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Biomedical subjects

J Fine

Publications and source records attributed to J Fine.

At least 37 records · Page 2Linked to original sources
PubMed1993

Evaluation and acute management of psychotic symptomatology in alcohol and drug addictions.

The practical clinical evaluation of patients manifesting psychotic symptomatology and addictive illness is approached in diverse and contradictory ways. While addiction specialists may not recognize the existence of Axis I disorders that prevent the utilization of treatment in the system, trained mental health professionals are traditionally prone to deny or minimize the addictive process and its capacity to produce psychiatric symptoms. This may result in premature diagnosis, and in a poor response to psychiatric treatment. The purpose of this paper is to describe a pragmatic model, based on clinically observable conditions, for the evaluation and acute management of major psychiatric symptomatology associated with diagnosed drug and alcohol addiction. Before describing the model, psychotic illness and symptoms in the general population versus the drug and alcohol addicted will be examined. The model will be applied to a few discrete syndromes based on common clinical presentations.

Female↗
PubMed1993

Current epidemiology of comorbidity of psychiatric and addictive disorders.

Some major epidemiologic studies have assumed that treatment of the psychiatric symptoms will result in a lowered morbidity and mortality from the addictive disorders or, more specifically, that the addictive disorders are dependent on the psychiatric disorders and etiologically linked to them as an effect or secondary consequence. There is little systematic evidence beyond anecdotal and intuitive supposition to support this popular and only hypothetic position. The consequence is that to insist on the priority of the psychiatric disorder in diagnosis and treatment is to perpetuate artifactual prevalence rates for psychiatric comorbidity in addictive disorders, and to preclude the definitive treatment to reduce the psychiatric morbidity and mortality caused by addictive disorders.

Comorbidity↗
PubMed1992

Histologic evaluation of pigmented lesions in Connecticut and its influence on the reporting of melanoma.

BACKGROUND: Underreporting of melanoma to state tumor registries has been identified as a problem in gathering accurate statistics on melanoma incidence. OBJECTIVE: Our purpose was to examine two factors that could influence the reporting of melanoma to the Connecticut Tumor Registry: histologic diagnosis of melanoma in the private offices of dermatologists and histologic diagnosis of melanoma in out-of-state laboratories. METHODS: From December 1990 to April 1991, questionnaires were sent to all known practicing dermatologists in the state of Connecticut (N = 149). Of the 127 dermatologists who were eligible, 124 (97.6%) completed the survey. RESULTS: The estimated number of melanomas diagnosed in private offices during 1990 was 9 to 18; this was based on the number of dermatologists who officially read their own slides (n = 19), the estimated number of melanomas diagnosed by these 19 dermatologists (n = 91), and the percentage of melanomas and uncertain pigmented lesion cases sent for consultation (80% to 90%). According to the estimates of Connecticut dermatologists, out-of-state laboratories diagnosed 84 of 523 melanomas (16%) in Connecticut residents. CONCLUSION: The diagnosis of melanoma in private offices did not appear to be a significant factor in underreporting whereas the diagnosis of melanoma in out-of-state laboratories did appear to be more significant. However, the possibility exists that some of these latter melanomas would eventually be reported at the time of reexcision.

Biopsy↗
PubMed1992

An analysis of interobserver recognition of the histopathologic features of dysplastic nevi from a mixed group of nevomelanocytic lesions.

BACKGROUND: The diagnostic criteria for the histopathologic recognition of the dysplastic nevus are defined, but difficult to apply in practice. However, the use of skin biopsy is on the increase to search for this nevus because of a possible role in melanomagenesis. OBJECTIVE: The aim was to determine the degree of observer reproducibility in the detection of histologic nevomelanocytic dysplasia as measured across multiple observers and to test whether each observer was precise over a wide sample population. A second aim was to gain some measure of the threshold a person has for such lesions. METHODS: Histologic specimens from 50 coded nevomelanocytic tumors, which included a group of dysplastic nevi, were independently read by five observers in a blinded fashion. At study completion, the same 50 cases were read again by a melanoma reference pathologist and results analyzed by Cohen's kappa to assess agreement and interobserver variation. RESULTS: Corrected rates of agreement for dysplastic nevi ranged from 0.32 to 0.71. CONCLUSION: Continued study and experience are required for precision and reproducibility in the histologic recognition of dysplastic nevi.

Dysplastic Nevus Syndrome↗
PubMed1992

Safe sex behavior in drug-addicted males as a function of object relations.

An inventory of sexual behavior was administered in a hospital detoxification program to 127 drug-addicted males, who also completed a modified form of the Defense Mechanisms Inventory (DMI) which yields a measure of object relations. Condom use was shown to be related to an object relations mode that typifies the individual who can structure reality and needs without requiring an integral aspect of "the other" in his approach. Standardization and factor analytic data are also presented for the DMI and the object relations measure for this population. The resulting pattern and the small effect size are discussed within the reality constraints of the addicted patient, as well as within the psychometric parameters inherent in psychoanalytic research.

Adult↗
PubMed1991

The use of intonation to communicate in pervasive developmental disorders.

The objective of this paper was to employ a functional linguistic approach to explore pragmatic failure in the spontaneous speech of subjects with pervasive developmental disorders (PDD). Patterns of intonation use were compared among subjects with Asperger's syndrome (AS), high-functioning autism (HFA), and psychiatric out-patient controls (OPC) with a variety of non-specific social problems. Written transcripts and audio-recordings were used to measure rates of various intonation types relative to the amount of speech produced. The major finding of the study was that the HFA subjects less often tend to employ useful patterns of intonation for communication than the AS or OPC groups. This suggests that HFA either send random intonation signals to hearers or else demonstrate systematic misuse of the linguistic system. AS subjects differed little from the controls. The implications of these results for understanding the communicative failure of PDD subjects is discussed.

Adolescent↗
PubMed1991

Airway oedema and obstruction in guinea pigs exposed to inhaled endotoxin.

Protein extravasation and airway conductance (SGaw) were examined in awake guinea pigs exposed to inhaled endotoxin or saline for three hours. A significant increase in protein extravasation (as estimated by the leakage of protein bound Evans blue dye) was seen in the conducting airways of endotoxin exposed animals compared with saline exposed animals. Mean dye extravasation was significantly increased by one to threefold in the mainstem and hilar bronchi of endotoxin exposed animals. These changes in extravasation were accompanied by decrements in pulmonary function and by an influx of polymorphonuclear leucocytes into the airway wall. The SGaw decreased significantly by 60-90 minutes into exposure to endotoxin and had decreased by 22% and 34% at the end of exposure in the low and high dose endotoxin groups, respectively. Similar findings were obtained in animals exposed to cotton dust. Contrary to studies suggesting that platelet activating factor (PAF) is involved in the systemic and peripheral lung effects of endotoxin, pretreatment with the PAF antagonist WEB2086 did not prevent the conducting airway injury produced by inhaled endotoxin.

Aerosols↗
PubMed1990

The relationship of prostaglandins to cAMP, IgG, IgM and alpha-2-macroglobulin in gingival crevicular fluid in chronic adult periodontitis.

Gingival crevicular fluid, collected from 8 patients with chronic adult periodontitis before and 21 days after root planing and scaling, was analysed for prostaglandin E2, 6KPGF1 alpha, cAMP, IgG, IgM and alpha-2-macroglobulin, and their inter-relationship evaluated. There was a significant decrease in the levels of prostaglandin E2, IgG, IgM and alpha-2-macroglobulin after treatment, whereas the levels of 6KPGF1 alpha and cAMP remained essentially unchanged. The level of prostaglandin E2 decreased by 35%, IgG by 32%, IgM by 90%, and alpha-2-macroglobulin by 79%. There was a significant degree of correlation between prostaglandin E2 and 6KPGF1 alpha and cAMP before treatment but not after, but no correlation between prostaglandin E2 and IgG, IgM and alpha-2-macroglobulin either before or after. This correlation pattern indicates the involvement of E2, prostaglandin 6KPGF1 alpha and cAMP in inflammation in the periodontium. The changes in IgG, IgM and alpha-2-macroglobulin reflect yet another mechanism of host response which appears to be independent of prostaglandins.

6-Ketoprostaglandin F1 alpha↗
PubMed1990

AIDS-related risk behaviors among substance abusers.

Ninety-two substance abusers were surveyed about AIDS-related risk behaviors. The questionnaire administered elicited information on demographics, sexual practices, substance abuse, and risk behaviors involving the use of needles. Results indicated an appropriate base of prevention knowledge and patients' efforts to modify vulnerability to HIV exposure. Nevertheless, patients continue to engage in behaviors resulting in HIV exposure and transmission.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Extracellular nucleotides stimulate receptor-mediated calcium mobilization and inositol phosphate production in human fibroblasts.

In human skin fibroblasts, low concentrations of extracellular ATP stimulated 45Ca2+ efflux from a slow-turnover intracellular pool, accompanied by inositol phosphate generation. These effects of ATP were not due to a generalized increase in plasma-membrane permeability. The EC50 (concn. giving 50% stimulation) for ATP was dependent on Ca2+ and Mg2+ concentrations in a manner which indicates that a form of ATP uncomplexed with bivalent cations is the active species. The rank order of potency of nucleotides was: ATP = UTP greater than adenosine 5'-[gamma-thio]triphosphate greater than ITP greater than ADP greater than UDP greater than other nucleoside triphosphates. Adenosine 5'-[alpha beta-methylene]triphosphate, adenosine 5'-[beta gamma-methylene]triphosphate and 2-methylthio-ATP were inactive. Thus the nucleotide specificity of this receptor is different from that of previously characterized P2 purinoceptors. Nucleotide-stimulated 45Ca2+ mobilization and inositol phosphate production were markedly inhibited by phorbol ester, and partially inhibited by pertussis-toxin pretreatment. These findings suggest that the coupling of nucleotide receptor to phospholipase C is mediated both by a pertussis-toxin-sensitive G-protein and by a pertussis-toxin-insensitive mechanism.

Adenosine Triphosphate↗
PubMed1989

Tear gas--harassing agent or toxic chemical weapon?

Tear gas has gained widespread acceptance as a means of controlling civilian crowds and subduing barricaded criminals. The most widely used forms of tear gas have been o-chlorobenzylidenemalononitrile and omega-chloroacetophenone. Proponents of their use claim that, if used correctly, the noxious effects of exposure are transient and of no long-term consequences. The use of tear gas in recent situations of civil unrest, however, demonstrates that exposure to the weapon is difficult to control and indiscriminate, and the weapon is often not used correctly. Severe traumatic injury from exploding tear gas bombs as well as lethal toxic injury have been documented. Moreover, available toxicological data are deficient as to the potential of tear gas agents to cause long-term pulmonary, carcinogenic, and reproductive effects. Published and recent unpublished in vitro tests have shown o-chlorobenzylidenemalononitrile to be both clastogenic and mutagenic. Sadly, the nature of its use renders analytic epidemiologic investigation of exposed persons difficult. In 1969, eighty countries voted to include tear gas agents among chemical weapons banned under the Geneva Protocol. There is an ongoing need for investigation into the full toxicological potential of tear gas chemicals and renewed debate on whether their use can be condoned under any circumstances.

Adult↗
PubMed1989

Extracellular adenosine triphosphate activates phospholipase C and mobilizes intracellular calcium in primary cultures of sheep anterior pituitary cells.

In primary cultures of sheep anterior pituitary cells extracellular ATP (ED50 0.4-0.8 microM) stimulated efflux of 45Ca2+ from a slow-turnover intracellular pool. ADP was also effective whereas AMP and adenosine were not. The ATP effect was not due to cell permeabilization as 100 microM ATP did not elicit efflux of 2-deoxy[3H]glucose metabolites. This 45Ca2+ mobilization may be mediated by inositol trisphosphate, since ATP (ED50 1 microM) stimulated inositol phosphate generation. These results demonstrate P2-purinoceptors in sheep anterior pituitary cells which are coupled to phospholipase C activation and intracellular Ca2+ mobilization, and raise the possibility of a regulatory role for extracellular ATP in the anterior pituitary.

Adenosine Triphosphate↗