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Biomedical subjects

L Sher

Publications and source records attributed to L Sher.

At least 73 records · Page 4Linked to original sources
PubMed2000

Controversies in the medical management of persistent and recurrent acute otitis media. Recommendations of a clinical advisory committee.

Streptococcus pneumoniae is the predominant bacterial pathogen associated with acute otitis media (AOM), causing an estimated 7 million cases annually in the United States. Bacterial resistance should be considered when selecting an antimicrobial agent for otitis media. Significant increases in drug-resistant S pneumoniae are documented worldwide, and less than 50% of S pneumoniae strains are fully susceptible to penicillin in some regions of the United States. Although amoxicillin is recommended for uncomplicated AOM, treatment guidelines should be flexible and adaptable, taking into consideration local and regional susceptibility patterns, the age of the patient, the frequency of prior infections, and the response to prior therapy. Resistant organisms are more prevalent in children younger than 2 years of age and in those who have recurrent or persistent AOM. Overdiagnosing AOM, selecting inappropriate empiric therapy, or both, leads to overuse and misuse of antibiotics and causes increased drug resistance. This article reviews persistent and recurrent AOM and discusses the pitfalls of diagnosis and the practical limitations of current treatment recommendations.

Acute Disease↗
PubMed1999

The role of genetic factors in the etiology of seasonal affective disorder and seasonality.

The study of the genetic basis of seasonal affective disorder (SAD), a condition where depressions in fall and winter alternate with nondepressed periods in the spring and summer, has recently received attention. The data on the genetics of seasonal affective disorders are of three types: 1. Familiality: Studies on the prevalence of psychiatric disorders among relatives of patients with SAD suggested a familial contribution to the development of SAD; 2. Heritability: A survey of a cohort of twins showed that genetic effects exert a global influence across a variety of behavioral traits and accounted for at least 29% of the variance in seasonality in men and women; 3. Molecular genetic research: two genetic variants related to serotonergic transmission, the 5-HTTLPR and the 5-HT2A-1438G/A gene promoter polymorphisms, are associated with SAD; the former but not the latter polymorphism is related to seasonality. Future research may clarify the role of different genes in the development of SAD.

Adult↗
PubMed1999

Free thyroxine and thyroid-stimulating hormone levels in patients with seasonal affective disorder and matched controls.

Seasonal affective disorder (SAD) is characterized by recurrent episodes of depression in the fall and winter that alternate with nondepressed periods in the spring and summer. Because some symptoms of SAD, such as decreased energy and weight gain, also occur in hypothyroidism, it is possible that individuals with SAD have a subtle decrease in thyroid function. To test this hypothesis, we studied blood levels of free thyroxine (T4) and thyroid-stimulating hormone (TSH) in SAD patients and matched controls in the winter. We found that free T4 blood levels were slightly but significantly lower in patients than in healthy volunteers. The difference between TSH levels in SAD patients and controls was not statistically significant. Future research will be needed to determine whether the difference in thyroid function between SAD patients and controls is an epiphenomenon or is related to the biological mechanisms that cause symptoms of SAD.

Adult↗
PubMed1999

Association between seasonal affective disorder and the 5-HT2A promoter polymorphism, -1438G/A.

Genes involved in serotonin metabolism are good candidates for the pathogenesis of seasonal affective disorder (SAD). A functional variant in the serotonin transporter promoter, 5-HTTLPR, has recently been shown to be associated with SAD and seasonality. The purpose of this study was to determine whether -1438G/A, a polymorphism in the 5-HT2A promoter, is associated with SAD and seasonality, and whether it has additive effects with 5-HTTLPR on seasonality. Sixty-seven individuals with SAD and 69 normal volunteers, all screened with the SCID and diagnosed according to DSM-III-R criteria, were genotyped for the -1 438G/A 5-HT2A promoter polymorphism. All had been previously genotyped for 5-HTTLPR and had been assessed for seasonality by the Global Seasonality Scale. There was a significant increase in the frequency of the -1438A variant allele of the 5-HT2A promoter polymorphism in SAD patients (0.47) compared to matched controls (0.36) (P < 0.01). The difference in genotype distribution was also significant (P < 0.05). We found no association between the -1438G/A polymorphism and seasonality scores, and there was no additive effect with 5-HTTLPR on seasonality. In conclusion, we have shown that the -1438G/A 5-HT2A promoter variant is associated with SAD but not with seasonality. We suggest that the association may instead be with the depressive symptoms of SAD. However, these results should be treated with caution until replicated because of the possibility of false-positive findings in case-control association studies.

Adenine↗
PubMed1999

On the role of neurobiological and genetic factors in the etiology and pathogenesis of suicidal behavior among immigrants.

Immigrants have higher rates of suicidal behavior than those in their countries of origin and their new countries. Immigration is a stressful life event which may lead to depression and suicidal behavior. Depressive disorders and suicidal behavior have a firm neurobiological and genetic basis. The author suggests that most immigrants who exhibit suicidal behavior in the new country had suicidal tendencies, and/or some degree of depression, and/or certain maladaptive personality traits in their countries of origin. The paper emphasizes the role of genetic and neurobiological factors in the human response to stressful events.

Depression↗
PubMed1999

Effects of psychological factors on the development of cardiovascular pathology: role of the immune system and infection.

Psychological factors affect the condition of both healthy and sick people. Acute and chronic stress, depression, anxiety, maladaptive personality traits, and other behavioral disorders cause the diseases of the heart and blood vessels. The same psychological factors suppress the immune system and promote infection. Recent studies have demonstrated that infections can play an important role in the development of coronary artery disease. The author suggests that the immune system may mediate the harmful effects of certain psychological factors on the cardiovascular system.

Cardiovascular Diseases↗
PubMed1998

Short note: Behavioral genetic research: achievements and concerns.

Behavioral genetic research is advancing rapidly. This can result in the improvement in diagnosis and treatment of psychiatric disorders. However, humankind may not be able to use reasonably the results of research into the genetic basis of behavior, and genetic discoveries may lead to the violation of human rights. The author calls for international cooperation in order to make sure that the results of genetic research will be used for the sake of people.

Ethics, Medical↗