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Biomedical subjects

E Goldstein

Publications and source records attributed to E Goldstein.

175 records · Page 10Linked to original sources
PubMedDate not supplied

"Abnormal" electrocardiograms in patients with cocaine-associated chest pain are due to "normal" variants.

"Abnormal" electrocardiograms are found in 56% to 84% of patients with cocaine-associated chest pain. This study was designed to assess whether these findings can be explained by "normal" variations in young patients' electrocardiograms. This cross-sectional study was conducted in a municipal hospital emergency department and walk-in clinic. History and results of an electrocardiogram for consecutive patients with cocaine-associated chest pain, aged 18 to 35 years, were compared to normal controls matched for age, race, and gender. Electrocardiograms underwent detailed analysis by two physicians blinded to both the study protocol and the hypothesis. Interphysician concordance for electrocardiographic diagnosis was substantial. There were 112 patients enrolled, 56 in each group. There was no significant difference found in the mean frequency of electrocardiographic diagnoses between the cocaine-associated chest pain patients and controls. The early repolarization variant was common. In conclusion, "normal" variations (J point and ST segment elevations) account for many of the "abnormal" electrocardiograms observed in young patients with cocaine-associated chest pain. Further study is needed to define the prevalence of these "normal" variations, and to determine if standard electrocardiographic criteria for thrombolysis apply to young patients.

Adolescent↗
PubMedDate not supplied

Effect of near ambient exposures to sulfur dioxide and ferrous sulfate particles on murine pulmonary defense mechanisms.

An infectivity model was used to test the safety margins for presently established air quality standards for sulfur dioxide and sulfate particles. Mice and rats were exposed to atmospheres of sulfur dioxide and mono-disperse ferrous sulfate particles from 3 to 6 times the standard for 17 hr prior to, or 4 hr after infection with aerosols of Staphylococcus aureus or Group C Streptococci. Exposure to these concentrations of pollutants did not impair the rodents' ability to ingest and inactivate the minimally virulent Straphylococcus or enhance the virulence of the Group C Streptococci. Insofar as these results can be extrapolated to man, the present air quality standards for sulfur dioxide and sulfate particles are protective in regard to respiratory bacterial infection.

Aerosols↗
PubMedDate not supplied

Effect of ferrous sulfate aerosols and nitrogen dioxide on murine pulmonary defense.

A murine infectivity model was used to test the effect of exposure to atmospheres containing 290 +/- 50 microgram/m3 of respirable sized ferrous sulfate (FeSO4) particles (0.4 micron mass median aerodynamic diameter) and 1.0 ppm nitrogen dioxide (NO2) prior to infection with aerosols of Staphylococcus aureus or group C streptococci. Exposure to these combined pollutants for 24 or 48 hr did not impair pulmonary inactivation of S. aureus. Exposure to FeSO4 or NO2 for 48 hr, or to both pollutants for 24 or 48 hr, resulted in significant decreases in inactivation of inhaled group C streptococci. Mortality studies following pollutant exposure demonstrated earlier, but not an increased number of deaths. These studies demonstrate the importance of the test organism in assessing air quality standards with the infectivity model and enhanced toxicity and prolongation of exposure to relatively low levels of submicron-size particles of FeSO4 and NO2.

Aerosols↗
PubMedDate not supplied

Applications of computerized microscopic image analysis in infectious diseases.

Advances in computerized microscopy have resulted in image analysis systems that rapidly and precisely measure various aspects of cellular morphology and physiology. These systems-composed of a microscope and attached photomultiplier tube or camera, an image processor, and a computer-have been used to measure lysosomal enzymes, pH, and calcium within phagocytes; to detect viral nucleic acids in in situ hybridization preparations; and to quantitate rates of cellular movement. These experiments have shown that (1) the intracellular proliferation of virulent microorganisms is associated with reductions in acid phosphatase, beta-glucuronidase, and lysozyme activity; (2) virulent Toxoplasma gondii, Legionella pneumophila, and Nocardia asteroides inhibit phagosomal acidification; and (3) changes in intracellular calcium movement affect phagocytic function. These methods have also been used to detect the AIDS virus within cultured lymphocytes and to measure cellular chemotaxis and chemokinesis. Further advances in technology should produce improved microscopic image analysis systems with wider applications for the investigation of infectious diseases.

Antibodies↗
PubMedDate not supplied

Hydrolytic enzymes of alveolar macrophages.

Hydrolytic enzymes are major constituents of alveolar macrophages, which in recent years have been shown to be involved in many aspects of the inflammatory response in addition to their better-known role in bactericidal processes. This review summarizes the general properties, physiologic function, cellular physiology, and clinical associations of four important hydrolytic enzymes of alveolar macrophages--lysozyme, elastase, plasminogen activator, and collagenase--with particular attention to the relationship of these enzymes to the pathophysiology of lung disease. The information reviewed shows that much is known about the biochemistry of these enzymes, that each is produced in greater quantity when alveolar macrophages are stimulated, that each has a distinctive physiologic role in the inflammatory process, and that they function as part of the overall pulmonary antibacterial defense system. Studies of the pathophysiologic effects consequent to the elaboration of excess quantities of these enzymes by stimulated macrophages show that some hydrolytic enzymes injure the lung by attacking normal as well as inflammatory tissue sites that are susceptible to degradation. Such damage is normally limited by enzymatic inhibitors, like alpha-antitrypsin, but the inactivating capacity of the inhibitors can be overwhelmed and in these instances excess enzyme contributes to the development of emphysema. This newer understanding of the pathophysiologic role of hydrolytic enzymes may lead to therapeutically beneficial methods for modulating the pulmonary inflammatory response.

Animals↗
PubMedDate not supplied

Diagnosing the 'strange' child.

The diagnosis of children with a spectrum of autistic features, who do not qualify for the diagnosis of classical autism, has increased during the past decade. A case is reported of an 8-year-old child originally diagnosed as learning disabled with attention disorders and hyperactivity, who was later diagnosed as having an autistic spectrum disorder when abnormalities of social interaction and play activity became more obvious. The frequency of learning and attention problems in school-age children may obscure more significant psychiatric pathologies, such as autistic disorders. Improved awareness of disorders of social functioning and play activity in the school-age child and use of screening tools may lead to earlier detection, definitive diagnosis and treatment for these children. In addition, assessments from multiple sources, i.e. the school, the home and the clinic, are needed in the diagnostic process. Periodic re-evaluations of the school-age child with problem behaviour are necessary to insure that more significant pathologies, which were not clear on initial evaluation, are diagnosed at the earliest opportunity.

Attention Deficit Disorder with Hyperactivity↗
PubMedDate not supplied

Variations in the electrocardiograms of young adults: are revised criteria for thrombolysis needed?

OBJECTIVE: The evaluation of chest pain in young adults has changed with the recognition of cocaine-induced myocardial ischemia. The high frequency of abnormal electrocardiograms (56-84%) in the cocaine-user population is largely due to "normal" electrocardiographic variants (early repolarization). The authors sought to determine the frequency of these "normal" variants in a young population, and whether these findings can be confused with acute ischemia. METHODS: A prospective convenience sample of subjects aged 18 to 35 without known heart disease was interviewed and had 12-lead electrocardiographic tracings performed. An emergency physician (physician 1) and a cardiologist (physician 2) read the tracings while blinded to patient history, age, and race. When the physicians disagreed, another physician adjudicated the diagnosis. RESULTS: Four hundred fourteen subjects (127 black, 175 Hispanic, and 112 Caucasian) were enrolled. Overall, 154 tracings (37%) were normal, 245 (59%) were abnormal but nondiagnostic for ischemia, and 15 (4%) were consistent with ischemia. Frequencies of repolarization "abnormalities" as determined by physicians 1 and 2, respectively, were: blacks, 32%, 51%; Hispanics, 26%, 35%; Caucasians, 17%, 27%; chi-squared, p = 0.02 and 0.0004. Patients with ischemic electrocardiograms according to physician 1 had a high frequency of repolarization "abnormalities" according to physician 2, and vice versa (100%, 61%). Electrocardiographic criteria for thrombolytic use per physician 2 were present in 31 patients (7%): blacks, 9%; Hispanics, 10%; and Caucasians, 2%; chi-squared, p = 0.03.

Adolescent↗
PubMedDate not supplied

Role of the alveolar macrophage in pulmonary bacterial defense.

This review concerns the role of the alveolar macrophage as part of the coordinated mucociliary, macrophge and immune bacterial defense mechanisms of the lung. Alveolar macrophages are end-stage phagocytes that are derived from two precursor sources; an uncommitted pleuripotential hematopoietic stem cell, and a committed differentiated pulmonary precursor which can renew itself, as well as mature into functional alveolar macrophages. Sufficient numbers of alveolar macrophages are distributed throughout the lungs to ensure their proximity to any bacteria that penetrates alveolar regions. Studies with rodents have shown that these alveolar macrophages ingest, inactivate, and degrade inhaled microorganisms within eight hours of their entrance into alveolar regions. The biochemical mechanisms responsible for this antibacterial function involve the elaboration of chemotactic factors consequent to the interaction of bacteria, antibody, and complement, and the presence of bactericidal substances within the macrophage itself. Normally, these cellular mechanisms enable the alveolar macrophage system to maintain the lungs bacteria-free. However, if macrophage function is impaired due to pollutant or viral exposure, the host-parasite balance is upset and bacterial proliferation ensues. In such circumstances, polymorphonuclear leucocytes and additional macrophages enter the area of bacterial proliferation to produce the classical inflammatory reaction of pneumonia.

Animals↗