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Biomedical subjects

S Shapiro

Publications and source records attributed to S Shapiro.

At least 271 records · Page 15Linked to original sources
PubMed1991

Reduction of experimental neuroma formation with ricin.

Twenty rat sciatic nerves were bilaterally transected, one as control, and one intraneurally injected with ricin. At 11 weeks, all controls demonstrated large neuromas. Ten injected nerves had no neuroma or a significantly smaller one, while the other 10 had neuroma formation similar to controls. No effect on distant dorsal root ganglia or spinal cord was seen. Thirteen additional rats underwent nerve injection with I125-labeled ricin. At one week, most radioactivity was localized to sciatic nerve, surrounding muscle, and thyroid, with trace amounts in dorsal root ganglia and spinal cord. Intraneural ricin can inhibit neuroma formation in transected nerve, but results in unpredictable uptake of ricin by nerve and excess spillage into surrounding tissues.

Animals↗
PubMed1991

Steroid receptor status and the epidemiology of breast cancer.

This case-control study examined risk factors for breast cancer according to tumor estrogen receptor (ER) status and progesterone receptor (PR) status. The data included 607 case patients and 1214 control subjects matched by age and residence. Of 528 case patients with steroid receptor information, 67% had ER-positive tumors and 55% had PR-positive tumors. Odds ratios for ER-positive and ER-negative breast cancer were similar with respect to menopausal status, age at menarche, history of cystic breast disease, and Quetelet Index. Family history of breast cancer was a stronger risk factor for ER-negative than for ER-positive breast cancer and the odds ratios for number of births were suggestive of a different effect. While ER and PR status were highly correlated, there were some differences in their associations with risk factors. Odds ratios for PR-positive and PR-negative breast cancer differed for number of births and were suggestive of differences with respect to menopausal status, Quetelet Index, and family history of breast cancer. These findings do not suggest different causal pathways for ER-positive and ER-negative breast cancer. However, they do indicate that PR status may play a role in the etiology of breast cancer.

Adult↗
PubMed1991

Risks of agranulocytosis and aplastic anemia in relation to the use of cardiovascular drugs: The International Agranulocytosis and Aplastic Anemia Study.

The risks of agranulocytosis and aplastic anemia in relation to the use of cardiovascular drugs were estimated in a population-based case-control study conducted in Israel and Europe (total population, 23 million). Cardiovascular drug use in the week before onset of illness was compared between 270 patients hospitalized with agranulocytosis and 1870 hospitalized control subjects. Propranolol (relative risk, 2.5), dipyridamole (3.8), digoxin (2.5), and acetyldigoxin (9.9) were significantly associated with agranulocytosis. The excess risks attributable to these drugs ranged from one to three cases per 10 million persons exposed for up to 1 week. Increased risks were also observed for cinepazide (used by six cases and no control subjects), procainamide (7, 1), and aprindine (5, 1); based on crude relative risk estimates, the excess risks for the latter two drugs were approximately three per million persons exposed for up to 1 week. The use of cardiovascular drugs in a 5-month period ending 1 month before hospital admission was compared between 152 patients with aplastic anemia and 2180 control subjects. Furosemide was the only significantly associated drug (relative risk, 3.1); the excess risk attributable to any exposure in a 5-month interval was 1.7 per million.

Adrenergic beta-Antagonists↗
PubMed1991

Modern management of aneurysmal subarachnoid hemorrhage.

This article reviews the modern approach and advances in the management of aneurysmal subarachnoid hemorrhage. Early diagnosis along with aggressive medical and surgical clipping appears to reduce morbidity and mortality. Computed tomography scan is greater than 95% sensitive for diagnosis. Aneurysm clipping within 48 hours has been performed successfully in 44 patients at the Indiana University Medical Center in Indianapolis. Early aneurysm clipping allows a more aggressive approach to managing the 20% to 30% incidence of delayed ischemic vasospasm. These aggressive treatments include transcranial Doppler analysis, volume expansion, hypertensive therapy, hemodilution and calcium channel blockers. Additional treatment strategies are being investigated to prevent vasospasm.

Humans↗
PubMed1991

What is HR 2691?

Explore the source record for details and available documents.

Humans↗
PubMed1991

Development of laparoscopic anterior seromyotomy and right posterior truncal vagotomy for ulcer prophylaxis.

This study investigated the feasibility of a laparoscopic antiulcer procedure. The following antiulcer operations were performed laparoscopically in 20 pigs: truncal vagotomy and pyloroplasty (n = 5), highly selective vagotomy (n = 5), right truncal vagotomy and left highly selective vagotomy (n = 5), and anterior seromyotomy and posterior truncal vagotomy (n = 5). Each procedure was videotaped and assessed in terms of ease of access, need for additional trocars, requirements for suturing, and complexity of the procedure. The anterior seromyotomy and posterior truncal vagotomy provided the optimal combination of antiulcer prophylaxis and adaptivity to the laparoscopic approach. We employed a Nd:YAG laser operating at 20 W delivered via a 600 micron sculpted tip which simplified the anterior seromyotomy. Anterior seromyotomy-posterior truncal vagotomy was then performed in three cadavers without evidence of perforation of the stomach. Our initial experience in a 46-year-old male demonstrates that the procedure can be performed with relative ease in humans. Thus, an effective antiulcer operation, anterior seromyotomy-posterior truncal vagotomy can be performed laparoscopically and may be a reasonable alternative for treating those patients who had a poor response to medical therapy.

Animals↗
PubMed1991

The emerging profile of dental manpower in Oklahoma. 2. Tulsa county.

This is the second report of a three part study. Part I focused upon the dental manpower profile of Oklahoma County between the years 1972-1989. Part II emphasizes the dental manpower profile of Tulsa County. Part III, will be inclusive of the dental manpower profile of all other Oklahoma counties. In all phases of the study, data has been assessed for general practitioners, specialists, full-time general practice dental faculty, full-time specialist dental faculty, and public health dentists. The demographic data analyzed in Part I, revealed an increasing average of the dentists from 45.33 years of age in 1972 advancing to 48.83 years of age in 1989 for Oklahoma County. The data presented in Part II documents that in Tulsa County there was an increase in age from 45.68 in 1972 to 50.60 in 1989. Trends in location of dental school education, demonstrated that the University of Oklahoma College of Dentistry is currently the primary resource for the dental manpower pool in Tulsa and Oklahoma Counties. Changes in the dental manpower pool indicate a downward turn in the percentage of dentists choosing to locate in either Tulsa or Oklahoma County.

Dentistry↗
PubMed1991

Cyclosporine and methylprednisolone after allogeneic marrow transplantation: association between low cyclosporine concentration and risk of acute graft-versus-host disease.

A combination of cyclosporine (CSA) and methylprednisolone (MP) was used as graft-versus-host disease (GVHD) prophylaxis in 25 patients age 11-47 years (median 27 years) who received HLA-compatible sibling marrow transplants after myeloablative therapy for leukemia, myelodysplasia or lymphoma. CSA was initiated at 3 mg/kg/day in two divided doses, and the dose was adjusted to maintain a trough whole blood h.p.l.c. concentration between 200 and 800 ng/ml. While on i.v. CSA, the dose of CSA was increased for 10 of the 25 patients. The actuarial rate of grades II-IV acute GVHD was 37%. Those patients who developed moderate to severe GVHD had a significantly higher early mortality than those who did not (56% vs 12%, p = 0.02). There was a significant association between the development of acute GVHD and a mean week 2 CSA trough concentration less than 250 ng/ml. Life threatening regimen-related toxicities in the first 100 days included capillary leak syndrome, acute pancreatitis and small bowel perforation. Although the combination of CSA and MP in this dosing schedule was active in preventing acute GVHD, nephrotoxicity remained a problem, and outcome was limited by the inability to achieve the target CSA trough concentration in a substantial proportion of patients.

Acute Disease↗
PubMed1991

Affect integration in psychoanalysis: a clinical approach to self-destructive behavior.

Self-destructive behavior can be an attempt to reverse self-fragmentation or breakdown secondary to feeling overwhelmed by unbearable affect. Therapeutic attention to blocks in the development of affect integration may help individuals process painful feeling states more efficiently, thus dealing with tension states more constructively. The author describes two cases that illustrate therapeutic removal of such blocks, followed by cessation of the self-destructive behavior and resumption of the normal developmental process.

Adult↗
PubMed1991

Percutaneous lumbar discectomy: a new adjunct to open surgery.

Percutaneous automated lumbar discectomy is a new and alternative method to open operations for lumbar disc disease. The procedure and indications for the procedure are explained in this article. The results of the first 24 such procedures performed at the Indiana University Medical Center will be examined and discussed.

Humans↗
PubMed1991

Multimodal treatment of adult intracranial gliomas.

Recent advances, experimental treatments and future protocols of adult intracranial gliomas are discussed in this article. Adult intracranial gliomas are not benign, and most are incurable with poor prognosis, despite aggressive treatment. Breakthroughs will be found only through well-designed, experimental protocol evaluation on patients with intracranial gliomas.

Adult↗
PubMed1990

Decline in the risk of myocardial infarction among women who stop smoking.

To assess the relation of smoking cessation to the risk of a first myocardial infarction in women, we compared the smoking habits of 910 patients who had had their first myocardial infarction with those of 2375 controls in a hospital-based case-control study of women from 25 to 64 years of age. The estimate of relative risk among current smokers as compared with women who had never smoked was 3.6 (95 percent confidence interval, 3.0 to 4.4). Among exsmokers overall, the corresponding estimate of relative risk was 1.2 (95 percent confidence interval, 1.0 to 1.7). Among exsmokers, the estimate of relative risk was significantly elevated among women who had stopped smoking less than two years previously (relative risk, 2.6; 95 percent confidence interval, 1.8 to 3.8). Most of the increase in the risk had dissipated among the women who had stopped smoking two to three years previously, and the estimate of relative risk among the women who had not smoked for three or more years was virtually indistinguishable from that among the women who had never smoked. The same pattern of decline was apparent regardless of the amount smoked, the duration of smoking, the age of the women, or the presence of other predisposing factors. These data suggest that in women, as in men, the increase in the risk of a first myocardial infarction among cigarette smokers declines soon after the cessation of smoking and is largely dissipated after two or three years.

Adult↗
PubMed1990

Effects of tumor necrosis factor alpha on parathyroid hormone-induced increases in osteoblastic cell cyclic AMP.

Tumor necrosis factor alpha (10(-10) - 10(-8) M) had no effects on cyclic AMP production by the osteoblastic osteosarcomal cells, Saos-2 and G292, or normal rat calvarial cells. The cytokine did, however, inhibit the parathyroid hormone (PTH)-induced effect on cyclic AMP in the Saos-2 and normal rat osteoblastic cells. This inhibitory effect did not occur on prostaglandin E2-induced cyclic AMP increases in the osteoblastic cells. Interleukin-1 (10 U/ml-100 U/ml) did not produce any effect on basal levels or PTH-induced cyclic AMP increases in these cells.

Animals↗
PubMed1990

Biosynthesis and control of beta-lactam antibiotics: the early steps in the "classical" tripeptide pathway.

The interaction between growth and secondary metabolism develops from physiological responses of the producer organism to its environment. Nutrients are channelled into primary growth processes or into secondary processes such as antibiotic biosynthesis by a variety of metabolic controls, the nature of which has been extensively studied in organisms producing beta-lactam antibiotics via the tripeptide, delta-(L-alpha-aminoadipyl)-L-cysteinyl-D-valine. In the following article we review the early stages of beta-lactam biosynthesis in fungi and actinomycetes, keeping in mind the regulation of primary pathways that provide the amino acid precursors of this group of antibiotics, as well as the regulation of the secondary pathway itself. Of special importance to organisms engaging in secondary metabolism are the control mechanisms that suppress the nonessential process during rapid growth but allow secondary metabolic genes to be expressed and resources to be diverted when environmental factors generate the appropriate biochemical signals.

Journal Article↗
PubMed1990

Alcohol consumption and blood pressure in the 1982 Maryland Hypertension Survey.

This study examines the relationship between alcohol consumption and blood pressure in the 1982 Maryland Hypertension Survey, a crossectional population-based household survey of blood pressure control in adults residing in Maryland. In individuals less than 50 years old, a J shaped dose-response association was found with abstainers and heavy alcohol consumers having significantly higher blood pressures than moderate alcohol consumers (1 to 2 beverages per day). In individuals 50 years and older, alcohol was associated with higher blood pressures only at the highest levels of intake (greater than 2 beverages per day). The prevalence of hypertension was similarly affected in each age group. This association between alcohol consumption and blood pressure was independent of several variables that are associated with increased blood pressure such as age, sex, race, smoking, education, Quetelet index, social participation, and physical activity. The population attributable risk for hypertension due to heavy alcohol consumption is 5 to 7% in those greater than 50 years old and 6 to 8% in those less than 50 years old. These data suggest that alcohol consumption is a potentially important risk factor for elevations in blood pressure and hypertension.

Adolescent↗