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Biomedical subjects

G Goldberg

Publications and source records attributed to G Goldberg.

At least 37 records · Page 2Linked to original sources
PubMed1996

Women and minorities representation in alcoholism treatment research.

Demographic and clinical information and referral outcome were systematically collected from 347 alcoholics who telephoned to inquire about treatment on alcoholism clinical research protocols over a 1-year period. The ratio of male to female callers was 7:3, with 2:1 scheduling appointments, 3:2 keeping appointments, and 3:2 actually enrolling in a treatment study. These data indicate that although a smaller ratio of female alcoholics initially called for treatment, those who did call were more likely to actually enter treatment than were male callers. A ratio of 2:1 non-minority to minority alcoholics called the clinic, with 7:3 scheduling appointments, 8:1.6 keeping appointments, and 8:1 actually entering the study. These data suggest that minority alcoholics were less likely than non-minority alcoholics to enter treatment protocols. However, discriminant function analysis found income to be a better predictor of entry into treatment than race, age, or gender, and analysis of covariance found non-minorities and minorities did not differ in rate of entry into treatment when income was used as covariate.

Adult↗
PubMed1995

Enhanced sensitivity for peptide mapping with electrospray liquid chromatography-mass spectrometry in the presence of signal suppression due to trifluoroacetic acid-containing mobile phases.

A method is described for improving the sensitivity of peptide mapping with electrospray liquid chromatography--mass spectrometry using trifluoroacetic acid (TFA) containing HPLC mobile phases. The signal suppressing effects of TFA are shown to be due to the combined effect of ion-pairing and surface tension modifications. The post-column addition of a propionic acid-2-propanol (75:25, v/v) in a 1:2 proportion with the HPLC mobile phase counteracts the deleterious effects of TFA resulting in 10-100 x improvement of the signal-to-noise ratio. The system described introduces total HPLC flow (plus additive) directly into the electrospray source without splitting. Using 2.1 mm I.D. HPLC columns, minimum detectable quantities are below 40 pmol total protein. As examples, separations of proteolytic enzyme digests of several proteins are shown using standard HPLC conditions, comparing results with and without the addition of propionic acid. The application of the technique is shown in more depth in the identification of oxidative modification sites in glutamine synthetase. In this application, the enhanced sensitivity allowed location of a modified residue by comparison endoproteinase Lys C digest of native and oxidized forms of the protein without extensive sample preparation or concentration. A third application demonstrates the identification of glycosylation sites in an endoproteinase Arg C digest of single-chain plasminogen activator through the use of in-source collisionally induced dissociation.

Chromatography, High Pressure Liquid↗
PubMed1995

Multicenter trial for long-term safety and efficacy comparison of 0.05% desonide and 1% hydrocortisone ointments in the treatment of atopic dermatitis in pediatric patients.

BACKGROUND: Desonide, a class 6 nonfluorinated topical corticosteroid, has been available for more than two decades. Hydrocortisone is widely used in the treatment of dermatoses in children. OBJECTIVE: Our purpose was to compare the safety and efficacy of desonide ointment and 1.0% hydrocortisone ointment in children with atopic dermatitis. METHODS: One hundred thirteen children (mean age, 4.8 years) with mild to moderate atopic dermatitis were enrolled in a multicenter, randomized, investigator-masked, parallel-group study. Treatments were applied twice daily for 5 weeks and extended to 6 months in 36 of the patients. Signs of atrophy were evaluated. Efficacy was determined by measuring global improvement, erythema, lichenification, excoriations, oozing or crusting, pruritus, and induration. RESULTS: No differences in safety were observed between hydrocortisone and desonide. The investigator's global assessment of improvement significantly favored desonide over hydrocortisone during 3 months of treatment (p < 0.05). CONCLUSION: Desonide ointment showed greater efficacy, produced more rapid improvement, and demonstrated an equivalent cutaneous safety profile when compared with 1% hydrocortisone ointment for up to 6 months.

Child↗
PubMed1995

Critical evaluation of clinical research.

This focused review contains a suggested core of material that will help residents or practicing physiatrists critically review research papers published in the medical literature. Before accepting the results of a clinical trial, physiatrists must critique the experimental methods and study design carefully to decide whether to include these new ideas into their clinical practice. Medical research relies on statistical methodology, and statistics pervade the medical literature. This article begins with an introduction to rudimentary statistics. Fortunately, most studies depend on a rather small body of statistical concepts. The elements of experimental design--clinical trials, randomization, single-subject design, meta-analysis, epidemiological studies--are presented in a concise review. Finally, the elements of statistics and experimental design are integrated into a step-by-step method strategy for reading the medical literature.

Epidemiologic Methods↗
PubMed1995

Audiological findings in a Phase I protocol investigating the effect of WR 2721, high-dose cisplatin and radiation therapy in patients with locally advanced cervical carcinoma.

WR 2721 (ethiofos) protects against the toxic effects of the heavy metal compound cisplatin, which is used in the treatment of solid tumours. In a Phase I protocol designed to determine the maximum dose of WR 2721 which could be tolerated when administered in combination with cisplatin and radiation therapy to patients with cervical carcinoma, 11 patients were evaluated by audiologic testing before and after cisplatin WR 2721 administration in an attempt to identify the degree of ototoxicity. Forty-five per cent were noted to have significant hearing threshold changes, predominantly in the high frequencies. There were no significant changes in the speech frequencies in this series. This contrasts with the greater degrees of ototoxicity observed in controls treated in the same way who received cisplatin without WR 2721 protection.

Amifostine↗
PubMed1995

Lack of efficacy of interferon-alpha therapy in recurrent, advanced cervical cancer.

Human papillomavirus (HPV) is associated with 65-95% of in situ or early invasive squamous cell carcinomas of the cervix. A multiinstitutional, prospective phase II clinical trial was initiated by the Eastern Cooperative Oncology Group (ECOG) to study the activity of IFN-alpha 2b in women with metastatic or locally recurrent cervix cancer. The activity of IFN-alpha 2b was correlated with the presence of HPV as measured by Southern blot hybridization or polymerase chain reaction techniques in 17 patients. All patients had failed prior definitive therapy with surgery, radiation, and chemotherapy. IFN-alpha 2b was administered at 10 MU/m2 subcutaneously three times per week. Among 31 patients enrolled, 3 achieved a clinical response to treatment. Tumor was accessible for biopsy in 17 patients. The presence of HPV was assayed by Southern blot hybridization (2 of 17) and/or polymerase chain reaction (PCR) technology (15 of 17). Of the 17 assays, 16 were informative. HPV was detected in 5 of 16 patients. Of 5 HPV-positive women, 2 responded to treatment, versus 1 of 11 HPV-negative women, thus not permitting reliable statistical analysis. It is concluded that IFN-alpha 2b has only minimal activity against advanced, recurrent cervical cancer.

Adult↗
PubMed1994

H reflex latency in the healthy elderly.

The purpose of this study was to evaluate prospectively and analyze the relationship of tibial nerve H reflex latency to age, sex, leg length, and skin temperature in a large healthy elderly population. The H reflex was recorded bilaterally in 92% of 103 carefully screened individuals aged 60-88 years. The mean H reflex latency was 30.8 (SD = 2.6) and 30.7 (SD = 2.6) ms for right and left legs, respectively. A high correlation (r = 0.55, P < 0.05) was present between H reflex latency and leg length. No significant correlation existed for H reflex latency and age. The upper normal limit for the difference between right and left H reflex latencies was 1.8 ms. This limit is greater than that reported in the literature for younger individuals due to a larger standard deviation. These findings suggest that aging increases the between-leg variability of H reflex latency in individuals. This greater difference must be taken into account when using side-to-side H reflex latency comparison to detect unilateral pathology in the elderly.

Aged↗
PubMed1994

Gender and arm length: influence on nerve conduction parameters in the upper limb.

Median, ulnar, and radial nerve conduction studies (NCS) were performed in 44 subjects. Student's t-test was used to compare nerve conduction velocities (NCV), distal latencies (DL), and distal amplitudes (DAMP) for the two sexes. Only the sensory DAMPs showed statistical significance (p < .001) for gender. Women had greater mean median (52.4 microV vs 31.4 microV), ulnar (52.9 microV vs 27.0 microV), and radial (46.1 microV vs 20.1 microV) sensory DAMPs. Stepwise linear regression analysis of NCVs, DLs, and DAMPs on gender and arm length showed statistical significance only for the median (R2 = .46, p < .001), ulnar (R2 = .59, p < .001), and radial sensory DAMPs (R2 = .29, p < .001) for gender. Arm length did not account for any additional variability. Gender showed an effect on the distal sensory DAMPs obtained by antidromic technique in this study. In contrast to the reported effect of leg length and height on lower limb studies, arm length did not affect upper limb studies.

Adult↗
PubMed1994

Standardized nerve conduction studies in the lower limb of the healthy elderly.

Nerve conduction studies are commonly performed in elderly individuals. No complete set of reference data for the distal lower limb nerves exists for this population, making it difficult to accurately interpret electrodiagnostic findings. The purpose of this study was to provide reliable reference data by comprehensively examining conduction characteristics in routinely tested peripheral nerves of the lower limb in a healthy elderly population. Conduction studies of the tibial, deep peroneal, sural and medial dorsal cutaneous nerves were performed in one lower limb of 122 healthy elderly individuals between the ages of 60 and 89 years. Peak amplitudes of the sural sensory action potential and the tibial compound muscle action potential correlated significantly with both age and leg length. All other parameters did not show significant correlation with age. Conduction velocities and distal latencies slowed significantly with increasing leg length except for tibial distal latency.

Aged↗
PubMed1994

A double-blind, placebo-controlled pilot study to evaluate the efficacy and safety of oral nalmefene HCl for alcohol dependence.

A dozen studies have been published showing that opiate antagonists suppress alcohol drinking in animals, and two independent placebo-controlled, double-blind clinical trials of naltrexone found this agent was associated with decreased alcohol craving and consumption in alcohol-dependent patients. Nalmefene is a newer opiate antagonist that has a number of potential advantages over naltrexone in the treatment of alcoholism, including no dose-dependent association with liver toxicity and more effective binding to central opiate receptors. Consequently, a double-blind pilot study was conducted to gather preliminary data on the safety and efficacy of nalmefene for reducing alcohol consumption in alcohol-dependent subjects. Twenty-one alcohol-dependent subjects meeting admission criteria were randomly assigned to 12 weeks of double-blind treatment with 40 mg nalmefene, 10 mg nalmefene, or placebo, resulting in 7 patients/treatment group. Nalmefene was well tolerated, with no serious adverse drug reactions. The 40 mg group had a significantly lower rate of relapse (p < or = 0.05), and a greater increase in the number of abstinent days/week (p < or = 0.09), than the other treatment groups. A significant decrease in the number of drinks/drinking day was noted for both nalmefene groups (p < or = 0.04), but not for placebo. These results were supported by parallel decreases in ALT. These pilot data provide preliminary support for the hypotheses that nalmefene can be safely given to alcoholics, and that nalmefene may have a role in reducing alcohol consumption and preventing relapse, particularly at the 40 mg level. A full-scale study is underway to confirm these preliminary findings.

Alcoholism↗
PubMed1993

Hemispatial factors in mirror writing.

The effect of the hemispace in which writing was performed was assessed in two left hemisphere stroke patients who demonstrated left-handed mirror writing. Both patients produced significantly more mirrored words when writing in right, as compared to left (body) hemispace. We suggest that writing in the right hemispace activates the left hemisphere. Further, we propose that mirror writing in the right hemispace is attributable to activation of the damaged left hemisphere spatial system, which fails to assist in the translation of right hand motor programs into those appropriate to the left hand. Writing in left hemispace, in contrast, activates the intact right hemisphere based spatial system which guides the execution or monitoring of motor productions in left hemispace. The result is writing which remains directionally correct when the left hand is used in left hemispace.

Agraphia↗
PubMed1993

Multi-modal hemispatial deficits after left hemisphere stroke. A disorder of attention?

We report a patient who, after suffering infarcts involving the left temporo-parietal and left anterior cingulate regions, performed significantly worse on a variety of motor, language and sensory tasks when he acted in or attended to right hemispace. Performance on a number of tasks was better when acting in near as compared with far peri-personal space and with his head deviated to the left as compared with the right. Additionally, performance with the 'unaffected' left hand was often worse in right as compared with left hemispace. We propose that his deficits are attributable to a disruption of a left hemisphere-specific attentional system which normally serves to regulate the activation and articulation of left hemisphere processing modules.

Adult↗