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Biomedical subjects

J Zimmerman

Publications and source records attributed to J Zimmerman.

At least 127 records · Page 7Linked to original sources
PubMed1985

Chronic pain: a multiple-setting comparison of patient characteristics.

Chronic pain patients attending four different pain management programs (N = 160) were compared on multiple variables encompassing demographics, the nature of the pain problem, and treatment history. Programs were selected because they differed on several dimensions (e.g., geographic location, general hospitals vs those serving veterans of Armed Services, university affiliated vs nonaffiliated) believed potentially to interact with treatment outcome. Results indicated differences between hospital programs serving veterans and general hospital programs (serving nonveterans) in terms of patients' age, percentage married, disability compensation, duration of pain symptoms, and treatment history. In addition, findings indicated that covariance among pain variables was dissimilar across the four types of pain programs, making it difficult to generalize from one type of setting to another regarding issues such as choice of optimal treatment.

Adult↗
PubMed1985

Electrophysiologic testing in patients with recurrent syncope: are results predicted by prior ambulatory monitoring?

Syncope is a common medical problem which can result from many etiologies, including cardiac dysrhythmias. Because ambulatory monitoring usually fails to capture a syncopal episode, electrophysiologic testing has been used to elucidate dysrhythmic mechanisms in patients with recurrent syncope. To assess whether findings on ambulatory monitoring not obtained during syncope can be used to indicate the results which are found on electrophysiologic testing in patients with recurrent syncope, we reviewed the ambulatory monitoring records of 59 such patients referred for electrophysiologic testing. Although 29 patients had abnormalities on electrophysiologic testing, 13 of which were severe, in only six were the findings suggested by the abnormalities recorded during ambulatory monitoring. Twenty-one patients actually had concordance between electrophysiologic testing and ambulatory monitoring results, but in 15 of the 21 results of both tests were normal. Severe abnormalities were more frequently detected in our patient population by electrophysiologic testing than by ambulatory monitoring, especially if patients had organic heart disease.

Adolescent↗
PubMed1985

Computer application in a gastrointestinal endoscopy unit.

A computerized system for accurate recording of endoscopic findings in the gastrointestinal tract is described. This system is easy to use, permits rapid retrieval of data of previous examinations, and permits collection and compilation of data for any purpose. A similar system can be adopted for use in any endoscopy unit.

Diagnosis, Computer-Assisted↗
PubMed1985

Recruitment of subjects for fecal occult blood screening: a comparison of two methods in Jerusalem.

Two approaches to the recruitment of subjects for screening for fecal occult blood were tested in two middle-class neighborhoods in Jerusalem. After invitations were mailed to 2,909 persons aged 40 and older, 855 (29%) requested the special "Colo-Screen" packet of slides; and 496, one-sixth of those contacted originally, ultimately returned stool specimens for examination. In a parallel campaign by family doctors, invitations were distributed personally to 324 patients visiting a Sick Fund Clinic; 225 (69%) requested Colo-Screen slides and 137 (42% of the persons invited) sent in stool specimens. Males and females responded equally. Of the 633 specimens received, 29 (4.6%) were positive for occult blood; two cancers and seven adenomatous polyps were found and resected. Screening programs for colorectal cancer should encourage greater personal participation of family doctors in the recruitment process.

Colonic Neoplasms↗
PubMed1985

Should we worry about gastric cancer in duodenal ulcer patients?

In three patients with active duodenal ulcer, carcinoma of the stomach was detected early during routine endoscopic examination. In all patients subtotal gastrectomy was performed, and pathological examination of the resected stomach revealed carcinoma confined to the mucosa. We review evidence for and against any association between gastric carcinoma and peptic ulcer disease.

Adenocarcinoma↗
PubMed1985

Guillain-Barré syndrome: a possible extraintestinal manifestation of ulcerative colitis.

In two elderly patients with ulcerative colitis, acute Guillain-Barré syndrome developed while the inflammatory bowel disease was in remission. The patients were treated with corticosteroids and recovered. Since both disorders are relatively uncommon, we suggest that the Guillain-Barré syndrome may have been causally related to the preexisting chronic inflammatory bowel disease. Guillain-Barré syndrome may be regarded as a possible extraintestinal complication of chronic ulcerative colitis.

Adrenal Cortex Hormones↗
PubMed1985

Early and late onset ulcerative colitis: distinct clinical features.

A review of 93 patients with ulcerative colitis revealed that in 47 (50.5%) symptoms first appeared between 21 and 30 years of age--"early-onset"--and in 26 (27.9%) at the age of 51 years or above--"late-onset." Proctocolitis was more common in late-onset patients (p = 0.077) and in males of both age groups (p = 0.002). Extensive colitis was significantly more common in females (p = 0.002). Patients with late-onset proctocolitis had more bowel movements/day and liver involvement than patients with early-onset disease. The first episode of proctocolitis was more protracted and the ensuing remission of shorter duration in late-onset patients. Most patients with early-onset disease improved on steroid enemas, whereas most patients with late-onset disease required systemic corticosteroid therapy (p = 0.0028). Female patients with early-onset proctocolitis tended to be more severely afflicted than males, with an increased incidence of weight loss, leukocytosis, increased erythrocyte sedimentation rate (ESR), and need for systemic corticosteroid therapy. We conclude that late-onset ulcerative colitis is distinct from early-onset disease in its relative refractoriness to therapy and its predilection for distal colonic involvement.

Adult↗
PubMed1985

Folate transport.

Although a matter of some controversy in the face of differing experimental systems employing a wide range of substrate concentrations and conditions, there is a growing consensus that monoglutamyl folates are taken up by the intestinal epithelial cell by a structure-specific and energy-mediated transport process coded-for genetically. This "carrier-mediated" transport system can be demonstrated in several mammalian species in vitro and can be shown to be the property of the intestinal microvillus membrane in studies of isolated membrane vesicles. The transport system is highly pH-dependent with an optimum slightly below pH 6 which is very close to the pH of the proximal small intestine. At or near optimal pH the folate transport system exhibits saturation kinetics, competition among different forms of monoglutamyl folates and methotrexate, counter transport, and sensitivity to metabolic inhibitors. This system is functional in the physiological range of folate concentration under 10 microM. At high concentrations of folate in the intestine which can be achieved by folate therapy, folate uptake by diffusion is demonstrable. This latter process predominates at pharmacologic concentrations of folate above 10 microM.

Animals↗
PubMed1985

Comparison of misoprostol and cimetidine in the treatment of duodenal ulcer.

The efficacy of misoprostol (a synthetic analogue of prostaglandin E1) and cimetidine in the treatment of duodenal ulcer was evaluated. Seventy-one patients with endoscopically proven duodenal ulcer were randomized in a double-blind manner in one of three groups that received four daily doses of either misoprostol, 50 or 200 micrograms, or cimetidine, 300 mg. Ulcer healing was assessed endoscopically after 4 weeks of treatment. The mean age, sex distribution, and tobacco, alcohol and caffeine consumption were similar in all treatment groups. Only one patient was lost to follow-up. On the misoprostol low dose, healing of the ulcer was observed in 60.9% of the patients. In contrast, healing on the higher dose of misoprostol was not significantly different to that with cimetidine. No significant clinical or laboratory side effects were observed in any of the patients. We found that the daily dose of 800 micrograms misoprostol is safe and effective in the treatment of duodenal ulcer.

Adult↗
PubMed1985

Comparison of misoprostol and cimetidine in the treatment of gastric ulcer.

The efficacy of misoprostol (a synthetic analogue of prostaglandin E1) and cimetidine in the treatment of gastric ulcer was evaluated. Thirty-two patients with endoscopically proven gastric ulcer were randomized, in a double-blind manner, in one of three groups that received four daily doses of either misoprostol, 50 or 200 micrograms, or cimetidine, 300 mg. Ulcer healing was assessed endoscopically after 4 weeks of treatment. The three groups were fairly comparable in their alcohol and caffeine intake, previous ulcer history and ulcer size. A relatively high proportion of patients in the cimetidine-treated group was smokers. Only one patient was withdrawn from the study. On the misoprostol low dose, healing of the ulcer was observed in 20% of the patients. In contrast, healing on the high dose of misoprostol (70%) was not significantly different from that on cimetidine (73%). No important clinical side effects were observed in any of the patients. These results (part of a multicenter, international study) suggest that the divided daily dose of 800 micrograms misoprostol is safe and effective in the short-term treatment of gastric ulcer.

Adolescent↗
PubMed1985

Fat absorption and triglyceride synthesis and secretion by cultured human intestinal mucosa.

Uptake and esterification of fatty acids from micellar lipid solutions by human small intestinal mucosa was studied in vitro. Small bowel biopsies, obtained during endoscopy, were incubated at 37 C in RPMI 1640 medium containing various concentrations of micellar lipids (sodium taurocholate, oleate and monoolein). Oleate uptake from the micellar solution was enhanced and correlated positively with micellar ingredient concentration at a range of 2.4 to 9.6 mmol/l taurocholate. Triglyceride (TG) synthesis during incubation was affected by micellar bile salt concentration, as well as by micellar concentration of oleate and monoolein. At a high concentration of bile salt, TG synthesis was decreased. Boiling of tissue specimens resulted in complete inhibition of TG synthesis, but did not affect oleate uptake. When intestinal biopsy tissue was incubated in a micellar lipid solution and subsequently organ-cultured, gradual depletion of tissue oleate and TG content was evident, concomitant with TG secretion to the medium. TG secretion persisted during 24 h of organ culture, but decreased with time. Intestinal TG synthesis was not affected by methylprednisolone, pentagastrin, nicotinic acid or insulin, but was decreased by cimetidine.

Cimetidine↗
PubMed1984

The effects of prednisone therapy on plasma lipoproteins and apolipoproteins: a prospective study.

The effect of prednisone therapy on plasma lipoproteins and apolipoproteins A-I, A-II, and E levels was studied prospectively in a heterogeneous group of six male and six female subjects. All patients were in a good general condition. The patients had normal hepatocellular, renal, and thyroid functions. During the first month of therapy, the following changes were noted: Plasma triglyceride (TG) levels increased slightly in female patients only. In the entire group, plasma cholesterol level increased (17.3% of initial value, P less than 0.01). Plasma high-density lipoprotein cholesterol (HDL-C) level increased by 68% (P less than 0.001), while plasma low-density lipoprotein cholesterol (LDL-C) level increased by only 10.9% (not significant), resulting in an increased ratio of cholesterol in the two (P less than 0.01). No change in levels of plasma apolipoproteins A-I, A-II, and E was evident. The ratio of HDL-C to plasma apolipoprotein A-I increased (P less than 0.01), indicating an increased lipid to protein ratio for this lipoprotein. Most of these changes were already apparent and significant 48 hours after initiation of treatment and persisted throughout the follow-up period (up to 18 months in some patients). Our results show that in patients with no major metabolic abnormality, prednisone induces significant changes of the lipoprotein system, especially in HDL.

Adult↗
PubMed1984

Prosthetic valve endocarditis in pregnancy.

A case of prosthetic valve endocarditis is described, caused by Streptococcus viridans in the third trimester of pregnancy. During her illness, the patient gave birth to a normal baby in an uncomplicated vaginal delivery. She had recurrent post-partum vaginal bleeding. Aspects relevant to the management of the case are discussed.

Adult↗
PubMed1984

Intravascular metabolism of the cholesteryl ester moiety of rat plasma lipoproteins.

The intravascular metabolism of the cholesteryl ester moiety of rat plasma LDL, HDL1, and HDL2 was determined in intact male rats. Biosynthetically labeled lipoproteins were prepared by zonal ultracentrifugation from the plasma of rats injected with [3H]cholesterol. The lipoproteins were concentrated by vacuum ultrafiltration as other procedures were found to alter the biological properties of the lipoproteins. After injection of labeled LDL, [3H]cholesteryl esters remained with the injected lipoprotein and decayed from plasma with a t1/2 of 7-8 hours. [3H]Cholesteryl esters in HDL1 behaved similarly and decayed with a t1/2 of 10.5 hours. With HDL2, however, a different metabolic pattern was observed with intraplasma conversion of some [3H]cholesteryl ester HDL2 particles to HDL1. Since such conversion of HDL2 to HDL1 was not observed after in vitro incubations of rat plasma, this process seems to depend on metabolic events that occur in vivo. [3H]Cholesteryl esters disappeared from HDL2 with a t1/2 of 6-7 hours, while the esters that were transferred to HDL1 decayed with a t1/2 of 10-11 hours, similar to labeled cholesteryl esters injected with HDL1. The study demonstrated that the high apoE content of rat plasma HDL1 is not associated with rapid catabolism of the lipoprotein and that a major source of HDL1 in the rat is the intraplasma conversion of HDL2 particles to HDL1.

Animals↗