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Biomedical subjects

M Fine

Publications and source records attributed to M Fine.

At least 19 recordsLinked to original sources
PubMed1992

Nosocomial infection and antibiotic utilization in geriatric patients: a pilot prospective surveillance program in skilled nursing facilities.

Prospective surveillance of nosocomial infection was conducted at seven skilled proprietary nursing facilities in Orange County, Calif., USA. The average incidence of facility-acquired infection was 5.2 infections/1,000 patient days. The most common source of infection was urinary tract (47%), followed by respiratory tract (26%) and skin (14%). The four most common pathogens isolated were Proteus spp. (20%), Escherichia coli (17%), Staphylococcus aureus (13%) and Pseudomonas spp. (11%). Trimethoprim-sulfamethoxazole (20%) was the most frequently used antibiotic among all prescriptions, followed by ampicillin (16%) and ciprofloxacin (14%). Among all residents surveyed, 33% received at least one course of antibiotics during the study. Of special significance was the fact that 4 (22%) of the 18 strains of Pseudomonas were gentamicin resistant as were 12 of 80 (15%) of the strains of Enterobacteriaceae. Furthermore, 9 of 29 (31%) strains of Pseudomonas tested were found resistant to norfloxacin as were 15 of 129 (12%) strains of enterobacteriaceae. Susceptibility patterns of the isolated pathogens were similar to those of the acute care hospital. This study indicates that infection continues to be a major problem in the skilled nursing facility and that antibiotic-resistant pathogens will be a challenge for the future.

Adolescent↗
PubMed1992

A comparison of the psychological profiles of teenage mothers and their nonmother peers: I. Ego development.

Two projective techniques were employed to explore the psychological characteristics of teenage mothers who were found, in a previous study, to have experienced more traumatic childhoods than the nonmother control group. Part I, presented here, investigated ego development using the Loevinger Sentence Completion Test. (Part II, responses to a set of TAT cards, will appear in a subsequent issue of Adolescence.) In comparison with the nonmothers, teenage mothers demonstrated more mature ego development. This is in distinct contrast with most reports in the literature, and the ramifications of these results are discussed. In addition, content analyses of the responses to the Sentence Completion Test confirm the highly involved mother-daughter and negative father-daughter relationships found in the previous study with this sample.

Adolescent↗
PubMed1992

A comparison of the psychological profiles of teenage mothers and their nonmother peers: II. Responses to a set of TAT cards.

In Part I of this investigation (Oz, Tari, & Fine, 1992), it was found that, in comparison with nonmother peers, teenage mothers demonstrated a higher degree of ego development. This was in contradiction to most of the literature on the subject. In the second part of the study, the Thematic Apperception Test was employed to examine defenses and motivations which may impact upon the young girls' functioning within family and heterosexual relationships. Results confirmed reports in the literature which have indicated that adolescent mothers attempt to resolve autonomy-dependence conflicts in heterosexual relationships, whereas nonmothers do so within the family of origin. Consistent with their enhanced ego maturity, teenage mothers were more likely to confront their conflicts than were nonmothers. However, whereas nonmothers reacted to environmental stressors by rejecting the source of the stress, teenage mothers tended to react with self-abasement. It is recommended that further research be directed toward uncovering the emotional and cognitive resources of teenage mothers rather than focusing on their more obvious weaknesses.

Adolescent↗
PubMed1991

Family relationship patterns: perceptions of teenage mothers and their non-mother peers.

Perceptions of self and family members were determined at two time periods for a sample of 30 teenage mothers and 30 non-mothers using the Family Relations Inventory and a family map exercise. Both at present and from childhood reminiscences, teen mothers perceived their mothers and sisters more positively than did non-mothers; fathers and brothers of the adolescent mothers were viewed more negatively than were those of the non-mothers. Results are discussed in light of prior explanations of adolescent motherhood with respect to family dynamics. An approach to intervention is suggested.

Adolescent↗
PubMed1991

Tyranny and freedom: looking at ideas in the practice of family therapy.

This article comments upon recent "second-order" family therapy concerns about the nature of the therapeutic relationship, and explores how ideas held by therapists may rule and restrict therapeutic conversations. Ideas are examined in the light of how adherence to them might open space (free) or close space (tyrannize) with respect to the therapeutic relationship. The authors propose a philosophical viewpoint, a methodology, and practical suggestions for therapists wishing to maintain a stance of relative freedom with respect to ideas in their work with clients.

Attitude of Health Personnel↗
PubMed1990

A mutant neomycin phosphotransferase II gene reduces the resistance of transformants to antibiotic selection pressure.

The neo (neomycin-resistance) gene of transposon Tn5 encodes the enzyme neomycin phosphotransferase II (EC 2.7.1.95), which confers resistance to various aminoglycoside antibiotics, including kanamycin and G418. The gene is widely used as a selectable marker in the transformation of organisms as diverse as bacteria, yeast, plants, and animals. We found a mutation that involves a glutamic to aspartic acid conversion at residue 182 in the protein encoded by the chimeric neomycin phosphotransferase II genes of several commonly used transformation vectors. The mutation substantially reduces phosphotransferase activity but does not appear to affect the stability of the neomycin phosphotransferase II mRNA or protein. Plants and bacteria transformed with the mutant gene are less resistant to antibiotics than those transformed with the normal gene. A simple restriction endonuclease digestion distinguishes between the mutant and the normal gene.

Anti-Bacterial Agents↗
PubMed1990

New and emerging etiologies for community-acquired pneumonia with implications for therapy. A prospective multicenter study of 359 cases.

Three hundred fifty-nine consecutive patients with community-acquired pneumonia admitted to university, community, and VA hospitals underwent a standardized evaluation, including specialized tests for Legionella spp. and Chlamydia pneumoniae (TWAR). The most common underlying illnesses were immunosuppression (36.3%), chronic obstructive pulmonary disease (32.4%), and malignancy (28.4%). The most frequent etiologic agents were Streptococcus pneumoniae (15.3%) and Hemophilus influenzae (10.9%). Surprisingly, Legionella spp. and C. pneumoniae were the third and fourth most frequent etiologies at 6.7% and 6.1%, respectively. Aerobic gram-negative pneumonias were relatively uncommon causes of pneumonia despite the fact that empiric broad-spectrum combination antibiotic therapy is so often directed at this subgroup. In 32.9%, the etiology was undetermined. Antibiotic administration before admission was significantly associated with undetermined etiology (p = 0.0003). There were no distinctive clinical features found to be diagnostic for any etiologic agent, although high fever occurred more frequently in Legionnaires' disease. Clinical manifestations for C. pneumoniae were generally mild, although 38% of patients had mental status changes. Mortality was highest for Staphylococcus aureus (50%) and lowest for C. pneumoniae (4.5%) and Mycoplasma pneumoniae (0%). We document that specialized laboratory testing for C. pneumoniae and Legionella spp. should be more widely used rather than reserved for cases not responding to standard therapy. Furthermore, realization that C. pneumoniae and Legionella spp. are common etiologies for community-acquired pneumonia should affect empiric antibiotic prescription.

Adolescent↗
PubMed1990

Deep vein obstruction and leg swelling caused by femoral ganglion.

We present a case of a rare ganglion cyst originating from the hip joint and compressing the common femoral vein producing signs and symptoms that mimicked a deep vein thrombosis. Excision of the mass promptly restored normal venous return. This condition has not been previously reported in the English-language medical literature.

Constriction, Pathologic↗
PubMed1990

The effect of nortriptyline in elderly patients with cardiac conduction disease.

Ten depressed, elderly patients with cardiac conduction abnormalities were given therapeutic doses of nortriptyline. Serial ECGs revealed no clinically significant adverse cardiac changes. These data, added to the findings of previous research, suggest that tricyclic antidepressants (TCAs) present little risk in patients with first degree atrioventricular block or hemiblock. Patients with bundle-branch block and bifascicular block are at greater risk of adverse cardiac sequelae but can be treated with TCAs. To maximize safety, the authors recommend monitoring serial ECGs and plasma TCA levels.

Aged↗
PubMed1990

Long-term changes in corneal endothelium after keratoplasty. A follow-up study.

In 1983, Abbott et al. assessed endothelial cell population and function in 100 clear corneal grafts (72 patients) that were an average of 17.4 years postkeratoplasty. The present study reports on 61 of these grafts (42 patients) followed for an additional 4-6 years. Forty-nine grafts without intercurrent complications or surgery were reexamined by specular microscopy to determine the change in endothelial population in each graft. In 10 others, the reasons for regrafting were recorded. In two cases of hereditary stromal dystrophy, stromal opacity precluded a cell count. Of the grafts studied, 49 (80%) remained clear despite a depleted and slowly decreasing endothelial population. The rate of change was independent of donor age, preoperative diagnosis, or graft longevity. Two grafts failed spontaneously, and all three grafts that had cataract surgery failed in the early postoperative period. The remaining five were regrafted to correct high astigmatism or other complications. We conclude that despite a small degree of continuous cell loss, corneal grafts have a favorable prognosis for long-term clinical stability. The remaining endothelium has a minimal functional reserve, however, resulting in a high risk of graft decompensation after additional endothelial trauma.

Cell Count↗
PubMed1989

Intergenerational relations and family therapy research: what we can learn from other disciplines.

Although there are a number of theories regarding intergenerational relations within the family therapy field, few of these theories have been empirically examined. Indeed, intergenerational family research is in its infancy in the family therapy world. This article explores the literature on intergenerational relations within the sociological and psychosociological disciplines in order to understand what is known, and how this information could assist family therapy researchers interested in developing systematic studies of intergenerational relations for the family therapy field.

Age Factors↗
PubMed1988

A comparison of childhood backgrounds of teenage mothers and their non-mother peers: a new formulation.

Thirty-nine teenage mothers and 35 non-mothers, acquired by snowball sampling, provided data regarding their demographic and childhood backgrounds for an exploratory, hypothesis-generating study. Teenage mothers tended to have experienced foster care, family violence, parental substance abuse, lower educational achievements, as well as violence, alcohol abuse, and lower education among their boyfriends to a greater extent than did non-mothers. These results were discussed in terms of a new formulation of antecedents to teenage pregnancy.

Adolescent↗