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S Shulman

Publications and source records attributed to S Shulman.

At least 19 recordsLinked to original sources
PubMed2006

Prognostic factors for visual acuity improvement after intravitreal triamcinolone injection.

PURPOSE: In some patients with macular oedema, intravitreal triamcinolone acetonide injection (IVTA) fails to improve visual acuity, although oedema shows clinical and angiographic improvement. Side effects can include increased intraocular pressure, cataract development, and (rarely) endophthalmitis. Our purpose was to identify prognostic factors for visual acuity improvement after IVTA. METHODS: Data on patients treated by IVTA for macular oedema were retrospectively reviewed. Three months postinjection, visual acuity was rated as 'improved' (two or more Snellen lines gained) or 'nonimproved' (unchanged or worsened). Comparative demographic data and pre- and post-IVTA clinical and fluorescein angiographic findings were analysed with SPSS software. RESULTS: Of 57 eyes (57 patients), 27 (47%) improved after IVTA. Initial visual acuity ('good', 'moderate', or 'poor') and aetiology of macular oedema (diabetic, venous occlusion, or pseudophakic) did not differ between the two groups. Improvement occurred in significantly more eyes with clinical or angiographic evidence of cystoid macular oedema (CME) than in those with diffuse retinal thickening (P=0.04) or diffuse leakage on fluorescein angiography (P=0.02), respectively, and in significantly more pseudophakic than phakic eyes (P=0.046). CONCLUSIONS: Pseudophakia and clinical or angiographic CME, but not aetiology or initial visual acuity, were prognostic of visual acuity improvement after IVTA for macular oedema.

Adult↗
PubMed2006

The application of Beckman Coulter VCS technology at a major cancer center, with emphasis on the detection of circulating immature plasma cells in plasma cell leukemia.

The St. Vincent's Comprehensive Cancer Center (SVCCC) has a large multiple myeloma program in downtown New York City. The laboratory at SVCCC is an integral part of the diagnosing and monitoring of its myeloma patients. Circulating plasma cells are not a common finding in multiple myeloma. Being able to detect plasma cells in peripheral blood is important because they are a prognostic indicator that correlates with disease progression. Furthermore, the peripheral blood plasma cell population can demonstrate morphologic variability. Immature plasma cells, both plasmablasts and proplasmacytes are associated with more aggressive disease and shortened survival. We encountered 3 multiple myeloma patients with circulating immature plasma cells that appeared as distinct populations on our hematology analyzer's automated white blood cell (WBC) differential. The immature plasma cells, given their unique cellular characteristics, appeared in a common place within the WBC differential scatterplot in each patient. In our laboratory, we have utilized this common graphic pattern to screen for immature plasma cells. This pattern has proven to be a useful tool in our large population of multiple myeloma patients. We have also used examination of the scatterplots in other hematologic malignancies such as chronic lymphocytic leukemia. Using this review policy, the laboratory has been able to achieve a smear review of 25% in our highly abnormal patient population.

Autoanalysis↗
PubMed2001

Adolescent romance: between experience and relationships.

This concluding and integrative paper calls attention to several features and conceptual issues addressed by the contributors of this special issue. The first issue pertains to developmental perspectives in the study of how adolescent romance evolves. The second deals with the various features and concepts of adolescent romance. The third topic discusses the association of adolescent romance with other close relationships occurring during this time span. The fourth topic highlights the importance of the diversity of developmental contexts in shaping romantic relationships. Finally, conceptual issues in the study of adolescent romance are reviewed and the need for future studies of early adolescent romantic experiences is discussed.

Adolescent↗
PubMed2001

Adolescent romantic relationships: a look from the future.

Employing a narrative approach, 40 young adult romantic couples were interviewed about their current relationships as well as about their relationship with a romantic partner that lasted for at least about 2 months when they were aged 15 or 16. When analysed, the transcribed interviews were found to portray adolescent and young adulthood romantic relationships in different terms. Adolescent romance was described more as a form of companionship and was valued for its experiences of totality and enthusiasm. Young adulthood romance, by contrast, was described more as a mature relationship characterized by trust, support, and stability. In addition, adolescent romance was described as less enjoyable, enduring more relationship problems. Males and females described differently their adolescent romance in relation to the quality of their current romantic relationship. Males, but not females, related a current more positive perception of the relationship to a more positive perception of adolescent romance. Adolescent romance is discussed within the framework of the developmental processes that characterize the development of romantic relationships.

Adult↗
PubMed2001

Parental divorce and young adult children's romantic relationships: resolution of the divorce experience.

Fifty-one romantically involved young Israeli adults, whose parents were divorced, were questioned about their romantic relationship, parents' conflict, and current feelings about and reconstruction of the divorce. An integrative perception of the divorce was found to be related to fewer problems and to higher levels of friendship, enjoyment, and intimacy in the relationship. Implications for research and intervention with young adults are discussed.

Adult↗
PubMed2001

A pharmacy discharge plan for hospitalized elderly patients--a randomized controlled trial.

OBJECTIVES: to investigate the effectiveness of a pharmacy discharge plan in elderly hospitalized patients. DESIGN: randomized controlled trial. SUBJECTS AND SETTINGS: we randomized patients aged 75 years and older on four or more medicines who had been discharged from three acute general and one long-stay hospital to a pharmacy intervention or usual care. INTERVENTIONS: the hospital pharmacist developed discharge plans which gave details of medication and support required by the patient. A copy was given to the patient and to all relevant professionals and carers. This was followed by a domiciliary assessment by a community pharmacist. In the control group, patients were discharged from hospital following standard procedures that included a discharge letter to the general practitioner listing current medications. OUTCOMES: the primary outcome was re-admission to hospital within 6 months. Secondary outcomes included the number of deaths, attendance at hospital outpatient clinics and general practice and proportion of days in hospital over the follow-up period, together with patients' general well-being, satisfaction with the service and knowledge of and adherence to prescribed medication. RESULTS: we recruited 362 patients, of whom 181 were randomized to each group. We collected hospital and general practice data on at least 91 and 72% of patients respectively at each follow-up point and interviewed between 43 and 90% of the study subjects. There were no significant differences between the groups in the proportion of patients re-admitted to hospital between baseline and 3 months or 3 and 6 months. There were no significant differences in any of the secondary outcomes. CONCLUSIONS: we found no evidence to suggest that the co-ordinated hospital and community pharmacy care discharge plans in elderly patients in this study influence outcomes.

Aged↗
PubMed2000

Prevalence of Müllerian duct anomalies detected at ultrasound.

The true prevalence of müllerian duct abnormalities is not well established. We used standard ultrasound examinations to establish the prevalence of müllerian duct abnormalities in girls and women who were evaluated for reasons unrelated to the presence of uterine anomalies. Prospective ultrasound examinations for nonobstetric indications in 2,065 consecutive girls and women (aged 8-93) showed that 8 had anomalies, including bicornuate uterus, septate uterus, and double uterus. In this first attempt to determine the prevalence of uterine anomalies in the general population, using noninvasive methodology, the rate of anomalies was 3.87 per 1,000 women (exact 95% confidence interval: 1.67-7.62), or approximately 1 in 250 women. This prevalence estimate may be greater than the true rate if selection biases are strong, or less than the true prevalence if ultrasound detection rates are low. As a first attempt to establish the prevalence by pelvic ultrasound in a consecutive series, these data may serve as a baseline estimate.

Adolescent↗
PubMed2000

Is there an association between Kawasaki disease and Chlamydia pneumoniae?

The clinical and epidemiological features of Kawasaki disease (KD) are consistent with an infectious cause. Because chronic infection with Chlamydia pneumoniae has been implicated in the pathogenesis of atherosclerosis, it has been suggested that it may also be involved in the pathogenesis of KD. Paired sera (baseline pretreatment and 1 year after treatment with intravenous immunoglobulin [IVIG]) from 26 children with KD and 29 age-matched controls were examined by microimmunofluorescence (MIF) serology and immunoblotting. There were no significant differences in the prevalence of anti-C. pneumoniae IgG, IgA, or IgM between cases and controls; however, 73%-85% of sera from cases and controls reacted with C. pneumoniae proteins by immunoblotting. There was significantly more reactivity in the pre-IVIG, but not post-IVIG, KD sera compared with sera from controls to proteins at 72-74 kDa and 74-76 kDa. They may be heat shock proteins. The results of this study do not support an association between KD and C. pneumoniae on the basis of MIF and immunoblot analysis.

Adolescent↗
PubMed2000

Family relationships, leaving home, and adjustment to military service.

Associations between family relationships and individual adjustment were studied within a sample of 19-year-old soldiers during their first weeks of basic training. Results showed that family relationships partly explained soldiers' closeness to best friends, number of social nominations, and commanders' ratings of soldiers' military and social competence. In addition, family relations explained soldiers' perceived social competence as assessed via closeness to best friends and number of sociometric nominations. Together, the results reiterate the role played by the family and attitudes toward offspring leaving home and toward their adjustment to military service.

Adult↗
PubMed2000

Close relationships and social competence of hospitalized and nonhospitalized adolescents.

This study was designed to examine the social relationships of adolescents with severe disorders. The study sample consisted of 33 adolescent inpatients in a psychiatric unit, as well as 33 nonhospitalized adolescents. Participants completed the Network of Relationship Inventory for an assessment of the quality of their relationships with mother, father, close friend, and other significant adults. In addition, friendship intimacy was assessed. Results showed nonhospitalized adolescents describing a close relationship with their parents, as well as with their close friends. Their relationships with their friends were mature. Hospitalized adolescents described a less close relationship with their parents, whereas they were close to and valued their relationships with their friends and other significant adults. Though both groups described similar levels of emotional closeness, hospitalized adolescents tended more to exert control or to evince a penchant for similarity to the other in their friendships. Results are discussed within the framework of adolescent social tasks.

Adolescent↗
PubMed1999

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Journal Article↗
PubMed1998

Cognitive appraisals, coping strategies, and support resources as correlates of parenting and infant development.

By applying R. S. Lazarus's (1993) theoretical model, the authors explored the dynamics of stress and coping as central mechanisms underlying parenting adjustment and infant development. Longitudinal assessment of 140 primiparous mothers included measures of cognitive appraisals of parenting, coping strategies used, and supportive coping resources at pregnancy and 1 month, 6 months, and 12 months postpartum. Maternal outcome measures of adjustment included maternal well-being, parental efficacy, and observed behaviors of caregiving and affiliation. Infant developmental outcome was measured by the Bayley Scales of Infant Development (N. Bayley, 1993). All measures of the stress and coping model showed systematic developmental changes across the transition to parenthood as well as relative stability of individual differences. In addition, the stress and coping variables were found to have additive and interactive effects in predicting both maternal adjustment and infant development.

Adaptation, Psychological↗
PubMed1997

Expression of an allogeneic MHC DRB transgene, through retroviral transduction of bone marrow, induces specific reduction of alloreactivity.

BACKGROUND: Transfer of MHC class II genes, through allogeneic bone marrow (BM) transplantation, induced long-lasting acceptance of renal allografts in miniature swine. To adapt this approach to the clinic, we have now examined whether somatic transfer of allogeneic class II DR genes, into otherwise autologous bone marrow cells (BMC), can provide the matching required for inducing immune tolerance. METHODS: Autologous BMC were transduced ex vivo with recombinant retroviruses for allogeneic DRB followed by BM transplantation. The recipients were then challenged with kidney allografts solely matched to the DRB transgene. RESULTS: Five miniature swine received autologous BMC conditioned with growth factors and transduced with recombinant retrovirus vectors containing allogeneic (n=4) or syngeneic (n=1) class II DRB genes and a drug-resistance marker. Expression of retrovirus-derived products in BM-derived cells was demonstrated by the detection of drug-resistant colony-forming progenitors and the presence of DRB retrovirus transcripts in peripheral cells. Analysis of selective mixed lymphocyte reaction responses to DR or DQ antigens indicated decreased reactivity toward the transduced DR gene product. Among all of the animals receiving fully mismatched kidney allografts, but with DRB matched to the transduced DRB, the one with the highest gene transduction rate showed stable allograft function and essentially normal renal histology for 2.5 years. A control animal, which received a syngeneic DRB gene, rejected its kidney allograft in 120 days after an earlier rejection crisis. CONCLUSIONS: These studies demonstrate that allogeneic MHC gene transfer into BM provides a new strategy for inducing tolerance across MHC barriers.

Animals↗