Search PubMed⌕ Search

Biomedical subjects

M J Gelfand

Publications and source records attributed to M J Gelfand.

At least 37 records · Page 2Linked to original sources
PubMed1997

Antecedents and consequences of sexual harassment in organizations: a test of an integrated model.

Sexual harassment of women in organizational settings has recently become a topic of interest to researchers and the general public alike. Although numerous studies document its frequency, the development of conceptual models identifying antecedents and consequences of harassment has proceeded at a slower pace. In this article, an empirical test of a recently proposed conceptual model is described. According to the model, organizational climate for sexual harassment and job gender context are critical antecedents of sexual harassment; harassment, in turn, influences work-related variables (e.g., job satisfaction); psychological states (e.g., anxiety and depression); and physical health. On the basis of a sample of women employed at a large, regulated utility company, the model's predictions were generally supported.

Adult↗
PubMed1997

Unilateral vesicoureteral reflux: association with protected renal function in patients with posterior urethral valves.

OBJECTIVE: The prognosis in patients with posterior urethral valves (PUV) is related to the degree of renal insufficiency. Urinary ascites or urinoma, congenital bladder diverticula, or severe unilateral vesicoureteral reflux has been associated with protected renal function. We present clinical and imaging findings in eight patients with PUV and unilateral reflux who have preserved renal function. Initial and follow-up sonography, voiding cystourethrography, and nuclear imaging were reviewed and compared with long-term serum creatinine levels. CONCLUSION: All eight patients had normal renal function on long-term follow-up, suggesting that unilateral reflux, which occurs in as many as 35% of boys with PUV, is associated with protected renal function. Although early nephrectomy of the refluxing unit has been advocated for patients with PUV and unilateral reflux into a dysplastic kidney (the vesicoureteral reflux and renal dysplasia syndrome), we found that significant renal function may be present in the refluxing kidney and that function may even increase with time. Most of these patients did well without nephrectomy. Therefore, a sufficient interval should elapse before nephrectomy is considered in these patients.

Child, Preschool↗
PubMed1996

Ga-67 scintigraphy in pediatric patients. Comparison of extended SPECT of the chest and abdomen with planar imaging.

Ga-67 SPECT has been shown to be more sensitive than planar imaging in several pediatric and adult studies. With multidetector SPECT cameras, SPECT imaging of multiple sites and volumes rendered images are possible. This study was performed to determine if SPECT of the chest, abdomen, and pelvis can be substituted for planar imaging of the same body regions. Fifty-one Ga-67 studies in 36 patients with lymphoma (29 patients) and inflammation (7 patients) were reviewed. Ga-67 SPECT of the chest, abdomen, and pelvis was compared with planar images of the same body regions. There were 52 abnormal sites on SPECT and 42 on planar imaging. Ten sites were positive only on SPECT; five of these sites were seen on SPECT because of improved three-dimensional separation of sites of gallium uptake. In the limited number of cases in this study, duplicate planar and SPECT imaging of the same volume was unnecessary.

Abdomen↗
PubMed1996

High-resolution multi-detector SPET imaging of the paediatric spine.

We reviewed the planar and single photon emission tomographic (SPET) spine images of 69 paediatric patients aged 2-17 years referred for undiagnosed back pain. The SPET images were obtained using a triple-detector camera and ultra-high-resolution collimation. Abnormal images were rated as slightly positive (1+) or strongly positive (2+). The planar and SPET images were normal in 48 of 69 patients. Thirteen of the remaining 21 cases had negative planar imaging with positive SPET images (SPET was 2+ in 10 cases and 1+ in 3 cases). Four of the 21 cases were 1+ on planar imaging, but clearly positive (2+) on the SPET images. Three of the 21 cases had 2+ planar abnormalities, but SPET demonstrated additional uptake abnormalities. Lastly, a single case that was 2+ on the planar images was demonstrated to be artefactual by SPET. Thirty-seven sites were abnormal by SPET, including 17 pedicle/parts interarticularis (11 patients), 10 spinous process (8 patients), 8 vertebral endplate (2 patients) and 2 vertebral body (2 patients) abnormalities. Sites that were abnormal on SPET and normal on planar imaging included 10 of 17 (59%) in the pedicle/pars region, 9 of 10 (90%) in the spinous process, 1 of 2 (50%) in the vertebral body and 2 of 8 (25%) in the vertebral endplates. The improved resolution of ultra-high-resolution collimated multi-detector SPET permits visualization of a greater variety of abnormalities than was seen with earlier single-detector cameras, particularly those involving the spinous process.

Adolescent↗
PubMed1996

Acute testicular torsion: comparison of unenhanced and contrast-enhanced power Doppler US, color Doppler US, and radionuclide imaging.

PURPOSE: To compare the usefulness of conventional color Doppler ultrasound (US), unenhanced and contrast material-enhanced power Doppler US, and radionuclide imaging in a model of acute testicular torsion. MATERIALS AND METHODS: Twenty rabbits underwent unilateral 360 degree testis torsion and contralateral orchiopexy. Gray-scale, color Doppler, and unenhanced and contrast-enhanced power Doppler US were performed 4-6 hours later. The side of torsion was determined, and intratestis flow was graded. Within 2 hours of US, technetium-99m pertechnetate was intravenously administered, the rabbits were killed, and the testes excised for radionuclide imaging. RESULTS: Intratestis perfusion was detected in 85% of torsed testes at US and radionuclide imaging. The side of torsion was correctly diagnosed in 25% of cases with radionuclide imaging and in 60% of cases with US. Power Doppler US demonstrated significantly greater intratestis flow in pexed than in torsed testes. Although the numbers of correct diagnosis with the three US modalities were similar, flow grades within torsed and normal testes were significantly different. CONCLUSION: Perfusion to torsed and normal testes was demonstrated equally well with color Doppler US, power Doppler US, and radionuclide imaging. Doppler US better depicted differences in intratesticular flow between torsed and normal testes.

Acute Disease↗
PubMed1995

Incentive spirometry to prevent acute pulmonary complications in sickle cell diseases.

BACKGROUND: This study was designed to determine the incidence of thoracic bone infarction in patients with sickle cell diseases who were hospitalized with acute chest or back pain above the diaphragm and to test the hypothesis that incentive spirometry can decrease the incidence of atelectasis and pulmonary infiltrates. METHODS: We conducted a prospective, randomized trial in 29 patients between 8 and 21 years of age with sickle cell diseases who had 38 episodes of acute chest or back pain above the diaphragm and were hospitalized. Each episode of pain was considered to be an independent event. At each hospitalization, patients with normal or unchanged chest radiographs on admission were randomly assigned to treatment with spirometry or to a control nonspirometry group. Each patient in the spirometry group took 10 maximal inspirations using an incentive spirometer every two hours between 8 a.m. and 10 p.m. and while awake during the night until the chest pain subsided. A second radiograph was obtained three or more days after admission, or sooner if clinically necessary, to determine the incidence of pulmonary complications. Bone scanning was performed no sooner than two days after hospital admission to determine the incidence of thoracic bone infarction. RESULTS: The incidence of thoracic bone infarction was 39.5 percent (15 of 38 hospitalizations). Pulmonary complications (atelectasis or infiltrates) developed during only 1 of 19 hospitalizations of patients assigned to the spirometry group, as compared with 8 of 19 hospitalizations of patients in the nonspirometry group (P = 0.019). Among patients with thoracic bone infarction, no pulmonary complications developed in those assigned to the spirometry group during a total of seven hospitalizations, whereas they developed during five of eight hospitalizations in the nonspirometry group (P = 0.025). CONCLUSIONS: Thoracic bone infarction is common in patients with sickle cell diseases who are hospitalized with acute chest pain. Incentive spirometry can prevent the pulmonary complications (atelectasis and infiltrates) associated with the acute chest syndrome in patients with sickle cell diseases who are hospitalized with chest or back pain above the diaphragm.

Acute Disease↗
PubMed1995

Culture, gender, and self: a perspective from individualism-collectivism research.

Individualism and collectivism are often equated with independent vs. interdependent, agentic vs. communal, and separate vs. relational self-construals. Although these same concepts have been used to characterize both cultural and gender differences, a perspective of cultural evolution suggests it is unlikely. A division of labor within society may produce gender differences, but this cannot explain cultural differences. A study of self-construal involving 5 cultures (Australia, the United States, Hawaii, Japan, and Korea) shows that differences between these cultures are captured mostly by the extent to which people see themselves as acting as independent agents, whereas gender differences are best summarized by the extent to which people regard themselves as emotionally related to others.

Adolescent↗
PubMed1995

I-123 MIBG scintigraphy in adults. A report of clinical experience.

Thirty-one adult patients with clinical findings suggestive of pheochromocytoma were studied with I-123 MIBG. All patients had images obtained at 24 and 48 hours. Five patients had abnormal uptake proved to be because of I-123 MIBG avid tumors. The remaining 26 patients had no proven tumors and showed physiologic uptake in various organs. The 24-hour images were of high quality. In all cases, the 48-hour images contributed no significant additional information. Only in 1 patient did the 48-hour image add some certainty. Physiologic uptake was seen in the salivary glands, liver, G.I. tract, and urinary bladder in all patients (100%). Uptake was also observed in the lung and heart (90%), normal adrenal glands (32%), thyroid (29%), spleen (23%) uterus (13%), and neck muscles (6%). The authors' experience indicates that I-123 MIBG gives superior images compared to the previously used I-131 MIBG, that the optimum imaging time for adults is 18-24 hours, and that normal distribution patterns including uterine and neck muscle uptake should be familiar to physicians interpreting the studies.

3-Iodobenzylguanidine↗
PubMed1995

Advanced fibrodysplasia ossificans progressiva.

Fibrodysplasia ossificans progressiva is a rare hereditary variant of heterotropic bone formation that is often difficult to diagnose. A bone scan of an advanced case of this condition is presented. Nuclear medicine physicians should be familiar with various aspects of this disease.

Adult↗
PubMed1995

Iodine-131 therapy of hyperthyroidism in pediatric patients.

UNLABELLED: The purpose of this retrospective study was to evaluate the utility of 131I as therapy for hyperthyroidism in children and to evaluate its short-term side effects. METHODS: The results of 131I therapy of hyperthyroidism were evaluated in a group of 35 pediatric patients. RESULTS: In 29 patients propylthiouracil or methimazole therapy was abandoned due to noncompliance (13), relapse or failure to control hyperthyroidism (13), vasculitis (1), neutropenia (1) or a lupus-like syndrome (1). Average treatment activity was 7.7 +/- 2.9 (s.d.) mCi, corresponding to 0.16 +/- 0.03 mCi/g. Thirty patients (86%) received a single radioiodine treatment and five (14%) were retreated. In patients who became hypothyroid after a single dose, hypothyroidism was noted within 100 days of treatment. Clinical management problems included vomiting in four patients and enuresis in four patients. Mild radiation thyroiditis occurred in one patient and nodularity was noted after therapy in two patients. CONCLUSION: Iodine-131 is effective for both initial treatment of hyperthyroidism and the treatment of medical treatment failures in pediatric patients. Awareness of vomiting and enuresis as potential management problems is crucial when using 131I in this age group. Therefore, special treatment precautions may be required.

Adolescent↗
PubMed1994

Neural crest tumors: I-123 MIBG imaging in children.

PURPOSE: To determine 24- and 48-hour distribution of iodine-123 metaiodobenzylguanidine (MIBG) and to establish an optimized pediatric imaging protocol. MATERIALS AND METHODS: Seventy-seven I-123 MIBG scans obtained in 33 children undergoing evaluation for neural crest tumor were reviewed. RESULTS: Activity in the salivary glands, myocardium, liver, gut, and bladder was demonstrated on almost all scans. Activity was noted in the neck muscles, thyroid gland, and uninvolved adrenal gland in fewer studies. In 20 studies, abnormal uptake was present in the chest or abdomen at 24 and 48 hours, and lesion identification was improved at 48 hours in 12 studies. Detection of skeletal lesions on 14 scans was similar at 24 and 48 hours. Foci of tumor were first detected at I-123 MIBG imaging in nine studies, and in only two patients was tumor involvement initially missed on I-123 MIBG studies. CONCLUSION: Distribution of I-123 MIBG on images in children differs from that in earlier descriptions in adults. Images of the torso at 48 hours after injection are a useful adjunct in detection of lesions.

3-Iodobenzylguanidine↗
PubMed1994

Iodine-123-MIBG SPECT versus planar imaging in children with neural crest tumors.

UNLABELLED: Iodine-123-metaiodobenzylguanidine (MIBG) SPECT was compared with 123I-MIBG planar imaging in 35 studies of 25 children with neural crest tumors. METHODS: Iodine-123-MIBG (0.070-0.140 mCi/kg intravenously) was followed at 24 hr by wholebody planar imaging and triple-detector, high-resolution thoraco-abdominal SPECT. At 48 hr, thoracoabdominal planar imaging was performed whenever a high-tissue background or gut activity interfered with the interpretation of the 24-hr planar images. SPECT views included a cine loop presentation of multiple volume-rendered projections. Two reviewers enumerated the number of abnormal sites on the planar and SPECT studies and rated the certainty of interpretation for each study on a scale from 0.1 (low certainty) to 1.0 (high). RESULTS: Abnormal uptake was noted on planar or SPECT imaging in 13 studies (seven patients). The average number of abnormal sites detected per study for all 35 studies was 2.7 for planar imaging and 2.9 for SPECT (p = not significant) (and 7.2 and 8.4 for planar and SPECT, respectively, for the 13 abnormal studies.) The certainty ratings for all 35 studies were 0.74 for planar studies, 0.82 for SPECT (p = 0.05, chi-square, compared with planar) and 0.86 for planar and SPECT combined (p = 0.01 compared with planar alone). On volume-rendered images, gut activity was seen as diffuse and/or linear intraluminal activity. CONCLUSION: When 123I-MIBG SPECT is used, the number of lesions detected is not increased, but there is a significant improvement in the certainty of interpretation over planar imaging.

3-Iodobenzylguanidine↗
PubMed1993

Meta-iodobenzylguanidine in children.

Meta-iodobenzylguanidine (MIBG) is an effective imaging agent for neuroblastoma and pheochromocytoma in children, MIBG is concentrated by the neurosecretory granules of normal and neoplastic tissues of neural crest origin. The typical normal scintigraphic uptake pattern of MIBG includes the salivary glands, lung, myocardium, liver, gastrointestinal tract, and contents of the urinary bladder. When MIBG is labeled with iodine-123 (123I), the adrenal glands often are seen. The sensitivity and specificity of MIBG imaging is extremely high in both neuroblastoma and pheochromocytoma. MIBG may detect extensive bone and bone marrow involvement in neuroblastoma, in the absence of findings on bone marrow aspiration and biopsy, plain radiographs, and bone scintigraphy. MIBG labeled with 131I has been used with moderate success in the palliation of advanced neuroblastoma and pheochromocytoma. Early therapeutic intervention in advanced neuroblastoma is promising. Current controversies in the application of MIBG include (1)131I versus 123I as a label for imaging studies: Although improved image quality and reduced absorbed radiation dose are achieved with [123I]MIBG imaging, is it actually more efficacious in the detection of neuroblastoma? (2) Use of bone scintigraphy in neuroblastoma: Given the small number of false-negative MIBG scans for bone involvement, can the bone scan be dropped as a routine study in the follow-up of neuroblastoma? (3) Other new imaging agents: Is there a role for labeled monoclonal antibodies, somatostatin analogs, and magnetic resonance imaging of marrow in the routine follow-up of neuroblastoma? (4) Iodine-125 MIBG therapy in neuroblastoma: Is the improved energy deposition of 125I at extremely short range useful in the ablation of micrometastases? (5) Early therapy with MIBG in neuroblastoma: Is there a role for MIBG therapy in the initial therapeutic regimens of children with advanced neuroblastoma? Twelve years after the initial report of its use in humans, MIBG has become an important imaging agent in pediatric neural tumors, one that is used routinely and efficaciously in many centers. In the next few years we will continue to learn more about its use, particularly in the therapy of advanced neural crest tumors.

3-Iodobenzylguanidine↗
PubMed1993

Multicystic dysplastic kidney in children: US follow-up.

Eighty-one cases of multicystic dysplastic kidney (MCDK) in children were diagnosed over the past 11 years at the authors' institution: 25 children had their kidneys surgically removed, eight with bilateral total involvement died, and 48 underwent serial follow-up ultrasonography (US) of their kidneys. Follow-up included 193 serial ultrasound (US) studies (mean, four per patient) for a total of 1,468 months (mean, 30.5 months). In the 48 patients followed up, 32 (67%) kidneys showed a decrease in size, nine (19%) showed no change, and five (10%) increased in size, and in two (4%), a change in size could not be determined. In seven of the 48 (15%) children, the MCDKs decreased in size, and, at follow-up US, no renal tissue could be found. In those patients in whom MCDKs decreased in size. Serial US characteristics changed from predominantly an enlarged cystic structure to a small dysplastic or absent kidney. Two of the five kidneys that increased in size were surgically removed, and MCDK was pathologically confirmed. A nonsurgical approach to the treatment of patients with MCDK is supported by this study.

Child, Preschool↗
PubMed1993

Simultaneous occurrence of rib infarction and pulmonary infiltrates in sickle cell disease patients with acute chest syndrome.

In order to determine if a relationship exists between rib infarction and the acute chest syndrome (ACS) in sickle cell disease patients, bone scans were reviewed in 55 episodes in 38 patients with pain of suspected osseous origin. A bone scan was positive for thoracic bone infarction if abnormally increased or decreased uptake was present in ribs, sternum or thoracic spine. Radiographs were considered to be positive for ACS if there was pulmonary infiltrate or pleural effusion in the absence of laboratory or clinical evidence of bacterial pneumonia. ACS by chest x-ray was present in 22 episodes, 21 of which showed evidence of infarction of the bony thorax on bone scan. Thoracic bone infarction occurred in the absence of chest x-ray changes in only 11 episodes. This association between bone infarction and radiographic ACS was statistically significant (p < 0.001, Fisher's exact test). A strong association exists between ACS and infarction of the bony thorax. It is possible that bone infarction leads to pain, hypoventilation and the clinical picture of ACS.

Acute Disease↗
PubMed1992

Hepatobiliary scintigraphy in pediatric liver transplant recipients.

The clinical usefulness of hepatobiliary scintigraphy was evaluated in pediatric liver transplant recipients. One hundred fifteen hepatobiliary scintigraphic studies were performed in 30 patients who received 22 whole liver and 16 segmental grafts. Parameters that were useful in predicting an adverse outcome were failure to visualize excreted radiopharmaceutical at or beyond the biliary anastomosis on a study performed within 24 hours after transplant, and persistent or increasing delay in the time of visualization of excreted radiopharmaceutical. Abnormalities of liver uptake and excretion were seen in rejection, but they were also seen in patients who remained well without rejection or parenchymal disease. Significant biliary leaks were identified in the three cases in which they were known to be present. In liver transplant recipients, hepatobiliary imaging is useful in predicting graft survival and identifying biliary leaks.

Adolescent↗