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Biomedical subjects

M Greenberg

Publications and source records attributed to M Greenberg.

At least 91 records · Page 5Linked to original sources
PubMed1997

Professor Matthew Stewart: asbestosis research 1929-1934.

Matthew Stewart, Professor of Pathology at Leeds University, developed an interest in asbestosis during the late 1920s. In 1929, the Medical Research Council (MRC), encouraged by an advisory committee, funded research into asbestosis at Leeds University. Stewart supported by physicians designed a program of clinical, radiological and physiological studies to follow up Merewether's affected asbestos workers. Unfortunately, this met with opposition from industry, and the Home Office Factory Department was reluctant to assist, so it was abandoned. Industry did, however, cooperate with Stewart's studies on the effects of exposing guinea pigs in the factory environment, but this led to little in the way of publication. The failure of the Leeds School to realize its potential in investigating the effects of asbestos in humans, results in part from the discouragement it received and in part from the limited time and energies available to persons with a wide range of active interests. Some 45 years were to elapse before the MRC were enabled to carry out an analysis of the clinical, radiological and physiological data of a population of asbestos workers.

Asbestosis↗
PubMed1997

Successful intracoronary thrombolysis in cocaine-associated acute myocardial infarction.

We describe a case of cocaine-associated acute myocardial infarction managed by cardiac catheterization and intracoronary thrombolysis. Based on this and other reported cases, it appears that an invasive approach to the management of cocaine-associated acute myocardial infarction is advantageous over intravenous thrombolysis. Such a strategy would define the pathophysiology of acute myocardial infarction in the setting of cocaine use and allow mechanical intervention should pharmacologic therapy be unsuccessful.

Adult↗
PubMed1997

Intrapericardial teratoma in a twin fetus: diagnosis and management.

BACKGROUND: A rare cause of hydrops fetalis, intrapericardial teratoma is invariably associated with a pericardial effusion. In fetal life, the effusion or mass effect may cause cardiac tamponade, hydrops, and death. After delivery, ventilation and cardiac output may be compromised. CASE: One fetus of twins was diagnosed at 20 weeks' gestation with an intrapericardial teratoma. The affected twin underwent two intrauterine pericardiocentesis and had the tumor resected after delivery at 35 weeks' gestation. One year later, both twins are alive and well and have no evidence of tumor recurrence. CONCLUSION: Pericardiocentesis for tamponade secondary to a fetal intrapericardial teratoma, even when complicating a twin pregnancy, may prevent fetal death and allow delay of delivery until adequate fetal lung maturity has been achieved.

Adult↗
PubMed1997

Partnerships between self-help networks and health care facilities: the case of the Bayview Support Network.

This article discusses the role of patients and their families as peer support providers to other patients, and as decision makers within organizations. We use as a model the Bayview Support Network, a self-help network at the Toronto-Sunnybrook Regional Cancer Centre. We review the benefits of partnership, costs, limitations and risks. A list of features that contribute to effective partnership is also provided.

Cancer Care Facilities↗
PubMed1997

Cytotoxic aldehydes as possible markers for childhood cancer.

Concentrations of 22 known aldehydes (byproducts of lipid peroxidation), 5 acyloins, free and total carnitine and acylcarnitines were measured in plasma and urine obtained from pediatric patients with various forms of cancer before any treatment, and following treatment with doxorubicin or daunorubicin. Aldehydes, before the initiation of chemotherapy, were significantly elevated in cancer patients compared to controls. Aldehydes such as hexanal, heptanal, and malondialdehyde were strikingly higher in samples from cancer patients, while trans 4-cis-4-decenal was the prominent aldehyde in the blood of controls. In addition, in each form of cancer the pattern of aldehydes appeared to be unique when compared to controls, or to others forms of cancer. In cancer patients receiving chemotherapy there was a general trend toward a reduction 24 h after both the first and after the fifth doxorubicin dose. These changes however were not significant statistically due to large inter-patient variation. Free and total plasma carnitine levels remained in the normal range, and there were no abnormal acylcarnitines detected in urine. Possible hypotheses to explain the elevations in aldehydes, and the reasons for the changed aldehyde profiles in different forms of cancer are discussed.

Adolescent↗
PubMed1997

Region of birth, migration and homicide rates of African Americans.

A study was made of all homicide deaths among black Americans during the period 1979-1991 in order to test two competing hypotheses about region of birth and region of death. One hypothesis was that Southern-born blacks had the highest homicide rates in every region of the US. The competing hypothesis was that blacks who did not migrate out of their region of birth had the highest homicide rates. We found that Southern-born blacks had the highest homicide rates among the population 35+ years old in the Northeast, Midwest, South and West. Yet non-migrants (region-born population) had higher rates than their Southern-born counterparts among the population 15-34 years old. Long distance migrants who were born in the Northeast, West or were foreign-born had the lowest homicide rates, by far. The distressing implications of these findings for public health efforts to prevent violent death are discussed.

Adolescent↗
PubMed1997

Health promotion and early detection of cancer in older adults: needs assessment for program development.

The greatest risk factor for developing cancer is age, yet little is known about the cancer-related knowledge, attitudes and beliefs of the older adult (age > 55 years). A community-based needs assessment was conducted to understand these dimensions in a large metropolitan community. Ten focus groups (n = 158 older adults) and 9 individuals were interviewed. Content analysis for the audiotaped sessions was completed. The study participants focused on "being active" and living a healthy lifestyle. Many worried about illness interfering with their ability to do what they wanted to do. Many had had exposure to cancer through family members or friends, but still had many unanswered questions about cancer. Age was not seen as a risk factor for cancer, and a range of attitudes existed regarding cancer prevention and early detection. Overall, despite fearing cancer, participants thought older adults needed to know about cancer and suggested a wide range of approaches to disseminate information effectively to older adults.

Aged↗
PubMed1997

Neighborhood quality, environmental hazards, personality traits, and resident actions.

A survey of 798 New Jersey residents examined relationships among residents' neighborhood activities, perceptions of neighborhood quality, trust of experts, support for rebuilding cities and equal rights, and degree of optimism. Neighborhood activities increased with lack of trust and optimism. These personality characteristic measures were folded into multidimensional constructs that included local environmental hazards, respondents' ratings of their previous neighborhoods, and some demographic variables. Pessimism and values that support equal rights and rebuilding cities were weakly associated with poor quality neighborhood ratings.

Age Factors↗
PubMed1997

Design and methods of a population-based natural history study of cervical neoplasia in a rural province of Costa Rica: the Guanacaste Project.

This paper reports on the enrollment phase of a population-based natural history study of cervical neoplasia in Guanacaste, a rural province of Costa Rica with consistently high rates of invasive cervical cancer. The main goals of the study are to investigate the role of human papillomavirus (HPV) infection and its co-factors in the etiology of high-grade cervical neoplasia, and to evaluate new cervical cancer screening technologies. To begin, a random sample of censal segments was selected and enumeration of all resident women 18 years of age and over was conducted with the aid of outreach workers of the Costa Rican Ministry of Health. Of the 10738 women who were eligible to participate, 10049 (93.6%) were interviewed after giving written informed consent. After the interview on cervical cancer risk factors was administered, a pelvic examination was performed on those women who reported previous sexual activity. The pelvic examination included a vaginal pH determination and collection of cervical cells for cytologic diagnosis using three different techniques. Additional cervical cells were collected for determination of the presence and amount of DNA from 16 different types of HPV, and two photographic images of the cervix were taken and interpreted offsite by an expert colposcopist. Finally, blood samples were collected for immunologic and micronutrient assays. Women with any abnormal cytologic diagnosis or a positive Cervigram, as well as a sample of the whole group, were referred for colposcopy, and biopsies were taken when lesions were observed. The enrollment screening will serve as the basis for a prevalent case-control study, and the members of the cohort free from serious disease will be followed actively, at intervals of no more than a year, to study the natural history of HPV infection and the origins of high-grade squamous intraepithelial lesions (HSIL). Details of the field operation are outlined, with particular reference to the realization of this kind of study in developing countries. Descriptive data on the prevalence of disease and exposure to various risk factors are also presented.

Adolescent↗
PubMed1997

Trichloroethylene health risk assessment: a new and improved process.

Trichloroethylene (TCE), an environmental contaminant of National concern, is the focus of a new health risk assessment process incorporating the Proposed Cancer Risk Assessment Guidelines. This paper describes not only how TCE became an environmental problem for the Air Force, but also details the new Risk Assessment process envisioned by the Environmental Protection Agency's (EPA) National Center for Environmental Assessment (NCEA). Insights on epidemiological evaluations, both past and future, and their impact on the cancer classification of TCE are discussed. Examples of how physiologically based pharmacokinetics and dose-response characterization described in the new Cancer Guidelines are applied to TCE are provided. In addition, a variety of modeling techniques are discussed for the development of reference doses (oral exposure) and reference concentrations (inhalation exposures) for TCE. Finally, the role of risk communication is included. This new process provides an example of how interagency (EPA, Department of Defense. Department of Energy) and extramural (industry, academia) partnerships can provide greater gains to the nation, as a whole, than any of the parts on their own.

Animals↗
PubMed1997

Towards an inclusive cervical cancer screening strategy: approaches for reaching socioeconomically disadvantaged women.

Barriers to prevention and early detection of cancer among the socioeconomically disadvantaged are important areas for public health focus. A community coalition was established in North York, Ontario, to identify a suitable primary prevention initiative, cervical screening among young women of lower economic status. Two pilot communities were selected for the project. Community members, key informants and service providers participated in a series of individual and focus group meetings to identify barriers that impede cervical screening. The benefits and challenges of such a project will be importance to practitioners eager to work collaboratively on primary prevention initiatives. This article will be of interest to nurses wanting to foster a community coalition approach to program design, planning, implementation and evaluation. It will also assist nurses with utilizing needs-based assessment in their work. Although the findings relate to a population of women in a large urban centre, the results will be useful for nurses and other health professionals planning to engage in work related to cervical screening.

Female↗
PubMed1997

Health promotion and early detection of cancer in older adults: a practical approach.

Little is known about the cancer-related knowledge, attitudes and health behaviours of older adults (> 55 years), or about designing health promotion and early detection interventions responsive to their learning needs. A collaborative project was established with the intent of designing an appropriate program for older adults. The initial work included a community needs assessment using focus groups, one-on-one interviews and self-report surveys. The use of key community contacts was effective in locating older adult subjects (> 55 years) through pre-established linkages with agencies. Various ethnocultural groups, low income communities and isolated individuals, as well as other pre-established groups, were included in this study. The needs assessment found that: age is not perceived as a cancer risk factor; transportation is a barrier to screening; fear inhibits people from being screened; physicians are viewed as both the main source of expert cancer knowledge and as the gatekeepers to screening; family and peers are the main source of support, ethnospecific groups have different information needs; and finally, that lifestyle suggestions can reduce the risk of cancer. The findings indicated that community health promotion programs for older adults will require multiple approaches with a combination of strategies in order to meet their learning needs.

Aged↗
PubMed1997

Early life experiences linked to diabetes mellitus: a study of African-American migration.

African Americans experienced massive internal migrations that shifted more than 6 million Southern-born blacks to other sections of the United States over the past century, a trend that only recently has been reversed. Whenever mass migration takes place, there is an opportunity to examine the role of the native and relocated environments in the development of disease. This article examines those relationships for diabetes mellitus, a group of diseases that disproportionately affect African-Americans relative to other racial and ethnic groups in the United States. Age-specific and age-adjusted rates with 95% confidence intervals were calculated for males and females for combinations of five regions of birth and four regions of residence at time of death. Southern-born males had statistically significantly higher death rates from diabetes than did their counterparts who died in the same regions in 9 of 16 comparisons. For females, those born in the South had statistically significantly higher rates in 15 of 16 comparisons. The results of this study indicate that place of birth and early life experiences are statistically associated with diabetes mortality among African Americans regardless of place of residence at time of death.

Adult↗
PubMed1997

Physician perspectives on unconventional cancer therapies.

The popularity of unconventional therapies has grown dramatically in recent years. This paper reports on the results of a pilot study investigating the perspectives of physicians involved with cancer care regarding their reactions to this trend and their ways of trying to meet associated challenges. Nine oncologists, nine general practitioners, and one surgeon were interviewed over the telephone, employing open-ended questions. The physicians were unanimously interested in having information available about unconventional therapies. They also expressed a desire to be supportive of patient choices in this area, provided conventional therapy was not compromised. However, there was little interest in initiating communication about unconventional therapies, with most seeing such discussions as a poor use of their time. Suggestions for future research, as well as educational and policy strategies, are addressed.

Attitude of Health Personnel↗