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Biomedical subjects

E Hoffman

Publications and source records attributed to E Hoffman.

At least 55 records · Page 3Linked to original sources
PubMed1994

Love and sex after 60: how to evaluate and treat the impotent older man. A roundtable discussion: Part 2.

In the medical evaluation of older men with erectile dysfunction, obtain a detailed history to determine whether the dysfunction is organic or psychogenic. Determine if there are underlying pathologic processes--most notably vascular diseases--or other factors responsible for the dysfunction, such as medications or nerve or arterial damage from surgery. Lifestyle changes in mid-life (regular exercise, a low-fat diet, and smoking cessation) increase a man's chances of remaining potent as he grows older. Treatments for impotence include injection therapy, vacuum devices, and implants. Each therapy has advantages and disadvantages, and the informed patient plays an important role in choosing the therapy that is right for him.

Aged↗
PubMed1994

Love and sex after 60: how to evaluate and treat the sexually-active woman.

In the medical evaluation of older female patients with sexual problems, you need to assess the woman's psychological state, as well as her physical condition. An important question to ask is whether her level of sexual activity is satisfactory to her. Women's early sexual experiences, in some cases including childhood sexual abuse, impact greatly on their sexuality in later life. When sexual problems are related to the menopause, customized hormone replacement therapy is the treatment of choice. Other clinical factors that impact on older women's sexuality include urinary incontinence, breast surgery, and hysterectomy.

Aged↗
PubMed1994

Ultrafast computed tomography of the chest.

Improvements in scan speed and resolution are changing the role of the pulmonary imager. An understanding of airway mechanics and blood flow physiology is required to take full advantage of the new technology. Assessment of regional airflow and blood flow provides information that is currently unavailable from clinical tools.

Adult↗
PubMed1993

The Ah receptor nuclear translocator gene (ARNT) is located on q21 of human chromosome 1 and on mouse chromosome 3 near Cf-3.

We have mapped the Ah receptor nuclear translocator (ARNT) gene to a conserved linkage group located on mouse chromosome 3 and human chromosome 1. EcoRI-digested DNA from a panel of 17 human x mouse somatic cell hybrids was probed with a cDNA fragment of the human ARNT gene. Six of the 17 independent mouse x human hybrids were positive for human bands. Human chromosome 1 showed complete cosegregation with the gene, whereas discordant segregation was observed for all other human chromosomes. The human gene was localized to 1q21 by using DNA from mouse x human hybrid clones that retain translocations involving human chromosome 1, by segregation analysis in nine informative CEPH families, and by in situ hybridization. The mouse homologue was mapped to mouse chromosome 3 using a panel of 16 hamster x mouse somatic cell hybrids. Six of 16 mouse x hamster hybrids were positive for mouse bands, showing complete concordance with mouse chromosome 3. The mouse Arnt gene was regionally mapped on chromosome 3, using linkage analysis in an interspecific backcross. The results indicate that the mouse gene resides about 40 cM from the centromere and about 10 cM proximal to Cf-3, the gene for tissue factor.

Animals↗
PubMed1993

Hemodynamic changes due to intraoperative testing of the automatic implantable cardioverter defibrillator: implications for anesthesia management.

During the insertion of an automatic implantable cardioverter defibrillator, repeated induction of ventricular tachycardia or ventricular fibrillation and subsequent defibrillation is performed to determine the defibrillation threshold. In this study, the influence of these testing episodes on myocardial function was investigated in 13 patients under general anesthesia. Preoperative ejection fraction (EF) was 41 (14 to 84) % (median and range). Testing was performed 3 (2-5) times. During these testing episodes the patients received a total of 4 (2-8) countershocks. Patients with a preoperative EF < 30% (N = 5) showed a significant reduction of cardiac index (CI) from 2.2 (1.5-3.3) L/min/m2 before testing to 1.5 (1.3-2.3) L/min/m2 after the last testing episode, and of left ventricular stroke work index (LVSWI) from 32 (14-53) g.m/m2 before testing to 22 (7-43) after the last testing episode. These changes were not related to the total fibrillation time or the cumulative defibrillation energy. Patients with a preoperative EF > 30% (N = 8) showed no significant changes of CI (2.15 [1.8-3.0] L/min/m2 v 2.15 [1.7-3.0] L/min/m2) or LVSWI (35 [28-48] g.m/m2 v 33.5 [27-52] g.m/m2). Comparison of the two patient groups revealed similar hemodynamic baseline values, but significant differences in LVSWI after the last testing episode. Defibrillation testing may produce a further reduction in myocardial performance in patients with preexisting poor cardiac function.

Adolescent↗
PubMed1993

Women's health: designing and implementing an interdisciplinary specialty.

Contemporary physicians who wish to specialize formally in the care of women have inherited a surgical postgraduate program that focuses primarily on reproductive health. Mounting evidence suggests a broader perspective is needed. This article describes the role obstetrics-gynecology might play in this advancement.

Education, Medical↗
PubMed1993

Countertransference: a typological expansion.

Countertransference was viewed from the perspective of a 2 x 2 x n factorial typology (source x degree of consciousness x depth). This typology incorporated the conscious and unconscious influences of nonpsychological variables and their theoretical schema upon the analyst's therapeutic recommendations.

Countertransference↗
PubMed1992

The role of positron emission tomography in oncology and other whole-body applications.

Imaging and quantifying biochemical and physiological processes with PET clearly has major potential significance for all organ systems and many disease states. Although the full utility and potential of emerging new applications of PET in organs other than the heart and brain must be demonstrated in basic and clinical research studies, the rapidly accumulating aggregate experience in oncology in particular, and in other organ systems and disease states as well, indicates that PET is now truly becoming a modality of both clinical and investigative use for the body as a whole as well as for specific organ systems. Whole-body PET FDG imaging (Fig 9) illustrates the potential of biochemical imaging to map the distribution of cancer throughout the body. With the growing list of radiopharmaceutical and quantitative techniques applicable to cancer studies with PET, this field will continue to realize significant growth.

Humans↗
PubMed1992

Physician practices and attitudes on HIV-related issues: a survey of LSMS primary care physicians.

In recent years there has been a dramatic increase in the number of HIV/AIDS patients in Louisiana. Despite this increase, there has been little investigation of physician perceptions of (1) the adequacy of treatment or (2) attitudes toward general HIV related issues. A study of LSMS primary care members (n = 470) indicated that most had not treated a HIV-infected or AIDS patient although the vast majority would readily do so. Reluctance was related to concern over scientific knowledge rather than any bias against such patients. Among physicians treating such patients, there was strong concern over availability of adequate hospitalization and home health care.

Attitude of Health Personnel↗
PubMed1991

Idazoxan treatment in progressive supranuclear palsy.

To confirm the preliminary report that increases in norepinephrine neurotransmission improve motor performance, we administered the investigational drug idazoxan (IDA) to nine patients with progressive supranuclear palsy (PSP) according to a double-blind crossover protocol. There were seven women and two men, whose mean age was 70 years and mean duration of illness 4 years. All had an advanced parkinsonian syndrome, supranuclear ocular motor palsies, and poor responses to dopaminergic drugs. During administration of 40 mg tid of IDA, the total score and the motor subscale score of the United Parkinson's Disease Rating Scale significantly decreased. Features that improved most included mobility, balance, gait, and measures of digital dexterity. There were no significant changes in any measure during placebo administration. Corticobulbar manifestations and eye movements were not significantly improved during treatment. Side effects of IDA included transient hypertension, tachycardia, action tremor, flushing, and sweating, but none was so severe that any patient withdrew from the study. Among the few attempted treatments of PSP, IDA is the first medication shown in a double-blind study to improve aspects of motor function.

Adrenergic alpha-Antagonists↗
PubMed1991

The effect of underlying philosophy upon utilization of a program for impaired medical students.

In recent years, an increasing number of medical schools have implemented educational programs for their impaired, or potentially impaired, students. The present research analyzed one such program viewing it as an organizational innovation and employing a theoretical model from the organizational literature. A survey sample of 170 medical students representing all four classes and recently graduated interns was utilized. Subjects were queried as to anticipated program use, degree of exposure to the program, accuracy of knowledge of the program, and perceived program advocacy. Via ANOVA analysis (regression approach) it was found that the general advocacy stance of the medical school toward the innovation (general diffusion emphasis) was not an influential factor upon potential use of the program by medical students. However, its concentration upon the actual procedures to be employed (specific diffusion emphasis) was a much better predictor. The implications for such a finding on the structure of future kindred educational programs was discussed.

Diffusion of Innovation↗
PubMed1991

Uncompensated medical care in Louisiana: a survey of LSMS members.

Physicians have traditionally taken into consideration the financial situations of their individual patients and frequently provide free and/or reduced-fee care to patients in need. An attempt was made to measure this free care in Louisiana through a survey of the active members of the LSMS. The questionnaire contained several sections designed to obtain general information about the physician's practice, care provided to uninsured and indigent patients, donated medical services, Medicare and Medicaid participation status, and policies regarding waiver of copayments and deductibles. For methodology reasons, the data provided by respondents were not generalized to the entire LSMS physician member population. Even with this statistically conservative approach, however, the survey indicated that the 1,086 respondents provided free and reduced-fee care in the amount of $51,353,650 annually, or an average of $47,287 per physician respondent.

Delivery of Health Care↗
PubMed1990

The contralateral breast in ipsilateral breast carcinoma.

I examine the problem of the management of the opposite breast of a patient with ipsilateral carcinoma, reviewing the literature from the standpoint of the incidence of carcinoma in the contralateral breast, autopsy studies, blind biopsy results, and other factors such as age and multicentricity. In my series of 343 cases of carcinoma of the breast, there were 110 cases (32%) of bilateral mastectomy; 47 (43%) showed carcinoma in only one breast, 40 (36%) exhibited contralateral carcinoma, and 23 (21%) showed Consensus Added Risk Factors (CARF). The remaining 233 cases of carcinoma of the breast were treated by unilateral mastectomy. In 59 of these cases of bilateral mastectomy in which a prophylactic contralateral mastectomy had been performed, 15% showed carcinoma of the opposite breast and 22% showed CARF. In 51 cases, the contralateral mastectomy had been performed for clinical or radiographic indications. Of this group, 61% showed carcinoma and 20% showed CARF. All of my studies are based on routine pathologic studies and not on any specialized, subserial whole organ studies.

Adult↗
PubMed1990

Nonparasitic splenic cysts.

The ultrasound modality, the Scintiscan with technetium, and the CAT scan may make the diagnosis and may pinpoint the location of the splenic cyst. Physical examination may reveal no abnormalities. In some cases a mass may be palpable in the LUQ. Bulging of the left lower intercostal spaces has been reported. The diaphragm may exhibit impaired motion and elevation. Percussion and auscultation of the chest may reveal secondary pulmonary findings.

Adolescent↗
PubMed1990

Immediate reconstruction after mastectomy: team approach.

A review of 198 cases of breast reconstruction done at the time of mastectomy for carcinoma of the breast shows an extremely low morbidity. The technique of using a tissue-expander prosthesis enables immediate breast reconstruction without any fear of impairing prognosis, of spreading disease, or of impeding adjuvant therapy.

Female↗