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Biomedical subjects

J Rothman

Publications and source records attributed to J Rothman.

At least 19 recordsLinked to original sources
PubMed2005

Emergency department visits for concern regarding anthrax--New Jersey, 2001.

INTRODUCTION: In October of 2001, after letters processed in Trenton, New Jersey, resulted in multiple cases of anthrax, emergency departments (EDs) in New Jersey experienced an increase in visits from patients concerned about possible exposure to agents of biologic terrorism. Information about the effect of an actual biologic terrorism attack on the emergency department population might be useful in the design of biosurveillance systems, particularly with regard to their performance during the mitigation phase that occurs after an attack. In addition, such information might help identify issues that arise regarding the public health response in the ED setting. OBJECTIVES: The objectives of this report were to identify and characterize ED visits, by patients concerned with exposure to biologic terrorism agents, in selected New Jersey hospitals after the anthrax attack in fall 2001. METHODS: A retrospective cohort design was used in this study. The setting was 15 New Jersey EDs within a 55-mile radius of Trenton. Participants were consecutive patients evaluated by ED physicians for the following four periods in 2001: 1 month before September 11; 1 month after September 11; 1 month after October 11; and for the second month after October 11. Percentages of visits were calculated with a concern for exposure (CE) visits by using International Classification of Diseases, Ninth Revision (ICD-9) descriptors: Feared Complaint-No Diagnosis (ICD-9 code v65.6) and Screening for Infectious Disease (ICD-9 code v75.9) for all hospitals and for Trenton versus non-Trenton hospitals as a percentage of ED visits. Charts were reviewed by using a structured data form. RESULTS: A total of 225,403 ED visits occurred during the 4 months, of which 698 were CE visits. The percentages of CE visits for the four periods were 0.06%, 0.06%, 0.92%, and 0.10%, respectively. For the peak third period, the percentage was increased for the two Trenton hospitals, 1.81%, versus 0.82% for the 13 non-Trenton hospitals. This report is a summary of the 508 visits associated with concern for anthrax exposure during the peak third period: 47% reported exposure to powder, 13% were postal workers, 4% received chest radiographs, 65% had a nasal swab for anthrax, 13% had ED decontamination, and 32% received antibiotics. CONCLUSION: An increase in CE visits occurred during the 1-month period after October 11, 2001. During the peak month, a higher increase occurred in Trenton EDs. Considering the substantial variation in diagnostic evaluation and treatment, readily available guidelines are needed.

Anthrax↗
PubMed2004

The relationship between temperature and neuronal characteristics.

The purpose of this study was to determine a relationship between surface temperature of the limb and neuronal characteristics of the median and ulnar nerves in non-impaired individuals. Previous literature demonstrates that there is a negative correlation between distal latency and amplitude and temperature while a positive correlation exists between nerve conduction velocity and temperature. It is a common clinical practice to externally manipulate the temperature of a cold limb. Thirty-six participants (21 male, 15 female,) with an age range between 20-38 years old (mean age = 26.6) completed the study. Temperature of the limb was not manipulated by the researchers prior to testing and was measured at the distal wrist crease using a surface probe. Relationship was determined using a Pearson product-moment coefficient of correlation. A significant negative correlation existed for median distal sensory latency (DSL), ulnar DSL, ulnar motor amplitude (CMAP), and ulnar sensory amplitude (SNAP). The investigators conclude that temperature is a factor to consider when performing nerve conduction studies. The researchers suggest using mathematical correction factors to compensate for a cool limb rather than external heating.

Adult↗
PubMed2003

Domain wall pinning in narrow ferromagnetic ring structures probed by magnetoresistance measurements.

We present a magnetoresistance study of magnetization reversal and domain wall pinning effects in a mesoscopic narrow ferromagnetic Permalloy ring structure containing notches. The size and strength of the attractive pinning potential created by a notch is measured and the resistance minimum at remanence is found to occur when a single transverse domain wall is pinned at the notch, in agreement with the results of numerical simulations of the anisotropic magnetoresistance. When a field is applied in the direction corresponding to a potential well edge, a novel magnetic state with a very wide domain wall is stabilized, giving rise to a characteristic signature in the magnetoresistance at such angles.

Journal Article↗
PubMed2003

Role of oral anti-diabetic agents in modifying cardiovascular risk factors.

Patients with type 2 diabetes have an increased risk for cardiovascular disease (CVD) and it accounts for up to 80% of excess deaths in these patients. It has been recognized that type 2 diabetes is associated with an increased prevalence of CVD risk factors, including hypertension, dyslipidemia, microalbuminuria, and altered hemostasis. The benefit of cardiovascular protection can only be partially explained by controlling hyperglycemia. Some of the oral agents used to treat hyperglycemia significantly modify other cardiovascular risk factors. This article will review oral agents used to treat type 2 diabetes and their effects on modifying CVD risk factors.

Albuminuria↗
PubMed2001

A POP-1 repressor complex restricts inappropriate cell type-specific gene transcription during Caenorhabditis elegans embryogenesis.

In Caenorhabditis elegans, histone acetyltransferase CBP-1 counteracts the repressive activity of the histone deacetylase HDA-1 to allow endoderm differentiation, which is specified by the E cell. In the sister MS cell, the endoderm fate is prevented by the action of an HMG box-containing protein, POP-1, through an unknown mechanism. In this study, we show that CBP-1, HDA-1 and POP-1 converge on end-1, an initial endoderm-determining gene. In the E lineage, an essential function of CBP-1 appears to be the activation of end-1 transcription. We further identify a molecular mechanism for the endoderm-suppressive effect of POP-1 in the MS lineage by demonstrating that POP-1 functions as a transcriptional repressor that inhibits inappropriate end-1 transcription. We provide evidence that POP-1 represses transcription via the recruitment of HDA-1 and UNC-37, the C.elegans homolog of the co-repressor Groucho. These findings demonstrate the importance of the interplay between acetyltransferases and deacetylases in the regulation of a critical cell fate-determining gene during development. Furthermore, they identify a strategy by which concerted actions of histone deacetylases and other co-repressors ensure maximal repression of inappropriate cell type-specific gene transcription.

Animals↗
PubMed2001

Regular outpatient medical and drug abuse care and subsequent hospitalization of persons who use illicit drugs.

CONTEXT: Patients and the public could benefit from identification of factors that prevent drug users' heavy reliance on inpatient care; however, optimal health care delivery models for illicit drug users remain ill-defined. OBJECTIVE: To evaluate associations of outpatient medical and drug abuse care with drug users' subsequent hospitalization rates. DESIGN AND SETTING: Retrospective cohort study of data from longitudinally linked claims for all ambulatory physician/clinic services and drug abuse services covered by the New York State Medicaid program. SUBJECTS: A total of 11 556 human immunodeficiency virus (HIV)-positive and 46 687 HIV-negative drug users. MAIN OUTCOME MEASURES: Hospitalization in federal fiscal year (FFY) 1997 compared by 4 patterns of care in FFY 1996: regular drug abuse care (>/=6 months in 1 program), regular medical care (>35% of care from 1 clinic, group practice, or individual physician), both, or neither. RESULTS: Hospitalization occurred in 55.6% of HIV-positive and 37.5% of HIV-negative drug users, with a mean of 27.5 and 24.5 inpatient days, respectively. In HIV-positive drug users, the adjusted odds ratio (AOR) for hospitalization was lowest among those with both regular medical and drug abuse care (AOR, 0.76; 95% confidence interval [CI], 0.67-0.85) followed by those with regular medical care alone (AOR, 0.82; 95% CI, 0.74-0.91) and regular drug abuse care alone (AOR, 0.85; 95% CI, 0.76-0.96) vs those with neither. In HIV-negative drug users, the AOR of hospitalization was lower for those with regular medical and drug abuse care (AOR, 0.73; 95% CI, 0.68-0.79), regular drug abuse care alone (AOR, 0.71; 95% CI, 0.66-0.76), and regular medical care (AOR, 0.91; 95% CI, 0.86-0.95) vs those with neither. Both types of care showed favorable effects for all but drug abuse-related hospitalizations. CONCLUSION: Our data indicate that regular drug abuse care with regular medical care for drug users is associated with less subsequent hospitalization.

Adult↗
PubMed2001

Observation of a bi-domain state and nucleation free switching in mesoscopic ring magnets.

We present the results of a study of the magnetic properties of an array of 34-nm thick Co(100) epitaxial ring magnets, with inner and outer diameters of d(in) = 1.3 microm and d(out) = 1.6 microm, respectively. Magnetic measurements and micromagnetic simulations show that a two step switching process occurs at high fields, indicating the existence of two different stable states. In addition to the vortex state, which occurs at intermediate fields, we have identified a new bi-domain state, which we term the onion state, corresponding to opposite circulation of the magnetization in each half of the ring. The onion state is stable at remanence and undergoes a simple and well characterized nucleation free switching.

Journal Article↗
PubMed2000

Models of care in New York State Medicaid substance abuse clinics. Range of services and linkages to medical care.

PURPOSE: To explore the range of health care services in substance abuse clinics. METHODS: Survey of directors of a stratified random sample of 125 substance abuse treatment clinics offering methadone, drug-free therapy, or both, representing 344 clinics participating in the New York State (NYS) Medicaid program. Survey asked about clinic services and referral patterns. We defined five categories of linkage of substance abuse to medical care ranging from unlinked (e.g. referral to distant sites) to highly linked (e.g. on site). To estimate the number of patients served, State data on licensed patient capacity for each clinic were used. RESULTS: This sample represented 344 clinics statewide serving an estimated 60,914 patients. For patients with acute, chronic, or HIV-related medical conditions, weighted analyses showed highly linked care in 54 of the 344 (16%) clinics statewide, serving an estimated 13,741 patients. Unlinked care for all these medical conditions was found for 28% of statewide clinics, serving an estimated 8866 patients. Clinics offering both methadone and drug-free therapy were generally more likely to have medically related services on site. IMPLICATIONS: The extent of medical care services available at substance abuse clinics varies widely. Over one-quarter of clinics offered only loosely connected medical and substance abuse care.

Delivery of Health Care, Integrated↗
PubMed2000

Establishing the etiology of thrombocytopenia.

Hemostasis is dependent on an adequate number of well-functioning platelets in the circulating blood. As the number of circulating platelets decreases, the chance of bleeding increases. Thrombocytopenia, a platelet count of less than 150,000 per microliter, is a laboratory finding and not a diagnosis. Therefore, once thrombocytopenia is identified, a detailed history, physical examination, and further laboratory tests are used to establish an etiology. This article reviews the assessment, diagnosis, and treatment of thrombocytopenia.

Acute Disease↗
PubMed1996

Client self-determination and professional intervention: striking a balance.

Social workers find themselves caught in the cross fire between two imperatives: (1) outcome-oriented and competency-based practice requisites and (2) the principle of client self-determination. In this context, the authors hypothesize that social workers use a wide range of gradations along a continuum of practice directiveness. Furthermore, there is ethical justification for this diverse role repertoire. Directiveness modalities are influenced by specific conditional factors that guide practitioner behavior. A study is described that empirically explores and amplifies these hypotheses.

Adult↗
PubMed1992

Flavimonas oryzihabitans (CDC group Ve-2) bacteraemia associated with Hickman catheters.

Flavimonas oryzihabitans is a potential pathogen that may infect patients who have major medical illnesses, especially those who are undergoing surgery or have indwelling venous catheters in situ. Flavimonas oryzihabitans has been isolated from a wide range of body sites, and the portals of entry are major wounds or implanted foreign materials. We report two cases of F. oryzihabitans bacteraemia associated with the use of Hickman catheters for administration of the patients' chemotherapeutic agents. However, a common source for these infections could not be demonstrated.

Bacteremia↗
PubMed1991

A model of case management: toward empirically based practice.

Case management is highly valued as an intervention method for providing service to clients requiring long-term care. However, it lacks definitional consensus and conceptual clarity. An explicit, empirically based model of case management is presented on the basis of 15 functions and their dynamic interrelationship along a sequential dimension. A series of studies is described by means of which the model was devised, tested, and refined.

Continuity of Patient Care↗
PubMed1990

A profile of faculty development in physical therapy education programs.

The purpose of this study was to report on the status of faculty development in physical therapy education programs. A survey questionnaire was sent to the directors of 110 physical therapy programs nationwide. Analysis of responses from respondents (n = 79; 72%) demonstrated 1) criteria used to evaluate faculty members were similar among different institutions, 2) fewer than half of the institutions have a faculty development plan (FDP), 3) the majority of those institutions that have an FDP supported similar areas and activities to facilitate faculty development, and 4) respondents used creative ways to support faculty development. The results appear to indicate that most physical therapy programs do not have a formalized program to assist faculty members in their development of skills in research, teaching, and service. [Rothman J. Rinehart ME: A profile of faculty development in therapy education programs.

Education, Continuing↗
PubMed1988

The partialization strategy: an empirical reformulation of demonstration project planning.

The demonstration project approach to planning is described and analyzed. Reasons for its frequent failure as a chosen strategy are delineated. The article introduces the concept of partialization as a broader framework for understanding and using demonstration projects. Four key elements for implementing the partialization strategy through selecting an appropriate initial demonstration site are delineated: success potential, access, linkage, and acceptance by the larger population. Partialization in this context examined two research case studies. The case studies provide specific illustrations of how partialization, when conducted as postulated, facilitated desired diffusion of innovations.

California↗
PubMed1985

Biological effects of White-type polysaccharides of gram-negative bacteria.

The White-type polysaccharide (WPS), often called Freeman polysaccharide, was obtained by hydrolyzing gram-negative bacteria in 0.2 N acetic acid at 100 degrees C for 2 h. The crude product contained partially degraded O-antigens as well as other components that were active as immune adjuvants, enhancers of macrophage cytotoxicity of tumor target cells, and inducers of osteoclastic bone resorption. The same WPS preparation augmented the tumor cytotoxicity of normal mouse spleen cells and slightly retarded the take of L1210 leukemia in mice. The WPS preparations generated colony-stimulating factor in mice but were not active in lymphoproliferative (mitogenicity) tests. Chemical analyses of the WPS preparations did not detect the presence of components characteristic of the lipid moiety of endotoxins. The WPS samples were also negative in biological assays of endotoxicity such as local Shwartzman and toxicity tests. These findings indicate that gram-negative bacteria contain nonendotoxin components that are potent modifiers of some biological responses.

Actinobacillus↗
PubMed1984

A Phase II trial of high-dose intravenous interferon alpha-2 in advanced colorectal cancer.

Twenty-one patients with metastatic colorectal cancer were treated with high-dose intravenous interferon alpha-2 (30-50 X 10(6) units/m2) administered daily for 5 consecutive days. Courses of therapy were repeated every 2 to 3 weeks. No tumor responses were seen among 15 evaluable patients. In two subjects, disease remained stable for 3 and 7 months, respectively. Toxicity was substantial and a de-escalation of dose was frequently required. Fevers, gastrointestinal symptoms, fatigue, leukopenia, and elevated serum transaminases were common. High-dose interferon was found to be ineffective in the treatment of metastatic colorectal cancer. A daily dose of 50 X 10(6) units/m2 was greater than the maximum tolerated dose in this group of patients.

Adult↗