Search PubMed⌕ Search

Biomedical subjects

M Stein

Publications and source records attributed to M Stein.

At least 307 records · Page 17Linked to original sources
PubMed1989

Major depressive disorder and immunity. Role of age, sex, severity, and hospitalization.

An association between depression and altered immunity has been suggested but has not been consistently demonstrated. We have studied 91 patients with unipolar major depressive disorder, and no mean differences were found between the patients and concurrently studied matched controls in mitogen-induced lymphocyte proliferation, lymphocyte subsets, and natural killer cell activity. There were, however, significant age-related differences between the depressed patients and controls in mitogen responses and in the number of T4 lymphocytes. In contrast to age-related increases in mitogen response and in T4 cells in controls, depressed patients did not show increased lymphocyte responses or numbers of T4 lymphocytes with advancing age. Severity of depression and hospitalization status were also associated with immune system changes. Altered immunity does not appear to be a specific biologic correlate of major depressive disorder but may occur in subgroups of depressed patients.

Adolescent↗
PubMed1989

Results of radiation therapy in early glottic carcinoma (T1, T2 N0).

Glottic carcinoma is curable by either surgery or radiotherapy. A total of 60 patients were treated by radiation alone at the Northern Israel Oncology Center, Rambam Medical Center, Haifa, between 1970 and 1980. Twenty-nine (48%) were classified as T1 N0 and 31 (52%) as T2 N0. All patients received radiotherapy primarily with curative intent, with surgery reserved for recurrences. The 5-year actuarial survival for all patients was 90% and actuarial disease-free survival was 95%. In ten patients (17%) there was local failure, and five of them were salvaged by surgery. There were no significant acute or long-term complications of radiation. Factors influencing treatment outcome (anterior commissures involvement, degree of differentiation, treatment volume, and technique of irradiation) and the occurrence of second primary malignancies are discussed.

Adult↗
PubMed1989

[Chronic osteomyelitis and cancer of the fistula].

Malignant change following chronic osteomyelitis with draining sinuses is rare (0.38-2.7%). The time from onset of osteomyelitis until malignant changes differs but needs 30 years in an average. Most patients are men between 50 and 60 years of age. If there is any doubt about malignancy (bleeding, tumor growth) biopsy should be performed and repeated if histological findings give no clear diagnosis. Metastases should be excluded by x-ray of the chest, scintigram and CT of the regional lymphnodes. Correct surgical therapy can only be done by amputation or exarticulation of the extremity. Patients who were operated upon malignant carcinoma of a sinus after osteomyelitis ought to be controlled in a regular follow-up including blood test (tumor marker).

Adult↗
PubMed1989

The area moment of inertia of the tibia: a risk factor for stress fractures.

In a prospective study of stress fractures among Israeli infantry recruits, the area moment of inertia of the tibia was found to have a statistically significant correlation with the incidence of tibial, femoral and total stress fractures. Recruits with "low" area moments of inertia of the tibia were found to have higher stress fracture morbidity than those with "high" area moments of inertia. The best correlation was obtained when the area moment of inertia was calculated about the AP axis of bending at a cross-sectional level corresponding to the narrowest tibial width on lateral X-rays, a point which is at the distal quarter of the tibia. This finding indicates that bending forces about the approximate AP axis are an important causal factor for tibial and many other stress fractures. The bone's bending strength, or ability to resist bending moments, as measured by the area moment of inertia, helps determine risk to stress fracture.

Biomechanical Phenomena↗
PubMed1989

A statistical assessment of the dependability of transcutaneous tissue oxygen tension measurements.

Transcutaneous oxygen tension measurements (PtcO2) were obtained for subjects in two groups: peripheral vascular patients (N = 15) and disease-free controls (N = 9). Readings were taken in each of three locations, arm, knee and foot, in supine and erect positions, at fixed and random times, on each of 3 consecutive days. The dependability (the proportion of true variance in total variance) of PtcO2 measurements was evaluated using a generalizability model. The preliminary generalizability study analysis indicated that day-to-day variation of PtcO2 level was larger than within-day variation. Therefore, in order to decrease the measurement error variance one would preferably increase the number of days for measurements (nd) rather than increase the number of measurements within each day (nt). A decision study analysis was also performed which resulted in estimates of error variance and two interdependent dependability measures: dependability coefficients (DCs) and signal to noise ratios (S/Ns). PtcO2 dependability values were generally different for the two groups. Cases had high DCs and S/Ns (DC greater than or equal to 0.9, S/N greater than or equal to 9) in all location-position combinations except for arm measurements. On the other hand, controls had low and unacceptable DCs and S/Ns (DC less than 0.8, S/N less than 4) in all location-position combinations. Cases and controls had generally lower dependability values when PtcO2 ratios were analyzed. The only two ratio-position categories for which dependability values were in the acceptable range (DC greater than or equal to 0.8, S/N greater than or equal to 4) were foot/arm erect and foot/arm supine for the cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1989

The effect of postoperative smoking on femoropopliteal bypass grafts.

Effect of smoking habits on limb loss rates and cumulative patency rates of 136 arterial reconstructions performed for lower limb ischemia were analyzed in a five year follow-up retrospective study. Of 121 patients, 103 (85%) smoked before the operation and 43 of the smokers (42%) discontinued smoking postoperatively. Patients who continued to smoke more than 15 cigarettes per day (34 patients) increased the probability of losing their limb approximately five times at two years and three times at five years postoperatively, compared with nonsmokers and smokers of up to 15 cigarettes per day (87 patients) (p = 0.013). Cumulative patency rates of nonsmokers and smokers of up to five cigarettes per day (Group A, 66 patients) were not significantly influenced (p = 0.518) by preoperative symptoms (claudication versus limb salvage). However, for smokers of more than five cigarettes per day (Group B, 55 patients), at five years claudicants had a cumulative patency rate of 62.9% compared to 38.3% for limb salvage patients (p = 0.015). In group A at five years, autologous saphenous vein grafts had a cumulative patency rate of 74.2%, compared to 24% for prosthetic grafts (P = 0.013). In group B the CPR differences between autologous saphenous vein and prosthetic grafts were not significantly different (p = 0.394). Multiple interactions between smoking and variables like age, preoperative symptoms, and graft material demonstrate the complexity of the effects of smoking on cumulative patency rate and the need for sub-grouping and removal of confounding factors. In view of the adverse affects of continued smoking on postrevascularization prognosis, patients should be strongly advised to discontinue smoking.

Adult↗
PubMed1989

Percutaneous transluminal angioplasty without anticoagulation.

This paper presents the results of a retrospective study of 110 percutaneous transluminal angioplasties done over a period of two years on 110 consecutive patients. Anticoagulation or antiplatelet drugs were not used during or after percutaneous transluminal angioplasty. Life-table analysis was used to calculate success rates at one and three months following the procedure. Success rates were determined using three criteria: clinical improvement, pre- and post-percutaneous transluminal angioplasty Doppler studies, and radiographic appearance. Claudication was present in 87 (79%) patients and severe ischemia in 23 (21%) patients. Sixty-eight (62%) PCTAs were done in the iliac arteries, 35 (32%) in the femoral arteries, and 7 (6%) in the popliteal artery. The majority of patients (61%) had 50%-75% arterial stenosis and only 18% had complete occlusion. Percutaneous transluminal angioplasty in the iliac arteries had the best results with cumulative success rates of 90% and 85% at one and three months, respectively. Success rates in the femoral arteries were 83% and 79% and in the popliteal artery 71% and 57% at one and three months, respectively. None of our patients required amputation. Ten patients (9.1%) suffered the following complications within 30 days of percutaneous transluminal angioplasty: death (2), thrombosis (2), perforation (3), minor hematoma (2), and false aneurysm (1). In conclusion, we have shown that percutaneous transluminal angioplasty can be performed safely and effectively without the use of anticoagulation and its associated risks.

Adult↗
PubMed1989

Serological profiles in the connective tissue diseases in Zimbabwean patients.

The serological profiles of 104 Zimbabwean patients with clinically diagnosed connective tissue diseases were determined. The prevalence of rheumatoid factor was less than would have been expected in other geographical groups, but the prevalence of antinuclear antibodies was similar. Despite considerable racial, socioeconomic, and genetic differences in our patient group compared with other previously published studies the specificity and sensitivity of antinuclear antibodies, notably to DNA and Sm, correlated well with clinical diagnoses. This study validates the use of these serological tests in the investigation of this group of patients.

Adolescent↗
PubMed1989

Marcher's digitalgia paresthetica among recruits.

In a prospective study of 30 male Israeli military recruits a 47% incidence of digitalgia paresthetica was found. The mean time of onset of symptoms was in the fourth week of training. The numbness was bilateral in 11 of 14 of the cases and the mean number of toes involved was 4.5. The first toe was the most commonly involved (11 of 14 patients). No correlation between shoe type (either 3/4 running shoes or standard military boots) was found. At 9-month follow-up, 7 of 9 affected recruits reviewed were asymptomatic. This finding suggests that marcher's digitalgia paresthetica is a neuropraxia. In this study, it developed during the early phases of march training when recruits are adapting to marching with heavy pack and rifle.

Humans↗
PubMed1989

Combined effect of foot arch structure and an orthotic device on stress fractures.

In a prospective study, quantitative measures of the structure of the longitudinal arch of the foot were established and related to the incidence of stress fractures in the bones of the lower limbs of military recruits. In addition, the role of a semirigid orthotic device (Langer military stress orthotic) in preventing stress fractures was evaluated as a function of the structure of the longitudinal arch. Femoral and tibial stress fractures were found to be more prevalent in the presence of feet with high arches, whereas the incidence of metatarsal fractures was higher in feet with low arches. The use of an orthotic device reduced the incidence of femoral stress fractures only in the presence of feet with high arches and the incidence of metatarsal fractures only among feet with low arches. The findings suggest that the normal foot with a low arch acts as a better shock absorber than the normal foot with a high arch, and that an orthotic device may improve the shock absorbing capacity of the arch.

Adult↗
PubMed1989

[Treatment of stage I malignant melanoma].

In 259 patients with malignant melanoma of the skin referred here during 1973-1984, the median follow-up was 46 months. Of 182 with stage I disease, 97 (53.2%) were women and 85 men. Of these, 90.1% were Jews of European extraction and 8.2% were Jews of Asian-African extraction, while only 1.8% were non-Jews. 171 (94%) of the patients were treated by wide excision, with or without skin graft, as primary treatment, while 11 had limited local excision. In 16.4% the primary tumor was located on the upper limbs, in 34.6% the lower limbs, in 27.5% the trunk and in 19.2% the head and neck. 5-year survival was 70%. The 5-year actuarial survival was significantly influenced by: age (those under 50 had better survival, 79.5% vs 58.4%, p less than 0.05); by site of the primary lesion (88.5% for those of the upper limbs vs 59.4% for those of the lower limbs), p less than 0.01]; by depth of invasion as seen microscopically (81.2% for Clark I-II vs 52.8% for Clark IV-V, p less than 0.02); and by site of recurrence (43.4% if local vs 0 for distant, p less than 0.02).

Actuarial Analysis↗
PubMed1989

[Delay in the diagnosis of malignant melanoma].

We investigated delay in the diagnosis of malignant melanoma using the files of 180 patients diagnosed from January 1979 through October 1980, and interviewed 103 of the patients. 62% of the patients sought medical help more than 6 weeks after the appearance of symptoms, and the median delay was 6 months. There was no correlation between delay in diagnosis and sex or country of origin. Those in whom the primary tumor had bled were diagnosed earlier than those with other initial symptoms. Those with some knowledge of the signs of skin cancer did not seek medical care earlier than those without. The most frequent reasons for delay in diagnosis were that patients thought the lesions were insignificant or that they would heal without medical intervention. The first physician most patients consulted was their family physician or a dermatologist. Most family physicians (85%) immediately referred the patient to a dermatologist or plastic surgeon. 30% of the dermatologists did not refer the patient immediately for surgery, thus delaying diagnosis and treatment. Education of the public, and of physicians as well, is needed in the prevention and early detection of malignant melanoma.

Dermatology↗
PubMed1989

Stress, depression, and the immune system.

The major neurobiologic processes associated with stress have been observed in depression, and a consideration of the effect of stress on the immune system may provide further understanding of the biology of depressive disorders. A series of studies investigating stress-induced alterations of the immune system demonstrate that stress-induced modulation of immunity is complex and involves a range of neurobiologic mechanisms. Altered immune system measures do not appear to be a specific biologic correlate of major depressive disorder but may occur in subgroups of depressed patients.

Animals↗
PubMed1989

Fluoxetine treatment of obsessive-compulsive disorder: an open clinical trial.

The selective serotonin reuptake blocker fluoxetine was administered to 49 patients with obsessive-compulsive disorder in a 12-week open clinical trial. A minimum adequate trial of at least 8 weeks of treatment was completed by 39 patients. Response rates were 62% (24/39) of adequately treated patients and 49% (24/49) of the whole sample. These uncontrolled findings suggest that fluoxetine is of significant benefit for a substantial proportion of obsessive-compulsive disorder patients. However, controlled trials comparing fluoxetine with placebo and other active agents are needed to confirm this, as are studies aimed to delineate fluoxetine's full dose range, optimal length of treatment and relapse rate following discontinuation.

Adult↗