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Biomedical subjects

M S Goldstein

Publications and source records attributed to M S Goldstein.

At least 37 records · Page 2Linked to original sources
PubMed1984

Outcome evaluations in substance abuse: a comparison of alcoholism, drug abuse, and other mental health interventions.

Outcome evaluation studies in the areas of alcohol and drug abuse have suffered from design problems. The lack of control groups, prospective designs, adequate outcome measures, and sufficient follow-up has presented the major difficulties. This study reviews all such studies reported in 50 major journals between 1969 and 1979 and compares them to outcome evaluations on other mental health topics reported in the same journals. We find that significant problems remain in each of these areas. In general, drug abuse studies employ the least adequate methodologies. Alcohol evaluations are approximately as rigorous as other mental health evaluations. A major finding is the lack of rigor found in all types of outcome evaluations. Attention must be paid to these issues if outcome evaluations are to remain credible and able to secure continued support.

Adolescent↗
PubMed1983

Vaginal delivery after cesarean section. Experience in private practice.

To test whether vaginal delivery after cesarean section (VDAC) is a safe alternative to repeated section, a retrospective chart review of 2,350 deliveries during a ten-year period in a private practice group committed to VDAC was studied. Eighty-five parturients met six predetermined safety criteria and were permitted a trial of labor. These criteria were (1) prior low-segment transverse uterine incision; (2) vertex presentation; (3) carefully monitored labor with obstetrician present; (4) availability of emergency facilities; (5) no administration of oxytocin; and (6) patients' consent and desire to pursue VDAC. Seventy-six labors (89%) managed expectantly were successful in VDAC. No maternal or fetal morbidity was detected. No uterine ruptures were detected on postpartum examination or at the time of cesarean section. These results support the 1980 report of the National Institute of Child Health and Human Development recommending that labor and VDAC are of low risk to mother and fetus in properly selected cases.

Cesarean Section↗
PubMed1982

Identification of radiation-induced thymine derivatives in DNA.

A methodology for the separation of radiation-induced thymine derivatives in DNA using high pressure liquid chromatography is presented. DNA was subjected to enzymatic hydrolysis yielding 2'-deoxyribonucleosides and the hydrolysate cochromatographed with marker compounds. Confirmation of the presence of derivatives was accomplished by chromatography on Sephadex LH-20 and microderivatization. The method separates free bases from nucleosides allowing for identification of spontaneously released bases or those released through the action of repair enzymes. The results indicate that most of the thymine derivatives formed in irradiated cellular DNA were the same as those found in DNA irradiated in solution. However, the major cellular derivative was not present in the latter. This derivative was identified as 5-hydroxymethyl-2'-deoxyuridine (HMdU). HMdU has previously been shown to be cytotoxic to cells in culture and caused diarrhea and bone marrow failure when administered to mice. Thus, the presence of this radiation-induced thymine derivative in cellular DNA correlates with the known effects of ionizing radiation on cells and animals.

DNA↗
PubMed1982

A method for monitoring medication omission error rates.

A study was conducted of the number of doses omitted on eight patient care units in a hospital which employs a decentralized unit dose system. Omitted doses were doses of drugs that were returned to the pharmacy and that, as subsequently determined, should have been administered to patients. The number of omitted doses was 0.048 per patient day. The number of omitted doses per patient day varied among the patient care units. The results were reported to the Medication Practices Review Committee, a subcommittee of the Pharmacy & Therapeutics Committee. Subsequently, educational efforts by the Departments of Nursing and Pharmacy were directed towards reducing the omitted-dose rate. The study was repeated five months later. The number of omitted doses had fallen to 0.011 doses per day, a significant difference from the previous study. All patient care units but one had significantly fewer omitted doses, with the other patient care unit showing no change. This study showed that the rate of omitted doses can be estimated without the use of trained observers. Additionally, this method can be used to determine the changes in the omitted dose rate within a hospital.

Evaluation Studies as Topic↗
PubMed1981

Identification of the cis-thymine glycol moiety in chemically oxidized and gamma-irradiated deoxyribonucleic acid by high-pressure liquid chromatography analysis.

5,6-Dihydroxy-5,6-dihydrothymine (thymine glycol) is formed in DNA by chemical oxidants and ionizing radiation. We describe the separation of thymine glycol, 5,6-dihydroxy-5,6-dihydrothymidine (thymidine glycol), thymine, and thymidine by high-pressure liquid chromatography (HPLC). Enzymatic hydrolysates of chemically oxidized or gamma-irradiated single-stranded DNA were cochromatographed with 14C-containing marker compounds. In chemically oxidized DNA, thymidine glycol was the major derivative formed. In addition, there were four rapidly eluting thymine-derived components. In irradiated DNA, thymidine glycol constituted about 5% of the modified thymines, and the rapidly eluting fractions were proportionately increased. DNA isolated from gamma-irradiated and nonirradiated HeLa cells grown in the presence of [3H]thymidine was subjected to enzymatic hydrolysis and HPLC analysis. In control DNA, 0.3% of the thymines were modified. Thirty-six kilorads of gamma radiation caused a 30% increase in thymine damage. Thus, most of the base damage was due to internal beta radiation from incorporated [3H]thymidine. The chromatographic patterns of irradiated and nonirradiated samples were qualitatively the same, but the yields of some products increased 2-fold, while others remained unchanged. A comparison of the HPLC profiles of hydrolysates of in vitro oxidized and irradiated DNA with those of the cellular DNA revealed one fast eluting peak to be absent in cellular DNA, suggesting that it was formed only in single-stranded DNA. In cellular DNA, the major modified thymine was a more hydrophobic derivative not formed by in vitro radiation nor chemical oxidation. As in in vitro irradiated DNA, thymidine glycol constituted 5% of the modified thymines. The presence of cis-thymidine glycol in hydrolysates was confirmed by chromatography on Sephadex LH-20 using water and borate as eluants.

Chromatography, High Pressure Liquid↗
PubMed1981

Identification of the cis-thymine glycol moiety in oxidized deoxyribonucleic acid.

5,6-Dihydroxy-5,6-dihydrothymine (thymine glycol) is formed in DNA by reaction with oxidizing agents and as a result of ionizing and near-ultraviolet radiation. We describe a rapid purification of cis-5,6-dihydroxy-5,6-dihydrothymine and cis-5,6-dihydroxy-5,6-dihydrothymidine (cis-thymidine glycol) and their use as markers in identifying the thymine glycol moiety in oxidized DNA. Both glycols were prepared by oxidation of [14C]thymine and -thymidine with KMnO4 followed by purification on Sephadex LH-20 (LH-20). [3H]DNA was oxidized with KMnO4 and the thymidine glycol in DNA identified by enzymatic digestion of the DNA followed by cochromatography of the digest with marker [14C]thymidine glycol on LH-20. The cis conformation of the glycol was confirmed by the change in the elution pattern when borate rather than water was used as eluent. Alkaline hydrolysis of a mixture of [14C]thymine glycol and oxidized [3H]DNA followed by trichloroacetic acid precipitation and LH-20 chromatographic analysis of the neutralized supernatant yielded a complex pattern of radioactive degradation products with coincidence of one 14C marker- and one [3H]-DNA-derived peak. All applied radioactivity was recovered. This methodology should be useful in determining thymine glycol content of irradiated DNA and in elucidating the mechanism by which these altered residues are removed from cellular DNA by repair enzymes.

Chemical Phenomena↗
PubMed1979

Differential diagnosis between normal pressure hydrocephalus and cerebral atrophy on computed tomography.

A brain computed tomography--cisternographic correlation of 48 cases suspected of having normal pressure hydrocephalus (NPH) was undertaken, observing that the enlargement of temporal horns correlates with abnormal cisternograms compatible with NPH, and appears to be a reliable differential feature from cases of cerebral atrophy with "ex-vacuo hydrocephalus". The results of this correlation and typical images are presented.

Atrophy↗
PubMed1977

Medical education in Thailand: an alternate perspective.

This research is an attempt to provide greater understanding of two previously described medical education programmes in Thailand by placing them in historical perspective. One is a PhD programme to train medical school teachers and the other is a community health programme for medical students. The underying assumptions of the programmes are specified and through the use of archival material it is shown that in some respects the programmes are quite similar to earlier efforts to create western medical education programmes in Thailand. The analysis focuses on four major concerns of the programmes: creating small numbers of less well trained personnel; distributing medical resources to unserved rural areas; dealing with the special health needs of Thailand in the curricula; and self-consciously creating a professional elite. The discussion points up the need for historical data in evaluating the efficacy of medical education programmes.

Community Medicine↗
PubMed1977

Suicidal hanging. An association with the adult respiratory distress syndrome.

This study of two victims of suicidal hanging describes a previously unknown association between near-fatal hanging and the adult respiratory distress syndrome. We report on the pathophysiologic results of this pulmonary complication and the implications of this finding regarding the treatment of these patients.

Adult↗
PubMed1976

Pathology of bedouin skeletal remains from two sites in Israel.

Frequency of pathology and of some anomalies in skeletons of Bedouin living about 200 BP, uncovered in the Israeli Negev, is considered in relation to particular bone, sex, age-group, and kinds of defects. The environment of the Bedouin in relation to his "health-status" is noted. Two-thirds of the skeletons had one or more different bones with defects. Incidence of crania with defects was: males, 26%, females, 18%; the highest incidence occurred at age 35-49. Alveolar abscesses occurred in 28% of maxillae, 9% of mandibles. Of the long bones, the tibia was most frequently affected (15%): swelling of the shaft, relatively common, was apparently caused by bejel, a non-venereal form of syphulis, similar to yaws, endemic to the Bedouin. Forty-eight percent had defective vertebrae, usually an arthritic manifestation of one kind or another; half of this group had defects in more than one region of the spine. Defects also occurred relatively frequenly in the innominata, sacrum, scapula, and clavicle, mostly arthritic lesios except in the sacrum in which the percentage with sacral hiatus was high. Average age at death was, males, 43 years, females, 33 years (adults only), and 28 years for all ages.

Adolescent↗
PubMed1976

Dental health: what is being taught to college students.

An analysis of the dental health material in all college-level, health education textbooks published between 1966 and 1973 showed a deficiency in the amount, the thoroughness, and the quality of the dental health information given. Realibility of information from one source to another is low, and some information is inaccurate. On the basis of information in these textbooks, serious questions are raised concerning the adequacy of dental health education in college-level health education courses. The dentist is advised to review and to examine the dental health information that is being taught in these courses.

Adolescent↗