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Biomedical subjects

B Rosen

Publications and source records attributed to B Rosen.

At least 19 recordsLinked to original sources
PubMed1992

Analysis of the diminished skin perfusion in elderly people by laser Doppler flowmetry.

Clinical observations suggest an age-associated decline in skin perfusion but there are few quantitative in vivo data on skin perfusion at various ages. We studied skin perfusion of the dorsum of the foot by determining the capillary blood flow velocity (CBFV) expressed in millivolts (mV), using laser Doppler flowmetry, in ten young and 12 elderly men. Our data revealed that, at 32 degrees C skin temperature, the CBFV oscillations (vasomotions) are of higher median amplitude in young people than in elderly subjects: 9.4 mV (95% CI, 8.8-10.0 mV) and 4.6 mV (95% CI, 4.1-7.4 mV), respectively (p less than 0.05). The vasomotion frequency was similar in both age groups. At 44 degrees C skin temperature, the median CBFV peak in the young was 163 mV (95% CI, 128-192 mV), as opposed to 102 mV (95% CI, 92-124 mV) in the aged subjects (p less than 0.0005). The median increment in CBFV, driven by every heart beat, was also higher in the young age group: 86 mV (95% CI, 76.4-96.0 mV) compared with the elderly group: 63 mV (95% CI, 50-72 mV, p less than 0.005). Considering the fact that the magnitude but not the pattern of skin perfusion varied between the two groups, we conclude that ageing is associated with loss of capillary plexus functional units, and therefore the skin perfusion is lower in aged people.

Adult↗
PubMed1990

Reduced adipsin mRNA and circulating adipsin protein are modulated by adrenal steroids in obese Zucker rats.

We investigated expression of the adipose-specific serine protease adipsin in genetically obese Zucker rats and whether adrenalectomy modifies expression. Adipsin mRNA levels were determined by slot blot and Northern blot analysis of total RNA samples extracted from epididymal adipose tissue and isolated retroperitoneal adipocytes of obese (fa/fa) and homozygous lean (Fa/Fa) Zucker rats. Both 30-day-old and 4-mo-old animals were analyzed in experiment 1. In experiment 2, 10-wk-old obese and lean rats were either bilaterally adrenalectomized or sham operated, and adipsin mRNA levels were determined on tissue and cell samples 2 wk postsurgery. In both experiments, serum adipsin protein was determined by Western blot analysis and plasma insulin by radioimmunoassay. The data show that both adipsin mRNA and adipsin protein are reduced in obese compared with lean rats and that adrenalectomy restores these values toward normal in obese rats. The data thus suggest that adrenal steroids are involved in modulating adipsin expression in obese Zucker rats and that insulin may be an intermediary factor in such modulation.

Adipose Tissue↗
PubMed1989

Concurrent radiation and chemotherapy in vulvar carcinoma.

Between June 1984 and February 1988 the role of radiation with concurrent infusional 5-fluorouracil with or without mitomycin C (CT-RT) was examined in 33 patients with vulvar cancer. The median duration of follow-up is 16 months (range 5 to 45 months). Nine received adjuvant postsurgical CT-RT and none has relapsed in the radiation field. Seven are alive disease free. Two have died of distant metastases. Of the 9 receiving definitive primary CT-RT, 6 had initial complete response with subsequent vulvar relapse developing in 3. Seven of the 9 remain disease free after CT-RT alone (in 3) or with the addition of a local excision of residual or recurrent disease (in 6). One patient did not respond to CT-RT and required a radical vulvectomy and groin node dissection. Fifteen received CT-RT for disease recurrence following primary surgery. Disease was present in the vulva only in 11, vulva and inguinal nodes in 1 and nodes only in 3. Eight of the 15 had a complete response and no relapses occurred in the treated sites. Four of the 8 dying of disease developed pulmonary metastases. Serious late complications developed in 2 patients, 1 avascular hip necrosis and 1 proctitis requiring a defunctioning colostomy. CT-RT appears tolerable and may contribute to enhanced locoregional control in recurrent or advanced disease. As initial therapy it may allow lesser surgery with preservation of normal anatomy in selected primary vulvar cancers.

Adenocarcinoma↗
PubMed1989

Professional reimbursement and professional behavior: emerging issues and research challenges.

The decisions and actions of health care professionals have a major impact on such health care outcomes as cost, quality and equity. It is widely believed that professional behavior is determined, in part by how and how much they are paid. Professionals can respond to reimbursement incentives at both the individual level (treatment decisions, referral patterns, specialty choice, etc.) and at the level of the professional association. Health care analysts usually identify and discuss three principal reimbursement modes: salary, capitation, and fee-for-service. Mixed systems are proliferating and need to be evaluated. Payment levels are determined by a mix of equity, market, and political considerations. They are believed by many to influence the behavior of providers, who are thought to act so as to preserve target incomes. The target income hypothesis has been tested for the case of physicians operating in a fee-for-service environment. The impact of changes in reimbursement levels on the behavior of other groups of professionals and on the behavior of professionals working in other reimbursement modes remains unclear. Both policy-makers and researchers need to broaden the way in which they think about professional reimbursement. To date, the field has been dominated by economists, inquiry has focused heavily on physicians, and empirical work has emphasized those dimensions of outcome which are most easily measured. Changes in the organization of health services and in society-at-large intensify the need for a broader view.

Decision Making, Organizational↗
PubMed1988

Complete atrioventricular block induced by methyldopa.

We present two patients who developed complete heart block due to treatment with methyldopa. After discontinuing methyldopa, conduction disturbances completely disappeared and recurred upon rechallenge with the medication. It is assumed that methyldopa can impair the myocardial conduction system by its central sympatholytic effect. Conduction anomalies should be excluded prior to treatment with methyldopa, and during treatment with the medication, the patients should be routinely screened for the presence of conduction anomalies.

Aged↗
PubMed1987

Comparison of the effects of antihypertensive drugs on pre- and postglomerular vessels of the hydronephrotic kidney.

The in vivo renal microvascular effects of three antihypertensive drugs: nitrendipine, a calcium entry blocker, and two direct-acting vasodilator agents, hydralazine and minoxidil, were compared. The dilator responses of pre- and postglomerular vessels were directly observed after the topical or intravenous administration of each drug using the hydronephrotic kidney preparation and television microscopy. When applied directly to the kidney to avoid changes in systemic blood pressure, all three drugs preferentially dilated the preglomerular vessels. The largest increases in preglomerular vessel diameters were observed with nitrendipine followed by hydralazine and minoxidil, in the order listed. These drugs produced little change in efferent arteriole diameters though acetylcholine evoked significant dilator responses of the same vessels. When infused intravenously to lower blood pressure, the predominant effect of the drugs was on the afferent arteriole. No significant changes in the efferent arteriole diameter were observed with any drug. These data demonstrate that these vasodilators, which act primarily at preglomerular sites, probably increase glomerular capillary pressure, but to differing degrees.

Administration, Topical↗
PubMed1979

Comparison of the clinical effectiveness of "short" versus "long" stay psychiatric hospitalization. IV. Predictors of differential benefit.

One hundred seventy-three patients were randomly assigned to LT (long term, unlimited length of stay, mean 179 days) vs. ST (short term, 90-day limit) psychiatric hospitalization. Three-year follow-up results showed few between-group differences, although LT patients tended to be rehospitalized more and had superior relative ratings of psychopathology. Demographic and clinical data did not predict differential benefit from LT or ST hospitalization. Diagnosis did not generally predict differential benefit either, except that clinically diagnosed personality disorders, given LT as opposed to ST hospitalization, had poorer role functioning and less psychiatric treatments after discharge. Patients with a history of drug abuse did worse if given LT hospitalization in terms of role functioning and rehospitalization. Overall, this study agrees with other relevant studies in indicating that hospitalization should be kept as short as feasible.

Adjustment Disorders↗
PubMed1979

A method of structured brief psychotherapy.

Structured brief psychotherapy is a method of organizing treatment along problem-solving lines. The features of this method are the selection of problem areas, the translation of insight into specific activity, the structuring of psychodynamics and a concentration on termination events. The method is illustrated by clinical examples.

Adult↗
PubMed1978

Contract therapy.

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Behavior Therapy↗