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Biomedical subjects

E Friedman

Publications and source records attributed to E Friedman.

At least 451 records · Page 25Linked to original sources
PubMed1986

Is counting the dead enough? Strategies for monitoring health needs in New York City.

Determining health care needs--especially unmet needs--in New York City should continue as a research and policy priority, especially in a rapidly changing health care environment. Among the many data sources that can be used in assessing needs are: mortality data; census data; other vital statistics; National Health Interview Survey data; other interview and survey data; physician examination of patients. Among the uses to which these and other data are being put in an effort to determine unmet need and health status are: predicting age-sex-specific demographic, health status, and utilization trends; analysis of sentinel health events; developing hierarchies of need for small areas; development of city and neighborhood "health profiles"; provider determination of needs for program planning. Obstacles to progress persist, however, including the increasing costs of data gathering and analysis; lack of popular or political support for needs assessment; and problems in defining what health care needs are. Among high priorities for those interested in better assessment of health care needs in New York City are: recreating public and political interest in the issue; garnering more financial support for research; countering trends toward privatization and fragmentation of data collection and analysis efforts; new relationships between academic and other researchers; better definition of need and refinement of research methodologies and data bases; development of a clear strategy for assessing health needs in New York City in the future, and garnering broad support for implementing it.

Data Collection↗
PubMed1986

The Cohen syndrome in Israel.

Thirty-nine patients of 32 families affected by the Cohen syndrome are described with regard to clinical features, ethnic distribution and mode of presentation. Associated diseases, mode of inheritance and the apparent high prevalence of the syndrome among Jewish children are discussed.

Abnormalities, Multiple↗
PubMed1986

Doctors and rationing: the end of the honor system.

Physicians have traditionally held that to participate in "rationing" or resource allocation would betray their duty to advocate for everything possible for the patient. However, the record of physician behavior belies that, indicating instead that they have always rationed health care and their own time and services. Physician resistance to calls for "rationing" today appears to be based more on the nature of the process and on the fact that this process is being taken out of the hands of physicians. If American medicine does not rethink its own stance and develop not only a stronger resource allocation ethic but also a means of implementing it, it is unlikely that physicians will continue as the guardians of the quality of care and patient service.

Cost Control↗
PubMed1986

Allied health and the dilemma of nontraditional doctorates.

Opportunities to acquire doctoral degrees through nontraditional means have proliferated in recent years. These opportunities offer master-level allied health professionals a chance to obtain doctoral degrees without major interruptions in their careers or the need to leave their place of employment. However, many question the comparability of these degrees to those obtained through traditional programs. This report examines various types of nontraditional programs and attempts to assess their acceptance by deans of allied health programs based in academic health centers. Of ten deans surveyed, eight stated that they would consider candidates with nontraditional doctorates for faculty appointment. Two had nontraditional doctoral faculty on staff and have had no problems with promotion or tenure of those individuals. Only one indicated that promotion and tenure would not be possible for faculty possessing nontraditional degrees. The implications for allied health faculty possessing nontraditional degrees are explored in light of official and unofficial university policies, and an approach is suggested for junior faculty considering the nontraditional doctoral option.

Costs and Cost Analysis↗
PubMed1986

Inhibition of human colonic epithelial cell proliferation in vivo and in vitro by calcium.

Nine patients at high risk of developing colon cancer were placed on daily p.o. supplementation of 1500 mg of calcium for 4-8 weeks. The colonic epithelial cells in six of these patients showed a statistically significant decrease in their [3H]thymidine labeling indices in tissue culture so that they resembled those of patients at low risk of developing colon cancer. The three nonresponders had similar labeling indices before and after calcium supplementation. Biopsies from each of nine high-risk patients exhibited a decrease in proliferation when they were cultured in vitro with a high level of CaCl2 (2.2 mM compared with the 0.1 mM optimum value for proliferation). Two adenomas and two carcinomas showed a different pattern of response than normal cells, exhibiting no inhibition of growth at 2.2 mM CaCl2. These data indicate that the growth inhibition induced by high levels of extracellular calcium levels is lost at a stage in tumor development before cells become malignant.

Calcium, Dietary↗
PubMed1985

X-linked lymphoproliferative syndrome. A new kindred with variable phenotypic expression.

A kindred with five affected maternally related male members showed variable phenotypic expression of the X-linked lymphoproliferative syndrome. In one of the children, agammaglobulinemia developed following infectious mononucleosis. His brother had aplastic anemia in infancy and 21/2 years later died of overwhelming pneumonia resulting from ornithosis. A third brother died of reticulum cell sarcoma. Two maternally related male cousins died of reticulum cell sarcoma of the neck.

Adolescent↗
PubMed1985

Fragile X syndrome: associated neurological abnormalities and developmental disabilities.

The fragile X syndrome is a frequent cause of developmental disabilities. It is associated primarily with nonprogressive X-linked mental retardation. The neurodevelopmental abnormalities of 25 males and 3 females are described. Mental retardation was mild in 4, moderate in 11, severe in 6, and profound in 2 patients, while 4 patients had only learning disabilities. The presence or absence of a developmental disability could not be determined in the youngest (8 months). Seven patients had had infantile autism and 7 had epilepsy. Generally no major focal neurological abnormalities were observed but most of the patients exhibited minor signs. The severity of developmental disabilities in our patients varied between and within families and between genders. All adult males had macroorchidism. Unusual facial features were present in 13 males but none were seen in the females. Familial occurrences were found in 18 cases (64%); 10 cases (36%) were sporadic. Overall, males were more severely affected than females. Diagnostic tests including computed tomographic scans, electroencephalograms, and evoked potentials did not disclose any specific abnormalities.

Adolescent↗
PubMed1985

Genotypic variation in age-related changes in peripheral catecholamines.

The effects of aging on catecholamine concentrations in heart ventricle, aorta, and adrenal gland were evaluated in two inbred mouse strains (C57BL/6J and DBA/2J) and an F1 hybrid (B6D2F1). The effects of aging on ventricular norepinephrine (NE) levels were found to be strain specific; only the C57BL/6J strain showed a significant decline in ventricular NE levels with age. Though all strains showed a decline in ventricular epinephrine (EPI) levels with age, the magnitude of the decrease varied between strains. An age-related increase in ventricular dopamine (DA) levels was observed in each of the strains. Although strain differences in catecholamine levels were also observed in aorta and adrenal gland, no age-related changes in catecholamine concentrations were noted in any of the strains. The findings indicate strain and organ specific changes in the effects of aging on catecholamine concentrations in peripheral organs.

Adrenal Glands↗
PubMed1985

Do eye hospitals have a role in our future?

Eye hospitals, originally founded to care for the poor, have developed into academic centers and tertiary "hospitals of last resort." Inexorable economic pressures, especially price competition, are likely to close many of them, particularly those which are marginal in quality or management. Survival of the remainder may further depend on their ability to adapt to a rapidly changing environment and to fulfill, better than anyone else, the special mission of basic and clinical research and training. Society must be convinced that some of these complex, highly differentiated, relatively expensive eye hospitals are significant national resources, serve the public welfare, and are worth preserving.

Cost Allocation↗
PubMed1985

Cortical cholinergic impairment and behavioral deficits produced by kainic acid lesions of rat magnocellular basal forebrain.

The magnocellular basal forebrain (MNBF) provides extensive cholinergic innervation to frontoparietal cortex. In the rat, the MNBF is homologous to the human nucleus basalis of Meynert, a structure implicated in the cholinergic hypothesis of cognitive impairment in Alzheimer's disease (AD). Kainic acid (KA) was used to make lesions in the MNBF of rats which were compared with unoperated controls, sham-operated controls, and control rats injected with KA in the cortical area directly above the MNBF. The MNBF lesions depleted choline acetyltransferase in cortex but not in striatum or hippocampus. Cortical dopamine levels were unchanged; serotonin levels were unchanged in hippocampus and parietal cortex but decreased in frontal cortex. The metabolite levels of these neurotransmitters were unchanged in all brain regions examined. Compared with controls, rats with MNBF lesions were impaired in 24-hr retention, but not acquisition, of a passive avoidance task with escapable footshock. There were no differences between groups in mean number of daily avoidances on a bar-press active avoidance task, although the data suggested a slower rate of learning in MNBF rats. In a serial spatial discrimination reversal test with a snout-poke response, the MNBF rats performed significantly worse than controls, although all groups learned the task. This rodent model is useful for studying the role of the cholinergic system in memory and possibly for developing treatment strategies to alleviate the cognitive dysfunction of AD.

Animals↗