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Biomedical subjects

S H Shapiro

Publications and source records attributed to S H Shapiro.

At least 37 records · Page 2Linked to original sources

A psychiatric profile of street people admitted to an emergency shelter.

During the winter of 1981-82 the City of Philadelphia operated an adult emergency shelter for two months. After reviewing the available records, the authors compiled a psychiatric profile of the 193 residents admitted to the shelter. They grouped the residents into three classes: habitual street people, the episodic homeless, and those who did not usually live on the street but were undergoing an acute crisis. Although a large number of the street people who suffered from diagnosable mental illness improved with adequate treatment, the authors found it was extremely difficult to relocate many of the shelter residents. They discuss other problems such as the need for psychiatric expertise in treating the homeless and the lack of coordinated effort among several city government departments.

Adolescent↗

Free flaps and irradiated recipient vessels: an experimental study in rabbits.

In an experimental study in rabbits the effect of previous irradiation to the recipient vessels on the survival rate of free flaps was evaluated. Pre-operative radiotherapy was given in a single anterior neck field using a Cobalt60 unit, 1.25 MeV, SSD 80 cm in a fractionated dose corresponding to 5000 rad/5 weeks. An experimental model using paired data was established using two epigastric free flaps in each animal: one anastomosed to the irradiated vessels (carotid and jugular vein) and implanted outside the irradiated field and the other flap anastomosed to the normal femoral vessels and also implanted outside the irradiated field. In a sequential analysis it was found that free flaps anastomosed to irradiated recipient vessels within 12 weeks from the start of radiotherapy failed significantly more often than free flaps anastomosed to normal recipient vessels (p less than 0.10). This supports the view that preference should be given to the use of non-irradiated recipient vessels for microvascular transfer of free flaps.

Animals↗

Ultrastructure and morphometric analysis of hypertrophic nucleoli in non-Hodgkin's lymphoma and phytohemagglutinin-stimulated lymphocytes.

The ultrastructure of hypertrophic nucleoli in large cells from each of 5 successive cases of non-Hodgkin's lymphoma (regardless of predominant cell type) showed irregularly rounded or ovoid, mostly compact forms with few scattered light spaces. Occasional nucleolonemal forms were noted. Few ring forms or transitional forms between ring and compact or nucleolonemal types were present. Granular components occupied 78.5 +/- 1.0% of the mean total area of 132 lymphoma large cell nucleoli of all configurations studied. Hypertrophic nucleoli in 27 phytohemagglutinin (PHA)-stimulated lymphocytes were predominantly nucleolonemal with 74.2 +/- 10.6% granular composition. The qualitative and quantitative distribution of nucleolar granular moieties did not vary significantly between individual cases of lymphoma nor quantitatively between these and nucleoli in PHA-stimulated lymphocytes. These observations lend further credence to the suggestion of the lymphocyte as a common progenitor cell type for the large B and T cell of malignant lymphomas. Some functional similarity of their nucleoli and those of PHA-stimulated lymphocytes in their participation in ribonucleic acid synthesis is implied. Generally compact nucleoli of lymphomas in contrast to nucleolonemal forms of PHA-stimulated lymphocytes may be pathognomonic for large lymphocytic cells undergoing neoplasia.

Cell Nucleolus↗

Identification of Mallory bodies with rhodamine B fluorescence and other stains for keratin.

Rhodamine B staining in conjunction with fluorescence microscopy is shown to demonstrate Mallory bodies. Mallory body morphology, localization, and distribution in hepatocytes from griseofulvin-fed mice, human hepatoma, and human alcoholics were similar to those observed in the same tissues after conventional staining methods for Mallory bodies. The presence of these inclusions was further confirmed by specific cytochemical localization with indirect immunoperoxidase labeling, horseradish peroxidase labeling, and electron microscopy. Other tinctorial or histochemical procedures previously used for keratin or prekeratin (modified Mallory stain, Kreyberg method, Pauly method for histidine) also stained Mallory bodies for study with white light microscopy but with decreasing sensitivity respectively. Mallory bodies from mouse and human liver both appear to contain a keratin-like moiety. This entity may be simply, rapidly, and permanently stained with rhodamine B, and selectively and reproducibly demonstrated with fluorescence microscopy.

Animals↗

The first febrile seizure--antipyretic instruction plus either phenobarbital or placebo to prevent recurrence.

A randomized double-blind study was carried out comparing single daily dose phenobarbital plus antipyretic instruction to a placebo plus antipyretic instruction to prevent a recurrent seizure following an initial simple febrile seizure. Parents of 138 consecutive children presenting to an emergency room with a first simple febrile convulsion received verbal and written instructions about fever control. Seventy-nine then agreed to participate in this study. Children were randomized to receive either placebo with riboflavin tracer (n = 40) or phenobarbital 5 mg/kg in a single daily dose with a riboflavin tracer (n = 39) for 12 months or until another seizure occurred. Urine fluorescence for riboflavin was used to monitor compliance in all patients. Serum phenobarbital levels were obtained at each follow-up visit and averaged 1.4 mg/dl throughout the study. The significant difference (P less than 0.02) in the incidence of recurrent seizures between patients receiving phenobarbital (2/39) and those receiving placebo (10/40) suggests that a single daily dose of phenobarbital is more effective than counseling parents about antipyretic therapy in preventing recurrent seizures following an initial febrile seizure.

Child, Preschool↗

Side effects of phenobarbital in toddlers; behavioral and cognitive aspects.

Cognitive and behavioral effects of phenobarbital in toddlers were assessed in a randomized, placebo-controlled study of patients who had had a febrile seizure. There were no significant differences in IQ (Binet or Bayley Scales) between placebo and phenobarbital groups after eight to 12 months of therapy. However, detrimental effects of phenobarbital were found in memory, for which serum level influenced scores, and in comprehension, in that length of treatment time affected performance. Hyperactivity was not seen. Behavioral changes, reported by parents, were increased fussiness and a characteristic disturbance of sleep. These changes varied in severity and were classified as transient, dose related, or unacceptable. After 12 months in the study, most parents could not distinguish between phenobarbital and placebo. Our data suggest that although most toddlers do not have major side effects from phenobarbital therapy when treated for a year, serum levels and length of time on phenobarbital should be kept at a minimum to reduce negative cognitive and behavioral effects.

Child Behavior Disorders↗

Predicting blood pressure control in hypertensive patients: an approach to quality-of-care assessment.

In assessing the quality of medical care, techniques were needed which can predict which patients are likely to have good or poor health outcomes. This study describes one way of identifying a subgroup of hypertensive patients whose diastolic blood pressures (DBP) are at high risk of remaining uncontrolled while under treatment. Medical care and patient variables were measured for 123 hypertensive medical clinic patients. Stepwise discriminant analysis identified a set of six variables which best distinguished between patients with well-controlled and uncontrolled DBP. When measurements of these variables were divided into high and low risk responses for uncontrolled DBP, the number of high risk variables was directly related to the proportion of patients with uncontrolled DBP. The variables also predicted DBP control among 63 patients in an entirely different medical care setting.

Aged↗

Postembedding adjuvants in routine microtomy of paraffin-processed tissues.

Soaking the exposed face of routine paraffin-processed tissue blocks from human autopsies in solutions containing either 60% ethyl alcohol-glycerol 9:1; glycerol-aniline 9:1; 5% aqueous phenol; 5% aqueous Photo-flo, or 10% aqueous ammonium hydroxide for 2--4 hours at 0--4 C resulted in greater ease of ribboning and overall improvement of slide quality in the majority of sections compared to the results with the same blocks soaked only in water at 0--4 C. The use of postembedding adjuvants, especially 10% aqueous ammonium hydroxide, presents a simple, convenient, inexpensive means of increasing section quality with routine as well as refractory paraffin-embedded tissue without sacrificing tissue adhesion, staining qualities or cellular detail.

Aniline Compounds↗

CAT fever.

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Computers↗

On parallel processes in therapy and teaching.

Using the format of a continuous case conference, the authors demonstrate that the therapist-presenter develops unconscious identifications with the patient which are especially intense when difficulties (resistances) arise which he cannot resolve. The presenter then enacts these identifications in the seminar giving rise to responses from the seminar members which repeat the difficulties of the therapy. These parallel processes can be made explicit by eliciting the empathic responses of the seminar participants. By interpreting these parallelisms the authors have evolved a teaching methodology which, like therapy itself, provides an emotionally based learning experience for the participants.

Adolescent↗