Biomedical subjects
J Herman
Publications and source records attributed to J Herman.
Collaboration to enhance research productivity: the Adjunct Nurse Researcher program.
The Adjunct Nurse Researcher program is a collaborative initiative that facilitates design, funding, implementation, and application of clinical nursing research. A mutually beneficial effort between a veterans administration hospital and a college of nursing, the program was developed in response to clinicians' desire for research consultation and academicians' commitment to conduct clinical studies. The collaborative research program supports nursing research and fosters its research utilization in clinical decision making. The Adjunct Nurse Researcher program has led to mutual respect between clinicians and academicians, modification in delivery of nursing services, and enriched patient care, education, and research environments.
Elective mutism in family practice.
Explore the source record for details and available documents.
Slipping rib syndrome.
Slipping rib syndrome is a rare and underdiagnosed condition. Since approximately one third of the cases reported to date have involved patients considered to be psychoneurotic and/or who have undergone psychiatric evaluation, a conservative treatment approach is recommended. Many patients respond to simple reassurance, and in others, a single intercostal nerve block provides lasting relief. In the case reported here, radicular pain, a history of injury to the affected side, noncontributory findings on ancillary investigations, a positive response to the hooking maneuver, and relief of pain after intercostal nerve block led to the diagnosis.
Low incidence of loss of chromosome 10 in sporadic and hereditary human medullary thyroid carcinoma.
Genetic linkage has been recently documented between a centromeric region of chromosome 10 and familial multiple endocrine neoplasia type II (MEN II). This syndrome consists of initial thyroid C-cell and adrenal chromaffin cell hyperplasia which result in multifocal medullary thyroid carcinomas and bilateral adrenal pheochromocytomas. Other hereditary cancers, such as retinoblastoma, appear to result from a series of genetic events involving, first the inheritance of a germ line abnormality, and subsequent loss of chromosome loci opposite this initial defect. In these cancers, this loss of the normal alleles in both familial and sporadic cases, is frequently manifest as a reduction to homozygosity for polymorphic DNA markers near the involved locus. It might then be expected that chromosome 10 regions would be lost with high frequency in tumor DNA from patients with MEN II and sporadic medullary thyroid carcinoma (MTC). We now demonstrate that only two of 16 MTC tumors studied by analysis of restriction fragment length polymorphisms for multiple regions of the short and long arms of chromosome 10 showed loci reduced to homozygosity. One of these tumors was from a patient with MEN II and the other from a patient with nonfamilial MTC. Importantly, no such chromosome 10 changes were noted in pheochromocytomas from the patient with MEN II or his sister. These findings strongly suggest that the sequence of genetic events for familial MTC is either different from that for retinoblastoma or that loss of normal alleles opposite the germ line genetic defect occurs by mechanisms other than gross loss of chromosomal material in MTC. A model is proposed suggesting that the mechanism involving loss of alleles opposite one another is operative in hereditary tumors, such as retinoblastoma, which do not arise within a setting of initial polyclonal cellular hyperplasia. In contrast, in tumors such as familial MTC and polyposis coli which arise as individual clones of neoplastic cells from a setting of preexistent polyclonal hyperplasia, the first genetic event may underlie hyperplasia, and additional events, frequently at other chromosomal loci, may cause individual clonal neoplasms.
Sexual abuse of patients by therapists: strategies for offender management and rehabilitation.
Many therapists are unsure of how to respond to reports of sexual abuse of patients by previous therapists. The results of strategies developed in Minnesota and other jurisdictions suggest ways to handle the reporting, management, and rehabilitation of offenders in therapist-patient sexual abuse cases.
The diagnostic process--some unwitting uses.
Explore the source record for details and available documents.
Perimyocarditis. Report on an unusual cause.
A 29-year-old man had a febrile illness accompanied by chest pain and tachycardia. The ECG suggested either myocarditis or acute ischemia. Heart muscle enzymes were normal, the peripheral blood count showed absolute and relative lymphocytosis, and an echocardiogram disclosed a small pericardial effusion. After defervescence, splenomegaly was noted and the SGPT level was elevated to four times normal. There was a greater than fourfold rise in titer of IgM antibodies to cytomegalovirus. This is only the second report in detail of perimyocarditis caused by cytomegalovirus mononucleosis. An interesting aspect of the case was an afebrile prodrome that lasted for more than one week, during which prostration, palpitations, and breathlessness on exertion were present and the sole physical finding was tachycardia.
What's in a teaspoon? Underdosing with acetaminophen in family practice.
A study was made of 100 paediatric encounters in which an accompanying parent stated that the child had been given acetaminophen syrup during the preceding 24 hours. In 80% of cases a household teaspoon had been used to determine the amount of medication required. The volumes of these spoons were measured using a syringe. The range was from 1.5 to 5 cm3 with 79% containing 2 to 3 cm3. The mean volume was 2.95 cm3 (SD 0.79) and the median was 2.5 cm3. The mean dose administered was 62% of that recommended when the calculation was made according to age and 64% according to body weight. Much of the underdosing observed was due to parents' assumption that a household teaspoon contains 5 cm3 of acetaminophen syrup and also to a failure to correct for advancing age and increasing weight.
Pharmacokinetics and bioavailability of ronidazole from a prolonged release tablet in the homing pigeon (Columba livia).
The pharmacokinetics of ronidazole and the bioavailability of a prolonged release tablet were studied in the homing pigeon. After intravenous administration of 5 mg ronidazole, the drug plasma concentration profile fitted a one-compartment open model. The mean half-life of the drug was 11 h and the volume of distribution was 0.86 l/kg. Total body clearance was 0.056 l/h/kg. A sustained release matrix tablet exhibited prolonged drug release in vitro. After oral administration of the matrix tablet to pigeons drug absorption was nearly complete. When given on an empty stomach, the tablet failed as a prolonged release system. Administration to previously fed pigeons resulted in an increase in tmax and a decrease in Cpmax.
Longitudinal relationships between nutrition and oral health.
Explore the source record for details and available documents.
Tetanus immunity in kibbutz women.
The clinic records of 1,009 women, aged greater than or equal to 28, who comprised the entire cohort of the six kibbutzim studied, were reviewed concerning basic tetanus immunization and booster injections. Immunization was incomplete in 6.5% of women aged 28 to 39 years (the youngest age-group), 13.7% in those aged 40 to 49, 55% in the 50 to 59 year age-group, and 68.2% in those aged greater than or equal to 60. There were no significant differences between the age-groups regarding the number of booster doses given. Blood samples drawn at random from 120 of the women whose records were surveyed (30 from each age-group) showed that all had a protective titer of antibody to tetanus toxin as determined by the passive hemagglutination method: 15 of them (12.5%) had never received basic immunization or a booster dose. Whatever the method chosen for determining immunity--chart review or antibody titer--the level of protection was lower in the older age-groups. The implications of this finding for future immunization programs, and the possibility that there may be widespread, acquired natural immunity to tetanus in rural communities, are discussed.
Nonacute scrotal pain in adolescents.
Explore the source record for details and available documents.
A family physician's experience with rheumatic fever and acquired valvular heart disease.
Explore the source record for details and available documents.
Influence of storage conditions on the stability of anthralin in the presence of coal tar and salicylic acid in a white soft paraffin base.
Explore the source record for details and available documents.
The dissolution rate and bioavailability of hydrochlorothiazide in pellet formulations.
The influence of non-active ingredients in the manufacture of pellets on in-vitro dissolution rate and on bioavailability of hydrochlorothiazide has been studied. Pellets were formulated using either microcrystalline cellulose or microcrystalline cellulose-carboxymethylcellulose sodium blends as matrix, and hydrochlorothiazide as the active ingredient. In-vitro drug release from the different pellet formulations was retarded in comparison to a conventional tablet formulation and was dependent on the nature of the non-active ingredient and, for the microcrystalline cellulose-carboxymethylcellulose sodium blend, of the dissolution medium. In-vivo bioavailability of both pellet formulations was low compared with that of the conventional tablet and the plasma concentration-time profiles did not suggest slow release.
Psychiatric residents' sexual contact with educators and patients: results of a national survey.
In a national survey of PGY-4 psychiatric residents, 4.9% of the 548 respondents indicated that they had been sexually involved with psychiatric educators and 0.9% reported that they had been sexually involved with patients. Most residents reported no or minimal instruction in their residency programs about educator-resident and resident-patient sexual contact. The authors compare these results with those from previous surveys of psychologists. They discuss the need for expanding training curricula to include specific education on sexual exploitation.