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Biomedical subjects

M Friedman

Publications and source records attributed to M Friedman.

At least 775 records · Page 43Linked to original sources
PubMedDate not supplied

Prospective evaluation of colonic obstruction with computed tomography.

BACKGROUND: To determine whether computed tomography (CT) can satisfactorily diagnose and evaluate patients with suspected colonic obstruction. METHODS: Seventy-five patients with suspected colonic obstruction were evaluated prospectively by CT and compared with the gold standards of surgery and/or endoscopy in 65 patients, clinical course in nine, and contrast enema (CE) in one. A limited comparison between CT and CE (26) patients was also made in those patients who had both studies. RESULTS: CT successfully diagnosed colonic obstruction in 45 of 47 patients (96% sensitivity). Pseudo-obstruction was correctly diagnosed in 26 of 28 patients (93% specificity). CT correctly localized the point of obstruction in 44 of 47 patients (94%). CE successfully diagnosed obstruction in only 20 of 25 patients (80% sensitivity). CONCLUSION: In this study, CT proved to be a satisfactory modality in evaluating patients with suspected colonic obstruction. CT may in certain circumstances be preferable to the traditional CE in evaluating these patients.

Adult↗
PubMedDate not supplied

Neurogenic hypercholesterolemia: influence of autonomic drugs.

Eleven substances capable of either augmenting or depleting the alpha- and - beta-adrenergic capacities of the autonomic nervous system were administered to rats exhibiting hypothalamic hypercholesterolemia and to normal controls. Only the beta-adrenergic blocking agents propranolol and possibly 6-OH dopamine were observed to alter (raise) the serum cholesterol concentration, and this occurred in both experimental and control animals. Neither atropine, nor the serotonin-depleting agent, rho-chlorophenylalanine, nor the serotonin-antagonist cyproheptadine, were observed to alter serum cholesterol level. Such absence of effect was also noted with metaraminol, phenoxybenzamine, isoproterenol, epinephrine, reserpine, and alpha-methyl tyrosine.

Adrenergic alpha-Agonists↗
PubMedDate not supplied

Compliance with chronic disease regimens: diabetes.

Patient compliance with the prescribed management regimen is presented as the fourth component responsible for control of blood sugar in insulin-taking diabetics, along with insulin dose, food consumed, and exercise performed. Noncompliance is ascribed to a large variety of reasons which vary in importance from diabetic to diabetic. A survey of ten diabetic women, two of whom were uremic and eight of whom were renal transplant recipients, was conducted to assess their compliance with advised shoe prescriptions. Observed compliance with wearing acceptable shoes is delineated as occurring because it fits with patients' life-styles. It was found that three of ten women refused to wear recommended footgear all of the time, whereas one woman varied her acceptance of advised shoes. Contracts between patients and health care team members are offered as a means of encouraging compliance; individualizing the health team's care of the patient is put forward as the most significant approach.

Diabetes Mellitus↗
PubMedDate not supplied

Comparative performance of gated perfusion SPECT wall thickening, delayed thallium uptake, and F-18 fluorodeoxyglucose SPECT in detecting myocardial viability.

To evaluate the comparative abilities of gated single photon emission computed tomography (SPECT) wall thickening, delayed thallium-201 (Tl-201) SPECT, and F-18 fluorodeoxyglucose (FDG) SPECT in detecting myocardial viability, 23 patients with previous myocardial infarction and clinically suspected viability were studied. Each patient had at least 1 extensive fixed perfusion defect on rest/stress technetium-99m sestamibi SPECT. A total of 41 major vascular territories had fixed defects. The mean (+/- 1 SD) left ventricular ejection fraction determined from gated perfusion SPECT was 26% +/- 11%. Wall thickening was assessed in a semiquantitative fashion by the regional increase in myocardial intensity during systole and was considered normal when a > or = 20% increase was observed. Tl-201 SPECT was acquired 4 hours after resting tracer injection was administered. Viability was considered present when regional defect Tl-201 count density, determined by quantitative analysis, was > 20% greater than that on the resting sestamibi scan. FDG SPECT was performed independently with a 10 mCi F-18 FDG dose after oral glucose loading was performed. A camera equipped with ultrahigh energy collimation was used. Quantitative criteria for viability were the same as for Tl-201. In the 23 patients viability within the fixed sestamibi defects was manifest by preserved wall thickening in 8 patients, delayed Tl-201 uptake in 10 patients, and FDG uptake in 18 patients. Nine major vascular territories with fixed defects were judged viable by wall thickening, 11 by Tl-201 SPECT, and 24 by FDG SPECT (P = .0009). We conclude that FDG SPECT demonstrates more evidence of myocardial viability than either gated sestamibi wall thickening or delayed Tl-201 SPECT.

Female↗
PubMedDate not supplied

Artifactual reverse distribution pattern in myocardial perfusion SPECT with technetium-99m sestamibi.

BACKGROUND: The reverse distribution pattern (RDP), in which resting perfusion imaging demonstrates a de novo or more marked regional defect than that present in stress images, is observed frequently in patients with a low likelihood of coronary artery disease. METHODS AND RESULTS: To determine whether this scan pattern is artifactual and to investigate its causes, we retrospectively evaluated scans in 202 patients with a low likelihood of coronary artery disease (77 men and 125 women) undergoing single-day rest/stress technetium-99m sestamibi single photon emission computed tomography (SPECT). The presence and location of RDP was correlated with relevant body habitus parameters. RDP was observed in 15.3% of patients. The finding was significantly more frequent in patients who were obese (P<.02 in men, P<.03 in women), in men with abdominal protuberance (P<.05), and in women with prominent breast "shadows" observed on planar projection images (P<.008). RDP was most frequent in the right coronary artery territory in men and the left anterior descending coronary artery territory in women. It was demonstrated by means of a cardiac SPECT phantom experiment that soft tissue attenuation effects were most evident in low count density SPECT studies with localized soft tissue attenuation, accounting for the higher than clinical observation of RDP in obese patients undergoing low-dose rest/high-dose imaging. CONCLUSIONS: RDP is a frequently encountered artifact in obese patients undergoing rest/stress Tc-99m sestamibi SPECT, particularly in men with abdominal protuberance and in women with large, dense breasts.

Artifacts↗
PubMedDate not supplied

Browning prevention in fresh and dehydrated potatoes by SH-containing amino acids.

N-Acetyl-L-cysteine and reduced glutathione were excellent inhibitors of browning of potatoes. In most cases, these two SH-containing compounds were more efficient inhibitors than L-cysteine and approached the effectiveness of sodium sulphite. These considerations suggest that N-acetyl-L-cysteine and reduced glutathione merit extensive evaluation as potentially useful inhibitors for food products.

Acetylcysteine↗
PubMedDate not supplied

The burn as a continuous traumatic stress: implications for emotional treatment during hospitalization.

Relating to the patient with burns as being posttraumatic calls for specific guidelines in emotional therapy. But it seems that burn injury differs from other posttraumatic situations in that it confronts the patient with a much more complex situation, including not only the actual burn experience but also the ensuing difficult period of hospitalization and the subsequent renewed encounter with the social environment. That is why we see the patient with burns as suffering from a Continuous Traumatic Stress Disorder rather than from a Posttraumatic Stress Disorder. Although both disorders confront the patient with the same symptoms and with the experience of shattering the stimulus barrier and that of the basic assumptions, like the concept of self, invulnerability, and the world, they still differ in duration of the trauma. This calls for "dos and don'ts" as treatment principles at the time of the hospitalization, which help the patient's ability in coping with the continuous trauma.

Adaptation, Psychological↗