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Biomedical subjects

G Goodman

Publications and source records attributed to G Goodman.

At least 37 records · Page 2Linked to original sources

Factors associated with multiple hospitalizations of patients with borderline personality disorder.

OBJECTIVE: The study sought to identify aspects of borderline personality disorder and comorbid axis I conditions associated with multiple hospitalizations in a sample of patients with borderline personality disorder. METHODS: Data were collected as part of a larger study of treatment course of inpatients with this disorder. Predictors of multiple hospitalization from three domains were considered: demographic characteristics, criteria of borderline personality disorder, and comorbid axis I pathology. A sequential model-building strategy was used, with each domain considered separately and result combined into an overall regression model of factors related to multiple hospitalization. RESULTS: Three factors were related to frequency of hospitalization: anorexia, psychotic symptoms, and suicidality. Other variables that are often assumed to be related to hospitalization, such as depression, did not emerge as significant predictors. CONCLUSIONS: Clinicians should intervene early to address the emergence of certain axis I conditions among patients with borderline personality disorder. Increased expenditure of outpatient resources may prevent hospitalization when these conditions are present.

Adolescent↗

Polydactylous Bowen's disease of the nail bed.

A case is presented with tender swelling and nail bed hyperplasia in 2 fingers. Histopathology revealed Bowen's disease in both fingers and after amputation, invasive squamous cell carcinoma in one finger.

Amputation, Surgical↗

The beta-carotene and retinol efficacy trial (CARET) for chemoprevention of lung cancer in high risk populations: smokers and asbestos-exposed workers.

CARET is a multicenter, two-armed, double-masked randomized chemoprevention trial in Seattle, Portland, San Francisco, Baltimore, Connecticut, and Irvine, to test whether oral administration of beta-carotene (30 mg/day) plus retinyl palmitate (25,000 IU/day) can decrease the incidence of lung cancer in high risk populations, namely, heavy smokers and asbestos-exposed workers. The intervention combines the antioxidant action of beta-carotene and the tumor suppressor mechanism of vitamin A. As of April 30, 1993, CARET had randomized 1,845 participants in the 1985-1988 pilot phase plus 13,260 "efficacy" participants since 1989; of these, 4,000 are asbestos-exposed males and 11,105 are smokers and former smokers (44% female). Accrual is complete everywhere except Irvine, which was the last center added (1991), and the safety profile of the regimen to date has been excellent. With 14,420 smokers, 4,010 asbestos-exposed participants, and 114,100 person-years through February 1998, we expect CARET to be capable of detecting a 23% reduction in lung cancer incidence in the two populations combined and 27, 49, 32, and 35% reductions in the smokers, female smokers, male smokers, and asbestos-exposed subgroups, respectively. CARET is highly complementary to the alpha-tocopherol-beta-carotene study in Finland and the Harvard Physicians Health Study (beta-carotene alone) in the National Cancer Institute portfolio of major cancer chemoprevention trials.

Aged↗

Dermabrasion using tumescent anesthesia.

BACKGROUND: Dermabrasion is a very useful and versatile technique. However, it suffers from side effects and difficulties that limit its popularity among operating dermatologic surgeons and the public. OBJECTIVE: To show that it is possible to eliminate the need for chlorofluorocarbons, improve the standard dermabrasion technique, decrease the healing time, improve its side effect profile, and reduce risks to the operating surgeon. METHODS: Tumescent fluid containing dilute Xylocaine, bicarbonate, and epinephrine in saline was infiltrated before coarse wire brush dermabrasion. Eutectic mixture of local anesthetic (EMLA) was also used topically. The first 14 patients dermabraded by this method are reported on here. Their healing, progress, side effects, and results are described. A patient questionnaire was completed by 12 of the patients who describe the procedure and results from the patient's viewpoint. RESULTS: The procedure was found to be effective in producing anesthesia, eliminating the use of freezing the skin, and limiting the necessity for sedatives, narcotics, and other anesthesia. It gives a firm surface to dermabrade against, makes the procedure more rapid and technically easier, and produces less splatter and therefore less risk for the surgeon. The results subjectively and objectively would appear to be at least as good as standard techniques. The healing in this small sample would appear to be faster both to reepithelialization and to reestablishment of normal color. There was only one case of transient hyperpigmentation lasting less than 1 week. Otherwise there were no cases of pigmentary or scarring side effects. CONCLUSION: Tumescent dermabrasion is safe, effective, and has many benefits over traditional methods.

Acne Vulgaris↗

Mercury inhalation poisoning and acute lung injury in a child. Use of high-frequency oscillatory ventilation.

Acute mercury inhalation poisoning is a rare cause of acute lung injury. It is commonly fatal in the young child because of progressive pulmonary failure. We describe a 3-month-old infant who survived this insult with the use of high-frequency oscillatory ventilation. This form of support may be an option in the patient with severe adult respiratory distress syndrome (ARDS) or air leak syndromes.

High-Frequency Ventilation↗

Development of infant botulism in a 3-year-old female with neuroblastoma following autologous bone marrow transplantation: potential use of human botulism immune globulin.

Infant botulism is a rare disease caused by the release of toxin produced in the intestinal tract by Clostridium botulinum. The disease primarily affects infants under 1 year of age. We report a 3-year-old child with stage IV neuroblastoma who developed symptoms of progressive motor weakness, bulbar palsy and respiratory failure 42 days after autologous BMT. The diagnosis of infant botulism was established by identifying botulism toxin in the stool. Human botulism immune globulin (HBIG) was administered. Following the diagnosis, the patient made significant recovery over the next 7 weeks and was successfully extubated from mechanical ventilation. However, her neuroblastoma eventually recurred and she subsequently died of progressive disease. Although the etiology of the development of infant botulism in this case following autologous BMT still remains unclear, alteration of the intestinal microbial environment from gut sterilization and laminar airflow room isolation or, alternatively, immune suppression during pre- and post-autologous BMT and activation of endogenous spores may have contributed to the development of this disease. The use of HBIG in children with botulism over 1 year of age may be beneficial.

Bone Marrow Transplantation↗