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Biomedical subjects

R Segal

Publications and source records attributed to R Segal.

At least 91 records · Page 5Linked to original sources
PubMed1996

Ethnic differences in temporal orientation and its implications for hypertension management.

Research indicates that health beliefs and perceptions are shaped and organized by life experiences. Time perception, also structured by life experiences, can systematically alter individuals' perceptions of disease and evaluations of treatment options. Using the Health Belief Model (HBM), this study examines the effects of ethnicity and hypertension temporal orientation on the health perceptions of 300 African Americans and White Americans with hypertension. Results revealed that African Americans were more present-oriented than White Americans regarding their daily experiences with managing hypertension. Compared to more future-oriented respondents, present-oriented people perceived themselves to be less susceptible to the consequences of hypertension, believed more in the benefits of home remedies and negative aspects of prescribed medication, and believed less in the benefits of prescribed medication and negative aspects of home remedies. We concluded that ethnicity influences hypertension temporal orientation and that hypertension temporal orientation affects perceptions about hypertension and its management. Implications for health and medical care are addressed.

Black or African American↗
PubMed1995

Clinical review of adult granulosa cell tumors of the ovary.

Granulosa cell tumors are uncommon neoplasms that are characterized by their long natural history and for their tendency to recur years after an apparent clinical cure. As such they are difficult tumors to study. In the majority of cases, the initial therapy is surgical although the extent of the necessary procedure remains controversial. The role for any adjuvant therapy after complete resection remains to be established. In patients with advanced disease, combination chemotherapy consisting of cisplatinum/vinblastine/bleomycin has the highest identified response rates. In patients with recurrent or metastatic disease therapy is palliative and has not yet been standardized. Treatments therefore need to be individualized.

Female↗
PubMed1995

Methotrexate treatment in murine experimental systemic lupus erythematosus (SLE); clinical benefits associated with cytokine manipulation.

The objective of this study was to determine the effects of Methotrexate (MTX) on the development and the course of experimental murine SLE, as well as on the cytokine profile involved in the disease. SLE was induced in naive BALB/c female mice by injection of the human anti-DNA MoAb bearing a common idiotype (16/6 Id). Six weeks following immunization, when high levels of autoantibodies were demonstrated, the mice were treated with MTX (2 mg/kg once a week) for a period of 10 months. MTX treatment had no effect on 16/6 Id-induced autoantibody production. However, MTX treatment had beneficial effects on the clinical manifestations of the experimental disease (i.e. leucocyte counts, levels of protein in the urine and immune complex deposits in the kidneys). Thus, only 20% of 16/6 Id-immunized BALB/c mice that were treated with MTX had immune complex deposits in their kidneys compared with 100% of SLE-afflicted BALB/c mice that were not treated. We have observed a significant elevation in IL-1, tumour necrosis factor (TNF) and IL-10 secretion in BALB/c mice afflicted with experimental SLE. IL-2, IL-4, IL-6 and interferon-gamma (INF-gamma) levels were decreased in these mice compared with the levels detected in healthy controls. Treatment with MTX reversed the levels of all the above cytokines to normal levels observed in control mice. These studies demonstrate therapeutic effects of MTX on murine experimental SLE. The normal cytokine profile observed following treatment with MTX is suggested to play a role in the amelioration of the clinical manifestations of experimental SLE.

Animals↗
PubMed1995

Evaluating the value, accuracy, and operational feasibility of DUE criteria.

The purpose of this investigation was to evaluate the value, accuracy, and operational feasibility of indicators/criteria in a drug use evaluation (DUE) examining IV histamine2-receptor antagonists (H2-RA). Pharmacists in 40 hospitals collected DUE data concurrent with hospital stays on a total of 1,200 patients. After completing the DUE, pharmacist data collectors were asked to evaluate each DUE criterion. Most reported that criteria relating to indications for use, therapeutic drug monitoring, and adverse drug reactions/drug interactions should be included in a DUE, but some criteria were not easy to collect or were inaccurate. The data suggest the need to carefully select DUE criteria that can be used for continuous improvements that meet JCAHO accreditation requirements.

Data Collection↗
PubMed1995

Clinical and subclinical condyloma. Rates among male sexual partners of women with genital human papillomavirus infection.

Sixty-three regular male sexual partners of women with proven genital human papillomavirus (HPV) infection or its associated lesions were examined by colposcopy and biopsy (when necessary) to determine the prevalence of penile condyloma among them. Fifteen (24%) were found to have histologic evidence of condyloma. The severity of the women's lesions did not necessarily reflect that of lesions found in their sexual partners. The majority (54%) of the HPV-associated lesions were located on the penile body, followed by the penile root (25%). We found no cases of premalignant or malignant penile lesions. After controlling for the confounding factors of socioeconomic status and lesion location and comparing the data to those compiled from the English-language literature, we arrived at various theories about the very low rate of infection in our population. One possibility is the protective effect of circumcision, partly because the preputium is a major site of bacterial and viral colonization. The possibility of different strains of HPV in the Jewish Israeli population and certain socioeconomic factors that may limit the spread of sexually transmitted diseases may be the basis for future study.

Adult↗
PubMed1994

Molecular analysis of HLA-B27 haplotypes in Caucasoids. Frequencies of B27-Cw in Jewish and Spanish populations.

PCR in combination with SSO probes was used to analyze the polymorphism in exons 2 and 3 of HLA-B27 subtypes and HLA-C-related alleles in two genetically distant Caucasian groups: Spanish and Jewish populations. AS patients and healthy B27 donors from both populations were analyzed in order to ascertain B27-Cw haplotypes. Three different ancestral haplotypes were found to be represented in both populations: B*2705/Cw*0102, B*2705/Cw*02022, and B*2702/Cw*02022. The B*2705 (92.5%) was the most frequent allele found in the Spanish population, carried by B*2705/Cw*0102 (60.9%) and B2705/Cw*02022 (30.4%) haplotypes. In contrast, B*2702 (59.4%) was the most prevalent allele found in the Jewish population and was carried by the B*2702/Cw*02022 (63.3%) haplotype. No different allelic and haplotypic distributions were among healthy and AS patients in either Spanish or Jewish populations. The differences found in the distribution of B27 haplotypes among Spanish and Jewish Caucasian populations are consistent with the genetic distance of these ethnic groups. When the Jewish population was subdivided into Ashkenazi (A) and non-Ashkenazi (NA) groups, no significant differences were observed in the distribution of B*2702/Cw*02022 haplotype. Minor differences were observed in the underrepresented B*2705 haplotypes. The present results reflect the ancestral affinities of A and NA Jewish populations. A possible HLA-B27 evolutive pathway in Caucasians is proposed according to the data available for the B27/Cw ancestral haplotypes in Spanish and Jewish groups.

Base Sequence↗
PubMed1994

Successful therapy for cerebral phaeohyphomycosis due to Dactylaria gallopava in a liver transplant recipient.

A 68-year-old liver transplant recipient who was being treated with FK 506 and immunosuppressive steroid therapy was admitted to our medical center because of a tonic-clonic seizure. Computed tomography of the head revealed multiple discrete cerebral abscesses, and culture of fluid drained intraoperatively yielded a dematiaceous fungus. The isolate was susceptible to amphotericin B and itraconazole but was resistant to flucytosine and fluconazole. The patient was successfully treated with a prolonged course of amphotericin B colloidal dispersion and itraconazole, as evidenced by both clinical and radiographic resolution of disease over a 2-year follow-up.

Aged↗
PubMed1994

Metastatic prostatic carcinoma histologically mimicking malignant melanoma.

Prostatic carcinoma rarely metastasizes to the skin. We describe a case in which inguinal metastasis occurred. Histologically, the tumor was composed of pale-staining cells which had pronounced epidermotropism, producing a pagetoid pattern mimicking that seen in malignant melanoma. The diagnosis was confirmed by demonstrating prostatic specific antigen in tumor cells.

Aged↗
PubMed1994

Inhibition of autoantibody production in experimental SLE by pre-immunization with DNA.

Experimental SLE can be induced in susceptible mice by their immunization with the human monoclonal anti-DNA antibody that bears a major idiotype-16/6 Id. The SLE afflicted mice produce a variety of autoantibodies including anti-DNA antibodies. It was of interest to find out the effect of DNA on the induction of the experimental disease. To this end, mice were immunized with combinations of 16/6 Id and DNA. The results indicated that whereas mice primed with 16/6 Id developed high titers of antibodies to the 16/6 Id and a variety of autoantibodies typical to the experimental SLE, preimmunization of mice with ssDNA led to a reduction in the 16/6 Id specific antibodies and in the autoantibody titers. No significant differences could be detected in the clinical manifestations which are present in the mice with experimental disease (increased erythrocyte sedimentation rate, leukopenia, proteinuria and glomerular immune complex deposition) in all mice immunized with 16/6 Id including those pretreated with DNA. Thus, no direct correlation exists between the autoantibody levels and the clinical pathology, and probably other factors are involved in the development of the experimental disease.

Animals↗
PubMed1994

A pharmacoeconomic analysis of IV H2-receptor antagonist use in 40 hospitals.

The objectives of this study were to determine (1) the expenditures of hospitals for IV histamine2-receptor antagonists (H2-RA), and (2) the cost savings that might be realized if only a single IV H2-RA was purchased for use. Forty hospitals provided data about purchase prices for each IV H2-RA dosage form purchased (cimetidine, ranitidine, and famotidine), the number of each dosage form used during the 12-month study period, purchase price and extent of usage for supplies, labor costs for preparing and administering IV H2-RAs, and IV H2-RA dosage schedules. The study showed that most hospitals were spending more money for IV H2-RAs than necessary given the pricing structures of the three products available to them at the time of this study. Also, that significant cost savings could be realized if a single H2-RA was used exclusively.

Cimetidine↗
PubMed1994

Increased levels of a 21-kDa protein in the circulation of tumor-bearing patients.

A novel non-ras 21-kDa protein (p21) was detected in sera of cancer patients by enzyme-linked immunosorbent assay (ELISA), using polyclonal anti-p21 antibodies. While only 4.6% of the healthy donors (n = 43) showed p21 serum levels higher than the mean +/- 2 SD of the normal group, 33 to 80% of the cancer patients (n = 94) with various tumors were positive in the ELISA test. In particular, patients with malignant lymphoma, urogenital, and gastrointestinal tumors had a 2.8- to ninefold increase in p21 serum levels. Elevated serum levels were also found in patients with benign prostatic hyperplasia (3.2-fold increase). In 17 out of 22 patients with urogenital tumors, changes in serum p21 levels correlated with the clinical course of the disease. In 15 patients, a favorable response to therapy was correlated with a decline in serum p21 level. Two patients with renal cell carcinoma showed increased or persistently high levels of p21 after surgery and were subsequently found to have distant metastases. Expression of p21 in ten renal cell carcinoma tissues was determined by Western blotting. There was a trend toward a higher content of p21 in the less-differentiated tumor tissues. In conclusion, p21 may be a useful indicator in monitoring the outcome of treatment in patients with various malignant tumors. In patients with renal cell carcinoma, p21 serum levels may be of particular importance because no other tumor marker is available.

Adult↗
PubMed1994

Secondary milia following bullous erysipelas.

Secondary milia associated with bullous erysipelas developed in the right leg of a 64-year-old woman. The milia, measuring up to 6 mm, appeared one month after healing of the erysipelas. Findings of histopathologic and immunohistochemical studies showed that the milia were related to dilated eccrine ducts and not to the hair follicle. Topical treatment with 0.05 percent tretinoin cream resulted in almost full resolution of the lesions.

Eccrine Glands↗
PubMed1994

Renal protective effects of enalapril in hypertensive NIDDM: role of baseline albuminuria.

The primary results of a three-year prospective, double-blind, placebo-controlled trial in non-insulin-dependent diabetic (NIDDM) patients show that an anti-hypertensive regimen, which includes the ACE inhibitor enalapril, preserves renal function to a greater extent than therapy with antihypertensive agents excluding ACE inhibitors (J Am Soc Nephrol 3:335, 1992). The influence of baseline urinary albumin excretion on the renal protective effects of enalapril treatment in these subjects was the objective of this further analysis. Adequate data were available in 121 patients of the 165 hypertensive NIDDM individuals studied [baseline glomerular filtration rate (GFR) 30 to 100 ml/min/1.73 m2]. Twenty-four hour urinary excretion of albumin (UAE), protein, urea nitrogen, creatinine and isotopically determined GFR were measured at baseline and six month intervals. Glycemic control and blood pressure regulation were assessed every three months. The rate of loss of GFR was significantly greater in patients with overt proteinuria at baseline (UAE > 300 mg/24 hr) as compared to patients with baseline sub-clinical proteinuria (UAE < or = 300 mg/24 hr). Antihypertensive treatment with enalapril preserved GFR significantly better (P < 0.01) in the patients with sub-clinical proteinuria at baseline (UAE < or = 300 mg/24 hr) than other antihypertensive treatments which excluded the ACE inhibitor. Furthermore, only 7% of the enalapril-treated group progressed to clinical albuminuria compared to 21% of control treated patients. Although the enalapril-treated group had a lower mean blood pressure during the maintenance period, no correlation between blood pressure (systolic, diastolic or mean arterial) and rate of change of GFR was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1993

In vivo modulation of natural killer cell activity by tamoxifen in patients with bilateral primary breast cancer.

Natural killer (NK) cell activity, the autologous mixed lymphocyte reaction (AMLR) and proportions of T cell subpopulations (CD3+/CD4+ and CD3+/CD8+) and NK cells (CD16+) were studied in 21 patients with bilateral primary breast cancer (BBC), 10 patients with single-breast cancer (SBC) and 20 healthy controls. All patients studied had no evidence of disease and had been off radiotherapy and/or chemotherapy for at least 1 year. Ten patients with BBC were also treated with tamoxifen. Patients with SBC had NK cell activity, AMLR responses and T cell subpopulations that were comparable to those of normal controls. In patients with BBC, a significant (P < 0.01) increase in NK activity compared to that in normal controls (42 +/- 13% versus 21 +/- 10%, effector-to-target cell ratio, 25:1) and a significant (P < 0.05) decrease in CD4+ T cell proportions (30 +/- 15% versus 49 +/- 13%) and absolute numbers (472 +/- 82/mm3 versus 953 +/- 131/mm3) were found. However, the proliferative response of BBC patients' T lymphocytes in AMLR was in the range of the normal controls. Lymphocytes derived from 10 BBC patients treated with tamoxifen exhibited NK cell activity that was comparable to that of normal controls and patients with SBC, and was significantly (P < 0.01) reduced compared to the pretreatment period. BBC patients who received tamoxifen also show a reduction in the proportion of CD4+ T cells and in AMLR proliferative responses, which decreased compared to levels in normal controls. Taken together, these results indicate that long-term tamoxifen treatment modulates immune responses in BBC patients.

Adult↗
PubMed1993

Bidirectional effects of GABAergic agonists and antagonists on maintenance of voluntary ethanol intake in rats.

The effects of THIP (GABAA agonist) and picrotoxin (GABA antagonist) on the maintenance of voluntary ethanol ingestion were examined. Thirty-three male Long-Evans rats were initially exposed to a screening procedure in which increasing concentrations of ethanol (from 2% to 9%) were presented in a free choice with water, on an alternate day schedule. Following the screening procedure, the rats were exposed to five ethanol presentations at a concentration of 9%, which constituted the baseline period, and five additional ethanol presentations during which the effects of the GABAergic manipulations were determined (test period). During the test period, the animals received IP injections of either 16 mg/kg of THIP, 2 mg/kg of picrotoxin or saline. The results suggested that the differential GABA manipulations resulted in bidirectional effects on the consumption of ethanol. More specifically, the GABAA agonist THIP increased the intake of ethanol as compared to baseline measures, while the GABA antagonist picrotoxin decreased ethanol intake. Similarly, the administration of THIP increased ethanol preference. In contrast, preference for ethanol over water was decreased following the administration of picrotoxin. It appears that the effects of these GABAergic manipulations are specific to ethanol, since total fluid intake was not influenced by the administration of either drug (i.e., THIP or picrotoxin). In light of the literature suggesting that THIP and picrotoxin are active at different sites within the GABAA chloride-ionophore receptor complex, the present findings would suggest that the GABAA receptor may play a role in regulating the voluntary intake of ethanol.

Alcohol Drinking↗