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Biomedical subjects

S Benjamin

Publications and source records attributed to S Benjamin.

At least 91 records · Page 5Linked to original sources
PubMed1988

How to examine patients using the Abnormal Involuntary Movement Scale.

The Abnormal Involuntary Movement Scale (AIMS) examination has been widely recommended for periodic screening for tardive dyskinesia and follow-up of patients diagnosed with the disorder. However, few guidelines exist about how to use the examination in clinical practice. The authors discuss for whom, when, and how the AIMS examination can be used in a multidisciplinary setting; amplify the original instructions for the examination; and propose conventions to clarify scoring. Noting that the AIMS examination is not specific for tardive dyskinesia, they discuss a clinical approach to the patient who is found to have abnormal movements. The AIMS examination is best conducted within the context of an ongoing treatment program, the authors say, and should be part of the informed consent process necessary with patients treated with neuroleptic drugs.

Antipsychotic Agents↗
PubMed1988

The ultrasonographic appearances of hilar cholangiocarcinoma (Klatskin tumours).

The findings on ultrasound of 40 patients presenting between 1984 and 1987 who were subsequently proven pathologically to have hilar cholangiocarcinoma were reviewed. The sonograms of 17 other patients in whom pathological confirmation was not obtained but who were also presumed to have Klatskin tumours on clinical and radiological grounds, were also reviewed. All patients demonstrated intrahepatic bile duct dilatation with no evidence of free communication between the right and left hepatic ducts. A hilar mass was observed in 74% of the patients. Seventy-nine per cent of the hilar masses were of increased echogenicity relative to surrounding liver, 19% were of reduced echogenicity and 2% of mixed echogenicity. An intraluminal mass was seen in 21% of the patients and bile duct wall thickening was observed in 4%. The mass detection rate of different ultrasound equipment was also compared. In 15 patients the ability of ultrasound to predict the order of intrahepatic bile duct involvement was compared with cholangiography.

Adenoma, Bile Duct↗
PubMed1988

Acute esophageal stricture after bone marrow transplantation.

Gastrointestinal complications following bone marrow transplantation are common and may result from the conditioning regimen, immunosuppression, graft-versus-host disease, or a combination of these factors. These effects may be acute (mucositis, enteritis, esophagitis) or delayed (xerostomia, stricture formation) in onset. We describe here a case of esophageal stricture developing within 1 month of allogeneic bone marrow transplantation.

Adult↗
PubMed1987

Comparison of enzymatic and pharmacological activities of lysine-49 and aspartate-49 phospholipases A2 from Agkistrodon piscivorus piscivorus snake venom.

The basic Lys-49 phospholipase A2 (PLA2) from Agkistrodon piscivorus piscivorus venom is homologous to the basic Asp-49 PLA2 from the same venom as well as other snake venom PLA2 enzymes. It differs, however, in several respects, most important being replacement of the previously invariant Asp-49 at the calcium binding site by Lys, resulting in a reversed order of addition of calcium and phospholipid, phospholipid binding first. Although the preferences for phospholipid substrates of the two enzymes are identical, the apparent Vmax of the Lys-49 PLA2 was only 1.4 to 3% that of the Asp-49 enzyme. Similarly, the Lys-49 PLA2, compared to the Asp-49 PLA2 had less than 3% of the intraventricular lethal potency and 4% of the anticoagulant activity. The intravenous lethal potency of the Lys-49 enzyme was 20% that of the Asp-49 PLA2 and both had little direct hemolytic activity. In contrast, both enzymes were approximately equipotent on the phrenic nerve-diaphragm preparation and on the isolated ventricle strip of the heart. On the cardiac and neuromuscular preparations, the effects of the Asp-49 PLA2 were accompanied by hydrolysis of phosphatidylcholine and phosphatidylethanolamine, whereas no phospholipid hydrolysis was observed with the Lys-49 PLA2. Evaluation of the present results, along with earlier findings using Asp-49 PLA2 enzymes from Naja nigricollis, Hemachatus haemachatus and Naja naja atra venoms, allows us to conclude that: The A. p. piscivorus Asp-49 PLA2 enzyme resembles the Asp-49 enzymes from N. n. atra and H. haemachatus. In contrast, the A. p. piscivorus Lys-49 PLA2 has much lower enzymatic and anticoagulant activities than the Asp-49 enzymes, but equal cardiotoxic and junctional effects. In contrast to some previous suggestions, basic PLA2 enzymes are not necessarily more toxic than neutral or acidic enzymes. Pharmacological effects upon the heart and phrenic nerve-diaphragm preparation correlate neither with in vitro measurements of PLA2 activity nor with actual levels of phospholipid hydrolysis in the heart or diaphragm. This suggests that PLA2 enzymes exert effects independent of phospholipid hydrolysis.

Animals↗
PubMed1987

The Self Care Assessment Schedule (SCAS)--I. The purpose and construction of a new assessment of self care behaviours.

The Self Care Assessment Schedule (SCAS) is a new questionnaire which measures the frequency of ten behaviours during a period of fourteen days. Data are presented for five patient samples and a group of non consulting controls and the distributions of scores between groups show expected differences. In some groups scores are significantly greater for male subjects and those with the most chronic disorders but scores are not related to age. It is tentatively suggested that the SCAS may be used to determine the severity of aspects of disability based on percentile scores.

Activities of Daily Living↗
PubMed1987

The Self Care Assessment Schedule (SCAS)--II. Reliability and validity.

Evaluation of the SCAS in three groups of patients demonstrates high levels of test-retest reliability and satisfactory internal consistency. Multiple investigations of validity support the use of the SCAS as a measure of self care deficit which is related to social disability. The potential uses of the SCAS in clinical work and research are discussed.

Activities of Daily Living↗
PubMed1984

The effect of illness behaviour on the apparent relationship between physical and mental disorders.

Evidence for associations between organic disease and psychopathology is reviewed and it is concluded that some of this is determined by complaint and consultation behaviours. The concept of illness behaviour is described. The Self Care Assessment Schedule (SCAS) is a new measure of illness behaviour and has been used to provide an independent assessment of psychiatric day patients, gynaecology and surgical outpatients. Only weak positive correlations were found between SCAS scores and mental illness, measured using the General Health Questionnaire (GHQ). Subjects with organic pathology differed little from those without organic pathology, with regard to SCAS and GHQ scores. However SCAS and GHQ scores were more highly correlated in those without organic pathology. It is concluded that claimed associations between physical disease and psychopathology should be based on objective evidence rather than subjective complaints and that this should be found across the entire spectrum of illness behaviour.

Ambulatory Care↗
PubMed1982

Community screening for mental illness: a validity study of the General Health Questionnaire.

The 60-item GHQ was validated in a community population by comparison with the CIS. The GHQ failed to identify nearly half of the psychiatric 'cases' in this population. Those missed were similar to those detected except for greater chronicity of illness and more frequent social and interpersonal problems. The GHQ appears to be unsuitable as a screening instrument for mental illness in the community and the possible reasons are discussed. Principal components and analysis resulted in a 15-item GHQ factor which, when used with Likert scoring, resulted in considerable improvement and failed to identify only 4 per cent of 'cases'. It is suggested that this may prove a more satisfactory screening instrument.

Adult↗
PubMed1981

Evaluation of standardized behavioural treatment for agoraphobic in-patients administered by untrained therapists.

Using a standardized behavioural programme, nine in-patients with severe agoraphobia were treated by staff who had minimal training in the theory and practice of behaviour therapy. With one exception patients showed marked reduction in subjective fear and avoidance, both following treatment and at follow-up. The indications for such treatment are considered and compared with those for alternative behavioural approaches that have recently been advocated.

Adult↗
PubMed1980

Portal hypertension associated with systemic mastocytosis and splenomegaly.

An unusual case of systemic mastocytosis with splenomegaly, portal hypertension, and bleeding esophageal varices is presented. Arteriograms and liver biopsy suggested the mechanism of the portal hypertension was due to increased blood flow in the splenic vein, although splenic arteriovenous shunting secondary to histamine release and increased intrahepatic resistance secondary to mast cell infiltration might have played a role. The portal hypertension was relieved by splenectomy.

Esophageal and Gastric Varices↗
PubMed1980

Scars without wounds: spectrum of delayed manifestations of histoplasmosis outside of the endemic area.

This short series represents a spectrum of histoplasmosis usually described only in places where the infection is nearly universal. In fact, most of the patients in this series were born in such places (17 of 19 patients with complicated presentations; 2 had recent suspicious exposures). As young adults, they had moved away to pursue military life, usually in coastal areas where the evidence of infection with H. capsulatum is a statistical rarity. The implications of these observations are straightforward. At the clinical level, they focus on histoplasmosis as a possible cause of pulmonary, mediastinal, or other lesions of obscure etiology, whether or not the patient has recently lived in "the endemic area". The simple determination of CF gamma titers may heighten the index of suspicion, especially when not confounded by skin testing with histoplasmin, a practice which rarely provides useful information. [Table: see text] With regard to pathogenesis, it seems noteworthy that common form of histoplasmosis was not seen in this brief experience. That is the "marching cavity" described by Goodwin and Des Prez, and other forms of chronic cavitary disease. The absence of such lesions is consonant with the view that they require continuous exogenous infection for their development. As for the forms of histoplasmosis which were seen in this series, it appears that most of the illnesses developed outside of what is usually considered endemic areas. The term endemic, as construed medically, has been defined as "restricted to and constantly present in a particular country or locality". Such a construction is unduly pedantic and rigid for clinicians. A more probabilistic view is needed, with attention to the possible role of inapparent infection early in life and of environmental foci of infection in places where the organism is not notoriously present. The mobile nature of our society makes it likely that the radiographic manifestations of once-regional diseases such as this one will be encountered more generally than in the past.

Adolescent↗
PubMed1979

Pulmonary amyloidoma and hilar adenopathy. Rare manifestations of primary amyloidosis.

Three cases of primary intrathoracic amyloidosis are reported. Two of these three patients initially had localized parenchymal pulmonary amyloid tumors (or pulmonary amyloidomas). The third patient developed bilateral enlargement of the hilar lymph nodes as a manifestation of primary amyloidosis. These rare manifestations of primary amyloidosis are illustrated, and their clinical signifiance is discussed. Amyloidoma should be considered in patients with unexplained pulmonary nodules or enlargement of hilar lymph nodes.

Aged↗