Search PubMed⌕ Search

Biomedical subjects

E Feldman

Publications and source records attributed to E Feldman.

At least 91 records · Page 5Linked to original sources
PubMed1989

High-dose, potentially myeloablative chemotherapy and autologous bone marrow transplantation for patients with advanced Hodgkin's disease.

Twenty three patients with Hodgkin's disease were treated with BCNU (carmustine), etoposide, and cyclophosphamide at doses of 450-600 mg/m2, 1500-2000 mg/m2, and 120 mg/kg respectively. Bone marrow refrigerated at 4 degrees C for 2-5 days or cryopreserved at -80 degrees C was used to reconstitute bone marrow function. The median age was 28 (range 16-48), and the median Karnofsky performance status was 70. Nineteen patients had progressive disease while on chemotherapy. The median number of prior regimens was three (1-7), and the median number of prior chemotherapy drugs was 10 (range 4-12). Ten patients had received at least two of the drugs used in this study and four had had all three. Indicator lesions included lung (10), peripheral lymph nodes (9), retroperitoneal nodes (8), liver (3), and chest wall masses (2). Ten patients achieved a complete remission (43.5%; 95% confidence limits 23-64%), and five patients had a partial remission (21.7%; 95% confidence limits 5-39%). The median duration of complete remission was 6 months (range 2-13+ months). Responses were shorter in duration for patients with primary refractory disease. Liver function abnormalities were noted in nine (39%) cases. Post transplant, the recovery time was 18 days (range 11-43) for WBC and 24 days (11-77) for platelets. Two patients died of septic episodes while neutropenic. The median number of RBC units used was seven (range 1-45). Ten patients had evidence of pulmonary dysfunction. In seven patients there was symptomatic improvement with steroid therapy, but three patients who were not treated with steroids died as a result of interstitial pneumonia. Future programs should consider bone marrow transplantation in patients with Hodgkin's disease earlier in the course of disease, at the time of minimal residual disease, and employ newer, potentially less toxic drugs.

Adolescent↗
PubMed1988

What happens to medical patients with psychiatric disorder?

Medical, psychiatric and social outcome were examined in medical in-patients previously identified as suffering from psychiatric disorder. One third of patients with an affective (emotional) disorder on admission were still psychiatrically ill four months after discharge. Persistent disorder was associated with continuing physical illness. During the year following admission those with affective disorder on admission continued to make greater demands on medical, social and psychiatric services than matched controls and had double the mortality rate (not significant). Patients with organic mental states on admission had a high mortality and morbidity, and made considerable continuing use of general hospital social and psychiatric services. Improved recognition of psychiatric disorder during hospital admission could result in better overall care of medical patients' psychiatric and social difficulties and more effective use of medical resources.

Adult↗
PubMed1988

Treatment of sagittal sinus thrombosis associated with cerebral hemorrhage and intracranial hypertension.

Two cases of complete sagittal sinus occlusion with multiple brain hemorrhages, elevated intracranial pressure, and disseminated intravascular coagulation are described. These patients were successfully managed using pentobarbital-induced coma to ameliorate intracranial pressure elevation. This therapy was combined with monitoring of intracranial pressure and intermittent drainage of cerebrospinal fluid to further control intracranial pressure elevations. Thrombus and coagulopathy resolved with pentobarbital alone in one patient and after pentobarbital plus heparin therapy in the second patient. It is suggested that cases of severe distal sagittal sinus thrombosis with brain hemorrhage and intracranial hypertension may benefit from combined pentobarbital coma and intraventricular drainage. This allows for stabilization of bleeding tendencies before instituting heparin therapy when necessary. Management of sagittal sinus thrombosis with barbiturates or ventricular drainage is best performed in an intensive care unit environment with continuous monitoring of intracranial pressure and substantial electrophysiologic and neuroradiologic support.

Adult↗
PubMed1988

Amsacrine with high-dose cytarabine is highly effective therapy for refractory and relapsed acute lymphoblastic leukemia in adults.

Thirty-six patients with relapsed acute lymphoblastic leukemia (ALL) and four with primary refractory ALL were treated with a regimen that included amsacrine, 200 mg/m2, intravenously daily for three days with cytarabine, 3 gm/m2, by infusion over three hours daily for five days. There were 27 remissions in the 36 relapsed patients and two in the four patients with primary refractory disease. Seventeen of the 23 patients with common ALL, four of the six with T-cell ALL, one of the three with B-cell ALL, and seven of eight whose cells were not characterized responded. Toxicity of this regimen was comparable to other reinduction regimens for ALL, but the side effects characteristic of high-dose cytarabine therapy were absent. Since these results compare favorably with conventional induction regimens, its use in the primary treatment of adults and children with high-risk ALL is proposed.

Adolescent↗
PubMed1988

[Vaginal hysterectomy using the Porges method. Report on 100 cases].

The Porges technique for vaginal hysterectomy is described and a series of 100 cases is presented. The ease and advantages of the technique, such as fewer operative stages, shortened operating time, low morbidity and short hospitalization are emphasized. There were no complications related to the operative technique, either during or after the operation.

Adult↗
PubMed1988

Culture versus biology: children's attitudes toward thinness and fatness.

Many of the studies regarding children's acquisition of prevailing cultural concepts of physical attractiveness are flawed by small and unrepresentative samples, measurement instruments of questionable reliability and validity, and experimental designs that do not protect against bias. Additional studies in which these methodologic flaws are overcome must be carried out if we are to understand truly when and how cultural concepts of beauty are acquired. Nevertheless, the majority of the studies already done find that children acquire prevailing cultural values of beauty before adolescence and that thinness is desirable to girls considerably before puberty. It is suggested that the etiology of eating disorders and the reasons for their increasing prevalence will not be discovered by studying only clinical cases. We propose that those interested in this important health problem study children before adolescence in an attempt to learn how preoccupation with weight begins and why thinness is believed to be attractive. Once these are understood, a greater challenge will be the development and testing of interventions--be they in the schools or using the media--which can effectively prevent this public health problem. When culture and biology clash, people may suffer.

Attitude↗
PubMed1987

Amsacrine treatment of patients with supraventricular arrhythmias and acute leukemia.

Three patients with a history of supraventricular arrhythmia presented with relapse of acute leukemia. Two of the three patients were in sinus rhythm, receiving digoxin and/or verapamil daily. The third patient was in atrial fibrillation, but her heart rate was controlled with daily digoxin. All three patients received amsacrine without the occurrence of cardiac events. Although amsacrine may cause ventricular arrhythmias in the setting of hypokalemia, correction of the electrolyte abnormality permits its use in patients with a history of supraventricular arrhythmias.

Acute Disease↗
PubMed1987

Social information processing and sociometric status: sex, age, and situational effects.

Theoretically based measures of social information-processing patterns in specific situations were developed and administered to popular, average, socially rejected, and socially neglected girls and boys in the first, third, and fifth grades (total n = 95). Measures included interpretations of peers' intentions, quantity and quality of responses generated to problematic stimuli, evaluations of responses, and enactments of particular responses. Three kinds of situations were generated empirically as stimuli: being teased, being provoked ambiguously, and initiating entry into a peer group. Deviant children (rejected and neglected) were found to respond deficiently compared to average and popular children, but only in the situation in which they were teased. Older children performed more competently than younger children in all three situations. Interactions among gender, sociometric status, and age also were found. Findings were interpreted as evidence of the elusiveness and complexity of social information-processing defects among low sociometric status children.

Age Factors↗
PubMed1987

A new regimen of amsacrine with high-dose cytarabine is safe and effective therapy for acute leukemia.

Amsacrine and high-dose cytarabine (HiDAc), when administered as single agents, are effective treatment of acute leukemia. When used in combination, a high remission rate is also possible. We treated 47 patients with acute myelogenous leukemia (AML), acute lymphoblastic leukemia (ALL), and blastic phase of chronic myelogenous leukemia (CML) with a combination of amsacrine and HiDAc. The patients received amsacrine 200 mg/m2 daily for three days and, concurrently, HiDAc 3 g/m2 over three hours once daily for five days. Of 20 evaluable patients with AML in relapse, there were 12 remissions; of seven additional patients with primary refractory AML, there were two remissions, and of 12 patients with ALL in relapse, there were eight remissions. The three patients with blastic phase CML and the three patients with biphenotypic leukemia did not respond. Nausea, vomiting, stomatitis, hepatic dysfunction, and diarrhea were common, but cutaneous, conjunctival, and significant cerebellar and cerebral side effects were absent. We conclude that this regimen is highly effective therapy for AML and ALL and is also safe, eliminating the major toxicities encountered with HiDAc.

Acute Disease↗
PubMed1987

Psychiatric disorder in medical in-patients.

Four hundred and fifty-three general medical in-patients were screened for mood disorder (anxiety and depression), organic mental states and alcohol problems. Using the Present State Examination, affective disorder was identified in 14.6 per cent, being especially common in younger women. Organic psychiatric disorder was very common in the elderly, occurring in 31 per cent of those over 70 years, and 18 per cent of men and 4 per cent of women admitted to a drink problem. Mood disorder was not related to the type or severity of physical illness, but was significantly associated with previous psychiatric history and social problems. Two-thirds of those with mood disorder on admission who were still alive four months after discharge were improved. House officers and family doctors identified approximately half the cases of depression and anxiety, but house officers were no more likely to recognise the more severe cases than the milder ones. Organic psychiatric disorder was often missed, alcohol problems less so.

Adolescent↗
PubMed1986

Maternal and newborn levels of glucose, sodium and osmolality after preloading with three intravenous solutions during elective cesarean sections.

The influence of maternal i.v. loading with 1500 ml fluid prior to epidural anesthesia and elective cesarean section was studied in 60 healthy parturients near term. Three different solutions were used. Normal saline 0.9%, Hartmann's solution and dextrose 5%. A significant rise in glucose level accompanied by a significant decrease in sodium level was found in mothers and newborns of the group hydrated with the dextrose solution.

Blood Glucose↗
PubMed1986

Arachidonic acid metabolism in human granulosa cells: evidence for cyclooxygenase and lipoxygenase activity in vitro.

In view of the studies demonstrating the involvement of eicosanoids (prostaglandins and hydroxyperoxides, including leukotrienes) in ovulation in several mammalian species, we have examined the activity of the two enzyme systems, lipoxygenase and cyclooxygenase in human granulosa cells obtained from women undergoing in-vitro fertilization--embryo transfer. The activity of cyclooxygenase was assessed by radioimmunoassay of prostaglandin E and of 6-keto-prostaglandin F1 alpha, the conversion product of prostacyclin, accumulated in the culture medium of granulosa cells. Lipoxygenase activity was detected by the conversion of [14C]arachidonic acid into its products (hydroxyperoxides and leukotrienes) separated by reversed phase high-performance liquid chromatography. The results confirmed the activity of cyclooxygenase in human granulosa cells, production in vitro of prostaglandin E and prostacyclin and demonstrated the presence of active lipoxygenase enzymes. These results support the possible involvement of eicosanoids in ovulation of the human.

Arachidonic Acids↗
PubMed1986

Learned changes of feeding behavior in Aplysia in response to edible and inedible foods.

Feeding behavior in Aplysia fasciata and A. oculifera is modified by pairing the behavior with reinforcing consequences. Successful and unsuccessful attempts to transfer food from the buccal cavity to the crop act as positive and negative reinforcers, respectively. A number of changes in feeding behavior occur as a result of pairing of feeding with the negative reinforcer: feeding responses become less effective in leading to the entry of food into the buccal cavity; when food does enter the buccal cavity, it exits sooner; swallowing responses after food entry are less likely to occur; Aplysia eventually cease responding to food. Pairing successful transfer of food into the crop with feeding behavior produces opposite effects. Behavioral change is specific to pairing, as shown by lack of change when reinforcement is explicitly unpaired with feeding behavior. Behavioral change is specific to foods with a particular taste and texture; generalization to alternate foods was not observed. In spite of cessation of feeding, animals remain aroused, as shown by low response latency to alternate foods. Memory of response change persists for at least 48 hr.

Animals↗