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D Wasserman

Publications and source records attributed to D Wasserman.

At least 109 records · Page 6Linked to original sources
PubMed1989

Early separation and suicidal behaviour in the parental homes of 40 consecutive suicide attempters.

Forty suicide-attempt patients who were consecutively admitted to an intensive-care unit, their significant others and treatment personnel were investigated by semistructured interviews. The patients were divided into neurosis (n = 14), abuse (n = 19) and psychosis (n = 7) groups. Twenty-one of the patients (52%) had lost contact with one or both parents before the age of 18, in 25% of cases owing to death and in 27% because of the parents' divorce or separation. Parents and/or siblings of 19 patients (47%) had shown suicidal behaviour in the form of attempted suicide and/or suicide. Differences between the groups were not significant. Alcohol abuse in the parental home was overrepresented in the abuse group compared with the other groups. The role of identification with the dead and suicidal parent in prompting suicidal actions in adulthood is discussed, as well as that of the impeded evolution of stable external object relations owing to parental losses.

Adult↗
PubMed1989

Passive euthanasia in response to attempted suicide: one form of aggressiveness by relatives.

A total of 88 interviews were conducted with 40 people attempting suicide who were receiving care in an intensive-care unit, and 129 interviews were carried out with their relatives and friends. The subjects were divided into 3 diagnostic groups: neurosis (n = 14), abuse (n = 19) and psychosis (n = 7). The incidence of relatives' failure to provide care after the suicide attempt--turning-away reactions as well as do not resuscitate orders, a form of passive euthanasia--was investigated. In 8 cases, partners of patients in the abuse and neurosis groups showed turning-away reactions. In 2 cases, relatives of elderly patients in the neurosis group said to the doctor that life-preserving measures should not be taken. Relatives explained their behaviour by saying that they had the best interests of the suicidal individual at heart. In-depth interviews, however, revealed that these reactions were a manifestation of the relatives own psychic conflicts, brought forth by the confrontation with the depressed and suicidal patient. Turning-away reactions and do not resuscitate orders might be interpreted as expressing the relatives' aggressiveness towards the suicidal individual and attempts to escape from a difficult situation. It is important that doctors stand up for the interests of suicidal people, which at times may conflict with relatives' interests, and help the relatives to sort out their problems and wishes with respect to the problem areas of passive euthanasia.

Adaptation, Psychological↗
PubMed1988

Who commits suicide after a suicide attempt? An 8 to 10 year follow up in a suburban catchment area.

One hundred and sixty-three individuals in a suburban catchment area of 72,000 inhabitants made registered suicide attempts during 1975-1976 (i.e. 159/100,000 greater than or equal to 18 years). They were followed up by means of the Swedish Register of Death Causes over a period of 8-10 years. Police reports, autopsies and psychiatric records were also studied. Six cases of verified suicide were found and four additional cases were considered as probable or possible suicides. Thus the cumulative rate over 8-10 years was 3.7-6.1%. There was a mean number of 3.5 suicide attempts before the eventual suicide. The most important common factor overall was alcohol or drug abuse with social deterioration (seven in 10 cases). The rest (three in 10 cases) were depressed women with long-standing suicidal processes. The importance of recognizing chronic abuse as probably the most important background factor is stressed. The total group encompasses individuals with longstanding and severe life problems and difficulties in relating to society. The realistic chances of being able to provide effective suicide prophylaxes for most of these patients requires well planned and longstanding treatment and rehabilitation programmes.

Adolescent↗
PubMed1988

Regulation of glucose turnover during exercise in pancreatectomized, totally insulin-deficient dogs. Effects of beta-adrenergic blockade.

To examine whether glucose metabolic clearance increases and whether catecholamines influence glucose turnover during exercise in total insulin deficiency, 24-h fasted and insulin-deprived pancreatectomized dogs were studied before and during exercise (60 min; 100 m/min; 10% slope) with (n = 8) and without (n = 8) propranolol infusion (PI, 5 micrograms/kg-min). Exercise with or without PI was accompanied by four and fivefold increments in norepinephrine and epinephrine respectively, while glucagon (extrapancreatic) fell slightly. Basal plasma glucose and FFA concentrations and rates of tracer-determined (3[3H]glucose) hepatic glucose production (Ra) and total glucose clearance (including urinary glucose loss) were 459 +/- 24 mg/dl, 1.7 +/- 0.5 mmol/liter, 7.8 +/- 0.9 mg/kg-min and 1.6 +/- 0.1 ml/kg-min, respectively. When corrected for urinary glucose excretion, basal glucose metabolic clearance rate (MCR) was 0.7 +/- 0.1 mg/kg-min and rose twofold (P less than 0.0001) during exercise. Despite lower lactate (3.3 +/- 0.6 vs. 6.6 +/- 1.3 mmol/liter; P less than 0.005) and FFA levels (1.1 +/- 0.2 vs. 2.2 +/- 0.2 mmol/liter; P less than 0.0001) with PI, PI failed to influence MCR during exercise. Ra rose by 3.7 +/- 1.7 mg/kg-min during exercise (P less than 0.02) while with PI the increase was only 1.9 +/- 0.7 mg/kg-min (P less than 0.002). Glucose levels remained unchanged during exercise alone but fell slightly with PI (P less than 0.0001). Therefore, in total insulin deficiency, MCR increases marginally with exercise (13% of normal); the beta adrenergic effects of catecholamines that stimulate both FFA mobilization and muscle glycogenolysis do not regulate muscle glucose uptake. The exercise-induced rise in hepatic glucose production does not require an increase in glucagon levels, but is mediated partially by catecholamines. Present and previous data in normal and alloxan-diabetic dogs, suggest that (a) in total insulin deficiency, control of hepatic glucose production during exercise is shifted from glucagon to catecholamines and that this may involve catecholamine-induced mobilization of peripheral substrates for gluconeogenesis and/or hepatic insensitivity to glucagon, and (b) insulin is not essential for a small exercise-induced increase in muscle glucose uptake, but normal insulin levels are required for the full response. Furthermore, the catecholamines appear to regulate muscle glucose uptake during exercise only when sufficient insulin is available to prevent markedly elevated FFA levels. We speculate that the main role of insulin is not to regulate glucose uptake by the contracting muscle directly, but to restrain lipolysis and thereby also FFA oxidation in the muscle.

3-Hydroxybutyric Acid↗
PubMed1986

Interleukin 1 inhibitory activity secreted by a human myelomonocytic cell line (M20).

Culture supernatants from a myelomonocytic cell line (M20) were found to inhibit interleukin 1 (IL 1) activity in vitro. The factor, isolated from these supernatants, inhibited augmentation of phytohemagglutinin response of mouse thymus cells induced by IL 1 derived from several established cell lines. Various IL 1-dependent activities such as lymphocyte and fibroblast proliferation in vitro were also inhibited by the factor. The factor did not inhibit IL 2-induced or other proliferative responses not related to IL 1. Preliminary biochemical characterization of the factor indicated that the activity resides in a protein with a molecular mass of 52 kDa.

Cell Division↗
PubMed1984

Effect of the air hammer on the hands of stonecutters. The limestone quarries of Bedford, Indiana, revisited.

In the limestone quarries of Indiana, USA, pneumatic percussive hammers replaced the mallet and hammer around 1900. By 1917 the air hammer was being used exclusively for periods of eight to ten hours a shift. In 1918 Alice Hamilton investigated an unusual "disease" in these stonecutters of Bedford, Indiana, who complained of "attacks of numbness and blanching of the fingers coming on suddenly under the influence of cold and then disappearing." The prevalence of vibration induced white finger (VWF) found in this population of 38 stonecutters was 89%, with decreased light touch, pain, and temperature appreciation in advanced cases. In 1978 a VWF research team revisited these limestone quarries. During the 60 year interval the stonecutting industry had contracted from 4000 workers in 40 quarries in 1918 to 3-400 in 10 quarries in 1978, with only 50 employees remaining in the Bedford area. In a population of 30 stonecutters the prevalence of VWF in 1978 was 80%, with similar sensory loss in light touch, pain, and temperature appreciation. Between 1918 and 1978 no change had taken place in the design of the air hammers used for stonecutting. Vibration levels of 4859 metres/s2 on the chisel, and 2010 metres/s2 on the barrel were measured over a frequency range 6.3 to 1000 Hz. The fundamental frequency was 75 Hz. These measured vibration levels are outside the ISO/DIS/5349 (1979) recommended limits for human exposure to vibration transmitted to the hand. The VWF data presented in this paper, and those originally reported by Hamilton in 1918, call for an immediate redesign of stonecutting pneumatic hammers in order to remove one cause of Raynaud's phenomenon of occupational origin.

Adult↗
PubMed1984

Catecholamine responses and their interactions with other glucoregulatory hormones.

We have investigated catecholamine-glucagon-insulin interactions using three stress models: 1) hypoglycemia; 2) exercise; and 3) epinephrine infusion. Phlorizin caused mild hypoglycemia with hypoinsulinemia. Plasma glucagon increased as did hepatic glucose production. Catecholamines did not increase. Insulin caused severe hypoglycemia. Metabolic counterregulation was due mainly to the 40-fold increase in epinephrine. Glucagon played a role only in the recovery from insulin-induced hypoglycemia, which could reflect increased hepatic sensitivity to glucagon with declining plasma insulin. Glucagon suppression during exercise caused transient hypoglycemia due to an inadequate rise in glucose production. Exaggerated epinephrine release during hypoglycemic exercise prevented severe hypoglycemia by inhibiting glucose utilization and stimulating glucose production, with an associated increase in lactate and free fatty acid levels. Hypoglycemic exercise also caused increased cortisol release. Counterregulation was prevented by a euglycemic clamp. We conclude that, during exercise, glucagon is directly responsible for 80% of the increment of glucose production and controls glucose uptake by the muscle indirectly; thus glucagon spares muscle glycogen by increasing hepatic glucose production. Epinephrine infusion in normal dogs caused a transient increase in glucose production and a sustained inhibition of glucose clearance, resulting in hyperglycemia. Insulin rose transiently, followed by a relative inhibition of secretion. Glucagon suppression did not modify the metabolic effects of epinephrine. In alloxan-diabetic dogs, the glucagon response to epinephrine was augmented, whereas in depancreatized dogs, during subbasal insulin infusion, the hepatic response to glucagon was excessive. Glucagon suppression diminished hepatic responsiveness to epinephrine in both models. Stress-induced diabetic instability could relate to exaggerated glucagon release or to increased hepatic sensitivity to glucagon. Thus, during hypoglycemia, exercise, or epinephrine infusion, prevailing plasma insulin levels govern the relative metabolic roles of epinephrine and glucagon.

Adolescent↗
PubMed1981

A peripheral vascular insufficiency test using photocell plethysmography.

A preliminary laboratory study seeking an objective test for vascular insufficiency of the fingertips (Raynaud's syndrome) is described. In a limited number of subjects, circulatory changes in the vascular bed of one hand were examined by photocell plethysmography while the opposite had was immersed in ice water. The time to complete recovery after cessation of the cold stimulus was significantly longer with primary Raynaud's patients than with the control subjects (p = 0.0045). The analysis of another parameter, the relative change in pulse amplitude during cold immersion, was confounded by age and sex differences between the Raynaud's and the control group. A follow-up investigation of the application of this technique to a population of vibration-exposed chipper and grinder and control workers is in progress.

Adult↗
PubMed1980

Evaluation of arthritis and arthralgia in the pediatric patient.

The records of 250 consecutive children presenting to a university pediatric service with joint complaints of unknown cause were reviewed to determine the frequency of diagnoses and the utility of laboratory data and physical examination findings. Eighteen per cent of children had orthopedic disorders (Group I), 17.6 per cent had autoimmune disorders (Group II), 19.6 per cent had joint complaints related to a bacterial infection (Group III), and 44 per cent had miscellaneous problems (Group IV). Autoimmune or infectious disd/or erythrocyte sedimentation rate was greater than or equal to 30 mm/h was present than if absent (65% vs. 8% respectively); the sensitivity of fever and/or elevated erythrocyte sedimentation rate was 93 per cent for Group II and III patients. The presence of rash was predictive of an autoimmune disorder in 67 per cent of the instances; a positive joint examination was seen disproportionately in Group I patients. A negative joint examination all but ruled out an infectious etiology. Other test results, such as diagnostic radiograms, WBC greater than or equal to 15,000 per cu mm; or a positive ANA or rheumatoid factor were predictive but not sensitive indicators of selected groups. If the tiology of a child's joint complaints is unknown, the likelihood of an orthopedic, autoimmune or infectious disorder may be suggested by reviewing temperature and ESR data and skin and joint findings.

Adolescent↗
PubMed1975

Massive unilateral non-functioning hydronephrosis in horseshoe kidney.

The occurrence of non-function in one half of a horseshoe kidney resulting from hydronephrosis can, if unrecognized, create a serious surgical as well as medical problem. The anterior position of the ureter in relation to the isthmus, as well as strictures and accessory vessels increase the incidence of hydronephrosis, which if severe enough, can go on to non-function. The key diagnostic factor is the observation of the visualised side, which shows the characteristic malrotation of the calyces and the deviation of the long axis of the kidneys; these are associated with a mass effect on the obstructed side, with or without a 'crescent' sign. Five cases of this unusual occurrence are presented.

Adult↗
PubMedDate not supplied

Helical CT angiography. A diagnostic problem solving technique.

We describe a technique for making computed tomography (CT) angiographic studies more practical and workable. True CT angiography can be performed with arterial contrast injection combined with helical CT technique. Detailed angiographic images can be obtained; reconstructed images are aided by the helical technique, and other special studies can also be performed.

Angiography↗
PubMedDate not supplied

Restricted fetal growth and adverse maternal psychosocial and socioeconomic conditions as risk factors for suicidal behaviour of offspring: a cohort study.

BACKGROUND: Until now, sparse and contradictory results about an association between adverse neonatal, obstetric, and maternal conditions and heightened suicide risk in adolescents have been reported. The aims of this study were to investigate the relations between fetal growth, obstetric complications, and the mother's psychosocial and socioeconomic situation and the risk in early adulthood of suicide and attempted suicide in the offspring. METHODS: Obstetric, neonatal, and maternal risk factors for suicide and attempted suicide in 713370 young adults, born in Sweden between 1973 and 1980, who were followed-up until Dec 31, 1999, were examined by data linkage between Swedish registers. Univariate and multivariate hazard ratios, derived from proportional-hazard models, were estimated. FINDINGS: Significantly raised risk of attempted suicide was reported for individuals of short birth length, adjusted for gestational age (hazard ratio 1.29, 95% CI 1.18-1.41, p<0.0001); born fourth or more in birth order (1.79, 1.62-1.97, p<0.0001); born to mothers with a low educational level (1.36, 1.27-1.46, p<0.0001) (attributable proportion 10.3%); and those who, at time of delivery, had mothers aged 19 years or younger (2.09, 1.89-2.32, p<0.0001). Significant predictors of suicide were low birthweight, adjusted for gestational age (2.23, 1.43-3.46, p<0.0001), and teenage motherhood (2.30, 1.64-3.22, p<0.0001). INTERPRETATION: Multiparity and low maternal education predicted suicide attempt, whereas restricted fetal growth and teenage motherhood were associated with both suicide completion and attempt in offspring.

Adolescent↗