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Biomedical subjects

A Steinberg

Publications and source records attributed to A Steinberg.

At least 37 records · Page 2Linked to original sources

Somatosensory functioning in children with attention deficit hyperactivity disorder.

In order to test the hypothesis that attention deficit hyperactivity disorder (ADHD) is related to deficits in somatosensory processing, 49 ADHD male children and 49 matched controls were tested on a wide range of tactile tasks, and somatosensory evoked potentials (SEP) were also recorded. In addition, parents' and teachers' ratings on the children's typical responses to tactile stimuli were obtained. The results show that the ADHD children were less skilled on suprathreshold, but not on threshold tasks than were the controls. Further, a larger percentage of ADHD children were 'tactile defensive'. Finally, the ADHD children showed larger-than-normal amplitudes of late, but not early components of the SEP. These data suggest that some aspects of somatosensory processing by ADHD children are deficient.

Attention Deficit Disorder with Hyperactivity↗

The foundations and the development of modern medical ethics.

Modern bioethics is based on a pluralistic and multidisciplinary approach, deriving its sources from medicine, biology, philosophy, law, theology, social and behavioral sciences, and history. The moral foundation of modern biomedical ethics is based upon four prima facie principles: respect of autonomy, beneficence, nonmaleficence, justice. This approach, however, has been seriously criticized and challenged. A wide range of issues is discussed and debated in biomedical ethics. Several causes have intensified the recent flourishing of medical ethics: The enormous advancements in scientific and technological knowledge; the intense and widespread interest in bioethics by professionals as well as by the public at large; and the wide sociocultural and economic changes in western society, and in the conduct of medicine. The objectives of clinical medical ethics is outlined in the article.

Bioethical Issues↗

Physical and chemical effects of red cells in the shear-induced aggregation of human platelets.

Both chemical and physical effects of red cells have been implicated in the spontaneous aggregation of platelets in sheared whole blood (WB). To determine whether the chemical effect is due to ADP leaking from the red cells, a previously described technique for measuring the concentration and size of single platelets and aggregates was used to study the shear-induced aggregation of platelets in WB flowing through 1.19-mm-diameter polyethylene tubing in the presence and absence of the ADP scavenger enzyme system phosphocreatine-creatine phosphokinase (CP-CPK). Significant spontaneous aggregation was observed at mean tube shear rates, (G) = 41.9 and 335 s-1 (42% and 13% decrease in single platelets after a mean transit time (t) = 43 s, compared to 89 and 95% decrease with 0.2 microM ADP). The addition of CP-CPK, either at the time of, or 30 min before each run, completely abolished aggregation. In the presence of 0.2 microM ADP, CP-CPK caused a reversal of aggregation at (t) = 17 s after 30% of single cells had aggregated. To determine whether red cells exert a physical effect by increasing the time of interaction of two colliding platelets (thereby increasing the proportion of collisions resulting in the formation of aggregates), an optically transparent suspension of 40% reconstituted red cell ghosts in serum containing 2.5-micron-diameter latex spheres (3 x 10(5)/microliters) flowing through 100-microns-diameter tubes was used as a model of platelets in blood, and the results were compared with those obtained in a control suspension of latex spheres in serum alone. Two-body collisions between microspheres in the interior of the flowing ghost cell or serum suspensions at shear rates from 5 to 90 s-1 were recorded on cine film. The films were subsequently analyzed, and the measured doublet lifetime, tau meas, was compared with that predicted by theory in the absence of interactions with other particles, tau theor. The mean (tau meas/tau theor) for doublets in ghost cell suspensions was 1.614 +/- 1.795 (SD; n = 320), compared to a value of 1.001 +/- 0.312 (n = 90) for doublets in serum. Whereas 11% of doublets in ghost cell suspensions had lifetimes from 2.5 to 5 times greater than predicted, in serum, no doublets had lifetimes greater than 1.91 times that predicted. There was no statistically significant correlation between tau meas/tau theor and shear rate, but the values of tau meas/tau theor for low-angle collisions in ghost cell suspensions were significantly greater than for high-angle collisions.

Adenosine Diphosphate↗

Using the SCID-D to assess dissociative identity disorder in adolescents: three case studies.

The authors report on the diagnostic assessment of dissociative identity disorder in three adolescents using the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D; Steinberg, 1993b), a semistructured instrument for the diagnosis and assessment of dissociative symptoms and disorders. Although the SCID-D has received good-to-excellent ratings for reliability and validity in the adult population, these three cases are the first reports of the results of its administration to younger patients. Comparison of the three adolescent SCID-D interviews with findings in adults indicates that the profiles of the five dissociative symptoms measured by the SCID-D are virtually identical in adolescents and adults. The authors conclude with suggestions for future research regarding dissociative symptomatology in adolescents and outcome studies.

Adolescent↗

The interaction of ethanol with the cognitive enhancers tacrine, physostigmine, and AIT-082.

Because tacrine, a cognitive enhancing agent, was being considered for approval for use in Alzheimer's disease, its possible interaction with ethanol, a commonly used substance to which elderly individuals are generally more sensitive than younger individuals, was explored. For purposes of comparison, two other drugs, which have also been shown to improve memory in mice, at doses which had activity in a working memory paradigm, were evaluated for an interaction with ethanol. Ethanol-induced sedation in mice was increased by tacrine and decreased by physostigmine, whereas AIT-082 did not alter sedation. However, tacrine had no effect on body temperature or on ethanol-induced hypothermia. Neither tacrine nor physostigmine had any effect on the rate of ethanol elimination from the blood. As tacrine comes into clinical use in the treatment of Alzheimer's disease, adverse interactions with ethanol should be explored further.

Aminobenzoates↗

Cefetamet pivoxil vs cefaclor in the treatment of acute otitis media in children.

74 children with acute otitis media (AOM) were entered into an observer-blind randomised multicentre general practice study to compare the efficacy and safety of the new third generation oral cephalosporin, cefetamet pivoxil, at a dose of 10 mg/kg twice daily with the efficacy and safety of cefaclor 10 mg/kg twice daily administered for 10 days. Of 36 evaluable patients in the cefaclor treatment group, 28 (78%) were cured, and a further 4 were improved, giving an overall efficacy rate (cure/improvement) of 89%. Of 36 evaluable patients in the cefetamet pivoxil treatment group, 31 (86%) were cured, and a further 4 were improved, giving an overall efficacy rate of 97%. Adverse events were reported in 4 patients: 1 cefaclor recipient and 3 patients in the cefetamet pivoxil treatment group. Diarrhoea, the most frequently observed adverse event, occurred in both treatment groups. The study results indicate that cefetamet pivoxil and cefaclor appear to have similar efficacy and safety in the treatment of AOM in children.

Acute Disease↗

Effects of coping style on psychological reactions of low-income, minority women to colposcopy.

Patterns of coping and adjustment in 36 low-income, minority women with positive cytologic smears were assessed prior to diagnostic follow-up examination (colposcopy). Subjects were divided into high monitors (who attend to threatening cues) and low monitors (who avoid threatening cues) on the basis of their scores on the Miller Behavioral Style Scale, a well-validated measure of coping style. Multivariate analysis of variance showed that high monitors worried more about the seriousness of their condition, expressed more concern about the immediate sensory and procedural aspects of the diagnostic examination and felt more responsible for the onset and course of their disease as compared to low monitors. However, they were no more likely to be concerned about the overall importance or long-term consequences of their abnormal smears. Finally, high monitors displayed greater symptoms of intrusive and avoidant ideation in relation to their medical status. These results were independent of sociodemographic and medical confounding variables. Consistent with results in other populations, the findings suggest that it may be useful to assess attentional coping dispositions in minority populations with high-risk gynecologic conditions and to target psychosocial interventions accordingly.

Adaptation, Psychological↗

The terminally ill--secular and Jewish ethical aspects.

Many ethical, religious, social and legal dilemmas are involved in the care of dying patients. Major changes and developments in recent years have greatly intensified these moral problems. In this article a comprehensive analysis of the relevant principles and practical approaches is offered in order to enhance the ability of health care providers to attain morally sound decisions concerning the dying patient. The relevant ethical principles include the following: value of life, quality of life, nonmaleficence, beneficence, autonomy, paternalism, justice, and the physician's integrity. In practical terms, there are three major categories: the patient, the treatment and the decision maker. A comparative analysis between secular and Jewish attitudes towards the terminally ill patient has revealed significant differences both in the fundamental underlying principles as well as in the practical solutions to the diverse and difficult ethical problems.

Attitude to Health↗