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Biomedical subjects

J Gutman

Publications and source records attributed to J Gutman.

At least 19 recordsLinked to original sources

Autistic subjects with comorbid epilepsy: a possible association with viral infections.

This study evaluates the comorbidity of epilepsy as a variable supporting a viral hypothesis in Autism. Data covering a 30-year period (1960-1989), including general population live births, autistic births, and incidence of viral encephalitis and viral meningitis, were collected for Israel. 290 autistic births were evaluated. The annual birth pattern of subjects with comorbid epilepsy fit the seasonality of viral meningitis. These findings support the role of viral C.N.S. infections in the causality of this disorder.

Adolescent↗

Results of complete soft tissue clubfoot release combined with calcaneocuboid fusion in the 4-year to 8-year age group following failed clubfoot release.

A subset of postoperative recurrent clubfeet was isolated in a group of patients 4 to 8 years old. Twenty-seven consecutive patients who underwent redo surgery consisting of complete soft tissue clubfoot release combined with a calcaneocuboid fusion were reviewed for this study. Twenty-six feet of 27 feet in 20 patients had a long-term good result, suggesting that this procedure is the one of choice for this age group.

Algorithms↗

c-Myc target gene specificity is determined by a post-DNAbinding mechanism.

Uncertainty as to which member of a family of DNA-binding transcription factors regulates a specific promoter in intact cells is a problem common to many investigators. Determining target gene specificity requires both an analysis of protein binding to the endogenous promoter as well as a characterization of the functional consequences of transcription factor binding. By using a formaldehyde crosslinking procedure and Gal4 fusion proteins, we have analyzed the timing and functional consequences of binding of Myc and upstream stimulatory factor (USF)1 to endogenous cellular genes. We demonstrate that the endogenous cad promoter can be immunoprecipitated with antibodies against Myc and USF1. We further demonstrate that although both Myc and USF1 can bind to cad, the cad promoter can respond only to the Myc transactivation domain. We also show that the amount of Myc bound to the cad promoter fluctuates in a growth-dependent manner. Thus, our data analyzing both DNA binding and promoter activity in intact cells suggest that cad is a Myc target gene. In addition, we show that Myc binding can occur at many sites in vivo but that the position of the binding site determines the functional consequences of this binding. Our data indicate that a post-DNA-binding mechanism determines Myc target gene specificity. Importantly, we have demonstrated the feasibility of analyzing the binding of site-specific transcription factors in vivo to single copy mammalian genes.

3T3 Cells↗

Police attitudes toward mental illness and psychiatric patients in Israel.

The attitude of the public toward mental illness and toward psychiatric patients raises a serious and sensitive issue that indirectly affects the development of community mental health services. Most citizens feel that there is an association between mental illness and dangerous or violent behavior. Studies undertaken among police personnel in the 1970s demonstrated that their attitudes were similar to those of the general public in Israel. The objective of the present study was to assess the attitudes of police officers toward mental illness and psychiatric patients by means of a self-report questionnaire. Ninety-three policemen from five police stations within the Y. Abarbanel Mental Health Center catchment area participated in the study. All were young males (average age 32.1 years) and 75 percent had a high school education or higher. More than half (54.5%) had personally known a psychiatric patient in the past, and 20.4 percent of the police personnel graded mental illness as the severest form of disease in medicine. A minority (14.3%) of policemen agreed with the statement: "A psychiatric hospital should be fenced and manned by guards." One-third did not know whether psychiatric patients are dangerous. We conclude that training of police officers is called for to effect changes in their misconceptions about psychiatric patients. Psychoeducation may lead to improved handling by the police of incidents involving the mentally ill.

Adult↗

Forensic psychiatric service in Israel: ten years experience in an in-patient hospital unit.

In 1991 legislators revised the Mental Health Act in Israel, placing responsibility for forensic psychiatric evaluations with the district psychiatrist. The aim of the present paper is to describe the changing patterns of the forensic service in Israel's largest psychiatric hospital in the light of changing legislation. In the last 15 years a psychiatric forensic team provided evaluations both in an ambulatory clinic and a special in-patient ward. All medical records of subjects referred for forensic evaluations between 1982-1992 were re-examined. Demographic, forensic and psychiatric data were recorded. During this period the service experience a 15% increase in the number of evaluations. The team tended to prefer ambulatory evaluations. During the latter part of the period studied more referrals were with a previous criminal record and less with a history of mental disorders. An increase in drug and sex crimes was noted with a corresponding decrease in property and financial offences.

Adolescent↗

Side effect profile of azathioprine in the treatment of chronic schizophrenic patients.

Various findings suggest auto-immune changes in schizophrenia. We have recently demonstrated that platelets from schizophrenic patients bear autoantibodies (PAA) which cross-react with brain antigens. Accordingly, treatment of schizophrenia with an immunosuppressant might be of potential benefit. In a recent case study, a chronic schizophrenic patient treated with azathioprine has demonstrated a clear psychiatric improvement preceded by a decrease in PAA level. A phase I study designed for assessing side-effects of short-term azathioprine treatment in a group of schizophrenic patients is described here. From a group of 40 chronic non-responsive patients, 14 patients demonstrating high PAA level have entered the study and 11 have complied all along. Two groups were tested in parallel. In the first (6 patients) 150 mg/day was given for 7 weeks while in the second (5 patients) the same regimen was given for two periods of 7 weeks with an interval of 6 weeks. Blood biochemistry and cell count, as well as determination of PAA were carried out weekly, starting 3 weeks before the trial and continuing up to 7 weeks after the treatment. Two out of 11 patients developed leucopenia in week 4. No other side-effects were recorded in any of the patients. A substantial reduction in PAA was observed in 3 out of 6 patients in group I and 4 out of 5 in group II. Two patients showed improvement of psychiatric symptomatology. Our results demonstrate that short-term azathioprine treatment induces transient leucopenia in 18% of the patients receiving the drug, much alike the percentage reported for other patient populations.

Adult↗

Enhanced detection of proximal right coronary artery stenosis with the additional analysis of right ventricular thallium-201 uptake in stress scintigrams.

The value of right ventricular thallium-201 analysis in detecting proximal right coronary artery stenosis in exercise myocardial scintigraphy was analyzed in 52 patients, 27 with and 25 without proximal right coronary artery stenosis. For the detection of proximal right coronary artery stenosis, the sensitivity and specificity of thallium scintigraphic analysis were 59 and 88% for a right ventricular abnormality, 67 and 68% for a left ventricular inferior wall abnormality, and 93 and 56% for an abnormality of either. When both right and left ventricular thallium images were abnormal, all 9 patients had proximal right coronary artery stenoses, and when both were normal, 26 of 28 patients had a normal proximal right coronary artery. The sensitivity and specificity of blood pool scintigraphic variables during exercise (right ventricular ejection fraction and left ventricular inferior wall motion) were not significantly different for detection of proximal right coronary artery stenosis. Thus, the additional analysis of the right ventricle on thallium-201 stress scintigrams can improve the detection of proximal right coronary artery stenosis. When both right ventricular and left ventricular thallium scintigrams are abnormal (or normal), the ability to predict the presence (or absence) of proximal right coronary artery stenosis is very high.

Adult↗

Normal left atrial function determined by 2-dimensional echocardiography.

To obtain normal values for left atrial function noninvasively, volumes of the left atrium and ventricle were calculated in 52 volunteers by 2-dimensional echocardiography. A light pen digitizing and computation system, controlled by a microprocessor, was used to outline the left atrium and ventricle in orthogonal apical views. Then, to calculate end-systolic and end-diastolic atrial and ventricular volumes, a modified Simpson's rule formula was used. End-systolic left atrial volume (mean +/- standard deviation) was 37 +/- 11.7 ml or 21 +/- 6.6 ml/m2. The change in left atrial volume from end-systole to end-diastole was 24 +/- 7.6 ml or 13.5 +/- 4.3 ml/m2, which represented 37 +/- 12.9% of left ventricular stroke volume. The mean fractional emptying of the left atrium was 65 +/- 8.9% and the conduit volume was 41 +/- 14.0 ml or 23 +/- 7.9 ml/m2. These values are similar to those reported in studies in which left atrial function was calculated from contrast angiography.

Adult↗

Time to completed redistribution of thallium-201 in exercise myocardial scintigraphy: relationship to the degree of coronary artery stenosis.

The relationship between the severity of coronary artery stenosis and the time to completed redistribution of thallium 201 (TI-201) defects following maximal exercise was investigated in 59 patients undergoing stress-redistribution TI-201 scintigraphy, coronary angiography, and contrast ventriculography. Multiple view TI-201 scintigrams were obtained, beginning 6 minutes (immediately post stress), less than 1 hour (early), 3 to 5 hours (average), and 18 to 24 hours (late) following intravenous TI-201 injection at peak exercise. Angiographic lesions were grouped into five levels of severity by percent stenosis. In the 107 defects which were seen on the immediate post stress images, early redistribution was noted in 15 (14%) and late redistribution was found in 23 (21%). In addition, there was a correlation (r = 0.56) between the time to completed redistribution and the severity of the coronary artery stenosis (p = 0.001). In comparison to defects with early and average redistribution, the segments contralateral to those with defects showing late redistribution more often had a critical stenosis supplying that segment. The frequency of myocardial infarction on ECG and the number of segments with akinetic and dyskinetic wall motion were less in defects undergoing late rather than no redistribution. Thus the time to completed TI-201 redistribution following stress appears to be related to the severity of stenosis in the coronary artery supplying the defect. Also, late redistribution is associated with the presence and early redistribution with the absence of a significant stenosis in the coronary artery to the contralateral segment.

Adult↗

Physicians' exposure to health topics through mass media: An avenue for improving the dietitian's image.

Almost all (93 per cent of 150) of the physicians surveyed reported frequent exposure to mass media, and almost two-thirds (60 per cent) state that this exposure included health items. Over half replied that at least one mass media source was useful to them as a source of health information. And, one physician in five (21 per cent) indicated that mass media could influence his attitude about health. The success of the dietitian in the health care setting depends to a large extent on the physician's support. In view of the influence of the mass media on physicians, as reported in this survey, the recommendation is made that dietitians give more attention to this avenue of improving their image with the medical profession.

Dietetics↗