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Biomedical subjects

R Finkelstein

Publications and source records attributed to R Finkelstein.

At least 91 records · Page 5Linked to original sources
PubMed1985

Initial coping responses and psychosocial characteristics of children with insulin-dependent diabetes mellitus.

School-aged children with newly diagnosed insulin-dependent diabetes mellitus (IDDM) were studied longitudinally in order to document how they adjusted to the medical illness and to assess salient background factors. The extent of life stress and the prevalence of psychiatric disorders that predated the IDDM were within normative ranges, and there was no characteristic preexisting "diabetic personality." The initial strain of living with IDDM elicited two general modes of coping. The prototypical and subdued reaction (seen in 64% of the children) consisted of mild sadness, anxiety, feeling of friendlessness, and social withdrawal. The rest of the children (36%) exhibited reactions that met criteria for a psychiatric disorder; depressive syndromes were the most common presentations. Anamnestic factors and the parents' initial responses to their children's IDDM were unrelated to how the children themselves coped. However, psychiatrically diagnosable reactions were more likely among children whose parents were of low socioeconomic status and had marital distress. Coping with the diagnosis and the early impact of IDDM took no more than 7 to 9 months, no matter how severe the child's response was initially.

Adaptation, Psychological↗
PubMed1984

Depressive disorders in childhood. I. A longitudinal prospective study of characteristics and recovery.

In the context of a prospective, longitudinal, and controlled nosologic study, the characteristics and diagnostic validity of major depressive disorder, dysthymic disorder, and adjustment disorder with depressed mood were examined in a school-aged cohort. The entities were distinguishable on several dimensions such as age at onset and pattern of recovery. Time to recovery from onset was most favorable for the adjustment disorders (90% remission rate during nine months) and least so for the dysthymias (89% remission rate during six years). Major depression and dysthymia were similar with respect to the prevalence of concurrent nonaffective disorders. For both, early age at onset predicted a more protracted illness. Treatment contacts, none of which were under the control of the investigators, had no clear impact on recovery from the depressions.

Achievement↗
PubMed1984

Depressive disorders in childhood. II. A longitudinal study of the risk for a subsequent major depression.

As part of a longitudinal nosologic study of major depressive disorder, dysthymic disorder (DD), and adjustment disorder with depressed mood ( ADDM ) in a school-aged cohort, the predictive validity of each diagnosis was examined. Using all available data on the course of the disorders, the criterion was the first subsequent major depressive episode. Major depressive disorder and DD signaled a similarly high risk of a new bout of depressive illness. For the children who recovered from their first episode of major depression and then had their second one (40%), the free interval did not exceed two years; an underlying dysthymia increased the risk of recurrence. Major depression and dysthymia were distinct from ADDM and a set of control disorders; the latter two diagnostic groups were associated with a minimal risk for major depression.

Adjustment Disorders↗
PubMed1984

Staphylococcus aureus bacteremia and endocarditis: comparison of nosocomial and community-acquired infection.

Staphylococcus aureus bacteremia continues to be a frequent clinical problem even in communities where intravenous drug abuse is relatively rare. One-hundred-three evaluable cases of S. aureus bacteremia that occurred in a large tertiary care facility over a four year period (1979-1982) are reviewed. A comparison of nosocomial and community-acquired S. aureus bacteremia reveals several fundamental differences. Community-acquired S. aureus bacteremia frequently develops in the absence of a primary focus of infection and is more likely to result in endocarditis and secondary metastatic foci of clinical infection. In contrast, nosocomial S. aureus bacteremia tends to be diagnosed earlier, a primary site of portal entry is usually identified and endocarditis is less frequent as are secondary foci of infection. Irrespective of the epidemiological origin of S. aureus bacteremia, the mortality remains high particularly in nosocomial infection where the presence of severe underlying disease contributes to the high mortality. Methicillin resistant S. aureus adds a new dimension to the challenge of successful treatment of staphylococcal bacteremia.

Adolescent↗
PubMed1983

Millions of medical care dollars for indigents.

The medically indigent, a group traditionally underserved with health care, can obtain some needed free services from Hill-Burton facilities. These facilities (hospitals, nursing homes, clinics, and agencies) received Hill-Burton funds for their building programs and have, as a result, an obligation to provide a certain amount of uncompensated medical care to a defined medically indigent population. Health systems agencies (HSAS) or other interested agencies and groups can play an integral role in highlighting the Hill-Burton Program and helping the medically indigent obtain free care, This paper describes the Hill-Burton Program and explains how one HSA identified the Hill-Burton facilities in its area, determined the extent of their obligations, obtained allocation plans, and publicized and promoted the available health care services. From the interest shown by the community it was apparent that the HSA had provided a much needed and appreciated service that could be duplicated across the country by HSAS or other community groups.

Financing, Government↗
PubMed1983

Prognostic implication of detecting vegetations by M-mode echocardiography.

The prognostic significance of finding vegetations by M-mode echocardiography in patients with infective endocarditis remains controversial because many such patients are referred for early surgery. We detected vegetations in 7 of 25 consecutive subjects with active infective endocarditis (28.1%) studied by M-mode echocardiography. 11 patients died within 1 year and only 1 underwent surgery. Patients with vegetations had a higher likelihood of developing serious complications such as death, congestive heart failure or "severe congestive heart failure' when compared with patients without vegetation. This study validates previously reported series including a high percentage of patients "requiring surgery' and points to the serious prognostic implication of finding a vegetation by M-mode echocardiography.

Adolescent↗
PubMed1983

Texas Star-SR: attenuated "Vibrio cholerae" oral vaccine candidate.

Texas Star-SR, a laboratory-derived mutant of Vibrio cholerae El Tor Ogawa 3083, which produces B but not A subunit of cholera toxin was given to 68 healthy adult volunteers in doses of 10(5) to 5 X 10(10) organisms. 16 of 68 exhibited loose stools but in only one individual was stool volume notable. Vomiting occurred in 1 and abdominal cramps in 3 vaccines; malaise and fever were not seen. Texas star was recovered from stools of 22% who received low doses (10(5) or 10(6) organisms) and from 63% who received high doses (10(8), 10(10), 2 X 10(10) or 5 X 10(10)). The attenuated strain was also recovered from jejunal fluid of 76% in the high dose group; cultures revealed 10(2)-10(5) organisms/ml. Seroconversions of vibriocidal antibody occurred in 93% and peak organisms/ml. Seroconversions of vibriocidal antibody occurred in 93% and peak titers were resembling those seen following clinical cholera. In contrast, serum IgG ELISA antitoxin rose significantly in only 29% and levels were below those encountered after clinical cholera. Only 5 of 18 vaccinees tested so far had significant rises in intestinal SIgA antitoxin; these also manifested rises in serum antitoxin. The occurrence of loose stools did not correlate with dose ingested, excretion of vibrios or rise in serum antitoxin. 503 clones recovered from coprocultures and jejunal fluids were negative when tested for enterotoxin. One month following a single 5 X 10(10) organism dose of Texas Star, 7 vaccinees and 6 controls were challenged with 10(6) pathogenic El Tor Ogawa vibrios. Diarrhea occurred in 7 of 10 controls but in only 1 of 7 vaccinees (p = 0.05). Despite clinical protection, excretion of pathogenic V. cholerae was similar in vaccinated and control groups. Twelve vaccinees who received two 10(9) or two 2 X 10(10) organisms doses of Texas Star 1 week apart were challenged with 10(6) pathogenic V. cholerae El Tor of the heterologous serotype. Diarrhea occurred in 11 of 15 controls but in only 3 of 12 vaccinees (p. 0.01). The 3 vaccinees with diarrhea all had mild illness. Texas Star-SR is a prototype that commonly causes mild diarrheal responses but is genetically stable in vivo and stimulates protective immunity against challenge with either the homologous or heterologous serotype.

Adult↗
PubMed1982

Identification of a phosphoprotein specifically induced by the transforming DNA of rat neuroblastomas.

DNAs from nitrosoethylurea-induced rat neuroblastomas transform NIH/3T3 mouse fibroblasts in a transfection assay. DNAs of such transformed cells can be used in a subsequent cycle of transfection to generate secondary foci that contain virtually no foreign genetic material besides the sequences carrying the rat neuroblastoma transforming function. These secondary neuroblastoma transfectants were injected into young mice and grew out into fibrosarcomas. Sera from these mice were examined for reactivity with any proteins which were induced specifically by the neuroblastoma transforming sequence. These sera precipitate a polypeptide of about 185,000 daltons from 35S-methionine-labeled cell lysates of the rat neuroblastoma cells that served as DNA donors and in all transfection-derived primary and secondary foci. This protein is present in high levels in all neuroblastoma transfectant clones, but was not detectable in a variety of other transformed cells. Antisera were prepared from mice bearing tumors induced by transformed cells derived by transfection of DNAs from various tumor cell types unrelated to rat neuroblastoma. These antisera failed to immunoprecipitate the 185,000 dalton protein. These data indicate that the synthesis of the 185,000 dalton protein is specifically induced by the neuroblastoma transforming sequence. The protein may be encoded by the transforming sequence and may mediate transformation in this chemically induced tumor.

Animals↗