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Biomedical subjects

H Feldman

Publications and source records attributed to H Feldman.

At least 109 records · Page 6Linked to original sources
PubMed1971

A trial of deglycyrrhizinated liquorice in the treatment of duodenal ulcer.

A double-blind trial of deglycyrrhizinated liquorice was performed in 47 patients with active duodenal ulcer. Twenty-four patients received a placebo and 23 the trial medication (Caved-S) for one month. Both groups were clinically similar. No advantage of deglycyrrhizinated liquorice over placebo was found.

Adolescent↗
PubMedDate not supplied

Tobacco use measurement, prediction, and intervention in elementary schools in four states: the CATCH Study.

BACKGROUND: The Child and Adolescent Trial for Cardiovascular Health (CATCH) is a multistate field trial examining the effects of school environment, classroom curricula, and family intervention components in promoting the cardiovascular health of elementary school students. The purpose of this paper is to describe the CATCH tobacco use intervention and measurement, including the adoption of tobacco-free school policies. METHODS: In this study, changes in school tobacco use policies and smoking experimentation among students were assessed. Smoking experimentation was measured in all CATCH schools when the students were in their fifth-grade year. A total of 6,527 subjects in 96 schools in California, Louisiana, Minnesota, and Texas answered questions about behaviors and potential correlates of smoking as part of the CATCH health behavior questionnaire in Spring 1994. School tobacco use policy, an important complement to classroom- and home-based prevention efforts, was promoted as part of the CATCH intervention. The degree to which such policy was implemented was measured using surveys of school officials. RESULTS: At the end of fifth grade, only 4.8% of the subjects indicated that they had experimented with tobacco. School intervention condition was not a factor in the prediction of experimentation. Those whose best friend or sibling smoked, or who had ready access to cigarettes in the home, were more likely to have experimented with smoking. In the 3 years of the study, the percentages of tobacco-free schools went up from 49.7 to 76.8%. Though differences in the rate of policy adoption could not be directly attributed to the CATCH intervention, the implementation of the tobacco-free schools' policies did vary substantially from state to state. Minnesota and Texas, with stronger state laws supporting local policy, had nearly completely smoke-free schools. In spite of a statewide tobacco control initiative, California was slower to implement school policies. Louisiana, which allows local decision making regarding smoking policy, had the most difficulty establishing a policy for all districts. CONCLUSION: Future studies should examine the impact of parallel policy interventions that are ongoing at both school and state levels. Tobacco-free policies appear to be a crucial part of school-based interventions and must be tailored to political and regional factors affecting a given school district.

Adolescent↗
PubMedDate not supplied

The disability assessment for dementia scale: a 12-month study of functional ability in mild to moderate severity Alzheimer disease.

The Disability Assessment for Dementia (DAD) scale was developed and validated as a measure of functional ability in dementia. DAD results have been reported in Alzheimer disease (AD) randomized, controlled treatment trials of up to 6 months, but results beyond 6 months have yet to be described. SAB INT 12 was a randomized, double-blind, placebo-controlled, parallel-group study in mild to moderate AD that included DAD assessments at baseline, month 6, and month 12. One hundred forty-four patients with AD in the placebo arm of SAB INT 12 were followed up for 12 months. DAD scores were obtained at baseline (mean DAD = 70.1, SD = 22.2), 6 months (mean DAD = 63.7, SD = 25.2), and 12 months (mean DAD = 59.3, SD = 28.9). The rate of decline was consistent across the domains of basic activities of daily living (ADLs) and instrumental ADLs, as well as the scoring of initiation, planning, and organization. The decline in DAD total scores in mild to moderate AD averages about one point per month, which equates to the loss of one item on the DAD scale every 2 months.

Activities of Daily Living↗
PubMedDate not supplied

A Canadian cohort study of cognitive impairment and related dementias (ACCORD): study methods and baseline results.

The overall objective of the Canadian Collaborative Cohort of Related Dementias (ACCORD) study is to describe the diagnostic distribution, natural history and treatment outcomes of individuals referred from the community to dementia clinics in Canada. Between 1997 and 1999, an inception cohort of 1,136 subjects entered into this longitudinal study. At the baseline assessment, 10.9% of the subjects were classified as "not cognitively impaired" (NCI), 30.1% as "cognitively impaired not demented" (CIND), and 59% as demented. A subclassification of CIND included amnestic 25.1%, vascular cognitive impairment 18.1%, psychiatric 17.2%, neurologic 7.3%, medical/toxic metabolic 3.5%, mixed 7.6% and not specified 19.0%. The percentage of the cohort referred with dementia increased progressively each decade, while the proportions of CIND and NCI decreased. Within the dementia group, Alzheimer's disease accounted for 47.2% of the subjects, mixed dementias 33.7%, vascular dementia 8.7%, frontotemporal degenerations 5.4%, dementia with Lewy bodies 2.5%, and unclassifiable 1.8%. The ACCORD cohort will allow a detailed study of the longitudinal course of CIND, and the longer-term outcomes of both treated and untreated dementia subjects.

Adult↗
PubMedDate not supplied

Outcome measures for the study of activities of daily living in vascular dementia.

Decline in functional abilities is a major component of the dementia syndrome. The definition of dementia in the International Classification of Diseases (10th rev.) requires a cognitive impairment sufficient to impair personal activities of daily living (ADL). The Diagnostic and Statistical Manual of Mental Disorders (4th ed.) also requires cognitive deficits sufficiently severe to cause impairment in occupational or social functioning and must represent a decline from a higher level of functioning. However, the term disability is more appropriate than impairment to describe a loss in activities, as opposed to a loss of elementary functions, and is consistent with World Health Organization definitions of impairment, disability, and handicap. There is no doubt that ADL outcomes are required in therapeutic drug studies on vascular dementia, and there is a good rationale and some evidence for the use of ADL scales developed for therapeutic research in Alzheimer disease, favoring scales devoid of items sensitive to physical disabilities. Similarly, ADL-related clinical milestones could be used for longer-term studies aiming predominantly at slowing progression of disease in both early and later stages of dementia. Slower decline in ADL and delay in reaching ADL-related clinical milestones should be considered as valid outcomes by regulatory bodies in the process of dementia drug approval.

Activities of Daily Living↗
PubMedDate not supplied

[Results of the international hemodialysis study DOPPS in Spain and Europe].

The Dialysis Outcomes and Practice Pattern Study (DOPPS) is an international observational study of treatment conditions and medical outcomes in hemodialysis patients. Prospective sampling has yielded long-term observational data from randomly selected groups of patients receiving treatment at representative, randomly selected hemodialysis units in each country. The data shown were collected at 20 hemodialysis units/centers in Spain. The data pertaining to Spain--Sp--refers to 575 patients and their comparison with those of the Euro-DOPPS countries--Eu--(Germany, France, United Kingdom, Italy and Spain), which encompass 3,038 patients, represent the formal goal of this paper. Diabetes mellitus, at 21.5% in Eu and 21.7% in Sp, was the most common cause of renal insufficiency in dialysis and coronariopathy, as a concomitant disease, was present in 67.8% in Eu as opposed to 75.8% in Sp. Differences were observed in the incident of hypertension (73.4% in Eu vs 77.4% in Sp), hepatitis C (11.6% vs 19.5%), depression (12.7 vs 16.2%) and left ventricular hypertrophy (54.9% vs 62.3%). The patterns of vascular access were similar (79% vs 81% AV fistulas in Eu and Sp, and 10% synthetic grafts for both) and the mean applied dose of dialysis--Kt/V--smaller (1.19) in Sp than in Eu (1.24); likewise the duration of the dialysis (in minutes) was shorter (234 in Eu vs 217 in Sp) and the % of synthetic membranes used was smaller (60% in Eu vs 52% in Sp). There were no differences between the groups in the figures for urea, creatinine, albumin, nPCR, calcium, phosphate or PTH. There were also no differences in the mean values of Hb (10.7 for Eu vs 10.8 for Sp), given that the values of ferritin were noticeably lower in Sp (288 vs 355) and the dose of EPO/kg/week was higher to in Sp (115 vs 102); s.c. route was used in similar proportions (69% in Eu vs 67% in Sp). The level of medical care, understood as contact with the physician at all or almost all treatments, was noticeably better in Sp (90%) that in Eu (66%), whereas the number of patients per hour of specialized personnel and % of specialized staff, were smaller. Mortality (death/100 patients-years) was one point lower in Sp than in Eu (15.4 vs 16.3). These data suggest that an increment in dialysis time and in the percentage of synthetic membranes used, as well as in the supply of intravenous iron, would be justified.

Comorbidity↗
PubMedDate not supplied

Neurofilament inclusion body disease with early onset frontotemporal dementia and primary lateral sclerosis.

A small number of patients have recently been described with a sporadic neurodegenerative disease, associated with the neuropathological finding of neurofilament-immunoreactive neuronal inclusions. The clinical and pathological spectrum of this new disease entity has yet to be fully defined. We describe an additional case of "neurofilament inclusion body disease" (NIBD) with several unusual features. This young woman, who suffered from rapidly progressive frontotemporal dementia (FTD) and features of primary lateral sclerosis (PLS), died at age 29. Neuropathological examination disclosed numerous neuronal cytoplasmic inclusions in many regions of the central nervous system. The inclusions varied in morphology with some being immunoreactive for ubiquitin while others showed strong positivity for neurofilament proteins. Intranuclear neuronal inclusions were also present. There was no significant tau or alpha-synuclein pathology. There was severe degeneration of the corticospinal tracts but lower motor neurons were normal in number and morphology. This case confirms that NIBD should be considered in the differential diagnosis of FTD, particularly in young patients. In addition, it extends the clinical phenotype of NIBD to include PLS and better defines the anatomical distribution and morphology of the pathological lesions.

Adult↗