Anxiety, arousal, and the self-concept.
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Adult↗
Biomedical subjects
S Epstein
Publications and source records attributed to S Epstein.
Special considerations for restorative dentistry in geriatric patients.
Restorative dental procedures for the elderly patient should be conservative. The principal objectives should be to do what is most constructive to keep the dental structures intact, functional, comfortable, and cosmetically pleasing. The dentist has the responsibility to do whatever is possible or most expedient to improve and maintain the quality of life for the aged.
Acid Etching, Dental↗
New concepts in the etiology of osteoporosis.
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Aged↗
The person-situation debate in historical and current perspective.
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Behavior↗
On the origin of terpenes in symbiotic associations between marine invertebrates and algae (zooxanthellae). Culture studies and an application of 13C/12C isotope ratio mass spectrometry.
13C/12C ratios of sets of compounds, algal sterols and terpenes, isolated from dinoflagellate symbiont (zooxanthellae)-bearing soft corals and gorgonians were determined. In most cases, a significant difference was found between the delta 13C values of the terpenes and of the algal sterols from the same set, the algal sterols containing less 13C than the terpenes. These results can only be explained if terpenes are synthesized by the host. Cultured zooxanthellae, isolated from symbiotic associations, do not make terpenes. Algal sterols of the various sets do not all have the same delta 13C value: average values range from -18.2 to -24.3%. A consistent difference of about 7% in the delta 13C values of sterols of cultured symbionts isolated from two of the gorgonians was found. This has potential applications for the taxonomy of zooxanthellae, most of which are believed by some specialists to be one discrete species.
Animals↗
Differences in serum bone GLA protein with age and sex.
Serum bone Gla protein (BGP) was measured by radioimmunoassay in 166 healthy men and women aged 30-90 years. Serum BGP levels increased with age in both sexes and were higher in women than in men at all ages. The most striking rise occurred in women after age 40-49. BGP was significantly correlated positively with serum alkaline phosphatase and negatively with midshaft and distal bone mass in both sexes. In women only, BGP levels were significantly positively related to levels of immunoreactive parathyroid hormone (iPTH). When age was included in the multiple regression analysis BGP was still correlated with alkaline phosphatase in both sexes and iPTH in women only. Serum BGP levels were significantly higher in 13 osteoporotic patients than in age-matched controls. It is postulated that with increasing age 1,25-dihydroxyvitamin D levels fall, causing a rise in iPTH and thus in bone turnover, which is reflected by a rise in BGP levels.
Adult↗
The effects of exposure to diazepam during various stages of gestation or during lactation on the development and behavior of rat pups.
In the present study we have investigated the effects of diazepam (DZP) (10 mg/kg) treatment of rat dams during different periods of gestation or during lactation on the development and behavior of their offspring. The results show that DZP exposure during different phases of early development has differing effects on later behavior. Exposure during mid-gestation resulted in early and transient hyperactivity, but no learning or memory deficits at 2 months of age were observed. However, both late prenatal and early postnatal exposure to DZP resulted in significant behavioral changes. Late prenatal treatment caused no hyperactivity but resulted in poor performance on the learning and retention of a choice discrimination task, while early postnatal exposure resulted in consistent and lasting hyperactivity and in substantial discrimination learning and retention deficits at 2 months of age.
Animals↗
Evidence for abnormal regulation of circulating 1 alpha, 25-dihydroxyvitamin D in patients with pulmonary tuberculosis and normal calcium metabolism.
Available evidence indicates that hypercalcemia in pulmonary tuberculosis results from increases in circulating 1 alpha, 25-dihydroxyvitamin D [1 alpha, 25(OH)2D]. To further characterize vitamin D metabolism in this disorder, the effects of vitamin D, 100,000 units a day for 4 days, were compared in 25 normal subjects and 11 patients with active pulmonary tuberculosis who were normocalcemic and had not had hypercalcemia. Serum calcium, phosphorus, 25-hydroxyvitamin D (25-OHD) and 1 alpha, 25(OH)2D were measured. Whereas vitamin D increased mean serum 25-OHD from 20 +/- 2 (+/- SE) to 40 +/- 5 ng/ml (P less than 0.001) and did not change mean serum 1 alpha, 25(OH)2D in the normals (33 +/- 2 vs. 31 +/- 2 pg/ml), it increased mean serum 25-OHD from 21 +/- 4 to 55 +/- 13 ng/ml (P less than 0.05) and mean serum 1 alpha, 25(OH)2D from 28 +/- 2 to 35 +/- 3 pg/ml (P less than 0.05) in the patients. Serum calcium was normal and remained within the normal range in all subjects and patients. The findings indicate that there is a modest but significant abnormality in the regulation of circulating 1 alpha, 25(OH)2D in normocalcemic patients with pulmonary tuberculosis. The results are similar to those previously reported by us in normocalcemic patients with sarcoidosis.
Adult↗
The metabolic response and problems with nutritional support in acute tetanus.
Thirteen patients with severe tetanus were studied in the first and second week of illness in order to assess metabolic changes and nutritional requirements. Nine required muscular paralysis and subsequent assisted ventilation in order to control spasms. Symptoms and signs of sympathetic overactivity were especially common in the latter groups with a fourfold increase in urinary adrenaline and noradrenaline excretion. Other hormonal and metabolic abnormalities included hyperglycemia, mildly elevated insulin concentrations with no significant rise in cortisol, and glucagon. Evidence of excessive protein catabolism was obtained particularly during the second week of illness, mean urinary nitrogen excretion being 20.5 +/- 13.8 g/d. Maintenance of nutrient homeostasis proved impossible with conventional enteral-feeding techniques: high-density feeds exacerbated hyperglycemia and diarrhea; low-density feeds were unable to maintain nitrogen balance (-12.34 g/d in ventilated patients, second week). The results indicate that loss of lean body mass is inevitable in such patients unless the metabolic response can be suppressed or more aggressive forms of nutritional support (eg, total parenteral nutrition including sufficient insulin to maintain normoglycemia) are employed.
Acute Disease↗
A procedural note on the measurement of broad dispositions.
This article deals with the selection of items in a self-report test that measures a broad trait. There is an inherent conflict between selecting items that maximize internal consistency and ones that contribute to breadth. Alternative procedures, including criterion keying, combining homogeneous subscales, and construction of scales with divergent items with modest relations to the whole scale scores, were discussed. Although not included among recommended procedures by modern test theory, the latter approach has much to recommend it under appropriate circumstances. The discussion of psychometric principles was generalized to the person-situation debate.
Depression↗
Nutritional support of malnourished lactose intolerant African patients.
The effectiveness of two commonly available liquid diets was assessed in 40 severely malnourished black African patients. All patients were shown to have normal xylose absorption. The diets were given according to the manufacturer's recommendations. One diet was lactose containing (LC diet) (150 g/d) and high protein (112 g/d), the other normal protein and lactose free (LF diet) (protein 67 g/d), total energy content being similar. Patients were randomly divided into two equal groups and allocated (blind) to one of the diets. Tolerance and nitrogen balance were assessed over two three day periods on half and then full strength formulations. Severe intolerant symptoms were observed in 50% of patients on half strength and 94% of patients on full strength lactose containing diet with evidence of malabsorption of fluid, nitrogen, and fat. Despite high stool nitrogen losses (3.75 +/- 1.04 g/d), however, positive nitrogen balance was achieved in most patients receiving the full strength LC formulation. On the other hand, the full strength LF diet was generally well tolerated and was associated with significantly lower faecal losses and positive nitrogen balance. The results indicate that high density lactose containing liquid formulae are poorly tolerated by severely malnourished black African patients, while lactose free formulae containing approximately 10 g nitrogen/d are well tolerated and result in positive nitrogen balance.
Blood Glucose↗
The fat and the thin--a survey of nutritional status and disease patterns among urbanized Black South Africans.
The nutritional status of and disease patterns in 449 healthy and 803 hospitalized urbanized Blacks in Durban were surveyed. While unemployed males were generally less fat than controls, obesity (i.e. weight 40% over that expected) was extremely common among female factory (33%) and female hospital 'domestic' (65%) employees. Undernutrition was significantly more common amont patients and more marked in males, 82% having significantly reduced fat stores. Disease patterns were similar in malnourished male and female patients, with infective and respiratory diseases predominating. However, the pattern was different in overweight male and female patients, non-ischaemic cardiovascular diseases, particularly hypertension, predominating. The most common cause of death in males was respiratory disease, and in females cardiovascular disease. Overall, malnutrition was most common in the subgroup (N = 212) of patients who died. The results confirm the known associations between undernutrition and increased susceptibility to infection and mortality, and also between overnutrition and hypertensive cardiovascular disease. The observation that malnutrition and obesity can coexist within rapidly urbanized communities stresses the need for concurrent education on nutrition. The high incidence of 'hospital malnutrition' observed emphasizes the need for nutritional support in acutely ill patients.
Adult↗
Lack of influence of isoproterenol, propranolol, and dopamine on immunoreactive parathyroid hormone and calcitonin in normal man.
Available evidence in vitro and in vivo suggests that pharmacologic doses of isoproterenol stimulate the secretion of parathyroid hormone (PTH) and calcitonin (CT) and propranolol inhibits secretion. However, the findings in man are either quite modest or inconsistent. In view of this controversy, we examined the effects of isoproterenol, 0.15 micrograms intradermally (i.d.), dopamine, 5 micrograms/kg body weight over 60 min intravenously (i.v.), and propranolol, 1 mg over 5 min followed by 60 micrograms per min for 2 i.v. in normal human subjects. It was found that these agents did not alter serum calcium, serum immunoreactive PTH, or plasma immunoreactive CT. The findings do not support a physiologic role for biogenic amines in the control and regulation of PTH or CT secretion in normal man.
Adult↗
The effects of intravenous and oral cimetidine in primary hyperparathyroidism.
In vitro studies suggest that cimetidine affects parathyroid hormone secretion. It has been reported that cimetidine (Ci) reduces serum immunoreactive parathyroid hormone (iPTH) in hyperparathyroid subjects (HPTH) and chronic renal failure patients. Studies were performed to determine the effects of intravenous and 8 days of oral Ci on serum iPTH, total calcium (TCAL), ionized calcium (ICAL), phosphorus (PHO), and magnesium (MAG), as well as on the urinary excretion of calcium, PHO, and cAMP. Ci, 300 mg, was injected intravenously into 11 HPTH and 9 of these received normal saline as a control. Eight normal subjects (N) were similarly studied. Results analyzed by analysis of variance indicated that although IV Ci and placebo both caused a significant change with time in iPTH, in HPTH and N, the fall was greater with Ci (P less than 0.005). Intravenous Ci decreased iPTH in HPTH approximately 36% (P less than 0.001) and N approximately 25% (P less than 0.025). In HPTH and N, ICAL was affected by neither IV cimetidine nor placebo. IV Ci decreased TCAL and MAG in a similar fashion when compared to placebo, though change in each variable was statistically insignificant. In 6 HPTH an 8 day period of oral Ci, 300 mg every 8 hours, produced no consistent changes in the measured serum variables. In summary, though the acute effect of IV Ci was to reduce iPTH, it appears to have no independent effect on ICAL or TCAL. Oral Ci during an 8 day period of administration had no consistent effect on mineral metabolism. We conclude that the therapeutic efficacy of oral Ci in HPTH has yet to be demonstrated.
Administration, Oral↗
Methanogenic bacteria from the bondyuzhskoe oil field: general characterization and analysis of stable-carbon isotopic fractionation.
Selective enrichment culture techniques were employed to obtain mixed cultures of methanogenic rods and sarcina from surface flooding waters and deep subsurface ( approximately 1650 m) oil-bearing sedimentary rocks and formation waters sampled from an old oil field in the U.S.S.R. previously reported to display active biological methanogenesis. The methanogens were selectively isolated as colonies on agar petri dishes that were incubated in a novel container. The general cellular and growth features of three Methanobacterium isolates were determined. These strains grew optimally at 37 to 45 degrees C in anaerobic pressure tube cultures with a doubling time of 16 to 18 h on H(2)-CO(2) and proliferated as autotrophs. Acetate addition significantly enhanced the final cell yield. Growth of these strains was completely inhibited by either 0.6 g of sodium sulfide per liter or 31.0 of sodium chloride per liter, but growth was not inhibited by either 0.3 g of sodium sulfide per liter or 1.0 g of sodium sulfate per liter. One novel isolate, Methanobacterium sp. strain ivanov, was grown on H(2)-CO(2), and the stable-carbon isotopic fractionations that occurred during synthesis of methane, cell carbon, and lipids were determined. The results of this study were used to examine the anomalous relationship between the isotopic and chemical compositions of natural gas occurring in the deep subsurface environment of the oil field.
Journal Article↗
1 alpha,25-dihydroxyvitamin D3 corrects osteomalacia in hypoparathyroidism and pseudohypoparathyroidism.
Deficiency of circulating 1 alpha-25-dihydroxyvitamin D3 (1 alpha,25(OH)2D) regularly occurs in hypoparathyroidism (HP) and pseudohypoparathyroidism (PHP). Osteomalacia is occasionally found in the two diseases. Two patients, one with HP and the other with PHP, both with symptomatic and biopsy-proven osteomalacia, were studied before and after treatment with 1 alpha,25(OH)2D3. Laboratory values before treatment were as follows: serum immunoreactive parathyroid hormone was undetectable in the patient with HP and was elevated in the patient with PHP. Serum 25-hydroxyvitamin D, measured by binding assay, was 131.5 and 61.9 nmol/l (normal: 69.1 +/- 15.9 nmol/l); serum 24,25-dihydroxyvitamin D, measured by binding assay, was 13.9 and 3.8 nmol/l (normal: 3.4 +/- 1.4 nmol/l); serum 1 alpha,25(OH)2D, measured by bioassay, was 28.6 and 29.0 pmol/l (normal: 77.3 +/- 22.8 pmol/l) and, measured by receptor assay, was 36.2 and 41.0 pmol/l (normal: 71.8 +/- 35.8 pmol/l) in the HP and PHP patients, respectively. Serum calcium was low and serum inorganic phosphate was high in both cases. Treatment with 1 alpha,25(OH)2D3 (3-5 micrograms per day for 10-12 months) restored serum calcium and inorganic phosphate to normal, alleviated bone pain and healed the osteomalacia as shown on repeat bone biopsy. Our results provide further evidence that isolated deficiency of 1 alpha,25(OH)2D may cause osteomalacia or rickets.
Adult↗
A randomized controlled trial assessing the prevention of doxorubicin cardiomyopathy by N-acetylcysteine.
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Acetylcysteine↗