Search PubMed⌕ Search

Biomedical subjects

J Jacobson

Publications and source records attributed to J Jacobson.

At least 109 records · Page 6Linked to original sources
PubMed1990

No abortion-inducing effect of the ulcer-healing dose of the synthetic prostaglandin E2 analogue enprostil in first trimester.

Milligram-range doses of E2 prostaglandins have long been used to induce labor or abortion in the second and third trimesters of pregnancy. Enprostil, a synthetic dehydroprostaglandin E2 structural analogue, is administered in microgram doses for the treatment of acute duodenal ulcer and acute gastric ulcer. This study examined the effect of the ulcer-healing dose and twice the ulcer-healing dose upon women in the first trimester of pregnancy. Two hundred and seven women who had requested legal abortion in the first trimester participated in two randomized, double-blind, placebo-controlled, parallel studies. They received two doses of enprostil 35 micrograms (the recommended dose for the treatment of duodenal and gastric ulcer) (n = 51), 70 micrograms (twice the recommended dose) (n = 53), or placebo (n = 103) 12 h apart. No drug-induced abortions occurred in any of the first-trimester pregnancies. Vaginal bleeding occurred in 4% of volunteers receiving the lower dose and 4% receiving the higher dose of enprostil. Vaginal bleeding occurred in up to 2% of volunteers on placebo. Although not recommended for pregnant women, if enprostil is given inadvertently to pregnant women with ulcers, it is unlikely to endanger the pregnancy during the first trimester.

Abortifacient Agents↗
PubMed1990

Congenital hearing loss in Jervell and Lange-Nielsen syndrome.

Jervell and Lange-Nielsen syndrome is an autosomal recessive hereditary condition that presents with cardiac abnormalities characterized by a prolonged Q-T electrocardiographic pattern and congenital severe-to-profound auditory deficits. This paper describes the auditory history of twin boys born out of consanguinity and diagnosed with this syndrome. Both infants were products of the neonatal intensive care unit (NICU) and failed initial ABR screening. Diagnostic evaluation demonstrated profound hearing loss and developmental delays for each infant. Because sudden death is a consequence, audiologists are advised to recognize signs and symptoms associated with this syndrome.

Child, Preschool↗
PubMed1990

Hearing loss in Stickler's syndrome: a family case study.

Stickler's syndrome is an autosomal dominant hereditary condition that presents with pathognomonic facial features, dysplasia, myopia and auditory deficits. This paper describes the auditory history of a family with Stickler's syndrome. Given the expressive variability, a complete audiologic and otologic evaluation is encouraged when Stickler's syndrome is suspected.

Abnormalities, Multiple↗
PubMed1990

Cardiopulmonary effects of butorphanol tartrate intravenously administered for placement of duodenal cannulae in isoflurane-anesthetized yearling steers.

Cardiopulmonary effects of IV administered butorphanol tartrate (BUT) were assessed in 7 yearling steers medicated with atropine and anesthetized with guaifenesin, thiamylal sodium, and isoflurane in O2 for surgical placement of duodenal cannulae. Heart rate, respiratory rate, arterial blood pressures, pHa, PaCO2, PaO2, arterial [HCO3-], esophageal temperature, and end-tidal isoflurane concentrations were measured before and after IV administration of BUT (10 mg). Mean respiratory rate increased significantly (P less than 0.05) only at 45 and 60 minutes after BUT administration. Mean respiratory rate was 26 +/- 6.3 breaths/min before BUT administration and 46 +/- 12.1 breaths/min 60 minutes after BUT administration. Arterial blood pressures were increased significantly (P less than 0.05) at all times, except 5 minutes after BUT administration. The mean value for mean arterial pressure was 76 +/- 9.6 mm of Hg before BUT injection and 117 +/- 12.6 mm of Hg 60 minutes after BUT injection. Mean values for pHa and arterial [HCO3-] were significantly (P less than 0.05) higher at 60 minutes after BUT administration (baseline, pH = 7.25 +/- 0.04 and [HCO3-] = 29.9 +/- 3.5 mEq/L; 60 minutes after BUT, pH = 7.28 +/- 0.03 and [HCO3-] = 33.0 +/- 1.8 mEq/L). Although some statistically significant changes were recorded, IV administration of BUT to these steers did not have a marked effect on the cardiopulmonary variables measured.

Anesthesia↗
PubMed1989

Diagnostic characteristics and dispositions in suicidal hospitalized medical and surgical patients.

Suicidal ideation is frequently identified in psychiatric consultation patients, but the outcomes of patients with suicidal ideation are infrequently discussed. We reviewed 4 years of consultations and identified two groups of suicidal patients, those admitted following suicide attempts and those with medical illnesses. These groups and the remaining nonsuicidal patients were analyzed for lengths of stay, diagnoses, and outcomes. Suicidal patients were younger (p less than 0.001), and had earlier consultations (p less than 0.001) and shorter stays (p less than 0.001). There were more affective disorders (p less than 0.001) and Axis II disorders (p less than 0.001) in suicidal patients, but more adjustment disorders (p less than 0.005) in nonsuicidal patients.

Adjustment Disorders↗
PubMed1989

Cyclic Cushing's disease in association with a pituitary stone.

We have documented what we believe to be the first reported case of a pituitary stone in a patient with pituitary-dependent Cushing's disease. Pituitary stones have been reported exclusively in growth-hormone-producing or prolactin-producing pituitary adenomas. Our patient's ACTH and serum cortisol levels cycled for 15 months and then resolved spontaneously. A CT scan of the head showed calcification of pituitary tissue. Pituitary stones may occur in association with Cushing's disease. We hypothesize that the spontaneous resolution of the cyclic Cushing's disease was due to destruction and ultimate calcification of abnormal pituitary tissue.

Adenoma↗
PubMed1989

Results of surgical treatment for Menière's disease.

In 1985 the American Academy of Otolaryngology-Head and Neck Surgery Committee on Hearing and Equilibrium established revised guidelines for reporting treatment results for Menière's disease. Since then little information regarding the newly adapted criteria and their effects on the evaluation process has appeared. Thus we compared the results of different surgical procedures for Menière's disease using both the 1985 and 1972 guidelines. One hundred nine surgical procedures from 1969 to 1985 were reviewed. Six different surgical procedures were evaluated: the Cody-Tack, cochleosacculotomy, endolymphatic mastoid shunt, endolymphatic subarachnoid shunt, translabyrinthine vestibular nerve section, and transcanal labyrinthectomy. Results show that 68% of patients who had a Cody-Tack procedure continued to have vertiginous episodes in the same frequency postoperatively. Hearing was worse in 17 of these 25 patients. Of the patients who had a cochleosacculotomy, most had significant control of their vertiginous symptoms, but 10 patients had greater than 10 dB hearing loss postoperatively. Patients who had an endolymphatic mastoid shunt performed had better results when the 1972 guidelines were applied. In this group, the 1985 guidelines indicate that only 35% of the patients had significant relief of their vertiginous symptoms and 47% had hearing loss greater than 10 dB postoperatively. Six of the seven patients who underwent an endolymphatic subarachnoid shunt obtained significant relief of their vertiginous episodes, but hearing loss was more than 10 dB in four patients. Those patients who had either a labyrinthectomy or a translabyrinthine vestibular nerve section had relief of their vertiginous episodes. We conclude that the new guidelines appear to be superior to the 1972 guidelines for reporting results for the treatment of Menière's disease.

Auditory Threshold↗
PubMed1988

Administration of nasal nafarelin as compared with oral danazol for endometriosis. A multicenter double-blind comparative clinical trial.

Treatment with nafarelin, a gonadotropin-releasing hormone agonist, reversibly inhibits ovarian function and induces hypoestrogenemia. To determine the efficacy of such hormonal manipulation in the treatment of endometriosis, we randomly assigned 213 patients with laparoscopically confirmed endometriosis to receive, for six months, either nafarelin by nasal spray (400 or 800 micrograms per day) or oral danazol (800 mg per day). Placebo nasal spray and placebo tablets were used to double blind the study. Pretreatment and post-treatment laparoscopies were compared by means of the American Fertility Society's scoring system. More than 80 percent of the patients in each treatment group had a reduction in the extent of disease as assessed by laparoscopy. The mean laparoscopic scores decreased from 21.9 to 12.6 with 800 micrograms of nafarelin, from 20.4 to 11.7 with 400 micrograms of nafarelin, and from 18.4 to 10.5 with danazol (P = 0.0001 within each group; there were no statistically significant differences between the groups). The percentage of women with severely painful symptoms of endometriosis decreased from about 40 percent to 5 to 10 percent, whereas the percentage with no or minimal discomfort rose from 25 to 70 percent. Of the 149 patients who tried to become pregnant, 58 (39 percent) succeeded after the completion of treatment; similar rates of pregnancy applied to the three treatment groups. Danazol use decreased high-density lipoprotein levels and increased low-density lipoprotein levels. These changes were not observed in nafarelin users, but a higher percentage of them reported hot flashes and decreased libido. We conclude that nafarelin is an effective agent for treating endometriosis and has few side effects other than hypoestrogenism.

Administration, Intranasal↗
PubMed1988

Topical aminocaproic acid significantly reduces the incidence of secondary hemorrhage in traumatic hyphema in the rabbit model.

Systemically administered aminocaproic acid has been shown to reduce the incidence of secondary hemorrhage after traumatic hyphema. To date, no topical treatment has been shown to be effective in reducing the incidence of rebleeding in a double-masked study. Experimentally induced traumatic hyphemas in the rabbit model were treated with topical placebo gel (4% carboxypolymethylene gel only) or carboxypolymethylene gel with amino-caproic acid (treated group) in a double-masked fashion and were compared with untreated controls (control group). In both the control and placebo groups, there was a 33% rebleed rate. The treated eyes had a 10% rebleed rate that is statistically significant. The topically applied aminocaproic acid gel appears to be well tolerated locally without evidence of systemic toxicity. This study indicates that topical aminocaproic acid may be an effective alternative to systemic treatment to reduce the incidence of secondary hemorrhage in traumatic hyphema.

Acrylic Resins↗
PubMed1988

The effect of a gonadotropin-releasing hormone agonist analog (nafarelin) on bone metabolism.

The effect on bone metabolism of an agonist analog of GnRH, nafarelin, was studied in 16 premenopausal women, who received 200 micrograms nafarelin/day for 6 months, and 9 premenopausal women, who received 400 micrograms nafarelin/day for 6 months, followed by a 6-month follow-up period. Bone mineral content in the forearm (measured by single photon absorptiometry) and in the spine (measured by dual photon absorptiometry) significantly decreased after 6 months of treatment with 400 micrograms nafarelin, but 6 months after termination of treatment all bone mineral measurements had returned to pretreatment levels. The bone mineral measurements in the 200 micrograms group did not change throughout the study. In both treatment groups the biochemical estimates of bone turnover increased significantly to postmenopausal levels. Withdrawal of treatment resulted in an abrupt decrease in the bone resorption parameters (fasting urinary hydroxyproline to creatinine and calcium to creatinine excretion ratios and serum phosphate), whereas there was a protracted fall in the bone formation parameters (plasma bone Gla protein and serum alkaline phosphatase) 6 months after termination of treatment. Our findings demonstrate that nafarelin in both doses increased biochemical indices of bone turnover, that 400 micrograms/day nafarelin resulted in a significant decrease in bone mineral content, and that these effects were reversible.

Adult↗
PubMed1988

Managing diabetes in the home: a model approach.

The Diabetes Home Care Program has been an effective means of providing diabetes management and education to homebound, usually elderly, persons with diabetes. The program appears to be cost effective, the average cost per patient is less than one day of hospitalization. Reimbursement of the program has been good as patients have qualified for reimbursement under Medicare guidelines. Improved diabetes control has been demonstrated following the home care intervention. Since elderly persons with diabetes are frequently referred for home care, it would be appropriate for home care agencies to provide specialized care for persons with diabetes. The Diabetes Home Care Program can serve as a model of diabetes management and education for homebound persons with diabetes.

Diabetes Mellitus↗
PubMed1988

Problem visits to a family planning clinic.

In order to obtain information necessary for optimum delivery of services, data were collected on the nature of the services provided at a family planing clinic. Clinic visits were divided into initial, annual, routine, problem, supply, educational and unknown. An analysis of the "problem" visits was undertaken to assess various epidemiologic aspects of such visits and to identify areas of clinic efficiency that could be improved. Problem visits were defined as any visits for which the patient had a presenting complaint. Age, level of education, method of contraception and parity were statistically associated with problem visits. When compared to Pill users, diaphragm users, intrauterine device users and non-users had a higher-than-expected number of problem visits. Less educated women and teenagers had a lower-than-expected number of problem visits when compared to more educated and older women. Socioeconomic status and problem visits were not statistically associated. Problem visits required more time, utilized more medical services and resulted in more referrals to the gynecology clinic than did other visit types. As a result of this analysis, we have increased our educational efforts for patients at high risk of problem visits and have instituted a special problem-oriented family planning clinic in which a full complement of house staff and ancillary personnel are available. This arrangement makes the uncomplicated family planning clinic run more smoothly and efficiently and obviates the need for time-consuming and cost-ineffective referrals.

Adolescent↗
PubMed1987

Study of neuromotor reaction times under the influence of thyrotropin-releasing hormone.

Neuromotor reaction times (simple, choice, and decision) were measured when Thyrotropin-releasing hormone (TRH) was administered intravenously to nine healthy men in a double-blind study. Measurements were made of simple reaction time, choice reaction time, and decision time for each subject at various intervals over a 54-hr. period. Given the observed inherent interaction of the drug with the long time used (54 hr.), most analyses were conducted across separate time epochs. Injected subjects showed inhibition in the normal improvement of simple reaction time (which occurs with practice), and they reduced the time required to make a decision. Choice reaction time, however, remained unchanged across the drug-nondrug experimental conditions.

Adult↗
PubMed1987

Atherosclerotic plaque at the carotid artery bifurcation. Correlation of ultrasonographic imaging with morphology.

Morphologic characteristics of atherosclerotic plaque at the carotid artery bifurcation were compared to the appearance of the plaque on real-time B-mode ultrasonography. Mural plaques propagating along the wall of the carotid sinus had a 72% frequency of recent organizing hemorrhage. Nodular plaques causing local narrowing of the vessel had only a 23% incidence of organizing hemorrhage. This difference was significant (P less than 0.01). The presence of recent organizing hemorrhage in mural plaques may account for the increased frequency of symptoms previously observed to occur ipsilateral to mural plaques compared to nodular plaques.

Arteriosclerosis↗