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Biomedical subjects

R Segal

Publications and source records attributed to R Segal.

At least 181 records · Page 10Linked to original sources

Professional attitudes of Ohio pharmacists working in three practice settings.

The attitudes of pharmacists in three practice settings toward a set of attributes associated with professionalism were studied. A questionnaire that included the 40-item Shack and Hepler professionalism instrument was mailed to 1999 pharmacists in Ohio. Responses from 617 pharmacists who worked in hospital, independent community, or chain community pharmacy practice were used. There were significant differences between the responses of pharmacists who worked in the different practice settings (multivariate analysis of variance, p less than 0.01). However, the practice setting accounted for less than 10% of the variance in the responses. Statistically significant differences were also observed when the pharmacists were grouped according to sex, years since graduation, degree, and job position; however, less than 8% of the variance in the responses could be explained by the demographic variables. There did not appear to be any practical differences in beliefs about professional attributes among pharmacists working in hospital, independent community, and chain community practice settings.

Attitude of Health Personnel↗

Handling antineoplastic-drug admixtures at cancer centers: practices and pharmacist attitudes.

Results of a 1986 national survey of handling practices for antineoplastic drugs at cancer centers and pharmacists' attitudes toward the importance of recommended practices are reported. A sample of 323 hospitals representing the 27 comprehensive cancer centers (CCCs) and 296 member institutions of the Association of Community Cancer Centers (ACCC) was selected for participation in the survey. Respondents were asked to rate the importance of a recommendation using a five-point scale. Data were analyzed according to hospital bed capacity (small, medium, and large). A total of 175 usable questionnaires were returned, yielding a response rate of 54%. Overall, 99.6% and 94.7% of CCCs and ACCC member institutions, respectively, used vertical-laminar-airflow containment h oods. Personnel used in antineoplastic-drug preparation varied according to hospital size, with CCCs using technicians more frequently than ACCC members. Training methods for personnel were similar among hospitals, although CCCs reported using written testing during training more often than ACCC members. Concern about the safety of the pregnant or breast-feeding woman and of the fetus or infant has led to precautionary policies and procedures in many hospitals. Most hospitals handled antineoplastic waste separately from other waste and regarded this as extremely important. Incineration of antineoplastic waste was used by most hospitals. Antineoplastic-drug-handling precautions taken at CCCs and ACCC member institutions have improved during recent years; pharmacists' perceptions of the importance of various recommendations for handling antineoplastic agents may be helpful in analyzing and developing relevant guidelines.

Antineoplastic Combined Chemotherapy Protocols↗

The incidence of skin manifestations by dermatophytes in patients with psoriasis.

Thirty-four psoriatic patients (23 males, 11 females) were found to have skin manifestations of dermatophyte infection. Tinea pedis was observed in 20 cases, tinea cruris in 6 and tinea manuum in 2. T. rubrum was the causative agent in all of these with the exception of 2 cases caused by E. floccosum. Lesions of tinea corporis were found intermingled with psoriatic plaques in various areas of the body skin in 6 patients (4 males, 2 females); T. rubrum was isolated from 5 of these and M. canis from one. Twenty-one of these psoriatic patients also had lesions caused by C. albicans in the toe-webs and interdigital aspects of the fingers, the latter being associated with paronychia in 9 cases. These findings indicate that we should remain aware of the possibility of fungus manifestations in patients with psoriasis, which would not appear to be an exceptional occurrence.

Adult↗

The increasing role of Microsporum canis in the variety of dermatophytic manifestations reported from Israel.

During a period of 8 years 300 cases of dermatophytoses involving both hairy areas and the glabrous skin were found to be caused by M. canis. There was scalp involvement in 60%, including 8 infants and 27 adults; most of the adults presented Kerion-like lesions and presented various clinical aspects such as seborrhea capitis, folliculitis and discoid lupus erythematosus. In the 21 patients showing invasion of the beard the clinical manifestations included superficial erythemato-squamous patches with hyperemic slightly elevated margins, folliculitis or abscess-like lesions and Kerion-like lesions. Among the lesions found on the glabrous skin there were unusual aspects of tinea faciei in 19 adults, mimicking lymphocytic infiltration, granuloma faciale or discoid lupus erythematosus. Some of the cases of tinea corporis found in 70 patients also had lesions simulating various other dermatological entities, including erythema multiforme, psoriasiform eruption, pityriasis rosea and seborrheic dermatitis. The hands were invaded in 5 adults patients, with involvement of the finger nails in one. Repeated mycologic examinations were necessary to establish the true etiology in many of these cases.

Adult↗

Lymphocyte subpopulations in peripheral blood and malignant effusions of cancer patients.

The percentage of total T lymphocytes and helper and suppressor cells was determined in the peripheral blood and pleural and abdominal effusions of patients with advanced cancer. The ratio of helper to suppressor cells in the peripheral blood and in the effusions was calculated in each case. The percentage of total T lymphocytes and suppressor cells was found to be in a normal range. The percentage of helper cells in patients' peripheral blood and in ascites was slightly lower than normal. However, the percentage of helper cells in the pleural effusion was significantly higher than in the blood. The ratio of helper to suppressor cells in the pleural effusion was 1.46, compared to 0.82 in the blood (P less than 0.01). In patients with ascites the ratio in the blood was 1.05 and in the effusion 1.28. The ratio of helper to suppressor cells of all patients in the peripheral blood was 0.94, as compared to 1.36 in the effusion fluid (P less than 0.05). The imbalance in the T cell subsets found is most probably due to immunodepressions in the peripheral blood and immune reactivity in the effusions.

Ascitic Fluid↗

Spontaneous contrast visualization on the right side of the heart during echocardiography.

Microbubble contrast visualization within the right heart is almost always due to intravenous injections containing microbubbles. In the absence of immediate administration of agitated solutions, several other mechanisms for the occurrence of echo contrast spontaneously in the cardiovascular system have been postulated. Often overlooked as a source of contrast are microbubbles from remotely injected solutions that persist in the circulation because of markedly delayed clearance. Two patients were observed with apparently spontaneous contrast detected in the right heart chambers, both of whom had congestive heart failure, tricuspid regurgitation, and pulmonary hypertension. Regardless of the exact mechanism involved, the finding of this phenomenon reflects the presence of right heart failure and a low flow state.

Aged↗

Sarcoid nephrocalcinotic renal failure reversed by sodium cellulose phosphate.

A case of renal failure due to sarcoidosis with hypercalciuria and nephrocalcinosis is described. Prolonged treatment with inorganic absorbable phosphate significantly deteriorated the patient's renal function. After a sodium cellulose phosphate treatment, renal failure was completely reversed. We suggest that sodium cellulose phosphate is the treatment of choice in sarcoidotic renal failure induced by nephrocalcinosis.

Calcium↗

Malignant testicular tumors in identical twins.

Two cases of testicular malignancy in a pair of identical twins are reported. The literature is also reviewed. The tumors appeared within 7 years of each other. The histology was different in both cases.

Adult↗

Subarachnoid hemorrhage and the heart.

Electrocardiographic abnormalities, both morphological and rhythmic, are frequently seen in association with spontaneous subarachnoid hemorrhage. These changes, which often reflect subendocardial damage, seem to be caused by hypothalamic stimulation leading to an acute increase in sympathetic tone. As a result, potentially life-threatening ventricular arrhythmias may develop in subarachnoid hemorrhage patients. These arrhythmias have responded to sympathetic blocking agents, which may also have a protective effect on subendocardial tissue in this setting. There is no evidence that the prophylactic administration of propranolol or other autonomic blockers significantly alters outcome in these patients. Ultimate morbidity and mortality are clearly related to the degree of intracerebral-intraventricular hemorrhage and vasospasm. This article reviews experimental and clinical evidence regarding the causes of cardiac abnormalities after subarachnoid hemorrhage, the types of abnormalities most frequently seen, their relationship with subendocardial lesions, and the role of autonomic blockers.

Adult↗

Computerized tomographic and magnetic resonance imaging of intracranial lipoma. Case report.

Intracranial lipoma is an uncommon lesion that has been well described in both the neurosurgical and neuroradiological literature for many years. This lesion is usually only an incidental finding, but it may be symptomatic. The authors describe a case of symptomatic intracranial lipoma of the superior medullary velum with emphasis on the correlation between computerized tomography and magnetic resonance imaging in evaluation of the lesion.

Brain Neoplasms↗

Pharmacists' beliefs and values about advertising patient oriented services.

Pharmacists' beliefs about the utility of advertising sources and values for advertising outcomes were studied to learn about the decision-making process for advertising patient oriented pharmacy services in the ambulatory setting. The data suggest that pharmacists in the sample believe advertising through word-of-mouth communication is more likely to result in positive outcomes than either yellow pages or local newspaper advertising.

Advertising↗

Cost benefit and cost effectiveness analysis: a bibliography for pharmacists.

Cost benefit and cost effectiveness analysis refer to tools that may be helpful to pharmacists who wish to justify the implementation of new pharmacy services or the continuation of existing programs. This bibliography is intended to assist pharmacists by identifying relevant articles that describe cost benefit and cost effectiveness analysis and their implications to pharmacy practice. Having an understanding of the allocation techniques included in the bibliography may be useful in developing program justification strategies consistent with output-based payment systems.

Bibliographies as Topic↗

Analysis of antigen specific T cell helper function in first degree relatives of patients with systemic lupus erythematosus (SLE).

Fourteen families with first degree relatives of patients with systemic lupus erythematosus (SLE) were studied for the ability of their members to respond to the synthetic polypeptide antigen (T,G)-A-L. The family members were also tested for their HLA determinants. All SLE patients tested responded to (T,G)-A-L as measured by the production of (T,G)-A-L specific T cell helper factors by their antigen activated T cells, confirming our previous findings that 100% of SLE donors responded to (T,G)-A-L in contrast to 50% responders in a control population of healthy donors. The general defect in the regulation of immune responses in SLE patients was further indicated by the demonstration that an SLE patient who is a daughter of non-responder parents to (T,G)-A-L, responded to this genetically regulated antigen. In contrast to our observations with SLE patients, the genetic regulation of the ability to respond to (T,G)-A-L was shown not to be impaired in healthy first degree family members of SLE patients and the segregation of the immune response potential in these families was as expected from an inherited dominant trait.

Animals↗

Chylous ascites and chylothorax as presenting manifestations of stomach carcinoma.

Chylous ascites and chylothorax appeared as the presenting symptoms of metastatic carcinoma of the stomach in a 69-year-old male. Although in the last decade malignancies, predominantly lymphomas, have been responsible for most cases of spontaneous chylous ascites or chylothorax, carcinoma of the stomach was very rarely described as the cause of this entity. The criteria for diagnosis of chylous fluid and the etiology and treatment of this condition are reviewed.

Adenocarcinoma↗

The hemolytic activity of citral--II. Glutathione depletion in citral treated erythrocytes.

The role of glutathione in citral induced hemolysis was investigated. The concentration of intracellular glutathione diminished in citral treated erythrocytes. GSH disappeared before hemolysis started. Glucose inhibited citral induced hemolysis and restored the depleted cellular stores of GSH. The results presented confirm the previous suggestion that a free radical-peroxide mechanism is involved in citral induced hemolysis.

Acyclic Monoterpenes↗

Anticariogenic activity of licorice and glycyrrhizine I: Inhibition of in vitro plaque formation by Streptococcus mutans.

The effect of licorice and its active sweet component glycyrrhizin was tested on the growth and adherence to glass of the cariogenic Streptococcus mutans. Neither licorice nor glycyrrhizin promoted growth or induced plaque formation. In the presence of sucrose, glycyrrhizin did not affect bacterial growth, but the adherence (plaque formation) was markedly inhibited. At 0.5-1% glycyrrhizin, inhibition was almost complete. These results support our previous suggestions that glycyrrhizin might serve as an efficient vehicle for topical oral medications.

Anti-Bacterial Agents↗

Neurogenic hypertension: etiology and surgical treatment. I. Observations in 53 patients.

Although an extensive literature exists concerning essential arterial hypertension, the primary etiology has been unclear. Arterial compression of the left lateral medulla oblongata by looping arteries of the base of the brain was seen incidently in 51 of 53 hypertensive patients who underwent left retromastoid craniectomy and microvascular decompression for unrelated cranial nerve dysfunctions. Such compression was not noted in normotensive patients. Treatment by vascular decompression of the medulla was performed in 42 of the 53 patients. Relief in the hypertension was seen in 32 of the patients and improvement in four. Arteriosclerosis and arterial ectasia contribute to arterial elongation and looping. If pulsatile compression of the left lateral medulla occurs, hypertension may develop as a consequence of an imbalance in the neural control systems that normally regulate blood pressure. The hypertension may further contribute to arterial elongation, providing a vicious circle of pathophysiologic changes.

Adult↗