Search PubMed⌕ Search

Biomedical subjects

J Hoffman

Publications and source records attributed to J Hoffman.

At least 19 recordsLinked to original sources
PubMed1995

A survey of physician knowledge of drug costs.

Previous studies have indicated that physicians have inadequate knowledge of drug costs. This study was designed to determine actual pharmacy prices of 12 nonsteroidal anti-inflammatory drugs (NSAIDs) and physicians' knowledge of these prices. Pharmacists (N = 67) in a large urban area were surveyed to determine the lowest retail price of commonly prescribed medications. Pain clinic and orthopedic physicians (N = 95) were surveyed to determine their knowledge of prices for 12 NSAIDs. There was wide variation between pharmacies in the cost of medications. Eighty-one percent of physicians agreed that cost is an important factor to consider. Only 25% of physicians estimated at least one-half of the medications between the highest and lowest pharmacy price. The results of this study indicate that physicians need more information about prices of medications they prescribe.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1995

Intravenous regional guanethidine in the treatment of reflex sympathetic dystrophy/causalgia: a randomized, double-blind study. Guanethidine Study Group.

This double-blind, randomized, multicenter study was designed to determine the short-term and long-term efficacy of intravenous regional block with guanethidine in patients with reflex sympathetic dystrophy (RSD)/causalgia. Sixty patients were enrolled to receive four intravenous regional blocks at 4-day intervals with either guanethidine or placebo in 0.5% lidocaine. Each patient was randomized to receive either one, two, or four blocks with guanethidine. Follow-up visits were scheduled for 4 days, 1 mo, 3 mo, and 6 mo after their final block. At 4 days after the initial block, the group treated with placebo experienced a greater decrease in pain scores than those treated with guanethidine, although this difference was not statistically significant. On long-term followup there was no difference in pain scores between groups receiving one, two, or four guanethidine blocks. Overall, only 35% of patients experienced clinically significant relief on long-term followup even though all were treated early in the evolution of RSD.

Adult↗
PubMed1995

Failure of electron paramagnetic resonance spectroscopy studies to detect elevated free radical signals in liver biopsy specimens from patients with alcoholic liver disease.

Electron paramagnetic resonance spectroscopy (EPR) was used to study free radicals and transition metal complexes in liver tissue taken from patients with liver disease. Samples were frozen to 77K directly following biopsy to prevent deterioration. Our major aim was to compare signals from patients suffering from alcohol abuse with those from patients having liver damage not induced by alcohol. Samples were obtained from 19 chronic alcohol abusers and 7 non-alcoholic liver disease patients. Of the 19 alcoholic patients, 18 had an increased fat content, 6 had Mallory's hyaline, 12 had an acute inflammatory response, 9 had increased stainable iron and 4 had evidence of fibrosis. A signal derived from free radicals with a spectroscopic splitting factor of g = 2.0045 was found in all samples. This signal in the alcoholic patients had a mean amplitude of 2.96 cm (+/- 1.42 SD), and in patients with non-alcoholic liver disease 2.12 cm (+/- 0.82) (p = 0.10 NS), measured under identical instrument settings. The molar proportion of diene conjugated linoleic acid (DCLA), a free radical marker, in the sera of alcoholic patients was 2.68% (+/- 1.93), but did not correlate with the free radical signals obtained by EPR spectroscopy. Also, there was no correlation between the free radical derived EPR signal and fat content, Mallory's hyaline, inflammatory infiltrate, iron or fibrosis in the liver biopsy specimens. Similarly the concentrations of aspartate transaminase, albumin, and gamma-glutamyl transferase in serum samples showed no correlations with free radical concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Is CT portography (CTAP) really useful in patients with liver tumors who undergo intraoperative ultrasonography (IOUS)?

The objectives were to compare the role of CT during arterial portography (CTAP) and intraoperative ultrasound (IOUS) in the management of patients with primary or metastatic liver tumors; to study the ability of CTAP to define resectability before laparotomy in these patients; and to study whether the omission of CTAP in the imaging algorithm resulted in a diminished resectability rate. Eighty-eight consecutive patients with primary or metastatic liver cancer who underwent CTAP and/or IOUS between January 1990 and December 1993 were reviewed. Thirty patients had both CTAP and IOUS and underwent 31 laparotomies (Group I). The sensitivity of these two tests to detect liver tumors was compared. Twenty-eight explorations were performed for hepatic metastases and three for hepatocellular carcinoma. Fifty-three patients, including those in group I, underwent CTAP before laparotomy and were studied to assess the sensitivity of CTAP in determining unresectability (Group II). Thirty-five patients (Group III) had IOUS only and were studied to determine whether the omission of CTAP decreased the resectability rate. In Group I, 52 hepatic lesions were found by a combination of imaging studies, operative exploration, and pathologic examination. The sensitivity of CT, CTAP, IOUS, and exploration were 67 per cent, 65 per cent, 100 per cent, and 75 per cent, respectively. IOUS was more sensitive than any other modality in detecting liver tumors (P < 0.001). It added new information in 7/31 cases (23%). The false positive rate of CTAP was 4/31 (13%). In one case (3%), a false positive result would have precluded a curative resection. CTAP changed management of 4/53 patients (7.5%) by showing unresectable disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1994

Validation of the Multi-Attitude Suicide Tendency scale in adolescent samples.

The present study extended research on the factor structure and psychometric properties of the Multi-Attitude Suicide Tendency scale (MAST). A mixed sample of 215 adolescents, aged 15 to 18 years, participated in the study. Exploratory principal-components analysis of the 30 MAST items provided support for the four-factor structure of the scale: attraction toward and repulsion by life and death. The MAST subscales showed satisfactory levels of internal consistency. Specific and subset of the MAST subscales were identified for differentiating among adolescents who differed in degrees of psychopathology and suicidal behavior. Correlational and regression analyses examined the relations among the MAST subscales and self-report measures of suicidal behavior, social desirability, and general psychopathology. Limitations and suggestions for future research are discussed.

Adolescent↗
PubMed1992

Effects of cytokines from activated immune cells on vascular cell growth and HIV-1 gene expression. Implications for AIDS-Kaposi's sarcoma pathogenesis.

Kaposi's sarcoma (KS) arises more frequently in homosexual and bisexual men than in other groups of HIV-1 infected individuals. Clinico-epidemiologic data indicate that homosexuals often are infected with multiple microbial agents and/or subjected to other antigenic stimuli, preceding or accompanying HIV-1 infection. Signs of immune activation, in fact, frequently have been detected in these individuals, and the onset of KS can precede any sign of immunodeficiency. These data have suggested that products from activated immune cells may affect the development of AIDS-KS. Here we report that conditioned media from activated or dysregulated T cells contain a variety of cytokines that promote the growth of spindle cells derived from KS lesions of AIDS patients (AIDS-KS cells) and induce normal vascular cells, potential cell progenitors of the AIDS-KS cells, to acquire features of the KS cell phenotype ("spindle" cell morphology and growth responsiveness to the mitogenic effect of extracellular HIV-1 Tat protein). The same conditioned media or cytokines promote HIV-1 gene expression and rescue defective HIV-1 proviruses, interrupting HIV-1 latency and increasing Tat production. The cellular and viral effects of cytokines are increased in an additive or synergistic manner by picomolar concentrations of extracellular Tat. These data suggest that cytokines produced by activated immune cells cooperate with HIV-1 infection in AIDS-KS pathogenesis.

Cell Division↗
PubMed1992

Anuran amphibia which are not acclimable to high salt, tolerate high plasma urea.

1. The capacity of five anuran Amphibians (Bufo viridis, B. regularis, Rana ridibunda, Hyla arborea and Pelobates syriacus) to acclimate to NaCl and urea solutions was investigated. 2. All species could be acclimated to relatively high concentrations of urea solutions, while only Bufo viridis and Hyla arborea could be acclimated to 500 mOsm/kg or higher NaCl solutions. 3. The plasma urea concentration in B. viridis and H. arborea was elevated to levels over 140 mmol/l. 4. The sum of plasma sodium and chloride concentrations did not increase over 400 mmol/l in any species. 5. Urine osmolality, which was normally low, increased, but never exceeded the plasma osmolality. 6. In the urea acclimation conditions, urine electrolytes diminished, similarly in all species in this study. 7. It is concluded that anuran Amphibians can tolerate high plasma urea concentrations, but only those species which can elevate it, either through retention or net synthesis, can be acclimated to high salt solutions.

Adaptation, Physiological↗
PubMed1992

Initial experience with the HydroSonics instrument to soften cataracts before phacoemulsification.

An ultrasonically driven needle placed into the body of the nucleus, with subsequent injection of balanced salt solution (BSS), can be used to fragment the nucleus into sections or lamellae that can potentially be emulsified with greater ease and less ultrasound energy delivered to the eye. This separation of the nucleus has been designated hydrodelineation. The six surgeons participating in this study subjectively reported that the use of hydrodelineation facilitated phacoemulsification, on average, in 91% of their cases. Review of study data indicated that significantly less ultrasound time and cumulative displayed energy were noted in phacoemulsification of grade 2+ and 3+ cataracts after hydrodelineation than in cases in which hydrodelineation was not performed. The results in cases performed with and without hydrodelineation were statistically equivalent in complications and postoperative patient outcomes.

Cataract↗
PubMed1992

Preoperative self-efficacy and postoperative behaviors.

Preoperative instruction has been found to decrease postoperative complications; however, the mechanisms through which preoperative instruction exerts its effects remain unknown. In this study, the relationship between preoperative self-efficacy and postoperative behaviors was investigated. Subjects were 68 cholecystectomy patients. Subjects' scores on the efficacy expectations subscale were related significantly to postoperative deep breathing, ambulation, and recall of expected events; scores on the outcome expectations subscale were related significantly to postoperative requests for pain medication. Self-efficacy theory provided a link between self perceptions and behavior and may be the mechanism through which preoperative instruction exerts its effects.

Adult↗
PubMed1992

Sulphation of colonic and rectal mucin in inflammatory bowel disease: reduced sulphation of rectal mucus in ulcerative colitis.

1. Normal colonic mucin is heavily sulphated and this increases its resistance to degradation by bacterial enzymes. Any defect in mucus sulphation could therefore be important in the pathogenesis of ulcerative colitis. 2. Rectal biopsies taken at colonoscopy from patients with ulcerative colitis (n = 9), patients with Crohn's disease (n = 6) and control subjects (n = 16) were cultured for 24 h in the presence of N-[3H]acetylglucosamine and [35S]sulphate. Mucin was then extracted and purified, and the ratio of [35S]sulphate to N-[3H]acetylglucosamine incorporated into pure mucin was assessed. 3. The ratio of [35S]sulphate to N-[3H]acetylglucosamine incorporated into mucin was significantly reduced in rectal biopsies taken from patients with ulcerative colitis (0.463, 0.305-0.703, geometric mean and 95% confidence intervals) compared with control subjects (0.857, 0.959-1.111, P < 0.01). In patients with Crohn's disease the reduction in this ratio (0.559, 0.378-0.829) did not quite reach statistical significance (P = 0.06). There was no difference between the ratio of [35S]sulphate to N-[3H]acetylglucosamine incorporated into mucin in Crohn's disease and that in ulcerative colitis (P = 0.26). 4. In control subjects the ratio of [35S]sulphate to N-[3H]acetylglucosamine incorporated into mucin was higher in the rectal biopsies (0.882, 0.618-1.022) than in their paired proximal colonic biopsies (0.602, 0.421-0.861; P < 0.01), but this regional variation was not observed in either ulcerative colitis (rectum: 0.450, 0.262-0.773; right colon: 0.470, 0.321-0.690, P = 0.3) or Crohn's disease (rectum: 0.459, 0.260-0.815; right colon: 0.492, 0.260-0.929, P = 0.8).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Distribution of eosinophils in the nose in patients with perennial rhinitis.

The traditional method of classifying perennial rhinitis into eosinophilic and non-eosinophilic is by taking a single nasal smear from one nostril. In the light of personal experience it was felt that this method of sampling may be inadequate. The present study included 20 patients with perennial rhinitis undergoing nasal surgery. Serum total IgE levels were taken and those above 40 IU/ml had allergen specific IgE measured. Nasal smears and biopsies were taken from 5 sites on each side of the nose; middle and inferior turbinates and post nasal space. The smears significantly correlated with the biopsies (rs = 0.446, P < 0.001). The distribution of eosinophils between and within nasal cavities was found to differ. Representative sampling of the nose is important for accurate eosinophil expression. The definition of an eosinophil rich and poor nose requires greater clarification as it has great clinical relevance regarding management.

Biopsy↗