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Biomedical subjects

A Jaffe

Publications and source records attributed to A Jaffe.

At least 55 records · Page 3Linked to original sources
PubMed1990

The state of leukocyte adhesiveness/aggregation in the peripheral blood of patients with respiratory tract infections.

The state of leukocyte adhesiveness/aggregation (LAA) in the peripheral blood has been employed as a marker of inflammation. In the present study we examined patients with varying intensities of inflammation caused by respiratory tract infections to further investigate the reliability of the state of LAA for the detection and assessment of the severity of disease activity. The study includes 140 controls, 46 patients with upper respiratory tract infection, 30 with bronchitis, 27 with suspicion of pulmonary infiltrate, and 39 with small and 18 with large pulmonary infiltrate. Assessment was based on assuming an increasing severity of inflammation from the 1st to the 6th diagnostic category and by making use of discriminant analysis. It was found that the state of LAA proved to be the best variable to classify the patients into their diagnostic category (F to enter 27), followed by erythrocyte sedimentation rate at the 1st h (F to enter 20.8) and total white blood cell count (F to enter 8.3). These studies were followed by animal experimentation. A highly significant correlation (p = 0.005) was found between the state of LAA in the peripheral blood and the degree of pulmonary leukostasis in a model of endotoxemia in rabbits. These results suggest that the state of LAA is not an epiphenomenon and represents the tendency of the white blood cells to stick to the endothelium which facilitates their migration into the tissues.

Adolescent↗
PubMed1988

Thrombolysis in Myocardial Infarction (TIMI) Trial--phase I: hemorrhagic manifestations and changes in plasma fibrinogen and the fibrinolytic system in patients treated with recombinant tissue plasminogen activator and streptokinase.

Two hundred ninety patients with acute myocardial infarction were treated according to random assignment with an intravenous infusion of either 80 mg of recombinant tissue plasminogen activator (rt-PA) over 3 h or 1.5 million units of streptokinase over 1 h. Patients received an intravenous bolus of heparin (5,000 U [USP]) before pretreatment coronary angiography and a continuous infusion (1,000 U/h) starting 3 h later. The frequency of major and minor hemorrhagic events (33% rt-PA, 31% streptokinase) and associated transfusions (22% rt-PA, 20% streptokinase) were comparable in both groups. More than 70% of bleeding episodes in each group occurred at catheterization or vascular puncture sites. Precipitable fibrinogen levels, measured in plasma samples collected in the presence of a protease inhibitor (aprotinin), declined in rt-PA and streptokinase groups by averages of 26 and 57% at 3 h and by 33 and 58% at 5 h, respectively (rt-PA versus streptokinase, p less than 0.001). At 5 h the plasma plasminogen declined by 57% (rt-PA) and 82% (streptokinase) (p less than 0.001); plasma fibrin(ogen) degradation products were higher in streptokinase-treated patients (244 +/- 12 micrograms/ml, mean +/- SE) than in rt-PA-treated patients (97 +/- 9 micrograms/ml, p less than 0.001). At 27 h, plasma fibrinogen and plasminogen levels were lower and fibrin(ogen) degradation products higher than pretreatment levels in both groups. The frequency of hemorrhagic events was higher in patients with greater changes in plasma factors at 5 h; within treatment groups the levels of fibrin(ogen) degradation products correlated with bleeding complications (p less than 0.005). Thus, in the doses administered, rt-PA induces systemic fibrinogenolysis that is substantially less intense than that induced by streptokinase. The high frequency of bleeding encountered is related to the protocol used, including vigorous anticoagulation, arterial punctures and thrombolytic therapy. These findings emphasize the need for avoidance of invasive procedures and for meticulous care in the selection and management of patients subjected to thrombolytic therapy.

Clinical Trials as Topic↗
PubMed1988

Alcoholism training in a family medicine residency.

The literature in alcoholism education for the health professions reveals that despite some strides in the development of training programs, both medical students and practicing physicians exhibit negative attitudes toward alcoholics that may adversely affect the care offered to these patients. This paper presents a program of alcoholism identification and management training for family practice residents which has been developed to supplement an existing drug abuse treatment program. Residents spend four half-day sessions engaged in seminars, outpatient experiences, and inpatient rotations under the direction of a clinical psychologist specializing in substance abuse and under the direction of the medical staff of a voluntary hospital well-known as a center of alcoholism treatment. Training activities include participation in group therapy sessions with alcoholic patients, interviewing patients in the early stages of rehabilitation, participation in an adolescent alcoholism treatment program and attendance in seminars on the prevention, identification, and treatment of alcoholism. Residents' evaluations of the experience reveal overall satisfaction with the program and their roles in its conduct, but they indicate a need for more active roles in the hands-on management of emergency cases.

Alcoholism↗
PubMed1988

A one-year follow-up of fatigued patients.

To better understand the complaint "fatigue" and the characteristic features of patients who present with this problem, a one-year follow-up study was performed in a county health center. One hundred-fifteen fatigued adults were identified using scores on the Rand Index of Vitality (RIV). One hundred thirty-nine patients of similar age, sex, and socioeconomic status were identified as nonfatigued. One year later, these patients were followed up with a chart review, reassessment of fatigue (by RIV score), and a telephone interview. Seventy-three (64 percent) fatigued and 72 (53 percent) nonfatigued patients provided this information. On the RIV, 31 patients moved from the fatigued group to nonfatigued, and 15 nonfatigued patients' scores changed to the fatigued category. Patients categorized as fatigued in 1984 (by RIV score) returned for office visits more often (mean of 3.85 vs 2.51, P less than .05), and developed significantly more new diagnoses (2.75 vs 1.68, P less than .05) over the follow-up year, compared with those not fatigued. Fatigued patients also had a greater proportion of diagnoses containing a psychologic component than nonfatigued patients. Persistence of fatigue over the year was significantly associated with race and education (nonwhites and those completing high school remaining fatigued). No significant association between marital status, age, sex, employment status, and either the resolution or development of fatigue over the year was found.

Adolescent↗
PubMed1987

Sultamicillin in the treatment of superficial skin and soft tissue infections in children.

Fifty-two children with superficial skin and soft tissue infections were randomized to receive sultamicillin or cloxacillin for 7 days. Twenty-one children in each group finished the study. A total of 16 of 21 in the sultamicillin group and 13 of 21 in the cloxacillin group were cured. One child in the sultamicillin group and two in the cloxacillin group failed therapy. Four children who received sultamicillin and six who received cloxacillin had recurrences of lesions. Differences were not statistically significant.

Abscess↗
PubMed1985

Influence of life-style on the premenstrual syndrome. Analysis of a questionnaire survey.

The premenstrual syndrome (PMS) is influenced by parameters of life-style. An analysis was done of 384 questionnaires completed by women with a wide variety of life-styles. Four measures of PMS symptomatology were developed to assess the areas of edema, autonomic responses, affect and coping mechanisms. Significance associations were found between PMS symptomatology and regularity of periods, occupational level and educational attainment. Housewives were found to report the highest levels of symptom expression. Visits to physicians due to PMS were found to be higher than is usually reported in the medical literature.

Adaptation, Psychological↗
PubMed1984

A comprehensive clerkship in family medicine.

A 6-week family medicine clerkship that is comprehensive in its approach to the academic base of family medicine and in its integration of clinical and didactic experiences is discussed. The goals of the clerkship are to enable students to: acquire knowledge of common illnesses in ambulatory care; integrate compassion, concern and empathy in the delivery of comprehensive and personalized care; and to experience the medical and social issues of family medicine. The curriculum includes 50 hours of didactic preparation in the family life cycle, common illnesses, patient interviewing, problem-oriented medical records, genograms . compliance, and clinical problem-solving. Clinical experiences include placement in a family practice centre, an experience in a drug-abuse treatment centre and a brief rotation in geriatric medicine. Students are evaluated on their performance in clinical settings and in an objective test of primary care concepts. Test performance shows significant growth from student pre- to post-test scores. Student evaluations have been very favourable toward the clerkship, and self-reports reveal growth in knowledge of common illnesses, problems of the elderly, problems of drug abuse and the role of the family doctor.

Clinical Clerkship↗
PubMed1983

Anxiety disorders.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-III) has expanded descriptions of anxiety and includes new categories with definitive diagnostic criteria. It has also eliminated its previous psychodynamic and psychoanalytic approach to psychopathology. The new anxiety classifications reflect the growth of knowledge in neurochemistry, especially cell-membrane binding sites and specific pharmacologic actions of certain drugs. Many research conclusions have become questionable as a result in large part of their reliance upon the obsolete versions of DSM (I and II). Among major findings in research on anxiety are its relatively common incidence, especially in family practice, and its relationship to secondary depression and increased association with physical disorders, particularly if the anxiety disorder is of long duration. Family and genetic studies have revealed a high incidence of anxiety within families, though there is little evidence of heritability. The pathophysiology of anxiety is only beginning to be studied productively. Research in drug therapy and psychotherapy have supported the need for both therapeutic modalities in most circumstances.

Anti-Anxiety Agents↗
PubMed1982

Role of porin proteins OmpF and OmpC in the permeation of beta-lactams.

Mutants of Escherichia coli K-12 lacking major outer membrane proteins were obtained by selecting for resistance to the beta-lactam cefoxitin. Three classes of resistant strains were found: mutants in ompB, a regulatory locus for proteins OmpF and OmpC; mutants in ompF; and one mutant in tpo. The OmpF and OmpC proteins facilitate penetration of beta-lactams through the outer membrane.

Anti-Bacterial Agents↗