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Biomedical subjects

E Shapiro

Publications and source records attributed to E Shapiro.

At least 253 records · Page 14Linked to original sources
PubMed1982

An update on Tourette syndrome.

This summary of the present status of tic disorders in based on our experience with 650 patients and review of the literature. The three major tic disorders, Transient Tic of Childhood, Chronic Motor Tic, and Tourette syndrome, now thought to have similar organic etiology, form a continuum with heterogeneity of symptoms and severity. This paper summarizes current understanding of the demography, illness-related characteristics, psychopathology, neuropathology, genetics, neurochemistry, and treatment.

Adolescent↗
PubMed1982

Self-rated health: a predictor of mortality among the elderly.

Data from the Manitoba Longitudinal Study on Aging (MLSA) were used to test the hypothesis that self-rated health (SRH) is a predictor of mortality independent of "objective health status" (OHS). Subjects were a random sample of non-institutionalized residents of Manitoba aged 65+ in 1971 (n = 3,128). A single item measure of SRH was obtained during a survey conducted in 1971; a baseline measure of OHS was derived from physician and self-reported conditions and health service utilization data. Occurrence and date of death during the years 1971-1977 were known. Analyses of the data revealed that, controlling for OHS, age, sex, life satisfaction, income and urban/rural residence, the risk of early mortality (1971-1973) and late mortality (1974-1977) for persons whose SRH was poor was 2.92 and 2.77 times that of those whose SRH was excellent. This increased risk of death associated with poor self-rated health was greater than that associated with poor OHS, poor life satisfaction, low income and being male. These findings provide empirical support for the long held, but inadequately substantiated, belief that the way a person views his health is importantly related to subsequent health outcomes.

Aged↗
PubMed1981

Early distant metastases from epithelioid sarcoma of the hand.

The authors describe a patient with epithelioid sarcoma in whom the presenting lesion was cervical lymph node metastasis. This proved to be a difficult diagnostic problem, until the occult primary tumor was discovered in the ipsilateral hand. A cerebral metastasis became evident early in the course of the disease. The authors believe this to be the first case reported in whom the presenting lesion was a nonregional metastasis. The rapid clinical progression of this patient's malignancy is of interest and illustrates the need for early intervention in patients with an epithelioid sarcoma, since the clinical course is not always indolent.

Adolescent↗
PubMed1981

Tic disorders.

Explore the source record for details and available documents.

Humans↗
PubMed1981

The Manitoba longitudinal study on aging: preliminary findings on health care utilization by the elderly.

This research links survey data from a large probability sample of the elderly population of one Canadian province with provincial insurance data documenting all their health care use during the years before and after the interview. The data show that "the elderly" are not high users of the health care system. Instead, a small proportion of those age 65 and older account for a disproportionately of high health-care use and discusses the implications of its findings for health care policy, practice, and research.

Age Factors↗
PubMed1981

Regional non-uniformity of wall dynamics in normal left ventricle.

M-mode echocardiograms were performed in 31 normal children in order to compare myocardial wall dynamics in different regions of the left ventricle. Tracings were recorded at the level of the mitral valve ring (level 1), near the tips of the mitral valve leaflets (level 2), and in the region of the papillary muscles (level 3) and were digitised. Fractional shortening increased from 31.7 per cent at level 1 to 36.5 per cent at level 3. Peak VCF and minor dimension lengthening rate were the same at all three levels, as were end-diastolic posterior wall thickness and peak systolic wall thickening rate. Striking regional differences, however, were seen in the extent of systolic posterior wall thickening which increased from 55 per cent at the base to 106 per cent at the papillary muscles, and in peak posterior wall thinning rate, which increased from 6.4 cm/s at the base to 10.0 cm/s at the papillary muscles. There was greater systolic inward movement of epicardium at level 1 than at levels 2 and 3. The septum thinned and thickened more slowly than did the posterior wall and did not show major differences between levels. Systolic reduction in minor dimension thus occurs largely by thickening of the wall at level 3 and by sphincter-like inward movement of the entire wall at level 1. These regional differences can be explained by a circumferential arrangement of myocardial fibres at the base of the heart and a more prominent longitudinal component towards the apex. Thus, non-uniformity of function is a prominent feature of the normal left ventricle and may reflect regional variation in its structure.

Child↗
PubMed1981

The geriatric long-stay hospital patient: a Canadian case study.

This article examines the use of acute beds by the elderly in Manitoba over the five-year period, 1972--1976. The analysis reveals that transfers of long-stay (greater than 90 day) elderly to long-term care facilities took longer in 1976 than in 1972 despite major provincial initiatives which included construction of additional long-term treatment beds, expansion of home care resources, and extension of universal insurance coverage to long-term institutional and home care. Analyses of means to reduce long hospital stays prior to transfer suggests that building more long-term beds may be the least desirable policy alternative.

Aged↗
PubMed1981

Genetic analysis of Tourette syndrome suggesting major gene effect.

Data on Gilles de la Tourette syndrome are analyzed by multiple threshold models in inheritance that incorporate sex effect. The polygenic-multifactorial model is rejected. Single major locus inheritance can account for the data, although many of the occurrences of Tourette are due to nongenetic phenocopies. In both models, males and females share a common genetic environmental liability, but the less prevalent sex, that is, females, has a higher genetic loading for the disorder. The predicted population prevalences in the single major locus model are 2.3% for males and 0.8% for females. The implications for genetic and biological research in Tourette syndrome are discussed.

Female↗
PubMed1980

Predicting the "Wits" appraisal from the ANB angle.

The ANB and "Wits" values of fifty patients were correlated to see how accurately one can predict the "Wits" value, given the ANB measurement. There is no correlation between these two values when the "Wits" measurement is negative. In our study, when the positive ANB measurement was less than 4 degrees, the "Wits" values could be either positive or negative. When the ANB angle was between 4 and 8 degrees, all "Wits" values were positive. When both the "Wits values were positive and the ANB values ranged between 1 and 8 degrees, we could predict the "Wits" measurement with a 38 percent accuracy. If the ANB range was narrowed to 4 to 8 degrees, all "Wits" values were positive and we could predict them 28 percent of the time. Both these figures are statistically significant but clinically irrelevant. Further studies are needed to determine the exact nature of these interrelationships.

Adolescent↗
PubMed1980

Presynaptic membrane potential affects transmitter release in an identified neuron in Aplysia by modulating the Ca2+ and K+ currents.

We have examined the relationships between the modulation of transmitter release and of specific ionic currents by membrane potential in the cholinergic interneuron L10 of the abdominal ganglion of Aplysia californica. The presynaptic cell body was voltage-clamped under various pharmacological conditions and transmitter release from the terminals was assayed simultaneously by recording the synaptic potentials in the postsynaptic cell. When cell L10 was voltage-clamped from a holding potential of -60 mV in the presence of tetrodotoxin, graded transmitter release was evoked by depolarizing command pulses in the membrane voltage range (-35 mV to + 10 mV) in which the Ca(2+) current was also increasing. Depolarizing the holding potential of L10 results in increased transmitter output. Two ionic mechanisms contribute to this form of plasticity. First, depolarization inactivates some K(+) channels so that depolarizing command pulses recruit a smaller K(+) current. In unclamped cells the decreased K(+) conductance causes spike-broadening and increased influx of Ca(2+) during each spike. Second, small depolarizations around resting potential (-55 mV to -35 mV) activate a steady-state Ca(2+) current that also contributes to the modulation of transmitter release, because, even with most presynaptic K(+) currents blocked pharmacologically, depolarizing the holding potential still increases transmitter release. In contrast to the steady-state Ca(2+) current, the transient inward Ca(2+) current evoked by depolarizing clamp steps is relatively unchanged from various holding potentials.

Acetylcholine↗
PubMed1980

Presynaptic inhibition in Aplysia involves a decrease in the Ca2+ current of the presynaptic neuron.

By voltage clamping presynaptic cell L10 and using pharmacologic separation techniques, we have analyzed the specific ionic currents in the presynaptic cell that correlate with presynaptic inhibition while assaying transmitter release with intracellular recordings from postsynaptic cells. We have found that presynaptic inhibition can be elicited in conditions in which the Na+ and the various K+ channels are pharmacologically blocked and depolarizing current pulses produce only an inward Ca2+ current. Both inward currents and tail currents at and above the K+ reversal potential were always less inward during presynaptic inhibition. The changes in conductance associated with presynaptic inhibition were voltage sensitive and paralleled the voltage sensitivity of the Ca2+ channel. We therefore conclude that presynaptic inhibition is caused by a direct transmitter-mediated decreased of presynaptic Ca2+-channel conductance.

Animals↗