Search PubMed⌕ Search

Biomedical subjects

P Beck

Publications and source records attributed to P Beck.

At least 19 recordsLinked to original sources
PubMed1992

A room of one's own: the SRO and the single elderly.

A survey of 485 single-room occupancy housing (SRO) residents in New York City found elderly residents strongly preferred to remain in centrally located neighborhoods where apartment housing was beyond their means; did not wish to share a housing unit; and had little confidence that they could find acceptable housing if they lost their present unit. For many elderly residents, SROs meet needs not easily met by available alternatives. Results suggest the need to maintain this housing option for older persons and replace losses that have accompanied gentrification in many central city areas.

Aged↗
PubMed1992

A prospective study of amylase-rich pleural effusions with special reference to amylase isoenzyme analysis.

By analysis of pleural effusions from 200 patients, 25 cases of amylase-rich effusions were identified, for an overall incidence of 13 percent. Four of the 25 patients (16 percent) had evidence of pancreatitis. These patients had higher mean ratios of pleural fluid to serum amylase levels (18 +/- 6.3 [SEM] vs 4.8 +/- 1.3) compared to patients with nonpancreatic diseases (p = 0.003); all four exhibited a predominant pancreatic isoenzyme profile. Of the 21 patients with nonpancreatic amylase-rich effusions, lung cancer was the most commonly associated condition (8 patients). In 14 of the 21 patients in whom an isoenzyme profile was obtained, salivary-type amylase was predominant. Amylase-rich pleural effusions occur frequently, and pleural fluid isoamylase determination is specific for pancreatitis-associated effusions. The finding of a pleural effusion rich in salivary isoamylase should prompt an evaluation for carcinoma (particularly of lung primary), but may also be seen in other pleural inflammatory conditions.

Amylases↗
PubMed1991

Malignancy hypercalcemia: evaluation of parathyroid function and response to treatment.

In 53 patients with malignancy-associated hypercalcemia, we measured serum parathyroid hormone (PTH) with an immunoradiometric assay (IRMA) for intact PTH and a midregion-specific radioimmunoassay (RIA). Values were measured at baseline to detect clinically unrecognized hyperparathyroidism and after treatment with intravenous bisphosphonate to test for a parathyroid response. One patient probably had primary hyperparathyroidism, since his serum PTH values were not appropriately suppressed at baseline and increased markedly during treatment before normocalcemia was achieved. In each of the 51 other evaluable cases, the intact PTH value was suppressed below 25 pg/ml (normal range 10-55 pg/ml), confirming a nonparathyroid hypercalcemia. Midregion PTH values were less fully suppressed but supported the diagnosis in 44 out of 49 cases. The five patients with high midregion PTH values each had renal insufficiency but in four, the intact PTH values were also the highest we observed in these patients. This suggests either a poorly suppressible intact PTH secretion or prolongation of intact PTH half-life by the renal insufficiency. Overall, midregion and intact PTH values were highly correlated (p less than 0.001). Restoration of normocalcemia increased PTH in both assays into or within the normal range, and when posttreatment hypocalcemia occurred, PTH values became elevated in both assays. We conclude the following: (1) both assays are useful for detecting parathyroid hyperfunction but the intact PTH assay is the better diagnostic tool when renal insufficiency is present, (2) hypercalcemia seems to suppress intact PTH secretion more fully than secretion of PTH fragments, and (3) parathyroid glands chronically suppressed by hypercalcemia can increase PTH secretion within 1 or 2 days after the hypercalcemia is corrected.

Diphosphonates↗
PubMed1991

Characteristics of panic disorder patients responding to placebo.

Forty-one panic disorder patients receiving placebo were investigated in a double-blind comparison of alprazolam, imipramine and placebo in panic disorder. A significantly higher drop-out rate was found in the placebo group than in the active treatment groups, but placebo response was found in 34% of the patients, defined as reduction of panic attacks to zero, and in 23%, defined as a score of greater than or equal to 8 on the Physician Global Improvement Scale (0-10 points). Several predictors of response to placebo were found. The responders had fewer panic attacks than the nonresponders at baseline. They also reported less psychopathology and were less help-seeking than the nonresponders. The implications for psychopathology and possible response to psychotherapy among responders and nonresponders are discussed. It is hypothesized that the responders show more signs of realistic processing of internal and external stimuli and fewer signs of subjective distress than the nonresponders. Responders will therefore probably be more responsive to psychotherapy than nonresponders.

Alprazolam↗
PubMed1991

Biological activity of bacterial surface components. Immunogenicity and immunomodulatory properties of a bacterial extract from Escherichia coli.

The immunogenic and immunomodulatory properties of a lysed fraction from selected E. coli strains (OM-89, Uro-Vaxom) were determined in vivo and in vitro. It could be demonstrated that OM-89 constitutes an active immunogen in mice. Maximum OM-89-specific antibody titers were obtained after 4-5 i.p. immunizations; the titers could be further enhanced by the simultaneous injection of lipopeptide adjuvants. It was shown by ELISA that the antibodies obtained bound to the bacterial strains used for the preparation of the OM-89 extract. Immunogenicity was observed both after intraperitoneal and oral application of the extract. Besides being active as an immunogen. OM-89 was able to act in vitro as a polyclonal lymphocyte activator, as determined in splenocyte cultures of different inbred murine strains, and in cultures of human peripheral blood lymphocytes. Our results show that the B lymphocyte stimulating activity of the bacterial extract OM-89 was comparable to that of lipopeptide adjuvants. In conclusion, the bacterial extract both an active immunogen in vivo, and a polyclonal B cell activator in vitro. These findings may be of importance for the understanding of the therapeutic effect of OM-89.

Adjuvants, Immunologic↗
PubMed1990

How good are case notes in the audit of radiological investigations?

Audit based on the use of case notes completed in the ordinary course of patient care has not been widely used because of concern about the completeness and adequacy of such records. This paper describes the results of a study carried out to assess whether information contained in case notes was sufficiently reliable to enable clinical effectiveness to be measured. The study examines the extent to which a radiologist and an epidemiologist agree with two experienced clinicians in making retrospective judgements on whether out-of-hours radiological investigations are worthwhile. There was a high measure of agreement; only a relatively small amount of information in the case notes is needed to make valid judgements on clinical performance. The method described here may be applicable to other diagnostic investigations and the results of the study have wide implications for more effective and efficient management of resources within the NHS.

Clinical Competence↗
PubMed1990

Survival of the cornual pregnancy in a heterotopic gestation after in vitro fertilization and embryo transfer.

We present a case of combined intrauterine and cornual (interstitial) pregnancy after IVF-ET, with survival of the infant after the cornual pregnancy. The diagnosis of this rare phenomenon is difficult; a high index of suspicion and frequently ultrasound monitoring may enable early diagnosis in other forms of heterotopic pregnancy. Although the benefits of IVF-ET far outweight the risks of ectopic pregnancy, it is imperative that physicians who care for these patients be fully aware of the possibility of such a complication in this high-risk population.

Adult↗
PubMed1990

[Does silicone oil improve the prognosis of severe proliferative diabetic retinopathy?].

We report on a series of 135 consecutive cases of pars plana vitrectomy for proliferative diabetic retinopathy (average period of observation was 13 months). BSS was used in 69 eyes and silicone oil was used in 66 eyes as a vitreous substitute, the indications for silicone oil in these cases were the presence of several retinotomies or retinectomies as well as sharply increased risk for rebleeding. Postoperatively and after a minimum follow up of 6 months (55 eyes) the two groups with BSS or silicone oil achieved comparable functional results despite the different anatomical preoperative situation. Thus 18 out of 23 eyes of the silicone oil group, originally with detached macula and visual acuity of HM or FC, achieved a visual outcome of greater than = 0.02, showing the best postoperative result. In the BSS-group, with attached macula prior to the operation and same visual acuity, this result is attained by 27 out of 35 eyes. We interpret these figures as meaning, that silicone oil in proliferative diabetic retinopathy reduces some of the problems connected with more advanced retinal changes like retinal detachment and rebleeding thereby allowing a visual outcome which corresponds to the macular condition.

Adult↗
PubMed1990

[Biodegradable osteosynthesis applied to craniofacial surgery].

Since skin problems as decubitus and infections are well known risks in osteoplastic trepanations in congenital malformations in children, we searched for a reduction in size of the implants and the possibility to use biodegradable materials. After design of special constructions regarding dimension and stability purposes for children below one year, we performed osteoplastic trepanations in 27 minipigs. In 78% the healing was uneventful and the osteoplasty remained in place whereas in 22% (= 6 animals) we observed a local infection which lead to loss of implants as well as cranioplasty in 3 animals. Based on this research, we used our biodegradable implants in osteoplastic trepanations of congenital craniostenosis in children. The postoperative follow-up is now from 3 to 6 months in 4 children and the results are perfect in all. We did not observe any local infection, neither cutaneous problems, even not in bilateral frontal advancement and floating forehead procedures. The implants are presented as well as the results in animal research and the first follow-up in 4 children.

Acrocephalosyndactylia↗
PubMed1990

AIDS contact notification: initial program results in New Jersey.

As part of an 1988-89 evaluation of New Jersey's newly established HIV Notification Assistance Program (NAP), data were collected concerning number of HIV+ persons providing contact names; contact characteristics; reactions to NAP of HIV counselors, their clients, and of notified contacts; and program costs. There was initial resistance to the program both from HIV counselors and their clients. By mid-1989, acceptance of the program by referring HIV counselors had increased. The proportion of HIV+ clients who referred contacts was still low, but had increased to 10%. 160 contacts were notified: 72% sexual contacts and 28% needle sharing contacts, 59% male and 41% female, 58% black, 29% white, 13% Hispanic. 67% considered themselves at moderate or high risk for HIV; 31% stated that they had already been tested for HIV, with 7% having tested positive. Cost per notified contact was $2,260; cost per contact not previously tested HIV+ and unaware of risk was $3,014. Findings suggest that persuading counselors at HIV counseling and testing sites of the program's value is a key prerequisite for success, in situations where notification is carried out by a separate agency. Once the program has been in place for a time and has established credibility, the opportunity exists for initial resistance to be overcome.

AIDS Serodiagnosis↗
PubMed1989

Sequence and expression of a gene from Theileria annulata coding for a 70-kilodalton heat-shock protein.

A library consisting of randomly sheared Theileria annulata genomic DNA fragments in the vector lambda gt11 was screened with a Drosophila DNA segment containing the coding region of the 70-kDa heat-shock protein (hsp) gene. A positive recombinant was isolated and subjected to nucleotide sequence analysis. The DNA segment contains an open reading frame coding for a 71-kDa protein strongly homologous to hsp 70 from other organisms. Using this DNA as a probe, a homologous 2.5-kb RNA species was detected in sporozoites, piroplasms and a macroschizont-infected cell line, showing that this gene is constitutively expressed. The amount of this RNA increased following heat shock in the macroschizont-infected cell line. The T. annulata genome contains other sequences that hybridize weakly with this heat-shock gene.

Amino Acid Sequence↗
PubMed1989

Theileria annulata sporozoite surface antigen expressed in Escherichia coli elicits neutralizing antibody.

Theileria annulata is an economically important protozoan parasite that threatens an estimated 250 million cattle with the disease tropical theileriosis. Development of a defined subunit vaccine is one means of trying to develop control measures against the disease. To this end we have characterized a surface antigen complex of the infective stage (sporozoite), by using a monoclonal antibody that neutralizes sporozoite infectivity in vitro. We have cloned the gene coding for this complex and have demonstrated that a fusion protein expressed from a fragment of this gene elicits strong neutralizing antibodies. Furthermore we provide data on the structure and expression of this gene. In particular we show that the region of the gene, expressed in one clone, codes for a protein segment relatively rich in proline residues. Also we demonstrate that expression of this gene appears to be stage specific, transcripts being present only in the sporoblast and sporozoite stages. The relevance of these findings to the production of a defined subunit vaccine is discussed.

Amino Acid Sequence↗
PubMed1987

Hereditary angioedema and thyroid autoimmunity.

Sera from 91 patients with hereditary angioedema were screened for thyroid antibodies. The results for the 77 patients more than 17 years old were compared with previously published data for the prevalence of thyroid disease in a large community (Whickham). Of the female patients with hereditary angioedema, the prevalence of thyroglobulin antibodies (TGA) was 14.0%, higher than the expected 3% (p less than 0.001). The prevalence of thyroid microsomal antibodies (TMA) was 20%, also higher than the expected 7.6% (p less than 0.01). The age distributions of the females in both groups differed: in the group with hereditary angioedema there was a greater proportion of younger patients which should have resulted in a lower prevalence of thyroid antibodies. Adjusting for related patients with hereditary angioedema, there was still an increased prevalence of TGA (p less than 0.01) and TMA (p less than 0.01).

Adolescent↗
PubMed1986

Paracetamol toxicity: is enzyme induction important?

A female patient receiving carbamazepine developed severe liver damage after an overdose of paracetamol. Antidotal therapy was not administered because her plasma paracetamol concentration was below that normally indicating the need for such therapy. Subsequently, carbamazepine was readministered and resulted in marked induction of the metabolism of a single dose of paracetamol. Antidotal therapy may be indicated if the plasma paracetamol concentrations are 70% or more of those shown in the conventional treatment line, if the patients are also receiving enzyme-inducing drugs.

Acetaminophen↗
PubMed1986

Action of hormonal contraceptives on the coagulation system and some of its inhibitors.

Changes in the level of inhibitors of the coagulation system, primarily of thrombin neutralizing factors have been studied during the prolonged use of four products of contraceptive preparations containing various amounts of oestrogens and progestogens, two fixed dose pills (Bisecurin, Ovidon), a low dose combination pill (Rigevidon) and a biphasic preparation (Anteovin). Thrombelastographic values referred to hypercoagulability while the results of other examinations indicating activation of the coagulation system did not show definite changes in comparison with the control. The activity and quantity of antithrombin III decreased but never below 80%. Except Anteovin all contraceptives significantly enhanced alpha 1-antitrypsin while alpha 2-macroglobulin levels, remained nearly the same as the control values. Attention is called to that the increased alpha 1-antitrypsin level may be a biochemical risk factor. The results showed that the increased coagulability and disposition to thromboembolic disorders caused by hormonal contraceptives may be attributed not only to the decrease of thrombin inhibitors but also to increased alpha 1-antitrypsin levels which may cause increased inhibition of the fibrinolytic system.

Adolescent↗