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Biomedical subjects

M Miller

Publications and source records attributed to M Miller.

At least 343 records · Page 19Linked to original sources
PubMed1996

Apparent idiopathic hyponatremia in an ambulatory geriatric population.

OBJECTIVES: The purpose of this descriptive analysis is to demonstrate that among older patients with hyponatremia, there is a subset with apparent hyponatremia of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) type, which appears associated with the aging process. A retrospective chart review was done to identify patients with hyponatremia and to classify them into non-SIADH, SIADH, and idiopathic categories. DESIGN: The participants were the ambulatory population of The Mount Sinai Hospital's outpatient geriatric clinic. Pertinent data generated during the antecedent 24 months were collected from outpatient charts and included sets of laboratory values (consisting of one sodium, glucose, BUN and creatinine level), age, sex, race, clinical history, present diagnosis, medications, and prescribed diets for each patient in the total population. RESULTS: Patients demonstrating hyponatremia with serum sodium levels of less than 135 mEq/L were identified from the total population and were further divided into SIADH and non-SIADH etiologies. The SIADH patients were then subdivided into known etiology SIADH and apparent idiopathic SIADH. In an ambulatory geriatric population of 405 subjects, 46 had hyponatremia, with SIADH the apparent cause in 27. Of the SIADH population, seven patients were considered to have idiopathic SIADH. An apparent predilection for development of this syndrome was observed among non-black patients and the old old. CONCLUSIONS: The results support the hypothesis that aging is a risk factor for the development of SIADH-like hyponatremia in a subset of older patients who do not have an apparent underlying etiology. Thus, aging may be an independent etiology for the development of hyponatremia.

Age Distribution↗
PubMed1996

Injection drug use and risk of HIV transmission among homeless men with mental illness.

OBJECTIVE: The high seroprevalence of HIV that has been reported among homeless individuals with mental illness indicates an urgent need to examine HIV risk behavior in this population. METHOD: Injection drug use and sexual behavior were assessed in comprehensive interviews with 218 homeless mentally ill men in a New York City shelter. First, the proportion of men who had injected drugs was established. Then, among those who had injected drugs, the injection drug use behaviors associated with HIV transmission (i.e., whether they had ever engaged in high-risk behaviors and had ever engaged in risk-reduction behaviors) and their current sexual risk behaviors were examined. RESULTS: Fifty (23%) of the 218 men had injected drugs. Among these 50, the great majority had engaged in high-risk behaviors, including sharing needles (66%) and using shooting galleries (64%). Few had engaged in risk-reduction behaviors, such as cleaning needles with bleach (22%) and using a needle exchange program (2%). In the past 6 months alone, the majority of the injection drug users had had unprotected sex with women (48%) or with men (10%). CONCLUSIONS: This study documents a high lifetime prevalence of injection drug use in a group of homeless men with mental illness. The men who had injected drugs reported injection drug use and sexual behaviors with high risk of HIV transmission and gave scant evidence of risk-reduction behaviors. These individuals may fall between service systems and may be difficult to reach but, nonetheless, must be included in efforts to prevent transmission of HIV infection.

Adult↗
PubMed1996

Endocrine disorders: new technology allows quick, accurate diagnosis.

In the past 50 years, the development of radio-immunoassay and other precise diagnostic tools has led to elucidation of the pathophysiology of many endocrine disorders. This in turn has enabled clinicians to make quick, accurate diagnoses of diseases that increase in frequency with advancing age, such as thyroid disorders, diabetes, osteoporosis, and hyperparathyroidism. Specific, effective therapies such as the oral sulfonylureas for diabetes and both hormonal and nonhormonal treatments for osteoporosis have improved the longevity and quality of life of older individuals with these diseases. Newer tests give us the ability to closely monitor therapeutic effectiveness.

Aged↗
PubMed1996

Angiotensin converting enzyme gene I/D polymorphism, blood pressure and the renin-angiotensin system in Caucasian and Afro-Caribbean peoples.

The objectives of this study were to assess relations between ACE gene I/D polymorphism, essential hypertension, plasma renin activity and aldosterone in white (European descent) and black (Afro-Caribbean descent) peoples. Measurements were carried out on a total of 320 subjects (210 white: 116 men, 94 women; 110 black: 65 men, 45 women); all were on their usual sodium intake; none was on anti-hypertensive therapy and none had secondary hypertension. Genomic DNA was isolated from blood cells and ACE I/D genotype was established using polymerase chain reaction. Plasma hormones were measured by radioimmunoassay and blood pressure (BP) with an ultrasound sphygmomanometer. All subjects were grouped into normotensive, borderline and hypertensive according to WHO guidelines. The distribution of the I/D genotype in the white people was approximately 1:2:1; by contrast, in the Afro-Caribbean people there was a significantly higher frequency of the D allele (chi 2P = 0.04). Within the white people there was no significant association between ACE genotype and high BP; however, within the black people there was a positive association between the frequency of the D allele and increasing BP ( chi 2 for trend P = 0.03). In either group, there were no associations between ACE I/D genotype and plasma renin activity and aldosterone suggesting that ACE genotype does not contribute to the expression of the circulating renin-angiotensin system. This study highlights differences in ACE I/D polymorphism between white and black peoples and suggests the possibility of racial differences in the association between ACE genotype and BP.

Adult↗
PubMed1996

End stage liver disease in a 13-year old secondary to hepatitis C and hemochromatosis.

Hepatic parenchymal iron deposition is a well-known complication of chronic hepatic inflammatory states. This can make the differential between chronic hepatitis and hereditary hemochromatosis difficult, however. The case of a 13-yr-old male with chronic hepatitis C and hereditary hemochromatosis resulting in end stage liver disease and the need for orthotopic liver transplantation is described. There has been no previously described case of the coexistence of these two diseases in a pediatric patient, resulting in end stage liver disease. The progression to cirrhosis in a patient of this age suggests a more rapid progression of the combined diseases than with either disease alone.

Adolescent↗
PubMed1996

Type II diabetes: a treatment approach for the older patient.

Noninsulin-dependent (type II) diabetes mellitus occurs most commonly with advancing age. The disease is accompanied by significant risk for morbidity of many organ systems and by risk for premature death. Morbidity and mortality are linked to persistent elevation of blood glucose concentration of even moderate degree. Through diet, weight reduction, exercise, and drug therapies, it is possible to bring blood glucose concentrations to close to normal levels and to reduce the likelihood of development or progression of diabetic complications.

Aged↗
PubMed1996

Pseudonyms for cancer registries.

In order to conform to the rigid German legislation on data privacy and security we developed a new concept of data flow and data storage for population-based cancer registries. A special trusted office generates a pseudonym for each case by a cryptographic procedure. This office also handles the notification of cases and communicates with the reporting physicians. It passes pseudonymous records to the registration office for permanent storage. The registration office links the records according to the pseudonyms. Starting from a requirements analysis we show how to construct the pseudonyms; we then show that they meet the requirements. We discuss how the pseudonyms have to be protected by cryptographic and organizational means. A pilot study showed that the proposed procedure gives acceptable synonym and homonym error rates. The methods described are not restricted to cancer registration and may serve as a model for comparable applications in medical informatics.

Anonyms and Pseudonyms↗
PubMed1996

Diet and psychological health.

This article reviews research that suggests a relationship between diet and psychological symptoms. Mind-body dualism (as it relates to clinical practice) and the limited role of nutrition in mainstream biomedical training and treatment are discussed as background issues. Two areas of inquiry that have generated relevant research findings in this area are reviewed: (1) orthomolecular theory and vitamin deficiencies, and (2) clinical ecology/environmental medicine theory and the impact of "food allergies." Although clinical case reports and promising research findings have been reported, the impact of diet on psychological health is neither widely accepted nor integrated into mental health treatment methods. Ongoing research findings in brain biochemistry and psychoneuroimmunology point to communication pathways that can provide a clearer understanding of the links between nutritional intake, central nervous system and immune function, and psychological health status. These findings may lead to greater acceptance of dietary treatment approaches among health practitioners addressing psychological disorders.

Diet↗
PubMed1996

Preparation of social workers for serving individuals with developmental disabilities: a brief report.

A survey was sent to program directors of 498 social work schools to explore the developmental disabilities content in their curricula. The survey measured developmental disabilities content in terms of course content, practice opportunities, research opportunities, and value content. The response rate was 28.9%. Results indicated that very few schools offered developmental disabilities content in their curricula, and those that did offered it primarily as a field practica experience. Survey findings raise concerns about how well social work students are being prepared for practice in the field of developmental disabilities.

Curriculum↗
PubMed1996

Retroviral transduction of hematopoietic progenitor cells with mutant p53 promotes survival and proliferation, modifies differentiation potential and inhibits apoptosis.

Mutations in the p53 tumor suppressor gene have been shown to be associated with many human tumors and various leukemias and lymphomas. To examine whether constitutive overexpression of mutant p53 can effect transformation of normal hematopoietic cells, a mutant p53 gene was introduced into normal murine bone marrow hematopoietic cells by retroviral gene transfer. Compared to vector alone-infected cells, hematopoietic progenitor cells transduced with mutant p53 showed increased proliferative potential, enhanced cloning efficiencies and a modified differentiation pattern in vitro. In addition, mutant p53-transduced hematopoietic cells were more resistant to loss of viability and/or induction of apoptosis when cultured in a low concentration of serum or in the absence of both growth factors and serum. These effects occurred rapidly with no apparent contributory secondary events. No permanent cell lines or growth factor-independent cell strains were obtained. The results indicate that introduction of mutant p53 into normal hematopoietic cells in vitro contributes to transformation, including enhanced proliferative potential, modified differentiation and the suppression of apoptosis in these cells.

Animals↗
PubMed1996

[Effect of selected socio-economic factors on incidence and outcome of tuberculosis in Poland].

The purpose of the paper was to verify the widely held opinion about the influence of socio-economic conditions on tuberculosis incidence and outcome. The analysis of the relationship between different socio-economic factors and tuberculosis shows that level of education seems to be the most important indicator. The level of education of tuberculosis patients in Poland is lower than the average. Together with the standard of living it differentiates patients with regard to clinical form of the disease-the lower the level of education and standard of living conditions, the more fibrocavernous forms. The analysis also indicated that the level of education and employment or unemployment did not influence the choice of treatment regiments but influenced the outcome of treatment.

Adult↗
PubMed1996

[Results of anti-tuberculosis treatment of patients with tuberculosis--children and adolescents treated in Poland in 1993].

Treatment of 581 new cases tuberculosis in 215 children and 366 adolescents reported in 1993 were followed up for 12 months. The results show that 96.6% bacteriologically confirmed cases were cured (93.8% of children and 97.2% of adolescents). Among 409 bacteriologically negative cases (183 children and 222 adolescents) only in 7 (4 children and 3 adolescents) i.e. in 1.7% no radiological improvement was observed. 75.7% of cases BK+ received 4 drugs treatment regimen-85.4% adolescents and 40.6% children. Children with bacteriologically negative tuberculosis were treated with 2 drugs regimen -(53% of cases) and with 3 drugs regimen 43.2% of cases, while in adolescents majority of cases received 4 drugs (59.0%) or 3 drugs (33.8%). In almost all regiments there were INH and RMP. In spite of high efficacy of applied regimens, the duration of treatment was relatively long. In children BK+ , in 87.8% of cases it was longer than 6 months (in 43.8% of cases it was longer than 9 months). In adolescents BK+, in 81.2% of cases duration of treatment was longer than 6 months (in 34.7% it was longer than 9 months). Among cases BK(-), in 82.5% of children duration of treatment was longer than 6 months and 53.7% adolescents BK(-) were treated longer than 6 months.

Adolescent↗