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Biomedical subjects

S Friedman

Publications and source records attributed to S Friedman.

At least 595 records · Page 33Linked to original sources
PubMedDate not supplied

Human semen contains thyrotropin releasing hormone (TRH), a TRH-homologous peptide, and TRH-binding substances.

High levels of thyrotropin releasing hormone (TRH) and TRH-homologous peptide, with the general structure pGlu=X-Pro-NH2 where X is either Histidine (His) or a neutral amino acid residue, have been identified in rat and human prostate (Pekary et al, 1980, 1981a, 1982c). Because of the secretory nature of prostatic tissue, it was considered likely that these peptides would be measurable in human semen. The mean (+/- SD) TRH immunoreactivity (TRH IR) in semen from 26 normal donors, aged 26 and 41 years, was found to be 12.2 +/- 5.2 ng/ml. TRH and TRH-homologous peptide, were undetectable in unconcentrated human serum. TRH IR levels in semen from azoospermic donors were in the normal range. The level of TRH IR in semen from vasectomized donors was significantly less (P less 0.01) than in semen from normal subjects. Evidence for at least two TRH-binding substances, which coextract and bind to added synthetic TRH, was obtained by exclusion and cation exchange chromatography. Purification of extracts of human semen by TRH affinity chromatography or gradient, reversed phase high pressure liquid chromatography (HPLC) revealed two major TRH immunoreactive peptides, one corresponding to the TRH-homologous peptide previously reported in rat and human prostate and one cochromatographing with synthetic TRH.

Adult↗
PubMedDate not supplied

In vitro production of a TRH-homologous peptide and His-Pro diketopiperazine by human semen.

Fresh human semen, diluted 1:1 v/v with 0.15 M NaCl- 0.05 M phosphate, pH 7.5, undergoes a 3-fold increase in total thyrotropin-releasing hormone (TRH) immunoreactivity on incubation at 4 C for 8 to 16 hours. To identify the mechanism for this increase, pooled human semen was incubated at 4, 37, and 60 C, and the change in composition of the immunoreactive TRH peptides was quantitated by high pressure liquid chromatography and radioimmunoassay of TRH. His-Pro diketopiperazine, a biologically active metabolite of TRH consisting of a cyclic dipeptide of histidine and proline, also was measured by specific RIA. The concentration of TRH (pGlu-His-Pro-NH2) dropped precipitously within the first hour after dilution and incubation at all temperatures studied. A hydrophobic TRH-homologous peptide with the amino acid composition (Glu,X,Y,Pro), where X and Y are neutral, nonaromatic amino acids, increased 8-fold during 16 hours of incubation at 4 C. This TRH-homologous peptide is not derived from TRH because it lacks the histidine is not derived from TRH because it lacks the histidine residue. A 3- to 23-fold increase in His-Pro diketopiperazine levels occurred after 4 hours at 37 C. This was not due primarily to enzymatic removal of the pyroglutamyl residue from TRH by pyroglutamate aminopeptidase, since about 1 hour after ejaculation the initial His-Pro diketopiperazine levels were 9.7 +/- 5.1 micrograms/ml, or approximately 1000-fold greater than the corresponding levels of seminal TRH. Because cycloheximide, which blocks ribosomal protein biosynthesis, did not inhibit in vitro production of the TRH-homologous peptide and the His-Pro cyclic dipeptide, these peptides, like TRH, most likely arise from post-translational cleavage and processing from pre-existing macromolecular precursor proteins.

Chromatography, High Pressure Liquid↗
PubMedDate not supplied

[The costs of bipolar disorder].

INTRODUCTION: According to the estimates of the World Bank and the World Health Organization bipolar disorder is the sixth leading cause of handicap throughout the world. The burden of this disease is similar to the one of schizophrenia. But cost-of-illness studies are too seldom. Although preventive treatments of bipolar disorder are available for more than fifty years, their economic impact has rarely been studied. LITERATURE FINDINGS: This review shows that the yearly cost of bipolar disorder is between 10,000 and 16,000 euro (12,000 and 18,000 US dollars). Eighty percent are indirect costs, 15% are linked to hospitalization and 5% to drugs. Hospitalization costs are lower in Health Maintenance Organization or general population studies than in studies performed on populations receiving care from psychiatric institutions or with a low socio-economic status. DISCUSSION: The use of mood stabilizers has a substantial impact on direct costs which are halved and consequently on indirect costs. But different surveys all agree on the dramatic under-use of mood stabilizers which may be adequately prescribed to only a quarter of bipolar patients. CONCLUSION: Therefore, the optimization of mental health system resources should prompt incentives to better screen, diagnose, and treat patients with a bipolar disorder.

Anticonvulsants↗
PubMedDate not supplied

Suicidality in panic disorder: a comparison with schizophrenic, depressed, and other anxiety disorder outpatients.

Recent findings by Weissman, Klerman, Markowitz, and Ouellette (1989) that subjects with panic disorder, with and without comorbid conditions, may be at increased risk for suicide attempts have been controversial. In an attempt to further investigate this finding, we utilized the original National Institute of Mental Health Epidemiological Catchment Area (ECA) suicide questions in an outpatient psychiatric clinic. We examined patients with panic disorder (n = 101). other anxiety disorders (n = 47), schizophrenia (n = 22). and major depression (n = 19). No significant differences were found among all four groups on any of the ECA suicide ideation questions. Only two (2%) of the panic disorder patients and none of the other groups made a suicide attempt in the past year. While 17% of patients with panic disorder and 9% of patients with other anxiety disorders reported having made a suicide attempt at some other time in their life, the schizophrenic (33%) and depressed groups (40%) reported significantly greater histories of suicide attempts. In a forward stepwise regression analysis for panic disorder patients, a history of substance abuse and comorbid depression predicted suicidality. The actual clinical risk for suicide attempts in panic disorder patients appears to occur when they suffer with comorbid diagnoses. These results highlight the need to aggressively treat panic disorder patients so they do not suffer the all-too-common sequelae of depression and substance abuse.

Adult↗
PubMedDate not supplied

Ribosomal RNA sequence suggests microsporidia are extremely ancient eukaryotes.

The microsporidia are a group of unusual, obligately parasitic protists that infect a great variety of other eukaryotes, including vertebrates, arthropods, molluscs, annelids, nematodes, cnidaria and even various ciliates, myxosporidia and gregarines. They possess a number of unusual cytological and molecular characteristics. Their nuclear division is considered to be primitive, they have no mitochondria, their ribosomes and ribosomal RNAs are reported to be of prokaryotic size and their large ribosomal subunit contains no 5.8S rRNA. The uniqueness of the microsporidia may reflect their phylogenetic position, because comparative sequence analysis shows that the small subunit rRNA of the microsporidium Vairimorpha necatrix is more unlike those of other eukaryotes than any known eukaryote 18S rRNA sequence. We conclude that the lineage leading to microsporidia branched very early from that leading to other eukaryotes.

Animals↗
PubMedDate not supplied

Impact of financial incentives on documented immunization rates in the inner city: results of a randomized controlled trial.

OBJECTIVE: This study determined the effect of 2 financial incentives---bonus and enhanced fee-for-service---on documented immunization rates during a second period of observation. METHODS: Incentives were given to 57 randomly selected inner-city physicians 4 times at 4-month intervals based on the performance of 50 randomly selected children. Coverage from linked records from all sources was determined for a subsample of children within physician offices. RESULTS: Up-to-date coverage rates documented in the charts increased significantly for children in the bonus group (49.7% to 55.6%; P <.05) and the enhanced fee-for-service group (50.8% to 58.2%; P <.01) compared with the control group. The number of immunizations given by these physicians did not change significantly, although the number of immunizations given by others and documented by physicians in the bonus group did increase (P <.05). Up-to-date coverage for all groups increased from 20 to 40 percentage points when immunizations from physician charts were combined with other sources. CONCLUSIONS: Both financial incentives produced a significant increase in coverage levels. Increases were primarily due to better documentation not to better immunizing practices. The financial incentives appeared to provide motivation to physicians but were not sufficient to overcome entrenched behavior patterns. However, true immunization coverage was substantially higher than that documented in the charts.

Child, Preschool↗
PubMedDate not supplied

Comparison of preventive care in Medicaid managed care and Medicaid fee for service in institutions and private practices.

OBJECTIVE: To compare preventive screening for children in Medicaid managed care (MMC) with children in Medicaid fee for service (M-FFS) in private and institutional settings. METHODS: The sample included randomly selected institutions and private practice physicians in New York City. Within setting, children in MMC and M-FFS were sampled randomly and charts reviewed for immunizations and lead and anemia screening. RESULTS: In both institutions and private practices, children enrolled in MMC appeared more likely to be up-to-date than their M-FFS counterparts for immunizations (institution, P <.01; private practice, P <.05), lead screening (institution, P <.01; private practice, P <.01), and anemia screening (institution, P <.01; private practice, P <.01). However, children in MMC had more visits (P <.01) and were followed up for a longer time (P <.01). After controlling for these variables, effects of MMC diminished and only remained significant for screening among private physicians. When considering 10 different attributes of managed care plans, no clear pattern of association with better preventive care services was observed. CONCLUSION: The positive effect of managed care on preventive care services was largely explained by more visits and longer follow-up time; however, there were differences between institutions and private practices, with enrollment in MMC associated with some positive effect on screenings in private practices.

Cross-Sectional Studies↗
PubMedDate not supplied

A comparison of imaging techniques in patients with chronic sinusitis (X-ray, MRI, A-mode ultrasound).

Thirty-five patients age 9 to 67 were evaluated for chronic sinusitis by history, physical and laboratory examination, and imaging techniques (X-ray, magnetic resonance imaging (MRI) and flexible rhinoscopy). MRI was the most predictive. To establish the diagnosis of sinusitis, it was more sensitive than plain X-ray for intrasinus disease. Findings of edema, erythema, and drainage on flexible rhinoscopy were consistent with chronic sinusitis and were confirmed by MRI and sinus X-rays in 41% of the cases. Nasal smears for polymorphonuclear cells and eosinophils were suggestive of a diagnosis of chronic sinusitis, but other laboratory tests (CBC, sedimentation rate, quantitative immunoglobulins, total IgEs) were of very limited value in the diagnosis of chronic sinusitis.

Adolescent↗
PubMedDate not supplied

Induction of tubuloreticular structures in cultured human endothelial cells by recombinant interferon alfa and beta.

Tubuloreticular structures were induced in human umbilical vein endothelial cells cultured in media containing recombinant interferon alfa and beta but not in media containing recombinant interferon gamma or other agents that induce interferon, such as 5-bromodeoxyuridine or polyinosinicpolycytidylic acid. Recombinant interferon beta induced tubuloreticular structures in endothelial cells at a lower concentration and in a greater percentage of cell sections than recombinant interferon alfa. This report of tubuloreticular structures being induced in vitro in nonlymphoid cells provides evidence that interferon is the substance that causes the formation of tubuloreticular structures in endothelial cells in vivo.

Blood Proteins↗
PubMedDate not supplied

Internal bleaching with 10% carbamide peroxide in vitro.

This in vitro study assessed the efficacy of 10% carbamide peroxide to internally bleach discolored teeth. Following pulp removal, 38 tooth crowns were stained with erythrocytes and bleached 3 times over 14 days using either 10% carbamide peroxide or 30% H2O2 and sodium perborate. The pulp chambers were subsequently filled, and the tooth crowns stored for 3 months. The shades of the crowns were measured using reflectance spectroscopy prior to and at several time points following bleaching. Using statistical analysis, the authors determined that both materials significantly improved the shade of the crowns, and that 10% carbamide peroxide could be utilized clinically to internally bleach nonvital discolored teeth.

Analysis of Variance↗
PubMedDate not supplied

Child mental health in an HMO. A family systems approach.

HMOs have been growing at a rapid rate with increasing numbers of people receiving mental health services within this system of care. Among those people are children who represent a significant proportion of HMO members. The goal of providing high quality, cost-efficient mental health services to children and families in a staff model HMO represents a challenge and opportunity for the mental health practitioner. A family systems model is described for providing mental health treatment for children's problems in the HMO. Clinical vignettes from the author's practice are presented illustrating time-efficient principles of systems psychotherapy in this setting.

Child↗
PubMedDate not supplied

[Correlation between eating disorders and sleep disturbances].

Anorectics and bulimics often complain sleep onset insomnia and disrupted sleep. During awakenings bulimics can have binges. Conversely, eating disorders can be a clinical expression of a concomitantly occurring sleep disorder. Two clinical entities have been recently described: the Night Eating Syndrome (NES) and the Sleep Related Eating Disorders. The main goal of this literature review was to better characterize the relationships between eating disorders and sleep disturbances. No specific EEG sleep pattern emerges in anorectic and bulimic patients. However, all studies include several methodological limitations: a few number of patients, heterogeneous patient groups, various diagnostic criteria. The results of studies evaluating the impact of depression on sleep EEG in eating disorder patients are also subject to controversy. The only study examining the relationship between sleep EEG and morphological alterations in anorectics and normal weight bulimics shows that patients with enlarged cerebrospinal fluid spaces spent more time in slow wave sleep and that the duration of rapid eye movement (REM) sleep was reduced. The ventricular brain ratio was negatively correlated with REM sleep. The Night Eating Syndrome consists in insomnia, binge eating and morning anorexia. Other criteria are proposed to characterize the NES: more than 50% of the daily energy intake is consumed after the last evening meal, awakenings at least once a night, repetition of the provisional criteria for more than 3 months, subjects do not meet criteria for bulimia nervosa or binge eating disorder. Patients have no amnesia nor alteration of alertness, and no other sleep disorder. There is no modification of sleep EEG except sleep maintenance. The prevalence of the NES is 1.5% in the general population. Some neuroendocrine disturbances have been found in the NES. The delimitation with eating disorders is not yet clearly established. If it shares the compulsive features with eating disorders, particularly the "Binge Eating Disorder", and occurs during full awakenings, the night eating syndrome may be recognized as a specific eating disorder. The sleep related eating syndrome is also characterized by compulsive binge eating during awakenings. But in this case, night eating is linked with a reduced consciousness and sleep disorders, mainly somnambulism. Patients never experience hunger, abdominal pain, nausea or hypoglycemia. Night-eating takes place invariant across weekdays, weekend and vacations. Patients consumed high caloric foods and fluids but never alcohol and purging does not occur. Diurnal bulimia is frequently associated with the sleep-related eating disorder. In conclusion, the sleep related eating disorder seems rather be a clinical subtype of sleep disorders whereas the NES could be considered as an eating disorder.

Adult↗
PubMedDate not supplied

The right move.

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Accidents, Traffic↗