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Biomedical subjects

D Shapiro

Publications and source records attributed to D Shapiro.

At least 19 recordsLinked to original sources
PubMed1992

Continuous physiological changes and subjective reports in panic patients: a preliminary methodological report.

Six panic disorder patients and six matched control subjects were studied using a new technique allowing continuous and simultaneous monitoring of physiological responses (blood pressure, heart rate, respiration) and subjective reports of anxiety and panic. This was done before, during, and after CO2 inhalation. Panic patients had significantly higher variability in their heart rate, blood pressure, and breathing rate than the control subjects. They also had irregular breathing patterns with frequent pauses. We identified three different patterns of response to CO2 inhalation in the panic patients. Some patients who panicked on CO2 showed a definite association between changes in physiological responses that preceded their subjective ratings of anxiety; however, others did not show this pattern. The possibility of different physiological mechanisms of panic in different patients is discussed.

Adolescent↗
PubMed1992

Sarcomas of the flexor fossae in children: is amputation necessary?

Successful management of sarcomas of the extremities in children implies not only achievement of local control but also satisfactory function and maintenance of the growth potential. The popliteal and antecubital fossae, because of their complex neurovascular anatomy, all of which is essential, make resection with satisfactory margins difficult. We reviewed our experience with 14 patients (3 to 20 years old; median, 13 years) with soft tissue sarcomas arising in the popliteal (11 patients) or antecubital (3 patients) fossae. There were four rhabdomyosarcomas (3 alveolar, 1 embryonal) and 10 other sarcomas, the most frequent being synovial sarcoma (5 patients). Chemotherapy was given to all patients with rhabdomyosarcomas. The one patient presenting with metastatic disease was treated, after biopsy of the primary, by chemotherapy and radiation and survived 21 months. In three patients, the primary management was an above-the-knee amputation and two of three survived (3 and 43 months). In 10 patients a wide local excision of the primary tumor was performed. Radiation therapy was administered to five, either as external beam (3 patients) or as brachytherapy (2 patients). In this group, there were no local recurrences. Four patients remain free of disease (4 months to 18 years) and one developed pulmonary metastasis. Among the five non-irradiated patients, three developed local recurrences, requiring above-the-knee amputation for disease. The fourth patient relapsed in the lung and only one of the five is free of disease at 36 months. Of the 8 patients not treated with amputation, one acquired a leg length discrepancy, which required correction, and one has a minimal extension deficit of the knee.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Molecular biology mechanisms in the radiation induction of pulmonary injury syndromes: interrelationship between the alveolar macrophage and the septal fibroblast.

Pulmonary fibrosis is a crippling, essentially lethal chronic disease due to an interplay of events following irradiation between the pneumonitic and fibrotic phases. In this series of experiments it is demonstrated that there is no latent period after irradiation, but an immediate intercellular communication system which springs into action to initiate recovery. Latency was only a function of our inability to uncover the molecular events that precede and underlie the clinical pathologic course of organ/tissue irradiation. Current advances in understanding the production of growth factors by different cells provides new insights to autocrine, paracrine and endocrine messages as a basis for understanding radiation pathophysiology as a progressive process that is amplified by other injurious events such as chemotoxicity. This is the first demonstrated release of trophic factors (cytokines) after in vivo irradiation that persists up to a month after exposure, suggesting that the persistence of a small incremental stimulus during a silent "latent" period can be the basis for the clinical pathologic expression of a late radiation effect, that is, pulmonary interstitial fibrosis.

Animals↗
PubMed1992

Immunological variability associated with experimentally-induced positive and negative affective states.

Functional and phenotypic immunological parameters were examined immediately before, after, and 30 minutes after experimentally-induced short-term positive (happiness) and negative (anxiety, depression) affective states and a neutral state, in five healthy subjects. Results indicated that all affective states induced more immune fluctuations (regardless of the direction) than the neutral state. Furthermore, among the affective states, anxiety induced the most immunological variability and depression the least.

Adult↗
PubMed1992

Ambulatory blood pressure and heart rate in healthy male paramedics during a workday and a nonworkday.

Compared ambulatory blood pressure (BP) and heart rate (HR) in 30 paramedics during a 24-hr workday and a 24-hr nonworkday. During the 24-hr period as a whole, there were no BP differences between the workday and the nonworkday, but HR was higher during the nonworkday than during the workday. Systolic BP (SBP) recorded in the ambulance on the workday was elevated 9.8 mm Hg, compared to SBP recorded in a car on the nonworkday; it was also 7.2 mm Hg higher at the scene of an accident and at the hospital than during nonworkday activities. Ratings of moods in diaries indicated that paramedics felt more unhappiness, stress, and sadness and less feelings of pleasantness at work than at home. Rather than being elevated for the entire 24-hr period, work BP seemed to reflect the relatively high stress associated with specific situations in the work of a paramedic.

Adult↗
PubMed1992

Scandinavian clinical study of finasteride in the treatment of benign prostatic hyperplasia.

The effects of finasteride, a potent 5 alpha-reductase inhibitor, were assessed in patients with benign prostatic hyperplasia. Patients were treated with finasteride or placebo for 24 weeks in a double-blind multicenter study followed by a 12-month open-extension period. After 24 weeks, finasteride-treated patients, when compared to placebo-treated patients, showed a significant reduction in prostate volume (22.5% median decrease) and prostate significant antigen (32.4% median decrease), a significant increase in maximum urinary flow (1.6 ml/s mean increase from baseline) and a significant improvement in their obstructive symptom scores (two-point decrease from baseline). Finasteride was well tolerated, and the improvements in prostate volume, maximum urinary flow rate and obstructive symptom scores observed in the controlled study were maintained throughout the extension study.

5-alpha Reductase Inhibitors↗
PubMed1991

Increased concentrations of tumour necrosis factor in "cachectic" patients with severe chronic heart failure.

OBJECTIVE: To ascertain whether patients with cardiac failure and reduced body weight ("cardiac cachexia") have increased circulating concentrations of tumour necrosis factor (cachectin). DESIGN: Patients with cardiac failure were prospectively identified as "cachectic" (body fat less than 27% in men and less than 29% in women measured by skinfold thickness callipers) or "non-cachectic". Tumour necrosis factor was assayed blind to patient group. SETTING: Cardiology unit in a tertiary referral centre. PATIENTS: 26 consecutive patients (10 women) (mean age 61) admitted for investigation or treatment of chronic heart failure. All were in New York Heart Association class III or IV. RESULTS: In nine of the 16 cachectic patients the concentration of tumour necrosis factor was increased (mean (SEM) 74 (20) pg/ml) compared with one of the 10 "non-cachectic" patients (22 pg/ml, p less than 0.001). Patients with a raised circulating concentration of tumour necrosis factor weighed significantly less (55.6 (3.5) kg) than those in whom the concentration of tumour necrosis factor was normal (69.0 (4.1) kg) (p = 0.02). CONCLUSIONS: Circulating concentrations of tumour necrosis factor were increased in a significant proportion of patients with chronic heart failure and low body weight. Tumour necrosis factor stimulates catabolism experimentally and it may be a factor in the weight loss seen in patients with "cardiac cachexia".

Adult↗
PubMed1991

Bkm satellite DNA and ZFY in the coral reef fish Anthias squamipinnis.

We studied DNA from the protogynous sex-changing fish Anthias squamipinnis to evaluate the recent observation that male-specific bands are identified after hybridization with Bkm, a probe originating in the W chromosome of the snake Bungarus fasciatus. Sex-specific hybridization would imply modification of DNA structure during the sex-changing process. No sex-specific Bkm fragments were identified in our study, after digestion of DNA from 15 males and 11 adult females, despite the use of 12 different restriction enzymes. However, hybridization with Bkm did produce a distinct fingerprint pattern, similar to the fingerprint patterns described for other species after hybridization with GATA (GACA) type probes. In other experiments, the pDP1007 probe, which identifies the ZFY gene in the male-determining region of the human Y chromosome, generated identical hybridization patterns in DNA from males and females of A. squamipinnis and estimation of DNA mass by flow cytometry revealed identical genome sizes.

Animals↗
PubMed1990

The beat-to-beat blood pressure response to postural change in young and elderly healthy adult males.

Heart rate and blood pressure were studied with the beat-to-beat tracking cuff system in two groups (n = 20 per group) of healthy, unmedicated males, one between 60 and 75 years of age and the second between 18 and 29 years of age. The study confirms the previously reported blunted heart rate response to standing and the fact that, when blood pressure is recorded by conventional means, the response exhibited during orthostasis does not differ in healthy groups of young and elderly subjects. With the tracking cuff system, however, the elderly exhibited a smaller immediate systolic and diastolic drop in response to the change to upright posture and less variability in beat-to-beat blood pressure changes. The results have implications for cardiovascular studies, where age and posture can influence both blood pressure and heart rate.

Adolescent↗
PubMed1990

Cardiovascular response during postural change in the elderly.

In order to evaluate the heart rate and blood pressure response during sitting and standing, as well as during the change from sitting to standing, we studied 40 healthy men and women, aged 60-76 years, by means of a noninvasive beat-to-beat blood pressure tracking cuff. Heart rate and blood pressure curves immediately after standing exhibited pronounced flattening relative to a younger population, with no differences between men and women. Only four subjects showed systolic blood pressure drops of at least 15 mmHg in response to standing. Both handgrip and mental arithmetic significantly modified the cardiovascular response from sitting to standing, raising the possibility that individuals with orthostatic hypotension and impaired circulatory reflexes could be trained to utilize behavioral techniques as a means of preventing blood pressure from dropping too far during orthostasis.

Aged↗
PubMed1989

A two-site immunoradiometric assay for C-reactive protein in serum.

An immunoradiometric assay was developed for C-reactive protein in serum. The assay had a sensitivity of 5 micrograms/l and good precision. Correlation with radial immunodiffusion (r = 0.916) and EMIT (r = 0.935) was close. A reference range for healthy adults of 0.05-4.0 mg/l was derived.

C-Reactive Protein↗
PubMed1989

Impact of caffeine and psychological stress on blood pressure in black and white men.

The purpose of this study was to examine the effects of caffeine and psychological stress on systolic blood pressure (SBP) and heart rate (HR) in 40 healthy Black and White male regular coffee drinkers. Half the subjects had a positive family history of hypertension (FH+), and half did not. The effects of 250 mg of caffeine versus placebo (3 mg) in decaffeinated coffee were compared in a within-subject, double-blind, cross-over design. SBP and HR were measured at rest, after caffeine ingestion, during mental arithmetic stress, and during recovery. Results confirmed previous findings with White men that a moderate dose of caffeine produced significant increases in SBP and little effect on HR and that the pressor effects of caffeine and stress combined additively. Contrary to expectations, no overall race or family history differences in SBP levels or in SBP reactivity were observed. FH+ Blacks, however, evidenced slower SBP recovery than Whites. Whites evidenced higher overall HR levels than blacks, but this difference was not specific to caffeine or to mental stress. Mechanisms of racial differences in reactivity underlying differential risk for hypertension are discussed, as well as the utility of caffeine as a pharmacologic probe for such differences.

Adolescent↗
PubMed1989

Acute phase reaction during chemotherapy in small cell lung cancer.

We have measured the serum concentration of the acute phase reactant, C-reactive protein (CRP), in 20 patients with histologically proven small cell lung cancer undergoing their first pulse of induction cytotoxic chemotherapy. Baseline CRP concentrations were raised in 16 of 20 patients (median baseline CRP 18.5 mg l-1; normal range less than 10 mg l-1). CRP levels more than doubled in 11 of 20 patients during induction chemotherapy. This acute phase reaction was seen in seven of the 10 chemosensitive patients, but was not observed in any of the five non-responding patients. Five patients were non-evaluable for chemoresponse. These data indicate that there is a previously undescribed quantifiable acute phase response during chemotherapy for small cell lung cancer which has potential for predicting chemoresponse.

Acute-Phase Reaction↗
PubMed1989

Discrimination of mode of action of anxiolytics using an integrated computer data bank and Dynamic Brain Mapping (CNS effects of diazepam and lorazepam).

In a double-blind, placebo-controlled, crossover study, the CNS effects of intravenously administered diazepam and lorazepam were investigated in anxious subjects through the quantitative pharmaco-EEG (QPEEG) method. For up to 4 1/2 hours following administration the effects of each substance on brain function were measured using computer analyzed EEG recordings (CEEG) and a new technique called Dynamic Brain Mapping. The following observations were made: 1. Both active drugs produce statistically significant CNS effects as measured by CEEG changes. These changes were observed earlier with diazepam than with lorazepam. 2. Although both compounds are classified as anxiolytic by the routine computer EEG data base, the detailed brain mapping technology indicated that the CNS effects of diazepam and lorazepam were quantitatively and qualitatively different. 3. Clinical CNS side-effects (sedation) were seen more frequently with lorazepam than with diazepam. This was consistent with the EEG slowing producing properties of lorazepam. The EEG fast activity which is characteristic for all anxiolytics was established more with diazepam than lorazepam.

Adult↗
PubMed1989

The symptomatic lumbar spine in the athlete.

The lumbar spine is resistant to serious injury in normal athletic activity, but it can often be symptomatic. Although the symptoms are frequently musculotendinous in origin, it is important that structural causes be recognized early, particularly in the skeletally immature athlete. In the mature athlete, it is important to be aware of the normal aging process and the resultant structural changes that occur in the lumbar spine. Accurate assessment of this process is often necessary for sound management.

Aging↗