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Biomedical subjects

M Singer

Publications and source records attributed to M Singer.

At least 145 records · Page 8Linked to original sources
PubMed1993

Psychological distress, problem behaviors, and family functioning of sexually abused adolescent inpatients.

OBJECTIVE: By studying children and adolescents who have been sexually abused, improvements in identifying and treating emerging pathology can be gleaned before personality structures become more rigidly defined and less amenable to therapeutic interventions. It is through studying and comparing subgroups of victims and controls that clinical researchers can additionally elucidate abuse-related manifestations that contribute to the development of psychopathology. METHOD: A group of sexually abused adolescent psychiatric inpatients was compared with a control group of inpatient counterparts on measures of social competence, self-esteem, depression, substance abuse, and perceptions of family characteristics and functioning. Consecutive admissions to an adolescent inpatient psychiatric unit (N = 423) were carefully screened for a history of sexual abuse, then divided into two groups, each with 87 subjects, after matching on key variables including age, race, gender, socioeconomic status, and psychiatric diagnosis. RESULTS: Sexually abused and control group inpatient adolescents were similar on standardized measures of psychological distress and family functioning. Statistically significant differences were found between groups on substance abuse measures. CONCLUSION: The phenomenology of the relationship between sexual abuse and substance abuse and the implications for inpatient treatment are summarized.

Adolescent↗
PubMed1993

Intensive care.

Explore the source record for details and available documents.

Critical Care↗
PubMed1993

The optimal time for measuring the cardiorespiratory effects of positive end-expiratory pressure.

No study has elucidated the minimum time taken for oxygen delivery to reach steady-state levels after an increase in positive end-expiratory pressure (PEEP). We therefore investigated ten ventilated patients who received a total of 27 increments in PEEP of 5 cm H2O. Cardiorespiratory parameters were measured at baseline, at 1 min, and thereafter at 5-min intervals until 2 consecutive measurements of oxygen delivery were constant. Cardiac output was measured continuously using an esophageal Doppler transducer. The PEEP was increased to a maximum of 20 cm H2O or until oxygen delivery fell by 15 percent. Increases in PEEP were always associated with increases in oxygen saturation. Cardiac output decreased in the majority of cases, the greatest falls occurring in the first minute after an increase in PEEP, and with higher levels of PEEP. No significant changes in oxygen delivery occurred after 15 min. We therefore recommend that 15 min be allowed to elapse after an increase in PEEP before oxygen delivery is reassessed.

Adult↗
PubMed1992

Haemodynamic evidence for cardiac stress during transurethral prostatectomy.

OBJECTIVE: To compare haemodynamic performance during transurethral prostatectomy and non-endoscopic control procedures similar in duration and surgical trauma. DESIGN: Controlled comparative study. SETTING: London teaching hospital. PATIENTS: 33 men aged 50-85 years in American Society of Anesthesiologists risk groups I and II undergoing transurethral prostatectomy (20), herniorrhaphy (eight), or testicular exploration (five). MAIN OUTCOME MEASURES: Percentage change from baseline in mean arterial pressure, heart rate, Doppler indices of stroke volume and cardiac output, and index of systemic vascular resistance, and change from baseline in core temperature. RESULTS: In the control group mean arterial pressure fell to 11% (95% confidence interval -17% to -5%) below baseline at two minutes into surgery and remained below baseline; there were no other overall changes in haemodynamic variables and the core temperature was stable. During transurethral prostatectomy mean arterial pressure increased by 16% (5% to 27%) at the two minute recording and remained raised throughout. Bradycardia reached -7% (-14% to 1%) by the end of the procedure. Doppler indices of stroke volume fell progressively to 15% (-24% to -6%) below baseline at the end of the procedure, and the index of cardiac output fell to 21% (-32% to -10%) below baseline by the end of the procedure. The index of systemic vascular resistance was increased by 28% (17% to 38%) at two minutes, and by 46.8% (28% to 66%) at the end of the procedure. Core temperature fell by a mean of 0.8 (-1.0 to -0.6) degrees C. Significant differences existed between the two groups in summary measures of mean arterial pressure (p less than 0.05), Doppler indices of stroke volume (p less than 0.005) and cardiac output (p less than 0.005), index of systemic vascular resistance (p less than 0.0005), and core temperature (p less than 0.0001). CONCLUSIONS: Important haemodynamic disturbances were identified during routine apparently uneventful transurethral prostatectomy but not during control procedures. These responses may be related to the rapid central cooling observed during transurethral prostatectomy and require further study.

Aged↗
PubMed1992

Anomalous effect of mazindol on dopamine uptake as measured by in vivo voltammetry and microdialysis.

The effect of mazindol on the dopamine (DA) uptake system in the rat striatum was studied by in vivo voltammetry and microdialysis. An increase in the maximal uptake rate was observed by voltammetry 30 min after i.p. administration of 1, 5, 10, 15, and 20 mg/kg doses but not after a dose of 25 mg/kg, while stimulated release was enhanced at all doses. The increased maximal uptake is in contrast to increased levels of extracellular DA observed with microdialysis following mazindol administration. This divergence of action is anomalous in the context of current understanding of the DA uptake system.

Animals↗
PubMed1992

Individual differences in bridging inference processes.

The role of individual differences in bridging-inference processing was studied. Students (n = 135) read passages of short to moderate length. After each one, they answered corresponding questions about inferences that bridged causally related ideas that were either near or far apart in the text. The main hypothesis was that local bridging-inference processing is facilitated by the reader's predisposition to access pertinent knowledge during comprehension. Regression analyses provided support for this proposal and indicated that greater working-memory capacity and vocabulary knowledge promote inference processing. The following relationships between the predictors and inference processing were proposed: Knowledge access promotes the co-occurrence in working memory of the text ideas and knowledge needed to compute the bridge. Working-memory capacity enhances the likelihood that needed antecedent ideas will be available to the bridging processes. Vocabulary knowledge may promote inference processing because unfamiliar word meanings place more demands on working-memory resources than do familiar meanings.

Adult↗
PubMed1992

[Grice subtalar arthrodesis: a long-term follow-up in poliomyelitis sequelae].

A retrospective review was done of 19 poliomyelitis feet on which the standard Grice subtalar arthrodesis was performed for correction of valgus feet deformity. The average time of follow-up was 12.1 years. Seventy-nine per cent of the feet had satisfactory results, and all the failures were due to technical errors of graft placement. The calcaneo-first-metatarsal angle on the standing lateral radiograph was found to be the most objective angle and correlated best with the clinical results. The long term effects on the rest of the foot was negligible, with only 3 of the 10 feet, with a follow-up longer than 12 years showing minimal talonavicular arthritis and only 1 ankle developing a ball and socket joint. Ankle valgus was not a significant problem.

Adolescent↗
PubMed1991

Intraoperative radiation therapy for recurrent head and neck cancer.

Forty-seven patients with recurrent head and neck cancer in a previously irradiated field were treated with surgical resection and intraoperative radiation therapy (IORT). Recurrent disease occurred at a median of 18 months from primary treatment, and was at the primary tumor site in 31 and metastatic to regional lymph nodes in 16. Recurrences were squamous cell carcinomas in 42 and adenoid cystic in five. Surgical resection left microscopic residual disease in 41 and gross residual in six. All patients received IORT with a median of 20 Gy. Two-year actuarial survival is 54.9%, and 15 patients are alive and disease free with a median survival of 29 months. Two-year actuarial local control is 61.5%. A trend toward increased survival (P less than 0.09) and local recurrence control (P = 0.05) was noticed when treating microscopic residual disease as opposed to gross residual disease. Perioperative mortality was seen in 8.5% and there was no increase in morbidity secondary to IORT. The authors believe that surgical resection and IORT is an effective treatment modality for head and neck cancers recurrent in previously irradiated fields and is adaptable to tertiary care hospitals.

Combined Modality Therapy↗
PubMed1991

The complement binding-like domains of the murine homing receptor facilitate lectin activity.

The leukocyte homing receptor (HR), the endothelial leukocyte adhesion molecule, and gmp140/platelet activation-dependent granule membrane protein are members of a family of adhesion molecules, termed the lectin cell adhesion molecules (LEC-CAMS) which are unified by a multi-domain structure containing a lectin motif, an epidermal growth factor-like (egf) motif, and variable numbers of a complement binding-like (CB) motif. Previous data have indicated a predominant role for the lectin motif in cell adhesion directed by the LEC-CAMS, although the egf-like domain of the HR may also play a potential role in cell binding. While the role(s) of the CB domains in the LEC-CAMS is currently not understood, they have been hypothesized to act as rigid spacers or stalks for lectin and perhaps, egf domain presentation. In this paper, we analyze the functional characteristics of murine HR-IgG chimeras containing the lectin, lectin plus egf, and lectin plus egf plus CB domains. The Mel 14 mAb, an adhesion blocking antibody which recognizes a conformational determinant in the N-terminus of the HR lectin domain, shows a significantly decreased affinity for a HR construct which lacks the CB motifs, consistent with the possibility that the CB domains are involved with lectin domain structure. In agreement with this conjecture, HR mutants lacking the CB domains show a profound decrease in lectin-specific interaction with the carbohydrate polyphosphomannan ester, suggesting that the changes in Mel 14 affinity for the lectin domain are reflected in lectin functionality. Various assays investigating the interactions between the HR deletion mutants and the peripheral lymph node high endothelium, including cell blocking, immunohistochemical staining, and radioactively labeled ligand binding, all showed that removal of the CB domains results in a lack of HR adhesive function. These results imply that the CB domains of the HR, and, by analogy, the other members of the LEC-CAM family, may play important structural roles involving induction of lectin domain conformation and resultant functionality.

Antibodies, Monoclonal↗