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Biomedical subjects

E Frank

Publications and source records attributed to E Frank.

At least 451 records · Page 25Linked to original sources
PubMedDate not supplied

Characteristics of women US family physicians.

CONTEXT: There have been no national studies comparing women family physicians (FPs) with other physicians; determining FP characteristics is useful in workforce and health systems planning and may also be of inherent interest to FPs and others. DESIGN AND PARTICIPANTS: A comparison of the FP (n = 347) and other (n = 4154) respondents to the Women Physicians' Health Study. MAIN OUTCOME MEASURES: Personal and clinical practices. RESULTS: Women FPs are more likely to be US-born and self-defined as politically liberal than were other women physicians. Those graduating from medical school in the 1950s through 1970s were less and those graduating in the 1980s were far more likely to be board certified than were other women physicians. Although their personal and household incomes were significantly lower, their professional satisfaction was similar to those of other women specialists, and they reported a lesser frequency of severe work stress. Personal health-related habits and health status of women FPs were similar to those of other women physicians. For all 14 counseling practices examined, the amount of counseling they reported performing, the clinical relevance they ascribed to those practices, their self-confidence in performing the practices, and the amount of training they received was as high as or higher than that of other women primary care practitioners and usually exceeded those of non-primary care physicians outcomes at the P < .001 level. CONCLUSIONS: Although women FPs resemble other women physicians in some respects, they are more liberal, are professionally well-satisfied, and are relatively avid preventionists.

Adult↗
PubMedDate not supplied

Toxicology of n-pentane (CAS no. 109-66-0).

n-Pentane (CAS no. 109-6-0) is a hydrocarbon solvent with an estimated production volume of 50000 metric tons in Europe. The present work was carried out to strengthen the toxicological information available for regulatory decision-making, particularly product classification, occupational exposure limits and risk assessment. The work described in this report was sponsored either by the Pentane Special Interest Group under the auspices of the Hydrocarbon Solvent Producers Association of CEFIC (European Chemical Industry Council) or by Exxon Chemical Europe. The following results were obtained: n-pentane was not acutely toxic by oral or inhalation routes, it was not a skin or eye irritant and did not induce skin sensitization. It did not exhibit cumulative toxicity at levels up to 20000 mg m(-3), which is approximately one-half of the lower explosive limit and the highest level considered safe to test. It did not induce developmental toxicity and was not mutagenic. From this and other existing information, it is concluded that n-pentane does not require classification for potential toxic hazards (as defined by Annex VI of the EU Dangerous Substance Directive, 1993), although the physical properties indicate that it would be appropriate to warn for the potential for aspiration. Further, there is no reason to reduce the current occupational exposure recommendations. Finally, although there are some safety issues relating to the flammability of n-pentane, the absence of any demonstrable toxicity at high treatment levels indicates that the risk of adverse health effects is minimal for all segments of the population.

Administration, Inhalation↗
PubMedDate not supplied

Effect of continuation treatment on residual symptoms in late-life depression: how well is "well"?

UNLABELLED: The objectives of this report were (1) to describe residual depressive symptoms in elderly patients during continuation therapy with combined nortriptyline and interpersonal psychotherapy; (2) to determine which symptoms were persistent; (3) to determine the clinical correlates of residual depressive symptoms; and (4) to document distinct response pattern clusters during combined continuation therapy. METHOD: Box plot analyses of Hamilton depression scores and Global Assessment Scale scores, repeated twice monthly over 4 months, were conducted using data from 105 elderly depressives. Temporal trends in the data were examined via random regression analysis. Individual trajectories for each of the 105 patients were examined for patterns of response during continuation therapy. RESULTS: We observed a low mean Hamilton rating of 7 (SD = 2.3) at the start of continuation therapy and 5 (SD = 3.0) at the end. Both Hamilton and GAS scores showed modest but significant improvement over time. Hamilton variability was most apparent in symptoms of mood lowering, apathy, anxiety (psychological and somatic), feelings of guilt, anergia, insomnia, and loss of libido; other symptoms (retardation, agitation, hypochondriasis, loss of appetite, loss of weight, suicidal ideation, and loss of insight) showed clear resolution. A diagnosis of RDC situational depression was associated with higher levels of residual symptoms, while level of chronic medical burden, personality dysfunction, and social support were not. Examination of response patterns showed that a quarter of patients experienced one or more brief symptomatic exacerbations. CONCLUSION: On average, an excellent level of symptom resolution was achieved for most patients with Hamilton scores comparable to those seen in healthy elderly controls. These data support a position of therapeutic optimism in late-life depression and underscore full remission as an achievable therapeutic goal.

Aged↗
PubMedDate not supplied

Editors' requests of peer reviewers: a study and a proposal.

BACKGROUND: Despite the pivotal role of peer review in the scientific process, there has never been a formal study of the way in which reviewers' opinions are elicited. This article describes such a study and makes recommendations for a more standardized approach to the peer review process. We hope, through this publication and related efforts, to encourage such a process in Preventive Medicine and in other journals. METHOD: The study population included the top 100 journals (as rated by the 1989 Institute for Scientific Information citation frequency index). Only journals with primarily U.S.-based editorial offices are included (n = 73). Participants provided their reviewer forms, cover letters for reviewers, and instructions for reviewers that were used routinely. All data were collected in February 1992. RESULTS: The response rate was 97.3%. Journals varied substantially in many of their reviewer requests. While 96% of journals asked reviewers to recommend acceptance or rejection, only 72% asked reviewers to assess manuscripts' novelty, 69% requested assessments of clarity, and only 51% asked for assessments of the reasonableness of manuscripts' conclusions. Similarly, only 46% of journals reminded reviewers that manuscripts were confidential documents, 51% provided a separate cover letter, and 25% provided extensive (>1 full page) reviewer instructions. CONCLUSIONS: While review uniformity is not requisite, differences between review protocols may not be a function of specific journals' needs, but of some journals' excluding important review components from explicit mention. Based in part on the Council of Biology Editors' recommendations, standard components of reviews and of instructions for reviewers are suggested. If editors' expectations were more explicit, reviewers' comments could better serve editorial needs.

Humans↗
PubMedDate not supplied

Is bipolar II a unique disorder?

The authors investigated differences between 27 outpatients who met RCD "definite" criteria for bipolar II disorder and 188 unipolar patients on several dimensions: clinical characteristics, response to acute treatment, personality profiles after recovery, and family history. The bipolar II group was found to have a higher morbid risk for depression among fathers, a greater incidence of past suicidal attempts, and a greater frequency of psychomotor retardation. A high degree of selectivity for protocol inclusion may account for the similarity seen between the bipolar II group and the unipolars on the other variables examined. The present findings suggest these two groups can be successfully combined in the treatment of recurrent depressive episodes.

Adult↗
PubMedDate not supplied

Circadian patterns of unintended sleep episodes during a constant routine in remitted depressed patients.

Theoretical models of depression have hypothesized phase or amplitude alterations in circadian measures including the sleep-wake rhythm. Whether such abnormalities occur only during the depressed state, or whether they persist into recovery, is less clear. We investigated the circadian pattern of unintended sleep episodes during 36 h of constant wakeful bedrest in two groups: 26 drug-free patients whose depression remitted following psychotherapy treatment, and a contrast group of 17 healthy young adults. The contrast group was not matched for age or gender. Both remitted depressed and contrast groups showed statistically significant linear and quadratic trends in the number of unintended sleep episodes, indicating monotonic and circadian influences across the study interval. We found no significant group differences in the pattern of sleep episodes. The number and timing of sleep episodes did not correlate significantly with core body temperature amplitude or timing or with baseline sleep duration or efficiency. The results do not support the hypothesis of a phase or amplitude change in sleep propensity as a trait abnormality in depression. However, the inclusion of a moderately depressed out-patient cohort, which showed only minor sleep changes and normal temperature profiles even while depressed, may have biased against finding significant differences.

Adult↗
PubMedDate not supplied

Is diurnal variation a meaningful symptom in unipolar depression?

The present study found that defining groups of patients based on the presence or absence of diurnal variation highlighted several important differences between the two groups. Diurnal patients had longer episodes, better response to treatment, and were less frequently classified as RDC agitated. Within this diurnal population, evening sufferers had more decrease in appetite than morning sufferers. Equivalent percentages of diurnal-a.m. and diurnal-p.m. received RDC endogenous diagnoses, but more diurnal-a.m. patients were found in the DSM-III melancholia category. While this study found some evidence inconsistent with the generally accepted notion regarding the constellation of symptoms associated with endogenous and non-endogenous depressions, the authors suggest that diurnal variation may represent a predictor of unipolar depression which is biologically based.

Adult↗
PubMedDate not supplied

Analysis of time to stabilization in the treatment of depression: biological and clinical correlates.

The discovery of clinical and biological variables which correlate with the rate of treatment response is an important aim of outcome research. In this report, such items were assessed in a large group of patients with recurrent depression to determine what variables contribute to stabilization during treatment. Relatively few items were strongly related to time to stabilization aside from age, clinical severity of illness, and number of previous episodes. One biological variable, cortisol nadir, was positively related to the time of stabilization. Similar assessments of non-responders did not yield any specific predictors.

Adult↗
PubMedDate not supplied

Assessment of sexual function, interest and activity in depressed men.

Sexual function, interest, and activity were assessed in drug-free outpatient depressed men (n = 26) and in age-matched healthy control men (n = 20) by means of the Derogatis Sexual Functioning Inventory (DSFI), a retrospective sexual function questionnaire (SFQ), and a prospective daily sexual function log. Good test-retest reliability over 1 month was demonstrated for the DSFI and the SFQ in depressives and controls. Compared to healthy controls, depressed men reported significantly lower sexual interest and satisfaction, but no less sexual activity, on both retrospective questionnaires and prospective daily logs. Depressed men also showed significantly more negative body image and less 'manly' sexual role function as measured by the DSFI. Significant partial correlations (controlling for the effects of anxiety) were found between severity of depression and sexual interest, satisfaction, and role.

Adult↗