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Biomedical subjects

M Sacks

Publications and source records attributed to M Sacks.

At least 37 records · Page 2Linked to original sources
PubMed1991

Effectiveness in psychiatric care. I. A cross-national study of the process of treatment and outcomes of major depressive disorder.

Recent research suggests that, despite the development of effective psychiatric treatment, there is marked underuse of care. This pilot study had the objective of dissecting the process of care in an attempt to understand outcomes for patients with major affective disorder and for their families. Twenty-four patients with a DSM-III diagnosis of major affective disorder were identified 12 to 18 months after hospital admission in three countries (Italy, Japan, and the United States). The patients, their families, and their doctors were interviewed separately and then together, using instruments measuring delivery of treatment (using an ideal treatment criteria set) and percentage of achievement of treatment goals. These measures were then (using parametric and nonparametric statistics) correlated with resolution of the index episode and the patient's global outcome (using the Global Assessment Scale). The data demonstrated that physicians delivered about half (52%) and, subsequently, achieved about half (54%) of what would be considered ideal care to patients and other family members. The mean resolution of the index episode at follow-up was only 3.0 (on a 0- to 5-point scale). There was a significant positive association between the most important outcome measure, i.e., the resolution of the episode, and the achievement of treatment goals for both the patient (p less than .07) and the family (p less than .005). Patients and families with the best resolutions received significantly more good treatment than those with the worst resolutions (p less than .02), most notably with regard to medication (p less than .002).

Adult↗
PubMed1987

Carcinoma of the prostate clinically and radiologically simulating malignant lymphoma.

A 65-year-old man presented with supraclavicular, mediastinal, and retroperitoneal lymphadenopathy clinically thought to be due to malignant lymphoma. Biopsy of a supraclavicular lymph node revealed metastatic adenocarcinoma positive for prostatic-specific antigen. This site of the primary tumor was confirmed by needle biopsy of the prostate gland. The tumor regressed dramatically following treatment with estramustine phosphate.

Adenocarcinoma↗
PubMed1986

Serum prolactin correlates with depressed mood during alcohol withdrawal.

Alterations in central dopamine function have been identified in depression and in alcohol withdrawal. Attempts to determine the magnitude and direction of the central dopamine alteration in alcohol withdrawal have produced conflicting results. In this study serum prolactin (PRL) was used as an indicator of central dopamine activity since dopamine is the most important factor in the control of prolactin secretion from the pituitary. Increased serum PRL levels were found during alcohol withdrawal and they correlated significantly with high scores on the Hamilton Depression Rating Scale (HDRS). No significant correlations were identified with The Brief Psychiatric Rating Scale (BPRS), the 'Mini-Mental State' of Folstein (MMS), The Beck Depression Inventory (BDI) or The Modified Gross Alcohol Withdrawal Selective Severity Assessment Scale (GAWSSA). The authors concluded that the transient depressive symptomatology typically found in detoxifying alcoholic patients may be, in part, the result of a central hypodopaminergic state.

Adult↗
PubMed1985

Unrecognized drug dependence and withdrawal in the elderly.

The clinical diagnosis of drug abuse is frequently omitted from the differential diagnosis of transient fevers, arrhythmias and changes in mental status in the elderly despite the high risk of iatrogenic dependence in this age group. In pursuit of symptomatic relief from unrecognized depressions and from the chronic ailments of advancing age, the elderly receive many medications from numerous physicians. Therapeutic interventions are often duplicated or contradictory and result in the co-administration of tranquilizers, sedatives and analgesics. The result may be dependence which the patient and physician fail to recognize or to diagnose in the presence of withdrawal symptoms. In this report we present two such cases.

Aged↗
PubMed1985

Immunoblastic lymphoma and thymic epithelial hyperplasia in angioimmunoblastic lymphadenopathy following gold therapy.

A 62-year-old woman with well-established polyarthritis developed angioimmunoblastic lymphadenopathy (AILD) during gold therapy. She subsequently developed an immunoblastic lymphoma which showed monoclonality (IgA, lambda) by immunoperoxidase techniques. There was a tumor-like enlargement of the thymus gland due to involvement by AILD, with secondary proliferation of thymic epithelium. The finding of thymic involvement, which has not been described previously in AILD, might be one of the manifestations reflecting a disturbance of the immune system in this disease.

Arthritis, Rheumatoid↗
PubMed1983

Malignant fibrous histiocytoma of the spermatic cord.

We report the seventh case of malignant fibrous histiocytoma arising from the spermatic cord. The followup of our patient supports the generally accepted approach of radical inguinal orchiectomy along with wide en bloc local resection of the adjacent soft tissue.

Adult↗
PubMed1982

The biologic behavior of basal cell carcinoma: Part I.

The influence of histopathologic and clinical factors on the biologic behavior of basal cell carcinoma of the face is discussed on the basis of a retrospective study of 188 cases. Fourteen different parameters were studied and correlated with the histologic type and the frequency of incomplete excision of the lesions. The highest frequency of incompletely excised tumors was seen with the adenocystic and morphea types and with Clark level III lesions. The adenocystic type appeared to be the most aggressive form, with the highest frequency of thick lesions and the most marked mitotic activity. The histologic parameters studied provide more information about the behavior of basal cell carcinoma than the conventional subdivision into solid, morphea, and adenocystic types.

Adult↗
PubMed1982

The biologic behavior of basal cell carcinoma: analysis of recurrence in excised basal cell carcinoma: Part II.

On the basis of a study of 188 cases of basal cell carcinoma of the face, the differences between the characteristics of recurrent and incompletely excised lesions are stressed. There was almost no difference in the recurrence rate of completely excised lesions and those in which there was histologic evidence of tumor at one of the margins. On the basis of these findings, a policy of conservative management of incompletely excised basal cell carcinoma is outlined.

Adolescent↗
PubMed1981

Antibody pattern to human cytomegalovirus in patients with adenocarcinoma of the colon.

The role of human cytomegalovirus (CMV) was examined according to serological patterns in 37 patients with adenocarcinoma of the colon (ACC). The sera were examined for the presence of IgG antibodies by the immunoperoxidase antibody to membrane antigens (IPAMA) method and by the complement-fixation (CF) test. Antibody determinations were also performed by the IPAMA method for three other members of the herpesvirus group: Epstein-Barr virus (EBV), herpes simplex virus (HSV) and varicella-zoster virus (VZV). Comparison groups included normal subjects, ACC patients treated with chemotherapy, and patients operated on for benign diseases. No significant difference was found in the geometric mean titers (GMTs) for CMV and the other herpesviruses in the sera of nontreated ACC patients when compared with the control groups. However, a significantly elevated antibody titer to CMV was found in chemotherapy-treated ACC patients by both the IPAMA and CF methods. In this group, elevated titers were found by the IPAMA method for EBV and HSV, but not for VZV. The significance of serological studies in elucidating the role of CMV in ACC patients is discussed.

Adenocarcinoma↗
PubMed1981

Pathological identification as a cause of suicide on an inpatient unit.

After the suicide of a patient, staff on an inpatient ward anxiously take increased suicide precautions, including special attention to patients known to be associated with the victim. However, in identifying other patients at risk, they may overlook those who have formed pathological identifications with the victim as the result of a history of similar past experience, especially that of a suicidal or abandoning parent, and of the often unrecognized intimacy that occurs between patients during a brief hospitalization. Pathological identifications involved in a suicide, a subsequent suicide attempt, and suicidal preoccupation are illustrated by the case histories of three patients treated on an inpatient ward at the same time.

Adult↗
PubMed1980

Aberrant (ectopic) adrenocortical tissue along the spermatic cord.

Aberrant adrenocortical tissue along the spermatic cord is a far more common finding than has previously been reported. During a period of 12 consecutive months, 360 children, aged 13 days to 13 yr, underwent 386 operations for common inguinoscrotal pathology at the Soroka Medical Center. In 12 cases ectopic adreno-cortical tissue was found along the spermatic cord, an overall incidence of 3.8%. None was found in females. Considering the group operated upon for undescended testis, in which by nature of the procedure the spermatic cord was dissected throughout its length, the frequency of ectopic adrenal tissue found rose to 9.3%, the highest figure cited for this location. The nature of aberrant adrenocortical tissue is briefly discussed, including its embryology, histology, and clinical implications. It usually appears as an incidental finding during surgery. Its removal is indicated whenever found although no special attempt should be made to search for it.

Adolescent↗
PubMed1979

Primary malignant lymphoma of the small intestine in Israel. Changing incidence with time.

One hundred and eighty-one cases of primary small intestinal lymphoma were diagnosed in residents of Israel--145 Jews and 36 Arabs--during a 16-year period, 1960--75. The male:female ratio was 1.8:1. Incidence rates were higher in children, the middle-aged and the elderly than in teenagers or young adults. Crude and age-adjusted incidence rates were higher in Arabs than in Jews. The pattern among the subgroups of the Jewish population varied with age. In young adults of both sexes the rates were much higher among Jews born in North Africa or Asia than among those born in Europe or Israel. In elderly males, however, the rates were almost twice as high in European-born Jews than among those born in North Africa or Asia. The mean annual incidence of primary small intestinal lymphoma fell from 4.8 per million during 1960--67 to 3.6 per million during 1968--75. This was due to a marked fall in the rates in children and young adults, whereas the rates in those aged 40 years or more rose with time. The pattern of the change with time suggests that environmental conditions are an important factor in the causation of primary intestinal lymphoma in young adults.

Adolescent↗