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Biomedical subjects

M Rosenthal

Publications and source records attributed to M Rosenthal.

At least 361 records · Page 20Linked to original sources
PubMedDate not supplied

Lymphokines in the rheumatoid joint.

Joint fluids and culture supernatants of synovial tissue were examined for the presence of two lymphokines. Migration inhibitory activity was found in 16 of 22 rheumatoid fluids (73%), in 3 of 15 osteoarthritis fluids (20%), and in 3 of 11 fluids from patients with various inflammatory arthritides (27%). Blastogenic activity was present in 14 of 15 rheumatoid fluids and in 1 of 7 nonrheumatoid effusions. The active materials eluted with the third peak from Sephadex G-200 and were therefore smaller than immunoglobulin or immune complexes. These findings suggest that lymphokine-like substances were present in effusions and synovial tissue of most patients with rheumatoid arthritis and some patients with other forms of chronic synovitis.

Arthritis, Reactive↗
PubMedDate not supplied

Serotonergic (5-HT2) mediation of anxiety-therapeutic effects of serazepine in generalized anxiety disorder.

Serotonin 1a and serotonin-2 receptors are implicated in anxiety. Serazepine (CGS-15040A, (R,S)-1,3,4,16b-Tetrahydro-2-methyl-2H,10H-indolo[2,1-c] Pyrazino-[1,2-a][1,4] benzodiazepine-16-carboxylic acid, methyl ester hydrochloride]) is a representative of a novel pentacyclic ring system containing a stabilized indole. In chemical assays it was a highly specific inhibitor of serotonin (5-HT2) binding, and it was active in preliminary preclinical assays of anxiolytic potential. This multicenter trial of CGS-15040A in patients with generalized anxiety disorder demonstrated clinical anxiolytic effects consistent with established preclinical effects. Doses greater than or equal to 10 mg reduced Hamilton Anxiety Scale scores. However, the dose-response relationship was nonlinear. Effects appeared primarily related to the psychic components of anxiety.

Adult↗
PubMedDate not supplied

Fever response in lean (Fa/-) and obese (fa/fa) Zucker rats and its lack to repeated injections of LPS.

The thermal responses of Fa/- and fa/fa Zucker rats to injections of sterile saline and to four injections of 20 micrograms/kg LPS at 3-day intervals were measured by means of radiotelemetry. In response to injections of saline, only the Fa/- rats developed a short stress-induced increase in abdominal temperature. Such a stress-induced rise of core temperature was also monitored in Fa/- rats after a change of the animals' cages. In response to the first injection of LPS, the Fa/- rats developed the same stress-induced rise in abdominal temperature as observed after injection of solvent followed by a biphasic fever, the first phase within 100 and 225 min, and the second phase within 240 and 480 min after LPS injection. In the fa/fa rats the stress-induced rise in body temperature and the first phase of LPS-induced fever were significantly suppressed, whereas the second phase of LPS-fever was identical in FA/- and fa/fa rats. In response to further injections of LPS no febrile response was measurable at all; just the short stress-induced rise in abdominal temperature remained manifest in the Fa/- rats. When the first injection of 20 micrograms/kg LPS was followed by injections of 100 and 1000 micrograms/kg LPS, a febrile response remained manifest, but the second phase of fever was attenuated in response to the repeated challenge with higher doses of LPS. The complete endotoxin tolerance observed in response to the second and further injections of 20 micrograms/kg seems thus to be due to a strongly reduced sensitivity to LPS after its first administration. Because data from the literature indicate a reduced sympathetic outflow to brown adipose tissue of fa/fa rats in general and during fever in particular, we tried to determine the activity of the sympathetic nervous system by measurement of excreted amounts of noradrenaline. Attempts failed to determine noradrenaline excretion during fever in lean and in obese animals. The daily excretion of noradrenaline at an ambient temperature of 22 degrees C (basal values) was 53.8 +/- 4.7 nmol/kg in Fa/- and 25.9 +/- 3.4 nmol/kg in fa/fa rats. These values were increased by a cold exposure (5 degrees C) for 24 h to 123.1 +/- 12.4 nmol/kg in Fa/- rats (229% of the basal value) vs. just 48.7 +/- 2.5 nmol/kg in fa/fa rats (188% of the basal value). This small, but significantly larger rise of cold-stimulated noradrenaline excretion in Fa/- rats is indicative of a reduced sympathetic function in the fa/fa rats, but does not explain the lack of stress-induced rise in body temperature and of the first phase of LPS-induced fever in the obese animals.

Animals↗
PubMedDate not supplied

Social worker estimations of life span in terminal cancer patients.

The objective of this study was to evaluate the accuracy of the social worker estimation (SWE) of the length of survival of patients who were seen at the end stage of their terminal illness, in home-based palliative care treatment. Estimates were filled out on a form every 2 weeks during the time of the visits until the patient's discharge or death. The wording used by the social worker was the 'average survival period'. Survival was measured from the time of each survival prognostication until death from any cause. Both SWE and actual survival were categorized into 12 weeks. Then, 29 estimates were analyzed using the SPSS statistical software package. The mean and median actual survivals of the total cohort were 6.5 and 5.1 weeks, respectively. The minimum and maximum weeks of actual survival were 0.1 and 23.1, respectively. The mean and median differences between SWE and actual survival were 2.1 and 1.6 weeks, respectively (range: 18.7, minimum and maximum differences of -7.3 and 11.4 weeks, respectively). The Pearson correlation coefficient between actual survival and SWE was 0.827 (P<0.001). Overall, 59% (17/29) were correctly assigned by social worker to the correct survival categories. Our study suggests that the oncology social worker can be a valuable resource for information about the patient's prognosis of life span.

Journal Article↗
PubMedDate not supplied

Disparate recovery of resting and stimulated oxidative metabolism following transient ischemia.

To assess the residual effects of transient cerebral ischemia on mitochondrial oxidative metabolic function, changes in the reduction/oxidation state of cytochrome a,a3 and relative local blood volume were measured in situ from the exposed cerebral surface of rat brain before and after 10 minutes of carotid artery ligation. During the ischemic interval, cytochrome a,a3 became reduced and electrocortical activity was abolished. During the first 20 minutes of reperfusion cytochrome a,a3 was hyperoxidized beyond baseline with eventual recovery to the original steady state. Electrocortical activity returned more slowly. Increased energy demand induced by electrical stimulation of the cortex produced transient oxidation of cytochrome a,a3. The amplitude of this oxidative response was decreased during the first 30 minutes of reperfusion. During the first 2 hours of reperfusion the time required for re-reduction of the oxidative response was lengthened despite the recovery of baseline mitochondrial redox state. These data demonstrate residual metabolic dysfunction after transient ischemia not apparent under "resting" conditions but evident when the system is required to perform additional "work." We speculate this metabolic dysfunction could be due to relative substrate limitation.

Animals↗
PubMedDate not supplied

Evaluation of three potential screening tests for diabetes mellitus in a biethnic population.

We tested the ability of three potential screening tests for diabetes (fasting plasma glucose value greater than or equal to 140 mg/dl, 1-h postglucose (PG) load value greater than or equal to 200 mg/dl, and 2-h PG value greater than or equal to 200 mg/dl) to detect non-insulin-dependent diabetes in 130 diabetic Mexican Americans (MAs) and 50 diabetic Anglo Americans (AA) using the National Diabetes Data Group criteria as the standard. The sensitivity of the fasting plasma glucose (FPG) cutpoint in detecting diabetes was low in both AAs (36.0%) and MAs (59.3%) and was related to the age-adjusted prevalence rates of diabetes in the two ethnic groups (AAs, 4.9%; MAs, 10.9%). The 2-h PG load cutpoint had good sensitivity (greater than 93%) and specificity (greater than 99%) in both ethnic groups. The ethnic difference in the sensitivity of the FPG cutpoint appeared to be related to the greater hyperglycemia of diabetic MAs compared with diabetic AAs. Nearly 30% of diabetic MAs had FPG values greater than or equal to 200 mg/dl as contrasted with only 10% of diabetic AAs. The difference in severity of hyperglycemia between the ethnic groups appears to be unrelated to ethnic differences in adiposity, pharmacologic treatment, or delay in diagnosis, although longer disease duration in MAs may explain part of the difference.

Adult↗
PubMedDate not supplied

Role of obesity and fat distribution in non-insulin-dependent diabetes mellitus in Mexican Americans and non-Hispanic whites.

Recent data have suggested that central obesity is related positively to the prevalence of non-insulin-dependent diabetes mellitus (NIDDM). We examined whether central obesity (measured by the ratio of subscapular to triceps skinfold) was predictive of NIDDM prevalence independently of overall obesity (measured by body mass index, BMI) in 1231 Mexican Americans and 939 non-Hispanic whites who participated in the San Antonio Heart Study, a population-based survey of diabetes and cardiovascular risk factors. Mexican Americans are characterized by higher rates of NIDDM, greater overall obesity, and more central body fat distribution than age-matched non-Hispanic whites. Using multiple logistic regression with age, ethnicity, BMI, and central obesity as covariates, overall obesity was positively associated with NIDDM prevalence in both sexes (P less than 0.001) but central obesity was related to NIDDM prevalence only in women. Our data suggest that the effect of centrality decreases at higher levels of centrality. While both BMI and centrality narrow the ethnic difference in NIDDM prevalence, Mexican Americans still have an increased risk of NIDDM (odds ratio = 2.33 in men and 1.80 in women), suggesting that other factors, possibly genetic, may also be important determinants of the ethnic differences in NIDDM prevalence.

Adult↗
PubMedDate not supplied

Return to work after rehabilitation following traumatic brain injury.

The relationship of medical variables and discharge functional status to vocational and educational outcomes was examined in 79 closed head-injured patients who were consecutively admitted to an inpatient rehabilitation hospital during a two-year period. A follow-up study, conducted after hospital discharge (median, 16.5 months), found that 66% (n = 52) of the patients had returned to work or school, while 34% (n = 27) did not. Patients were divided into return and non-return to work groups. Traditional variables included age, severity of brain-damage as characterized by CT head scan, duration of post-traumatic amnesia, duration of coma, length of stay and acute inpatient rehabilitation program. Discharge functional scores were analysed by t-tests and chi-square analysis. Results suggest that traditional factors of younger age, shorter length of coma, minimal CT head scan findings and shorter length of stay were significant contributors to educational/vocational outcome. Their significance was enhanced by discharge functional profile measurement of medical, physical and psychological/neuropsychological integrity. Those functional measures not significant were in social, vocational, recreational and communication areas. These factors may continue to improve over a longer period of time and should be tracked in the post-acute rehabilitation phase for their significance in return to work/school.

Activities of Daily Living↗
PubMedDate not supplied

[Stimulation of immunoglobin synthesis and rheumatoid-factor production by rheumatoid synovial effusions and by supernatants of synovial tissue cultures].

Factors capable of stimulating the synthesis of immunoglobulin by circulating human lymphocytes, as measured by a radioactive immune coprecipitation method, have been demonstrated in rheumatoid synovial eeffusions but not in effusions from patients with other arthritides. The activity of the ffusions was localized in two fractions eluted from an agarose A 5m column: fraction II eluting with IgM and fraction E eluting with albumin. Fraction II enhanced immunoglobulin synthesis only in circulating rheumatoid lymphocytes, while fraction V enhanced immunoglobulin synthesis in both rheumatoid and normal lymphocytes. Similar active fractions were found in culture supernatants of rheumatoid synovial tissue. Enhanced immunoglobulin synthesis was also observed following addition of aggregated IgG to rheumatoid lymphocytes. Finally, increased synthesis of anti-IgG (rheumatoid factor) was observed following addition of fractions II and V to rheumatoid but not to normal lymphocytes. The possible relationship of the active material in fraction II to IgG-containing immune complexes and the active material in fraction V to a T cell produced lymphokine-like mediator of T cell function are discussed. The findings presented provide evidence that in addition to antigenic stimulation, the action of one or more enhancing factors liberated by antigen stimulated mononuclear cells, possibly T lymphocytes, plays a role in the immunoglobulin synthesis observed in rheumatoid synovial tissue.

Arthritis, Rheumatoid↗
PubMedDate not supplied

Developing methods and research instruments for assessing physical and psychosocial outcomes of patient care as a function of nursing staff mix.

This paper describes a study which assesses a wide variety of both physical and psychosocial outcomes of patient care against nursing care standards, and as a function of two different staff mixes--an 80% registered nurse (RN) 20% enrolled nurse (EN) mix and an all-RN staffing regimen. The study is divided into three stages: Stage I which concerned the design of the investigation and development of research instruments and procedures; Stage II which concerned the field-testing of all research procedures and assessment of the reliability of research instruments and Stage III which will constitute the main study and is presently being conducted in an acute medical and an acute surgical ward. This paper is confined to a report on Stages I and II and provides the conceptual framework for the study, a description of the research instruments and the ways they were developed and a description of the research methods. The results from Stage II show that the principal research instruments are highly reliable with coefficients always in excess of 0.80, and that all of the research methods and procedures are practical and feasible. The study is significant because outcome-based evaluations, while attractive in principle, are in their infancy and little guidance appears in the literature about how to conduct these types of investigations. This paper attempts to address this deficiency.

Humans↗