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J Greenberg

Publications and source records attributed to J Greenberg.

At least 73 records · Page 4Linked to original sources
PubMed1997

Effectiveness and economic impact of antidepressant medications: a review.

This article reviews the existing literature on the pharmacoeconomics and effectiveness of antidepressant medications. Although selective serotonin reuptake inhibitors (SSRIs) have not proved to be more efficacious than the older tricyclics, and their prescription costs are significantly higher, they provide superior effectiveness; ie, patients are less likely to discontinue taking them or switch antidepressants. Pharmacoeconomic studies consistently demonstrate a relationship between this superior effectiveness and reductions in overall treatment costs, often through decreased utilization of medical and hospital services. The most conservative study found a cost offset that more than negated the extra cost of drugs, although the cost savings were not statistically significant. Other studies found statistically significant lowering of utilization costs by using SSRIs rather than tricyclics. Studies comparing SSRIs with each other present conflicting findings, although fluoxetine appears to have an edge over sertraline and paroxetine with regards to effectiveness and pharmacoeconomics. More studies employing a prospective outcome design and naturalistic study setting need to be conducted with SSRIs and other new antidepressants.

Antidepressive Agents, Second-Generation↗
PubMed1996

Mapping of the gene for cleidocranial dysplasia in the historical Cape Town (Arnold) kindred and evidence for locus homogeneity.

Cleidocranial dysplasia (CCD) is an autosomal dominant disorder, features of which include a patient anterior fontanelle, a bulging calvarium, hypoplasia or aplasia of the clavicles, a wide public symphysis, dental anomalies, vertebral malformation, and short stature. The Cape Town kindred which is under our genetic management was originally described more than four decades ago and now consists of more than 1000 people. Following reports of rearrangements on chromosomes 6 and 8 in people with CCD, we have carried out linkage analyses between highly information microsatellite dinucleotide repeat markers in the rearranged regions and the disorder in a branch of this South African CCD kindred, consisting of 38 subjects, 18 of whom are affected. Maximum lod scores (at theta = 0.00) of 7.14 (for marker D6S459), 4.32 (TCTE), 4.99 (D6S452), 5.97 (D6S269), and 3.95 (D6S465) confirm linkage of the disorder to the short arm of chromosome 6. Our data indicate that the CCD gene is located within a minimal region of approximately 10 cM flanked by the marker D6S451 distally and D6S466 proximally. This information is vital towards isolating and characterising the gene for CCD, and is being used to construct a physical map of 6p21.1-6p21.3. More importantly, mapping of the locus in the South African kindred of mixed ancestry, in which the "founder" of the disorder was of Chinese origin, suggests that a single locus is responsible for classic CCD.

Child↗
PubMed1996

A classic revisited: Loewald on the therapeutic action of psychoanalysis.

Versions of the following papers were presented at the panel "Psychoanalytic Classics Revisited: Hans Loewald's "On the Therapeutic Action of Psychoanalysis' " (Gerald I. Fogel, chair) at the meetings of the American Psychoanalytic Association, December 1993. As a tribute to Loewald's lifetime of achievement, and in belated recognition of his preeminent position in the field of psychoanalysis, the exchange appears here almost in its entirety, rather than as a conventional panel report.

History, 20th Century↗
PubMed1996

Use of positron emission tomography and evoked potentials in the detection of cortical afferents from the gastrointestinal tract.

OBJECTIVE: Positron emission tomography permits precision identification of the cerebral regions involved in physiologic functions. As the cerebral localization for visceral sensation has not been identified, our aim was to examine the cerebral viscerotopic representation for rectal sensation. METHODS: Cerebral-evoked potentials were measured in five healthy volunteers who underwent rectal balloon distension. Simultaneously, cerebral blood flow was measured using positron emission tomography with 15H2O. RESULTS: A cerebral-evoked potential occurred with rectal balloon distension. An increase in cerebral blood flow was noted in the pre- and postcentral gyrus and the thalamus. CONCLUSION: The techniques for measuring cerebral-evoked potentials and cortical blood flow are useful in the delineation of the cerebral regions subserving visceral sensation.

Brain↗
PubMed1995

An eighth locus for autosomal dominant retinitis pigmentosa is linked to chromosome 17q.

Retinitis pigmentosa is one of the most common causes of severe visual handicap in middle to late life. Prior to this report, seven loci had previously been mapped for the autosomal dominant form of this disorder (adRP). We now report the identification of a novel adRP locus on chromosome 17q. To map the new locus, we performed linkage analysis with microsatellite markers in a large South African kindred. After exclusion of 13 RP candidate gene loci (including rhodopsin and peripherin-RDS), we obtained significant positive lod scores at zero recombination fraction (theta = 0) for D17S808 (Z = 4.63) and D17S807 (Z = 5.69). Multipoint analysis gave a maximum lod score of 8.28 between these two markers. From haplotype analysis, the disease locus lies in the interval between markers D17S809 and D17S942. Three candidate genes for retinal dystrophies map to this chromosomal region and these genes are currently being investigated for possible involvement with adRP in this family.

Adult↗
PubMed1995

Evaluation of the Alcopatch, a transdermal dosimeter for monitoring alcohol consumption.

BACKGROUND: The Alcopatch is an improved transdermal dosimeter for the measurement of alcohol consumption, by detection of ethanol in fluid excreted from the skin. The device is worn as a band around the ankle and provides a visual signal in the event of tampering. METHODS: Fourteen volunteers wore duplicate Alcopatches for a period of 7 or 8 days, while keeping a written record of their beverage alcohol consumption. Ethanol concentration in the Alcopatch was measured by gas chromatography and correlated with self-reported consumption. RESULTS: All alcohol consumption in excess of 0.25 g/kg/day resulted in measurable levels of ethanol in the Alcopatch. A positive correlation was observed between the reported consumption of ethanol (in g/kg/day) and the concentration of ethanol in the Alcopatch (square root, in mg/dl) (y = 0.91x + 0.28, r = 0.61) in 12 of 14 subjects. CONCLUSIONS: The Alcopatch detected the consumption of beverage alcohol with high sensitivity and specificity over a period of 7 to 8 days and may be useful for the study of target populations.

Adult↗
PubMed1995

Volatile organic compounds in the breath of patients with schizophrenia.

AIMS: To analyse the breath of patients with schizophrenia for the presence of abnormal volatile organic compounds. METHODS: A case comparison study was performed in two community hospitals in Staten Island, New York. Twenty five patients with schizophrenia, 26 patients with other psychiatric disorders, and 38 normal controls were studied. Alveolar breath samples were collected from all participants, and volatile organic compounds in the breath were assayed by gas chromatography with mass spectroscopy. Differences in the distribution of volatile organic compounds between the three groups were compared by computerised pattern recognition analysis. RESULTS: Forty eight different volatile organic compounds were observed in the breath samples. Three separate pattern recognition methods indicated an increased differentiation capability between the patients with schizophrenia and the other subjects. Pattern recognition category classification models using 11 of these volatile organic compounds identified the patients with schizophrenia with a sensitivity of 80.0% and a specificity of 61.9%. Volatile organic compounds in breath were not significantly affected by drug therapy, age, sex, smoking, diet, or race. CONCLUSIONS: Microanalysis of volatile organic compounds in breath combined with pattern recognition analysis of data may provide a new approach to the diagnosis and understanding of schizophrenia. The physiological basis of these findings is still speculative.

Breath Tests↗
PubMed1995

Psychoanalytic technique and the interactive matrix.

In this paper the concept of an "interactive matrix" is introduced. The interactive matrix is shaped, from moment to moment in every treatment, by the personal characteristics of the analysand and of the analyst. These include the beliefs, commitments, hopes, fears, needs, and wishes of both participants. It is only within the context of the interactive matrix that the events of an analysis acquire their meaning. The implications of this perspective for analytic technique are explored and illustrated with a clinical example.

Female↗
PubMed1995

Sorsby's fundus dystrophy. A South African family with a point mutation on the tissue inhibitor of metalloproteinases-3 gene on chromosome 22.

PURPOSE: The authors studied the variable expressivity of the phenotype and molecular genetics of a South African family with the fundus appearance of Sorsby's fundus dystrophy. METHODS: Seventeen members of a single family underwent examination. Five of these were affected. Clinical details of five other affected family members were obtained from their ophthalmologists. Patients were questioned about age of onset, history of night blindness, and color defects. Examination included fundoscopy, color testing, color photographs, and fluorescein angiography. Blood for molecular genetic analysis was taken from 23 family members. RESULTS: The age of onset of symptoms was 29 to 56 years, and the rate of progression was variable. Sudden decreased vision was associated with subretinal choroidal neovascularization. Slower visual decline was associated with central chorioretinal atrophy. Progressive retinal pigment epithelial atrophy and peripheral pigment clumping occurred in elderly relatives who lost ambulatory vision. DNA studies show linkage to the long arm of chromosome 22 and a point mutation in the tissue inhibitor of metalloproteinases-3 gene. CONCLUSION: This South African family presents with a dominantly inherited fundus dystrophy with clinical and molecular features compatible with Sorsby's fundus dystrophy.

Adult↗
PubMed1994

The type I macrophage scavenger receptor binds to gram-positive bacteria and recognizes lipoteichoic acid.

Macrophage scavenger receptors exhibit unusually broad binding specificity for polyanionic ligands and have been implicated in atherosclerosis and various host defense functions. Using a radiolabeled, secreted form of the type I bovine macrophage scavenger receptor in an in vitro binding assay, we have found that this receptor binds to intact Gram-positive bacteria, including Streptococcus pyogenes, Streptococcus agalactiae, Staphylococcus aureus, Enterococcus hirae, and Listeria monocytogenes. Competition binding studies using purified lipoteichoic acid, an anionic polymer expressed on the surface of most Gram-positive bacteria, show that lipoteichoic acids are scavenger receptor ligands and probably mediate binding of the receptor to Gram-positive bacteria. Lipoteichoic acids, for which no host cell receptors have previously been identified, are implicated in the pathogenesis of septic shock due to Gram-positive bacteria. Scavenger receptors may participate in host defense by clearing lipoteichoic acid and/or intact bacteria from tissues and the circulation during Gram-positive sepsis. Since scavenger receptors have been previously shown to bind to and facilitate bloodstream clearance of Gram-negative bacterial endotoxin (lipopolysaccharide), these receptors may provide a general mechanism for macrophage recognition and internalization of pathogens and their cell surface components.

Animals↗
PubMed1994

Desmethylimipramine, a potent inhibitor of synaptosomal norepinephrine uptake, has diverse effects on thyroid hormone processing in rat brain. II. Effect on in vivo 5'-deiodination of [125I]thyroxine.

We have studied the effects of desmethylimipramine (DMI), a tricyclic antidepressant, on thyroid hormone (TH) handling in rat brain in an effort to discover a pharmacological basis for reported interactions between TH, affective disorders and psychotropic drugs. An acute dose of DMI has been used in order to determine the primary effects of the drug in brain without perturbations from secondary effects. Recently we have reported that a single dose of DMI significantly decreases brain uptake of both [125I]thyroxine (T4) and [125I]3,3',5-triiodothyronine (T3) across the spectrum of thyroid states from hypothyroid (HYPO) to euthyroid (EU) to T4-induced hyperthyroid (HYPER). To investigate further the effects of DMI on brain processing of TH, we have measured effects of the drug on in vivo rates of T4 to T3 conversion in a series of experiments in which DMI (25 mg/kg) was given to HYPO, EU and HYPER male rats in conjunction with i.v. [125I]T4. Decreased in vivo conversion ratios (T3/T4 ratios) suggest that acute DMI treatment causes a significant decrease in 5'-deiodinase activity in balance of brain (but not cerebellum) in all DMI treated rats as compared to their saline treated controls (ANOVA, P < 0.0001). For assurance that reduced T3/T4 in DMI treated rat brain is not the result of DMI enhancement of 5-deiodination of T3 or T4, the effect of DMI on concentrations of labeled I-, rT3, and T2 (3,3'- and 3',5'-) was also observed. In no case was there a significant increase in any metabolite in DMI treated rats for any tissue studied.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1994

Role of consciousness and accessibility of death-related thoughts in mortality salience effects.

On the basis of terror management theory, research has shown that subtle mortality salience inductions engender increased prejudice, nationalism, and intergroup bias. Study 1 replicated this effect (increased preference for a pro-U.S. author over an anti-U.S. author) and found weaker effects when Ss are led to think more deeply about mortality or about the death of a loved one. Study 2 showed that this effect is not produced by thoughts of non-death-related aversive events. Studies 2 and 3 demonstrated that this effect occurs only if Ss are distracted from mortality salience before assessment of its effects. Study 4 revealed that although the accessibility of death-related thoughts does not increase immediately after mortality salience, it does increase after Ss are distracted from mortality salience. These findings suggest that mortality salience effects are unique to thoughts of death and occur primarily when such thoughts are highly accessible but outside of consciousness.

Affect↗