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Biomedical subjects

J Saltzman

Publications and source records attributed to J Saltzman.

12 recordsLinked to original sources

Theory of mind and executive functions in normal human aging and Parkinson's disease.

Although the majority of research in theory of mind (TOM) has focused on young children or individuals with autism, recent investigations have begun to look at TOM throughout the lifespan and in other neurological and psychiatric populations. Some have suggested that TOM may represent a dissociable, modular brain system that is related to, but separable, from other brain functions including executive functions (EF). Recently, studies have shown that TOM performance can be compromised following an acquired brain insult (e.g., damage to the right hemisphere). However, the relationship of such impaired TOM performance to other brain functions in these cases has not been explored. This study investigated the effects of both normal human aging and Parkinson's disease on TOM. The relationship of TOM performance and EF in these groups was also examined. The results suggested that although TOM performance appeared compromised in the group of individuals with Parkinson's disease, the elderly control participants were relatively unimpaired relative to younger individuals. Significant relationships between several measures of TOM and EF were also found. The implications of these findings, and also the finding that failure on one measure of TOM did not necessarily predict failure on all measures of TOM, are discussed.

Aged↗

Acceptance of an ABO-incompatible mismatched (AB(+) to O(+)) liver allograft with the use of daclizumab and mycophenolate mofetil.

Liver allograft survival rates of 50% to 60% are reported in blood group A, group B, group O (ABO)-incompatible mismatched grafts even when aggressive immunosuppressive protocols, including plasmapheresis, OKT(3), cyclophosphamide, cyclosporine, prostaglandin E(1), and steroids, are used. A 59-year-old woman, blood type O(+), required emergency retransplantation posttransplantation day 2 because of primary nonfunction of the liver allograft. A blood type AB(+) allograft was used. Induction immunosuppressive therapy included tacrolimus, mycophenolate mofetil, OKT(3) (muromonab-CD(3)), steroids, and prostaglandin E(1). In addition, plasmapheresis was performed daily for 9 days. OKT(3) and prostaglandin E(1) were also discontinued postoperative day 9. Biopsy-proven acute cellular rejection was diagnosed postoperative day 12 and was treated with double-dose OKT(3) (10 mg) for another 6 days. On the day OKT(3) was discontinued, daclizumab, 60 mg, was administered intravenously. This dose was repeated every 2 weeks for a total of 5 doses. At 1-year follow-up, the patient is doing very well with normal liver function. We are unaware of previous reports of the use of daclizumab and mycophenolate mofetil as part of an immunosuppressive protocol aimed to induce acceptance of ABO-incompatible mismatched liver allografts. Based on our experience with this case, it seems that mycophenolate mofetil is an adequate replacement for cyclophosphamide. We also believe daclizumab provided adequate protection at a critical time. Further experience with both these drugs is required to establish their role in ABO-incompatible mismatched liver allografts.

Antibodies, Monoclonal↗

The cultural bounds of maternal accommodation: how Chinese and American mothers communicate with deaf and hearing children.

Children with special needs typically require family accommodation to those needs. We explore here the extent to which cultural forces shape the accommodations mothers make when communicating with young deaf children. Sixteen mother-child dyads (8 Chinese, 8 American) were videotaped at home. In each culture, 4 mothers interacted with their deaf children, and 4 interacted with their hearing children. None of the deaf children knew sign language, nor spoke at age level. We found that mothers adjusted their communicative behaviors to their deaf children, but in every case, those adjustments were calibrated to cultural norms. American mothers, for example, increased their use of gesture with deaf children but stopped far short of the Chinese range--despite the obvious potential benefits of gesturing to children who cannot hear. These findings provide the first cross-cultural demonstration that children are, first and foremost, inculcated into their cultures and, only within that framework, then treated as special cases.

Child, Preschool↗

Neuropsychological function in mild hyperphenylalaninemia.

Whether specific cognitive deficits related to frontal-lobe dysfunction that have been reported in individuals with phenylketonuria (PKU) are also characteristic of mild hyperphenylalaninemia (MHP) was investigated. Tests of executive function and control tasks not assessing executive function were administered to a group of individuals with MHP and a group without MHP, similar in age, gender, and IQ. Tests of academic skills and behavior-rating questionnaires were also administered to the group with MHP. No group differences were found for any measure, suggesting that the mild elevations of phenylalanine in individuals with MHP are not sufficient to produce behavioral and cognitive impairments characteristic of PKU.

Adolescent↗

Colorectal intussusception: an unusual gastrointestinal complication of hereditary angioedema.

A 21-year-old man with a history of hereditary angioedema presented with protracted abdominal pain which failed to respond to infusion of C1 inhibitor concentrate. Evaluation by CT scan revealed extensive colorectal intussusception requiring surgical intervention. Under replacement therapy with C1 inhibitor concentrate, both the operation under general anesthesia and the postoperative phase were uneventful. The intraoperative examination suggested initiation of intussusception by local mucosal edema in the transverse colon.

Adult↗

[Bronchopulmonary sequestration].

Intrapulmonary sequestration is a rare disorder which should be considered when an intrathoracic mass is found in the lower part of the lungs. The clinical symptoms range, as in our two patients, from an asymptomatic mass in the chest X-ray film to frequent pulmonary infections. A definite diagnosis is possible only by visualization of the aberrant artery by arteriography, which is also helpful to the surgeon at lobectomy.

Adult↗

[Real-time sonography of cholangiolithiasis. Dependence of the diagnostic accuracy on the competence of the operator].

The reliability of sonography for demonstrating bile duct stones depends on technical factors and on the experience of the operator. The pick up rate of an experienced operator has been compared with that of three other doctors who had performed sonography only briefly and intermittently. This was based on the results of surgery in 142 patients. The sensitivity of the experienced operator was 72.4% and almost twice that of the other doctors, who showed an accuracy of 37.5 and 44%. The competence of the operator depends not only on adequate training, but also on continuous practice.

Adult↗

A new puncture needle (Seldinger technique) for easy antegrade catheterization of the superficial femoral artery.

Mainly for anatomical reasons a guide-wire or a catheter has a tendency to turn into the deep femoral artery during antegrade catheterization of the lower limb. To overcome this problem a curved puncture needle has been designed which allows positioning of the guidewire in an anterior direction. Antegrade catheterization of the superficial femoral artery was achieved in 25 patients without lengthy manipulations or complications. With this technique the rate of complications at antegrade catheterization will probably be reduced.

Catheterization↗

Developing new options in home-delivered meals: the SMOC demonstration elderly nutrition project.

The purpose of this project was to design and test alternative approaches to in-home nutrition services for the elderly. Two meals systems--weekly delivery of five frozen meals and the daily delivery of hot meals--were evaluated for client approval, effect on clients' social contacts, and costefficiency. The alternative frozen meals system met with clients' acceptance, maintained clients' usual social patterns, and produced a cost savings of at least 16%. The development of a more flexible approach to home-delivered meals offers possibilities both for better serving clients' needs and for improving cost efficiency. It therefore has implications for elderly nutrition services nationwide.

Aged↗