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Biomedical subjects

R Adelman

Publications and source records attributed to R Adelman.

16 recordsLinked to original sources
PubMed1989

Urinary symptoms in child sexual abuse.

Many common genitourinary complaints may be related to sexual abuse. We report five patients referred to a Pediatric Nephrology Clinic who demonstrate some of the symptoms and signs caused by abuse, such as dysuria, genital and urinary tract infections, voiding dysfunction, and genital trauma. Difficulties in eliciting histories are described. Although these genitourinary complaints may be due to a variety of etiologies, sexual abuse should not be overlooked. Suggestions for a management approach are made.

Child↗
PubMed1988

Parent salvage and parent sabotage in the care of chronically ill children.

Adaptive parental behaviors produced from dealing with prolonged illness may sabotage medical care of the chronically ill pediatric patient. Such parental behaviors may be the result of unsuccessful intrapsychic or interpersonal salvage operations in the response to the strains resulting from illness in their child. They may resemble psychopathology, but actually can be reversible. Five cases are presented to illustrate differential diagnosis of parent difficulties ranging from adaptive strain in normal parents to Munchausen's syndrome by proxy in parents of children with chronic illness. A typology of parent-child pathology in health and chronic illness is presented. The literature is reviewed, diagnostic features are elaborated, and management strategies are suggested.

Adolescent↗
PubMed1988

Oxidative damage to DNA: relation to species metabolic rate and life span.

Oxidative damage to DNA is caused by reactive by-products of normal metabolism, as well as by radiation. Oxidized DNA bases excised by DNA repair enzymes and excreted in urine were measured in four different species to determine the relation between specific metabolic rate (ml of O2 consumed per gram of body weight per hr) and oxidative DNA damage. An average of 6.04 nmol of thymine glycol per kg/day and 2.58 nmol of thymidine glycol per kg/day were found in mouse urine and 1.12 nmol of thymine glycol per kg/day and 0.95 nmol of thymidine glycol per kg/day were found in monkey urine. On a body weight basis, mice excrete 18 times more thymine glycol plus thymidine glycol than do humans, and monkeys excrete 4 times more thymine glycol plus thymidine glycol than do humans. When results among mice, rats, monkeys, and humans are compared, specific metabolic rate correlates highly with oxidative DNA damage. These findings are consistent with the theory that free radical-induced DNA damage may play a central role in the aging process.

Aging↗
PubMed1988

Elevation of the renal enzyme N-acetyl-beta-glucosaminidase in affectively disordered patients.

A minority of patients with affective disorders experience mild elevations of the renal enzyme N-acetyl-beta-glucosaminidase (NAG). Some affectively disordered patients also have reduced concentrating ability and reduced creatinine clearance. Thirty-one affectively disordered patients were compared to 17 healthy controls, to evaluate whether these various renal abnormalities are associated with one another and to further examine the proportion of affectively disordered patients experiencing NAG elevations. Twenty-nine percent of patients had an elevated NAG, whereas none of the controls did (P less than .005). There was a trend for an association between elevated NAGs and reduced creatinine clearance (P less than .08), but no association was found between concentrating ability and either elevated NAG or reduced creatinine clearance.

Acetylglucosaminidase↗
PubMed1988

The Mount Sinai Medical Center, New York.

Aging is the third great antecedent to all disease, along with genetic factors and the environment. Yet, the role of aging in the genesis of the conditions of old age constitutes relatively new territory that has not been adequately explored in terms of education, the health care system, and research. A commitment to these areas was made in 1982 when the Mount Sinai Medical Center established the nation's first and only medical school department of geriatrics--the Gerald and May Ellen Ritter Department of Geriatrics and Adult Development. Recognizing that aging of the population constituted a major global public health challenge, leaders of the medical center turned to Robert N. Butler, MD, who was then director of the National Institute on Aging, for guidance in setting up an institute of gerontology and geriatrics. Because only a full-fledged academic department would have a claim on resources, curriculum, and clerkship time, Dr Butler recommended that such a department be developed at Mount Sinai. The Ritter Department of Geriatrics and Adult Development emphasized the wide scope of this new discipline through educational programs, clinical services, health policy studies, and research projects.

Aged↗
PubMed1984

High failure rate of a plastic tubal (Bleier) clip.

Sixteen intrauterine pregnancies (8.6%) have been documented among 187 women who had undergone direct placement of American-made Bleier clips for sterilization. Of these, five pregnancies (10.2%) followed clip placement in 49 cesarean deliveries, nine pregnancies (8.2%) followed 110 infraumbilical postpartum procedures, and two pregnancies (7.1%) occurred in 28 interval minilaparotomy patients. Resterilization by tubal segment excision has been performed in five unsuccessful cases. In one case, the excised portions of tube with clips in place were studied by radiologic and histologic methods. Tubal patency may persist if the oviduct is trapped in the catch portion of the clip.

Adult↗
PubMed1981

Criteria for cessation of CPR in the emergency department.

Specific criteria have been proposed for the cessation of cardiopulmonary resuscitation (CPR) in the emergency department. Using these criteria and others, we developed a survey which was completed by 78 physicians practicing emergency medicine. The physicians surveyed did not make decisions to cease CPR that were consistent with any such criteria which might guide them in clinical decision making. In this survey, the type of residency training, the size of city in which the physician practiced, and the number of years an individual had practiced emergency medicine significantly correlated with how he made the decision to cease CPR. Based on a review of the current literature, and due to the fact that considerable and variable ethical and psychological factors weigh in each clinical circumstance, the authors recommend that no criteria be followed for ceasing CPR.

Adult↗
PubMed1976

Association of inflammatory bowel disease and large vascular lesions.

A case of inflammatory bowel disease with associated multiple large vessel vascular lesions similar to that seen in Takayasu's arteritis is described in a 15-year-old female. It is suggested that this type of vascular lesion may represent another rare systemic manifestation of inflammatory bowel disease.

Adolescent↗