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Biomedical subjects

B Rosenbaum

Publications and source records attributed to B Rosenbaum.

At least 19 recordsLinked to original sources
PubMed2006

Prospective investigations of the prodromal state of schizophrenia: review of studies.

OBJECTIVE: The paper presents a comprehensive overview of prospective studies monitoring or intervening in the pre-onset phase of first episode psychosis. METHOD: A systematic literature search was conducted and supplemented by a manual search. All relevant studies were ordered and intensively reviewed according to specified criteria. Methodological and conceptual issues are discussed. RESULTS: Reports of 23 prospective studies were found, some describing subsamples of larger samples. Major methodological and conceptual divergences exist. CONCLUSION: Applied criteria detect individuals with a significantly increased risk of psychosis within the schizophrenia spectrum, but these criteria are only validated on clinical populations. The significance of differences in sample-characteristics is unclear. Most study samples are small. Results are preliminary and in need of further research before they constitute a realistic knowledge base. Methodological and conceptual issues should not be underestimated.

Humans↗
PubMed2006

Prospective investigations of the prodromal state of schizophrenia: assessment instruments.

OBJECTIVE: To review assessment instruments used for detection of prodromal or at-risk mental states, and discuss their role in current research. METHOD: A systematic electronic literature search was conducted and supplemented by a manual search. All relevant scales were selected for the purpose of the review. RESULTS: Six interviews and four screening instruments were found. Two main traditions are prevailing: the Attenuated Positive Symptoms approach and the Basic Symptoms approach. Reports of psychometric properties of the interviews are preliminary. CONCLUSION: The instruments detect individuals with an increased risk of psychosis in clinical populations, but predictive validity and measures of reliability is insufficiently evaluated. Studies including instruments from both traditions should be conducted, in order to obtain an empirical basis of hypothesized relations between instruments. Instruments elucidating phenomenological aspects of anomalies in self-experience may contribute with valuable data on the pre-onset phase of psychosis.

Humans↗
PubMed2004

Suitability for psychoanalytic psychotherapy: validation of the Dynamic Assessment Interview (DAI).

OBJECTIVE: To examine the predictive validity of a particular interview and rating scale of patient suitability for psychoanalytic psychotherapy: The Dynamic Assessment Interview (DAI) scale. METHOD: Seventy-four psychiatric out-patients were interviewed with the DAI and the associations between DAI-scores and measures of outcome and of therapeutic alliance were investigated. RESULTS: Small to moderate correlations were found between the DAI suitability score and outcome (0.06-0.46) and between DAI suitability score and early rated alliance (0.14-0.45). The predictive value of the DAI-score was limited although on a par with the alliance measures used in the study. No other pretherapy predictor variable investigated was found significantly to predict outcome. CONCLUSION: The predictive power of the DAI measure was limited, a result, which is in agreement with results from former studies on suitability.

Adolescent↗
PubMed1998

Population densities of Sulawesi crested black macaques (Macaca nigra) on Bacan and Sulawesi, Indonesia: effects of habitat disturbance and hunting.

Population surveys of Sulawesi crested black macaques (Macaca nigra) were conducted on the Indonesian islands of Sulawesi and Bacan in 1992-1994 to assess the status of natural populations and determine habitat and anthropogenic factors affecting their population densities. We surveyed five sites for primates, including undisturbed and disturbed habitats. Data were collected on habitat structure and composition at two undisturbed and one disturbed forest site in which the primates were surveyed. The highest density of macaques was found in primary forest at Gunung Sibela Nature Reserve on Bacan (170.3 individuals/km2). Population density in logged forest on Bacan was high but significantly less than primary forest (133.4 individuals/km2). The high density of crested black macaques in primary forest on Bacan is best explained by the high carrying capacity found in primary forest. The lower food quantity and quality of food resources found in logged forest correlated with lower primate densities compared to primary forest. However, the large population of macaques in logged forest demonstrates the conservation value of such forest. Densities on Sulawesi at Tangkoko-Batuangas-DuaSudara Nature Reserve (TBDS) showed a continuing decline since earlier surveys. Primate densities were highest near the protected center of Tangkoko Reserve (66.7 individuals/km2). The peripheral areas of Batuangas and DuaSudara, even though adjacent and continuous, showed lower population densities of 46.4 and 23.5 individuals/km2, respectively. The best explanation for the continued decline of Macaca nigra populations at TBDS is hunting. Unless conservation measures are implemented immediately, M. nigra on Sulawesi risks extinction in the near future.

Animals↗
PubMed1998

Cerebrospinal fluid free choline in movement disorders of paediatric onset.

We measured free choline in cerebrospinal fluid (CSF) of 78 patients with movement disorders of paediatric onset and various controls as a putative index of central phospholipid metabolism. Most of the disorders studied were myoclonic disorders, such as progressive myoclonus epilepsy, the opsoclonus-myoclonus syndrome, and essential myoclonus, but other movement disorders, interictal seizure disorders, and different neurological and nonneurological disorders were also included. There were no significant differences in CSF choline concentrations in myoclonic disorders or other movement disorders compared with controls. The CSF choline levels were lowest in children with seizure disorders including progressive myoclonus epilepsy. In progressive myoclonus epilepsy, the CSF choline values resembled other epileptic disorders rather than other myoclonic disorders. When all the data were analysed collectively, no significant relation of CSF choline was found to patient age, gender, aliquot of CSF measured, or the length of time the sample was stored at -70 degrees C. Separate analyses of data from children and adults showed a trend toward a biphasic relation between patient age and CSF choline which could be pursued in developmental studies of normal subjects. Reduced CSF choline may indicate increased choline incorporation into brain phospholipids, disturbances of choline metabolism, decreased choline release, or non-neural factors.

Acetylcholine↗
PubMed1997

The Dynamic Assessment Interview: testing the psychodynamic assessment variables.

The Dynamic Assessment Interview (DAI) is a semi-structured interview with anchored scales to rate patients; suitability for psychodynamic psychotherapy. The DAI was inspired by the Personality Assessment Interview developed by Selzer et al. in 1987 and it introduces from the beginning of the assessment interview an explicit focus on the patient's immediate interactions with the interviewer. Seven theoretical derived variables are assessed, namely psychological mindedness, capacity for self-observation, capacity for empathy, tolerance of frustration, motivation, response to confrontation, and ability to contain and work with affect. In addition, the patient's attractiveness as a psychotherapy patient and his or her assumed confidence in the forthcoming treatment are assessed. The patient's personality organization ad modum Kernberg is measured from a global assessment of the interview. The present paper describes the DAI and presents its psychometric properties. An acceptable level of inter-rater agreement was found for the theoretically derived variables and for the personality organization diagnosis, with intra-class correlations or kappa coefficients ranging from 0.68 to 0.80.

Adult↗
PubMed1996

Containers, mental space and psychodynamics.

The concept of the container has a place within cognitive science as well as within psychodynamic theories. Cognitive semantics has shown that many metaphors giving meaning to daily life-events use the container as a basic reference point. Psychoanalytic theory, most notably, Freud's psychosexual developmental model, illustrates how the container of the body results in meaning. Object relations theory in psychoanalysis has shown how patients with borderline personality disorder behave according to the dynamics of container and containment. Both the cognitive and the psychodynamic conceptions of containers are clinically relevant. The fundamental notion of the container leads to an exploration of 'container dynamics' both in cognitive semantics and in psychodynamic work. A model of the cusp may be of help in the description of the dynamics at the border of the container. Furthermore, the descriptions of the patient's communication of emotion and thoughts may involve three interacting dimensions: an effective-perceptual dimension, a phantasy dimension and a socio-interactive dimension. The interaction between these dimensions has implications for dealing with container dynamics and the process of containment.

Borderline Personality Disorder↗
PubMed1994

In vitro susceptibilities of rapidly growing mycobacteria to newer antimicrobial agents.

The in vitro antimicrobial susceptibilities of 42 isolates of rapidly growing mycobacteria (Mycobacterium fortuitum, M. chelonae, and Mycobacterium species [other than M. fortuitum and M. chelonae]) to nine quinolones, including newer agents, two new aminoglycosides, and an aminocyclitol (trospectomycin) were determined by a broth microdilution method. The new quinolones, PD 117596, PD 127391, and PD 117558, showed excellent in vitro activities against M. fortuitum (MICs for 90% of isolates [MIC90s], 0.06, 0.06, and 0.12 microgram/ml, respectively). The MIC90 of ciprofloxacin for M. fortuitum was 0.5 microgram/ml. Only 14 to 28% of isolates of M. chelonae were susceptible to various quinolones. Most isolates of all three species were susceptible to the new aminoglycosides SCH 21420 and SCH 22591. The MIC90s of trospectomycin were 8 micrograms/ml for M. chelonae, 32 micrograms/ml for Mycobacterium species, and > 64 micrograms/ml for M. fortuitum.

4-Quinolones↗
PubMed1993

[Ambulatory psychiatry--a follow-up after 1 year].

This article describes the results of a one year follow-up investigation of patients suffering from psychiatric and mental diseases and psycho-social problems who were seen in general practice or by private practising psychiatrists and the psychiatric outpatient hospital clinic in a Danish county. 40-50% of the patients concluded treatment within the first year. The general practitioner and the private practising psychiatrist saw 10% of the patients more than 13 times. In the outpatient hospital clinic, 10% of the patients were seen more than 29 times. A psychotherapeutic approach to treatment was employed for 54-90% of the cases. Psychopharmacological medication was administered to 54-60% of the patients. Where patients in general practice and in the outpatient clinic were concerned, treatment in an emergency open unit and treatment in sheltered environments was required and supervision was necessary for 1/4 of the cases. The investigation demonstrates the role of the general practitioner in treatment and referral. After one year 25% of the patients were referred for other treatment. The general practitioner, private practicing psychiatrist and outpatient clinic treat different groups of psychiatric patients and work somewhat independently of one another.

Adolescent↗
PubMed1993

Correlation between susceptibility to demyelination and interferon-gamma induction of major histocompatibility complex class II antigens on murine cerebrovascular endothelial cells.

The induction of major histocompatibility complex (MHC) Class II expression was studied on cerebrovascular endothelial cells (CVE) obtained from strains of mice that are resistant (BALB/c) and susceptible (SJL and CBA) to Theiler's virus-induced demyelination (TVID). Following 24 h treatment with interferon (IFN)-gamma, MHC Class II was induced on CVE derived from susceptible but not resistant strains of mice. However, IFN-gamma induced the expression of MHC Class II on late passages of BALB/c CVE. These results demonstrate a correlation between susceptibility to demyelination and the ability of IFN-gamma to induce the expression of MHC Class II on CVE. In susceptible strains of mice, the presence of activated, IFN-gamma-secreting T cells, in the vicinity of CVE would increase the antigen-presenting capabilities of CVE and result in increased T cell traffic into the central nervous system.

Animals↗
PubMed1993

In vitro activities of free and liposomal drugs against Mycobacterium avium-M. intracellulare complex and M. tuberculosis.

We compared MICs and MBCs of various free- and liposome-incorporated antimicrobial agents against several patient isolates of Mycobacterium avium-M. intracellulare complex and certain American Type Culture Collection strains of M. avium, M. intracellulare, and Mycobacterium tuberculosis. Seven of 19 agents were selected for incorporation into liposomes. The MICs of these agents for 50 and 90% of isolates tested (MIC50s and MIC90s, respectively) ranged from 0.5 to 62 micrograms/ml. Members of the M. avium-M. intracellulare complex were resistant to killing by most of the other agents tested in the free form. However, clofazimine, resorcinomycin A, and PD 117558 showed complete killing of bacteria at concentrations ranging from 8 to 31 micrograms/ml, represented as MBC90s. Among the liposome-incorporated agents, clofazimine and resorcinomycin A had the highest killing effects (MBC90s, 8 and 16 micrograms/ml, respectively). Furthermore, both free and liposome-incorporated clofazimine had equivalent growth-inhibitory and killing effects on all American Type Culture Collection strains of M. avium, M. intracellulare, and M. tuberculosis tested. These results show that the antibacterial activities of certain drugs, particularly those of clofazimine and resorcinomycin, were maintained after the drugs were incorporated into liposomes.

Anti-Bacterial Agents↗
PubMed1993

Comparative efficacies of cilofungin (Ly121019) and amphotericin B against disseminated Candida albicans infection in normal and granulocytopenic mice.

The efficacies of cilofungin (Ly121019), a semisynthetic lipopeptide antifungal agent, and amphotericin B in the treatment of disseminated candidiasis in normal and neutropenic mice were compared. In mice infected with 2 x 10(6) CFU of Candida albicans, treatment with cilofungin in twice-daily doses of 25 or 35 mg/kg of body weight by intraperitoneal injection for 10 days gave survival rates of 83 and 90%. In contrast, there was 97% mortality in infected controls receiving 2 x 10(6) CFU intravenously and 93% survival in mice treated with 1 mg of amphotericin B per kg once a day. Mice rendered granulocytopenic by the administration of cyclophosphamide showed survival rates of 83 and 80% when treated with 25 or 35 mg of cilofungin per kg for 10 days compared with 43% survival rate in mice treated with 1 mg of amphotericin B per kg (P = 0.0030 and P = 0.0080, respectively). Similar results were obtained when the two antifungal agents were administered for a period of 30 days. Administration of 25 or 35 mg of cilofungin per kg twice a day to granulocytopenic mice receiving 10(6) CFU of C. albicans gave survival rates of 93% and 93% compared with 53% survival with amphotericin B. With 15 mg of cilofungin per kg twice a day for 10 days, a survival rate of 43 to 50% was observed in both normal and granulocytopenic mice compared with 56 and 60%, respectively, when this dosage was continued for 30 days. Cilofungin eradicated C. albicans from the kidneys, spleens, and livers of surviving animals. No toxic effects were observed with any of the dosage regimens used. The clearance of C. albicans from the kidneys, spleens, livers, and brains in normal mice was studied following infection with 5 x 10(5) and 1 x 10(5) intravenously. The mice in the treatment groups received 25 mg of cilofungin per kg twice a day for 10 days. In 8 to 12 days, this treatment was able to clear the organisms from the kidneys, spleens, and livers of mice infected with 5 x 10(5) C. albicans. Mice infected with 10(5) C. albicans and treated with cilofungin (25 mg/kg) twice a day for 10 days had no organisms in the kidney, spleen, and liver at days 8, 2, and 8, respectively. There was 1-log-unit reduction in C. albicans counts in brain tissue from mice of one of the treated groups between 2 h and 2 days postinfection, after which the numbers of organisms remained the same until day 12. These data demonstrate the efficacy of cilofungin in the treatment of disseminated C. albicans infections in normal and granulocytopenic mice. The treatment regimen used in this study was able to clear C. albicans from the kidneys, spleen, and liver but not from brain tissue.

Agranulocytosis↗
PubMed1993

In vitro antimicrobial susceptibilities of Nocardia species.

The in vitro activities of various quinolones, two new aminoglycosides, a new cephamycin analog (cefmetazole) and a new spectinomycin analog (trospectomycin), imipenem, and trimethoprim-sulfamethoxazole against 26 isolates of Nocardia asteroides, 7 isolates of N. brasiliensis, and 6 isolates of N. caviae were determined by a broth microdilution method. The three new quinolones, PD 117558, PD 117596 and PD 112739, inhibited 90% of N. asteroides at 1 to 2 micrograms/ml, and two new aminoglycosides, SCH 21420 and SCH 22591, inhibited 90% of N. asteroides at 2 to 4 micrograms/ml. Among the beta-lactams, cefmetazole was more active than imipenem. N. brasiliensis and N. caviae isolates were also very susceptible to the three quinolones (MICs for 50% of the isolates, 0.25 to 1 microgram/ml) and the two aminoglycosides (MICs for 50% of the isolates, 1 to 2 micrograms/ml). Cefmetazole was moderately active against N. brasiliensis, whereas imipenem showed poor activity against both of these species.

4-Quinolones↗
PubMed1993

Nonwound infections following head and neck oncologic surgery.

Little information exists regarding the comorbidity of postoperative nonwound infections (NWIs) in patients with head and neck cancer. Prospectively, 225 patients were randomized in a double-blind fashion to receive either clindamycin or ampicillin sodium/sulbactam sodium for prevention of postoperative wound infection. Of the 113 patients receiving clindamycin, 14 developed nonwound infections, compared with 10 of 112 patients receiving ampicillin/sulbactam. A single site of nonwound infection occurred in 21 patients, and 2 sites occurred in 3 patients. The majority of infections were pulmonary (22), followed by urinary tract (3), septic phlebitis (1), and acute sinusitis (1). Gram-negative organisms were isolated more frequently among patients on clindamycin (18) versus ampicillin/sulbactam (6) (P = .014). Risk factors for pulmonary nonwound infection included: longer surgery, a greater than 70 packs per year smoking history, blood transfusion, and hypoalbuminemia (P < .05). Nonwound infections produce significant postoperative morbidity and the predominance of gram-negative organisms isolated from these infections has therapeutic implications.

Adolescent↗