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Biomedical subjects

M Steiner

Publications and source records attributed to M Steiner.

At least 559 records · Page 31Linked to original sources
PubMedDate not supplied

Random drug excess.

If a patient is treated in a hospital, drugs are administered at 'deterministic', known times. However, if the patient is not supervised the times of drug intake may be less 'deterministic' and less well known. It seems therefore worthwhile to make a theoretical experiment in which one assumes that drugs are applied according to a random process. In the present article it is proposed that shot noise models could be used to represent concentration curves in such situations. By means of Monte Carlo methods different measures of random drug excess are described. An included program may encourage readers to consider these methods and to perform computer experiments.

Drug Administration Schedule↗
PubMedDate not supplied

Predicting outcome for borderline personality disorder.

The purpose of this study is to identify variables predictive of the psychosocial outcomes of borderline patients 2 years following an acute psychiatric hospitalization. Of the initial 88 inpatients scoring positive for the Diagnostic Interview for Borderlines (DIB), 65 (73.8%) were reinterviewed, 14 (15.9%) refused, five (5.7%) were unable to be located, and four (4.6%) suicided. The dropouts (n = 19) were significantly more likely to be single, separated, or divorced, to be male, and to be diagnosed as having co-existing antisocial personality disorder than the followed-up probands (n = 69). In terms of global functioning, over the 2-year follow-up period, 61 (87.7%) of the 69 probands were judged to be functioning normally less than 50% of the follow-up interval. Using logistic regression, two variables, initial impulse action scores and poor premorbid functioning, predicted poor versus good outcome. This study supports the literature, which indicates that the early course of borderline personality disorder (BPD) is stormy. Impulsivity and poor premorbid functioning may be predictive of poor short-term outcome in borderline patients.

Adult↗
PubMedDate not supplied

Effect of chilling on platelet cyclic adenosine 3:5-monophosphate and adenylate cyclase activity.

Exposure of platelets to 1 C led to a transient increase in cyclic AMP levels (determined either by a protein binding method or by radioimmunoassay) within five to ten minutes reaching a maximum 10 to 15 minutes after chilling was begun and returning subsequently to baseline values. Addition of EDTA to the platelet suspension medium prevented this increase. Rewarming at 37 C produced a sudden reduction in platelet cyclic AMP. To determine whether the cold-induced increase in cyclic AMP was due to a transient stimulation of platelet adenylate cyclase or a rapid inhibition of phosphodiesterase, these enzymes were assayed in ruptured platelet suspensions. Platelet adenylate cyclase activity was found to possess certain characteristics similar to those of the enzyme derived from other sources but there was a marked potentiation of fluoride-stimulated adenylate cyclase activity by 0.001 M EDTA. This effect was limited to low EDTA concentrations. Exposure of platelets to 1 C for up to 60 minutes did not increase adenylate cyclase activity but lowered it substantially compared with controls kept at room temperature. Phosphodiesterase activity at 1 C was depressed sooner and to a greater extent than was adenylate cyclase. The transient rise in cyclic AMP levels in chilled platelets appears to be due to a disproportionate reduction of cyclic nucleotide phosphodiesterase activity.

Adenosine Triphosphate↗
PubMedDate not supplied

Postoperative stroke in a child with cerebral palsy heterozygous for factor V Leiden.

A 5-year-old with spastic quadraparetic cerebral palsy suffered multiple strokes after extensive orthopedic surgery. Coagulation testing was undertaken to determine whether a familial thrombophilia was present. The patient was found to be heterozygous for factor V Leiden. Factor V Leiden may be a risk factor for central nervous system events in special-needs children, particularly when common medical conditions create additional procoagulant risks.

Brain Edema↗
PubMedDate not supplied

Hepatic mesenchymal hamartoma in a neonate: a case report and review of the literature.

To describe an unusual presentation of mesenchymal hamartoma in a critically ill neonate necessitating a novel therapeutic embolization before definitive resection. An unusual presentation of a large hepatic mass in a newborn complicated by pulmonary hypertension and vascular "steal" with renal insufficiency is presented. The mass was initially successfully embolized, but then revascularized, necessitating resection in an attempt to improve the clinical status of the critically ill neonate. The resected mass was a mesenchymal hamartoma with a necrotic center and extensive arterial collateralization. The patient began improving immediately after resection. Mesenchymal hamartoma may present in the neonate as a diagnostic dilemma. This is the first case report describing persistent pulmonary hypertension and renal compromise from this tumor. Embolization as a therapeutic modality to address this tumor is described. The cause of the persistent and severe pulmonary hypertension remains unclear,but may be related to the tumor.

Acute Kidney Injury↗
PubMedDate not supplied

Aspiration of a primary tooth in a patient with a tracheostomy.

Aspiration of a foreign object is uncommon in a patient with a tracheostomy. The following case history describes the consequences of failure to diagnose an aspirated object and how the aspiration of an exfoliated tooth can occur despite the presence of a tracheostomy tube. Dentists play an important role in preventing foreign body aspiration in debilitated patients.

Bronchi↗
PubMedDate not supplied

Dose response of dietary fish oil supplementations on platelet adhesion.

A dose-response study of dietary fish oil supplementation on platelet adhesion was performed in three groups of five normal individuals each. Fish oil equivalent to 3, 6, or 9 g eicosapentaenoic acid (EPA)/day was administered for 3 weeks, and platelet adhesion was evaluated under high and low shear rate conditions in a laminar flow chamber before, during, and after termination of fish oil administration. Platelet adhesion to collagen I and fibrinogen, the two test surfaces in this study, was greatly reduced in response to fish oil. The inhibitory effect was similar whether platelet adhesion was evaluated at high or low shear rates. Maximal inhibitory activity was noted at 6 g EPA/day. A delayed onset and prolonged washout period characterized the response. The washout period of the fish oil effect was inversely related to the level of dietary supplementation. Measurement of total fatty acid distribution in platelets showed a dose-related increase in n-3 polyunsaturated fatty acids. From these studies, it is concluded that fish oil is an effective inhibitor of platelet adhesion, which reaches its maximum effect at approximately 6 g EPA/day.

Adult↗
PubMedDate not supplied

Consolidation radiation therapy following cytoreductive surgery, chemotherapy and second-look laparotomy for epithelial ovarian carcinoma: long-term follow-up.

BACKGROUND: From 1979-1987, 139 stage IC-IV ovarian cancer patients who had undergone cytoreductive surgery received 6-11 cycles of cisplatin and adriamycin. STUDY DESIGN: Eighty-four clinically complete responders underwent second-look laparotomy, and 60 of them received consolidation abdominal irradiation. The patients were then followed for a median follow-up of 39 months. RESULTS: Five- and 10-year actuarial survival for all patients was 43% and 24%, for no residuum at primary surgery, 80% and 35%, for residual tumor <2 cm, 45% and 35%, and for residual tumor >2 cm, 20% and 4%. Median survival for stage III-IV patients negative at second-look laparotomy was 72 months in irradiated compared to 25 months in non-irradiated patients (P = 0.14) and 77 months in irradiated patients with microscopic disease at second-look laparotomy. Median survival in patients with macroscopic disease at second-look laparotomy was 23.5 months if irradiated compared to 18 months if not (P = 0.05). CONCLUSIONS: Consolidation whole abdominal irradiation in advanced stages of ovarian cancer may be of value in patients with negative or microscopic disease at second-look laparotomy. Unfortunately, despite the initial survival advantage observed in irradiated patients, owing to late recurrences there was no significant difference in their long-term survival probability.

Adult↗
PubMedDate not supplied

The impact of lubricants on latex condoms during vaginal intercourse.

The objective was to evaluate the impact of additional lubricant on condom breakage and slippage. Two hundred and sixty-eight couples used 6 new and 6 aged condoms during vaginal intercourse and were instructed to use 2 of each type with either water-based lubricant, oil-based lubricant or no additional lubricant. The use of either oil-based or water-based lubricant increased slippage rates of new and aged condoms, although only one pairwise comparison (oil-based lubricant vs. no additional lubricant) was statistically significant (8.5% vs. 3.8%, P = 0.004). The use of oil-based lubricant increased breakage, although not statistically significantly, in both new and aged condoms. Water-based lubricant did not impact the breakage rate of the new condoms and decreased the breakage rate of the aged condoms (no additional lubricant 4.5% vs. water-based lubricant 2.1%, P = 0.029). From a functional perspective, this study suggests that condom users should be told not to use oil-based lubricants. The negative impact of water-based lubricant on slippage may be outweighted by the protective influence on breakage, especially for aged condoms. Over three-quarters of the couples (76%) had at least some incorrect knowledge, according to current condom instructions, of the type of lubricant that should be used with condoms.

Adult↗