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Biomedical subjects

D Liberman

Publications and source records attributed to D Liberman.

At least 19 recordsLinked to original sources
PubMed1996

Effects of maximum performance instructions on the sentence completion test of ego development.

This modified replication of Jurich and Holt's (1987) test-retest study investigated the stability of scores on the Washington University Sentence Completion Test (SCT; Loevinger, 1985; Loevinger & Wessler, 1970; Loevinger, Wessler & Redmore, 1970) across alternate instructional formats. Initially, 90 adult participants completed the SCT using standardized instructions. After a 1-week interval participants were readministered the SCT based on random assignment to either a standardized instruction (control) group, a role-play instructional set, or a best-effort instructional set. A repeated measures multivariate analysis of variance yielded statistically significant differences in ego level scores across the 3 instructional sets. The differences in ego level scores were approximately one-half level higher for the role-play and best-effort instructional sets. Effect sizes for the experimental instructional sets ranged from .23 using item sum scores to .45 using total protocol ratings. Results are supportive of Jurich and Holt's (1987) findings, indicating that the standardized instruction SCT may be susceptible to the motivational set of the test-taker.

Adult↗
PubMed1992

The association between patterns of family functioning and ego development of the juvenile offender.

The present study revealed an association between the family configurations of cohesion and adaptability and juvenile offenders' level of ego development. This association was explained by four post hoc comparisons which revealed that functional perspectives of family cohesion and adaptability by the juvenile offender and one or both parents were associated with higher levels of ego development. Lower levels of ego development were associated with (a) shared dysfunctional perspectives of the family dimensions by the juvenile offender and both parents, and (b) a functional perspective of the family dimensions by the juvenile offender which was not shared by either parent. These results were based on 61 nonchronic juvenile offenders and their parents who were assessed by the Family Adaptability and Cohesion Evaluation Scales II. The offenders' level of ego development was assessed by the Washington University Sentence Completion Test.

Adolescent↗
PubMed1991

Effect of digoxin on respiratory muscle performance in patients with COPD.

The effect of 2 weeks oral digoxin administration on respiratory muscle performance (RMP) in 14 patients with chronic obstructive lung disease (COPD) was investigated in a randomized double-blind placebo-controlled cross-over study. All patients were ambulatory with severe air flow obstruction. FEV1/FVC was 0.44 +/- (SD) 0.11, FEV1 was 0.88 +/- (SD) 0.35 liter/s RMP was assessed by measuring maximal inspiratory pressure (PImax), maximal expiratory pressure (PEmax), and maximal voluntary ventilation. Although these parameters were significantly reduced in the COPD patients, 2 weeks of digoxin administration (with serum levels in the therapeutic range) did not alter any parameter of RMP or spirometry. We conclude that digoxin has no effect on RMP or spirometry in ambulatory patients with severe COPD.

Adult↗
PubMed1991

Comparison of a B2 adrenergic agonist and an anticholinergic agent given by sequential inhalation in patients with severe chronic obstructive pulmonary disease.

We evaluated the response of 15 male patients with severe chronic obstructive pulmonary disease (COPD) to sequential inhalations of an anticholinergic agent, ipratropium bromide 0.25 mg (IB) and a B2 adrenergic agonist, terbutalin 2.5 mg (TER), in a double-blind crossover study. We found no statistically significant difference in the bronchodilatory response between the two agents when comparing the change in forced vital capacity and forced expiratory volume in 1 sec. The subsequent effect of the sequential inhalation demonstrated some additional bronchodilatory response when IB was given after TER, but not when TER was given after IB. However, the end result after the two protocols was not statistically different. The results indicate that in COPD patients the two agents are equipotent. However, in order to prescribe the best treatment schedule for each patient, it is still necessary to evaluate how each individual patient responds to each of the agents. Sequential inhalation may be beneficial in some patients.

Adrenergic beta-Agonists↗
PubMed1989

Long-term survival of patients with chronic obstructive pulmonary disease following mechanical ventilation.

Fifty patients with chronic obstructive pulmonary disease (COPD) who survived their first artificial ventilation were followed for 15 years. Five-year survival was 30%, median survival 23.5 months, and average survival 44.9 months. Sudden death occurred in 47% of the patients (40% at home and 7% in the hospital). Using multivariate analysis, survival correlated positively and significantly with partial pressure of arterial oxygen (PaO2) on discharge (P less than 0.02), presence of wheezes or rhonchi (P less than 0.02), absence of right heart failure on admission (P less than 0.02), and male sex (P less than 0.05), and negatively with age (P less than 0.03). Sixty percent of the patients were artificially ventilated at least twice. Prognosis was better as the number of ventilations increased after the first ventilation. Our finding that discharge PaO2 was the factor that correlated best with survival suggests that treatment for these patients consist of continuous long-term use of domiciliary oxygen.

Cause of Death↗
PubMed1988

Immunological studies of pancytopenia in visceral leishmaniasis.

We report three cases of combined anemia, neutropenia and thrombocytopenia in patients with visceral leishmaniasis (kala-azar). Using immunofluorescence techniques and the common antiglobulin (Coombs') test, we showed membrane-associated antiplatelet, antineutrophil and antierythrocytic IgG antibodies in all three cases. Treatment with sodium stibogluconate raised the patients' platelet, neutrophil and erythrocyte count. At that time no antibodies were detected on peripheral blood cells. Immunological studies performed on these patients did not show marked abnormalities except for reduced T-helper cells and elevated OKM1-positive cells, which normalized after recovery. As bone marrow suppression was not found, it is suggested that pancytopenia resulted from rapid destruction of antibody-coated blood cells. Whether these antibodies are specific is not clear.

Adolescent↗
PubMed1986

Changing pattern of lung tuberculosis.

In 46 (20%) of 233 consecutive patients with active lung tuberculosis, the localization of the tuberculous process was unusual. The majority of patients (81%) were greater than 40 years of age. Men predominated in the usual localized tuberculosis group, whereas women predominated in the group with unusual localized tuberculosis (UNLT). The most common site of tuberculosis in the UNLT group was the anterior segment of the upper lobe or the middle lobe. In 17.5% of the patients in the UNLT group, the diagnosis was established by thoracotomy only. In patients with "protracted pneumonia," or chest X-ray suggestive of neoplastic disease, tuberculosis should be included in the differential diagnosis, irrespective of the site of the lesion.

Adolescent↗
PubMed1984

Exercise-induced left ventricular dysfunction in young men with asymptomatic diabetes mellitus (diabetic cardiomyopathy).

Radionuclide ventriculographic studies were performed at rest and during exercise on 30 consecutive men, aged 21 to 35 years with diabetes mellitus without evidence of coronary artery or any other cardiovascular disease, and in 20 normal age-matched subjects. Sixteen (53%) were treated with insulin and 14 (47%) were treated with either diet (6 patients) or oral antidiabetic therapy (8 patients). All patients from both groups had normal left ventricular (LV) ejection fraction (EF) at rest. In 5 of the 30 diabetic patients (17%), LVEF decreased after exercise, in 8 (27%) it remained unchanged and in 17 it increased normally. Mean LVEF at rest and after exercise in this group was 66 +/- 7% and 72 +/- 7% (+/- standard deviation), respectively. In all normal subjects, LVEF increased after exercise. Mean LVEF at rest and after exercise in the normal group was 66 +/- 7% and 76 +/- 9%, respectively. No patient had evidence of regional dysfunction at rest or after exercise. LV function was not related to serum glucose levels during the test, modality of treatment, insulin dependency or duration of the disease. Three of 4 patients with diabetic microvascular complications showed LV dysfunction. In 4 of 5 patients in whom LVEF decreased after exercise, thallium studies showed normal perfusion. Thus, diabetes mellitus may cause exercise-induced global LV dysfunction in young men with no evidence of cardiovascular disease. This phenomenon apparently does not seem to follow the known course of diabetic microvascular complications.

Adolescent↗
PubMed1982

A computer-assisted surgical pathology system.

SURPATH is a comprehensive, integrated computer-assisted system for service, research, and management in surgical pathology that has been in use at New England Medical Center (NEMC) since July 1, 1978. Functions of the system include: maintenance of patient-name and diagnostic files; generation, editing, and printing of preliminary and final specimen reports; SNOMED coding and indexing of diagnoses; retrieval and video display or printing of data on individual cases or groups of cases; billing and generation of billing reports; and, calculation of intervals between accession and signout of specimens. Use of the system has greatly facilitated the production of surgical pathology reports; increased the spread with which inquiries about individual specimens can be answered; provided rapid, accurate searches of the diagnostic files; improved timeliness, accuracy, and completeness of billing resulting in increased departmental revenue; reduced intervals between accession and reporting; and, improved the morale of the professional and support staffs.

Computers↗
PubMed1981

[Transtracheal aspiration in pulmonary infections].

Transtracheal aspiration (TTA) was performed 35 times in 33 patients with acute pulmonary infections. The indications for the procedure included pulmonary infection in immune-depressed or debilitated patients in whom the pathogenic organism could not be identified, either because of lack of sputum or suspected over-colonization of the oral cavity. The procedure was performed under full sedation with diazepam (Valium), by introducing a catheter (Intracath) through the cricothyroid membrane into the trachea, without local anesthesia. This modification markedly reduces the cough reflex and complications like subcutaneous emphysema and bleeding. Only two of our cases developed subcutaneous emphysema. The procedure enables the physician to make accurate and rapid therapeutic decisions and is recommended as a diagnostic tool.

Diazepam↗