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Biomedical subjects

A S Kaplan

Publications and source records attributed to A S Kaplan.

At least 19 recordsLinked to original sources
PubMed1991

The prediction of treatment response in bulimia nervosa. A study of patient variables.

To investigate the predictive value of a wide range of variables for distinguishing subjects who demonstrate a favourable treatment response from those who do not, 86 women with a DSM-III-R diagnosis of bulimia nervosa who completed a group treatment programme for eating disorders were studied. Discriminant-function analysis of demographic variables, weight history, specific eating-disorder psychopathology, mood status and social adjustment before treatment was performed; five factors (depression and core symptoms of eating disorder) best discriminated 'positive' from 'poor' treatment responders, accounting for 44% of the variance.

Adolescent↗
PubMed1991

Throw it away, Sam.

Explore the source record for details and available documents.

Periodicals as Topic↗
PubMed1990

Biomedical variables in the eating disorders.

Anorexia nervosa and bulimia nervosa are complex psychosomatic illnesses for which there may be significant biomedical diatheses and sequelae. This paper reviews these biomedical variables, focusing on the medical and nutritional assessment and management of patients with eating disorders and the medical complications that arise in these patients. The paper then examines the relationship between medical illness and eating disorders, including the medical misdiagnoses often given to these patients and the way in which a chronic medical condition such as diabetes mellitus predisposes a patient to an eating disorder. The relationship between eating disorders and pregnancy is also discussed. Through an understanding of these biomedical issues, iatrogenesis can be prevented and treatment can be improved.

Anorexia Nervosa↗
PubMed1990

Self-report symptoms that predict major depression in patients with prominent physical symptoms.

The diagnosis of depression in patients presenting with both depressive and physical symptoms is potentially confounded and problematic. The present study of 271 patients with four types of illness all with prominent physical symptoms--end-stage renal disease (n = 99), irritable bowel syndrome (n = 21), post-infectious neuromyasthenia (n = 25) and eating disorders (n = 126)--investigates if there are a group of symptoms on the Beck Depression Inventory (BDI) which predict the diagnosis of major depressive episode (MDE) made using the Diagnostic Interview Schedule (DIS). Discriminant function analysis of BDI responses yielded a four item function--self-hate, indecisiveness, loss of appetite and suicidal thoughts--which maximally discriminated between patients with and without a current MDE and correctly classified 75 percent of subjects.

Adolescent↗
PubMed1989

Anorexia nervosa and bulimia nervosa.

No definitive therapy exists for anorexia nervosa (AN) or bulimia nervosa (BN). Nevertheless, biologic and psychologic research into these disorders has increased over the last decade. We examine the various drugs available for treatment. Advances in pharmacotherapy for AN have been modest and have reflected efforts either to stimulate hunger and weight gain or to control complications of the starvation process. Food remains the "drug" of choice. Antidepressants have been found to be beneficial in the treatment of BN. The meaning of this in the context of a relation between BN and mood disorders remains unclear, since coexistent depression does not predict a positive response to these drugs. Pharmacotherapy represents a single but important dimension of the management of patients with eating disorders. The optimal integration of drug therapy and psychotherapy and the identification of predictors of a positive response to drugs have yet to be addressed by clinical research.

Anorexia Nervosa↗
PubMed1989

Unsuspected foreign body in the frontal sinus and anterior cranial fossa.

We present the case of a 46-year-old man who was involved in a motor vehicle accident in which his forehead struck the dashboard of his semi-tractor trailer. A toggle switch penetrated the anterior and posterior tables of his frontal sinus and lodged in the frontal lobe. The foreign body was not found on physical examination at an emergency care facility. The wound was closed, and the patient was sent home. Severe headaches prompted his return the next day. Skull roentgenograms showed the toggle switch, and the patient was referred to our institution for definitive care. This unusual case serves to emphasize the potential for a foreign body to penetrate the frontal sinus with few physical findings.

Accidents, Traffic↗
PubMed1989

The clinician-investigator interface in psychiatry I--Values and problems.

The two following papers describe some of the benefits and problems involved in integrating clinical and investigative work. It is stressed that there are a number of advantages to such integration. Researchers especially benefit from the proximity to patients and clinicians. Education can be significantly enhanced when researchers and clinicians are in one setting and this can benefit residents, medical students and non-medical health personnel. There are a number of problems to such clinical research in psychiatry. These are discussed especially as they relate to senior faculty and their resistances to research. The shortage of clinician scientists in teaching positions means that most residents are not involved with such people as mentors early in their training and do not consider this as a career option after their residency training. Reductionistic thinking on the part of some researchers and when researchers are not first-rate clinicians both contribute to residents not becoming involved in clinical investigation. Funding policies as well as chairmen's hiring policies also play a role here.

Canada↗
PubMed1989

The clinician-investigator interface in psychiatry: II--The role of the Clinical Investigation Unit.

The Clinical Investigation Unit has served as a natural focus for clinical research; as such it has a number of advantages and specific problems. On such units a variety of themes may occur. Some of these have the potential to interfere with the integration of clinical and research work. These include the theme that the research itself is therapy, or that research will find all the answers. Both may result in problems for the functioning of the ward. Most problematic of all is the theme that research is harmful and exploitative. Optimally, the unit develops an attitude that the research is compatible with excellent patient care. Problems of patients, staff, ethical issues, admissions policies and problems of the clinician-scientists are reviewed with recommendations on how to minimize difficulties.

Canada↗
PubMed1989

The DST and TRH test in bulimia nervosa.

Abnormal neuroendocrine responses have been found in depression and eating disorders. It remains unclear whether these reflect an underlying shared biology or epiphenomena. To evaluate this further, we conducted the 1 mg DST and the TSH response to 500 micrograms i.v. TRH in normal-weight bulimics and controls. Bulimics (n = 18) demonstrated significantly more DST non-suppression (45%) than controls (18%; n = 20). In the bulimic group, non-suppressors were significantly thinner than suppressors, but did not differ from them on any measure of depression. Bulimics (n = 19) and controls (n = 12) responded similarly without blunting on the TSH response to TRH. These data suggest that DST non-suppression may be related to non-specific variables such as weight. Bulimics do not demonstrate TSH blunting as found in some depressed patients. These tests do not support evidence for a biological link between these disorders.

Adult↗
PubMed1988

Role of glycoprotein gIII of pseudorabies virus in virulence.

Deletion mutants of pseudorabies virus unable to express glycoprotein gIII, gI, or gp63 or double and triple mutants defective in these glycoproteins were constructed, and their virulence for day-old chickens inoculated intracerebrally was determined. Mutants of wild-type pseudorabies virus defective in glycoprotein gIII, gI, or gp63 were only slightly less virulent (at most, fivefold) for chickens than was the wild-type virus. However, mutants defective in both gIII and gI or gIII and gp63 were avirulent for chickens, despite their ability to grow in cell culture in vitro to about the same extent as mutants defective in gIII alone (which were virulent). These results show that gIII plays a role in virulence and does so in conjunction with gI or gp63. The effect of gIII on virulence was also shown when the resident gIII gene of variants of the Bartha vaccine strain (which codes for gIIIB) was replaced with a gIII gene derived from a virulent wild-type strain (which codes for gIIIKa); gIIIKa significantly enhanced the virulence of a variant of the Bartha strain to which partial virulence had been previously restored by marker rescue. Our results show that viral functions that play a role in the virulence of the virus (as measured by intracerebral inoculation of chickens) may act synergistically to affect the expression of virulence and that the ability of the virus to grow in cell culture is not necessarily correlated with virulence.

Animals↗
PubMed1988

Selecting a screening mammography facility.

Breast cancer is the second most common cause of cancer mortality in women. During the past 20 years, two major mammography screening programs have demonstrated reduced mortality in patients over age 50. Mammography can be safe and effective. Physicians should recommend mammographic facilities with trained and experienced personnel, dedicated mammographic and processing equipment, and quality control procedures.

Breast Neoplasms↗
PubMed1987

Multiple defects in the genome of pseudorabies virus can affect virulence without detectably affecting replication in cell culture.

Several independently isolated vaccine strains of pseudorabies virus were studied to identify the functions that play a role in the expression of virulence of this virus. All the strains that were studied grew well in three different cell types. No differences that could be correlated with avirulence could be detected either in the virus yield produced by the cells or in the length of the eclipse phases. All the attenuated strains, however, had lost their ability to replicate efficiently in the brains of day-old chickens. The defects leading to the decrease in the virulence for day-old chickens varied in the different vaccine strains. The Tatarov vaccine strain is defective in the thymidine kinase (TK) gene; restoration of a functional TK gene restores to this strain its virulence for day-old chickens and for pigs. Three out of four different, independently isolated avirulent strains were found to be defective in different loci, as determined by their ability to generate virulent recombinants. Two strains, Bartha and Buk Z300, however, yielded few virulent recombinants, indicating that they were defective in at least one closely linked function. Furthermore, all the virulent recombinants obtained from cells coinfected with different pairwise combinations of the vaccine strains had higher LD50 values than virulent wild-type virus, indicating that the recombinants had not acquired all the functions necessary for optimum expression of virulence. Partial virulence was also restored to Buk Z900 by marker rescue with sequences originating from three different regions of the wild-type pseudorabies virus genome. All three of these regions were different from those that had previously been shown to rescue virulence of the Bartha strain (B. Lomniczi, S. Watanabe, T. Ben-Porat, and A. S. Kaplan, 1987, J. Virol. 61, 796-801). Our results thus show that (1) defects in several different loci of the pseudorabies virus genome can affect virulence without detectably affecting growth in cell culture and (2) most vaccine strains have multiple defects contributing to their lack of virulence.

Animals↗
PubMed1987

Role of a structural glycoprotein of pseudorabies in virus virulence.

The virulence of deletion mutants of pseudorabies virus defective in the expression of glycoprotein gI, gp63, or both was tested in 1-day-old chickens and young pigs. In the absence of expression of gI, the virulence of a fully virulent laboratory strain, PrV(Ka), for 1-day-old chickens was reduced approximately fourfold. Inactivation of glycoprotein gp63 appeared also to affect the virulence of PrV(Ka) only slightly, as did inactivation of both gI and gp63. The level of reduction in virulence, however, was considerably more marked in Bartha 43/25aB4, a less virulent virus strain. Inactivation of the expression of gI in Bartha 43/25aB4 reduced virulence for chickens at least 100-fold. The results obtained when the virulence of the mutants for pigs was determined were compatible with those obtained for chickens. These results indicate that gI plays a role in virulence, but that it does so in conjunction with at least one other viral function (a function that is defective in Bartha 43/25aB4).

Animals↗