Modern concepts in treating tuberculosis.
Explore the source record for details and available documents.
Ambulatory Care↗
Biomedical subjects
D A Solomon
Publications and source records attributed to D A Solomon.
A dynamic adaptation of the propensity score adjustment for effectiveness analyses of ordinal doses of treatment.
The propensity score adjustment is a method to reduce bias in observational studies. We propose a strategy that involves a novel combination of three data analytic techniques, which adapts the propensity adjustment for additional perturbations of longitudinal, observational studies. First, ordinal logistic regression examines propensity for ordinal doses of treatment. Second, a mixed-model approach incorporates the multiple treatment trials and multiple episodes that are characteristic of chronically ill subjects. Finally, a mixed-effects grouped-time survival model incorporates the propensity score in treatment effectiveness analyses. The strategy that is applied here to an observational study of affective illness can also be used to evaluate the effectiveness of treatments for other chronic illnesses.
Adolescent↗
Prodromal and residual symptoms in bipolar I disorder.
The objective of the current study was to better understand the nature of prodromal and residual symptoms of mania and depression, as reported by patients with bipolar I disorder and their family members. Prodromal and residual symptoms of mania and depression were elicited from 74 patients with bipolar I disorder. In 45 cases, an adult family member provided similar information. Three clinicians classified the symptoms into six broad categories: behavioral, cognitive, mood, neurovegetative, social, and other. The clinicians also categorized symptoms as typical or idiosyncratic. Seventy-eight percent of the patients reported prodromal depressive symptoms and 87% reported prodromal manic symptoms; greater than half of the patients disclosed residual symptoms of depression (54%) and mania (68%). Within each of these four illness categories, cognitive symptoms were consistently the most common symptoms reported by patients. A substantial number of symptoms were idiosyncratic, particularly those reported for residual depression. Agreement between patient and family members on reported symptoms was strong for the prodromal phase of both polarities, but less so for the residual phases. These preliminary results suggest that patients with bipolar I disorder and their family members can identify prodromal and residual symptoms, that these symptoms are quite common, and that prodromal symptoms may be more prevalent or easier to identify than residual symptoms. Cognitive symptoms were consistently the most common symptoms reported by patients.
Adult↗
Dual differentiation in small cell carcinoma (oat cell carcinoma) of the lung.
Two cases of small cell "undifferentiated" carcinoma (oat cell carcinoma) of the lung with dual neurosecretory and squamous differentiation are reported. One was treated with various regimens of chemotherapy and radiotherapy; the other was untreated at the time of biopsy. By electron microscopy, the same tumor cells showed membrane-bound, dense-core, neurosecretory-type granules and bundles of tonofibrils denoting squamous differentiation. This dual differentiation underlies the difficulty of ascribing an exclusively neural histogenesis to small cell carcinomas with neurosecretory-type granules. It is possible that entoderm-associated neuroectodermal tumors develop features of autochthonous entodermal tumors as a result of microenvironmental influences. An alternative hypothesis would be that small cell tumors are derived from basal reserve bronchoepithelial cells with pluripotentialities.
Aged↗
Chylothorax: report of a case complicating orthotopic heart transplantation.
We describe a case of a chylothorax that occurred in a 62-year-old man after orthotopic heart transplantation. Injury to collateral lymphatics in the anterior mediastinal or thymic areas was the probable cause of the chylous fistula. Excessive chyle drainage causes loss of large amounts of fat, protein, electrolytes, and lymphocytes. These losses further compromise the nutritional and immunologic status of the transplant patient. Conservative therapy with chest tube drainage and a strict medium-chain triglyceride diet allowed the chylous fistula to spontaneously close without the need for surgical intervention.
Chest Tubes↗