantations were reviewed. All patients were then interviewed and asked whether they considered the operation a success. RESULTS: All patients initially had complete relief of symptoms. Three patients who had four transplants are still symptom-free with a follow-up of 24-46 months. Five patients have had partial relief with marked variability in their patterns of recurrent pain. Three patient have symptoms as severe as those before operation. One kidney was lost because of acute thrombosis and another developed a urinoma. No patient had deterioration in renal function. CONCLUSION: Renal autotransplantation is a treatment option of last resort, with acceptable morbidity in patients with intractable, functionally disabling renal pain, but three-quarters of these patients may develop recurrent pain in the transplant site. A current or past history of depression or absence of haematuria may represent risk factors for a poor post-operative prognosis. Treatment failure is predictable by a poor response to sympathetic neurolytic block.

Adult↗
PubMed1993

The ethics of germ-line gene therapy: challenges to mainstream approaches by a feminist critique.

Many mainstream bioethicists visualize the ethical debate surrounding germ-line gene therapy (GLGT) as a conflict of rights and duties between a woman and her fetus and as representative of the larger tension between the principles of autonomy and beneficence and its corollary duty to nonmaleficence. Many feminist ethicists attempt to circumnavigate the purported inadequacies of mainstream ethical approaches and take a much broader, context-oriented approach to reproductive freedom. The first section will describe many of the mainstream conflicts surrounding GLGT and offer a feminist critique of the inadequacies of mainstream approaches. Instead of merely achieving a stalemate in ethical dialogue from the mainstream viewpoint, the application of a feminist view of the fetus and reproductive freedom provides a more equitable and ethically inclusive adjudication of the central issue surrounding the ethics of GLGT, as the second section will show.

Beneficence↗
PubMed1991

Structural and phylogenetic analysis of the chicken ventricular myosin heavy chain rod.

We have isolated and characterized five overlapping clones that encompass 3.2 kb and encode a part of the short subfragment 2, the hinge, and the light meromyosin regions of the myosin heavy chain rod as well as 143 bp of the 3' untranslated portion of the mRNA. Northern blot analysis showed expression of this mRNA mainly in ventricular muscle of the adult chicken heart, with trace levels detected in the atrium. Transient expression was seen in skeletal muscle during development and in regenerating skeletal muscle following freeze injury. To our knowledge, this is the first report of an avian ventricular myosin heavy chain sequence. Phylogenetic analysis indicated that this isoform is a distant homolog of other ventricular and skeletal muscle myosin heavy chains and represents a distinct member of the multigene family of sarcomeric myosin heavy chains. The ventricular myosin heavy chain of the chicken is either paralogous to its counterpart in other vertebrates or has diverged at a significantly higher rate.

Amino Acid Sequence↗
PubMed1991

Intrathecal baclofen for severe spasticity: five years experience.

Severe spasticity is a major problem in the rehabilitation of patients with dysfunction of the spinal cord or cerebral hemispheres. Oral baclofen is often effective. However, in patients with severe spasticity adequate control may not be obtained from oral therapy with the drug. Over the past 5 years we have developed a program for the use of intrathecal baclofen for severe spasticity, and in relation to this discuss patient assessment, practical aspects of drug administration, complications of therapy and patient benefits. Continuous intrathecal baclofen is a safe and effective adjunct to physical therapy in the management of patients with severe spasticity.

Adult↗
PubMed1988

The positive/negative symptom distinction in psychoses. A replication and extension of previous findings.

The independence and internal consistency of Andreasen's positive and negative symptom scales was found to be good for schizophrenics but not for a comparison group of manic patients, supporting the assumption that the symptom distinction is diagnosis specific. Discriminant function analysis revealed that ratings of positive and negative symptoms are capable of predicting diagnostic category for the two groups with a high degree of accuracy.

Adult↗