PubMed Health⌕ Search

Biomedical subjects

E Friedmann

Publications and source records attributed to E Friedmann.

At least 19 recordsLinked to original sources
PubMed1998

Pheromonal influences on sociosexual behavior in men.

This study tested whether synthesized human male pheromones increase the sociosexual behavior of men. Thirty-eight heterosexual men, ages 26-42, completed a 2-week baseline period and 6-week placebo-controlled, double-blind trial testing a pheromone "designed to improve the romance in their lives." Each subject kept daily behavioral records for 6 sociosexual behaviors: petting/affection/kissing, formal dates, informal dates, sleeping next to a romantic partner, sexual intercourse, and self-stimulation to ejaculation (masturbation) and FAXed them each week. Significantly more pheromone than placebo users increased above baseline in sexual intercourse and sleeping with a romantic partner. There was a tendency for more pheromone than placebo users to increase above baseline in petting/affection/kissing, and informal dates, but not in self-stimulation to ejaculation or in formal dates. A significantly larger proportion of pheromone than placebo users increased in > or = 2 and > or = 3 of the 5 sociosexual behaviors involving a female partner. Thus, there was a significant increase in male sociosexual behaviors in which a woman's sexual interest and cooperation plays a role but not in male masturbation which involves only the man. These initial data need replication but suggest that human male pheromones affected the sexual attractiveness of men to women.

Activities of Daily Living↗
PubMed1997

Psychological factors and survival in the cardiac arrhythmia suppression trial (CAST): a reexamination.

BACKGROUND: Evaluating the independent effects of psychosocial and physiological factors on survival of cardiac patients is difficult because it requires obtaining extensive physiological and psychosocial data and long-term follow-up of high-risk patients. OBJECTIVES: To examine the independent contributions of psychosocial and physiological status to survival of patients who had had myocardial infarction. METHODS: The sample consisted of 348 patients in the Cardiac Arrhythmia Suppression Trial who had asymptomatic ventricular arrhythmias after myocardial infarction. Psychosocial status was assessed with the Social Support Questionnaire-6, Social Readjustment Rating Scale, State-Trait Anxiety Inventory, Self-Rating Depression Scale, Jenkins Activity Survey, and Expression of Anger Scale. Physiological data included measurement of left ventricular ejection fraction; history of previous myocardial infarction, congestive heart failure, and diabetes; and results of Holter monitoring. RESULTS: At the first follow-up, after the effect of the physiological predictors was controlled for, psychosocial factors were significant independent predictors of survival. Among men in the nonactive medication group (n = 263), higher state anxiety, lower anger outward, more past life events, and lower expectations of future life events were predictors of mortality. Data suggested that the relationship of anger to mortality might differ for men and women. Increases in past life events and depression from baseline to first follow-up were greater among those who died than among those who lived. CONCLUSION: Among patients who had asymptomatic ventricular arrhythmias after myocardial infarction, psychological status during the period after infarction contributed to mortality beyond the effect of physiological status. The results reaffirm the critical interrelationship between mind and body for cardiovascular health.

Adult↗
PubMed1996

Adherence and arrhythmic mortality in the cardiac arrhythmia suppression trial (CAST).

Patient adherence to therapy is essential to assess treatment efficacy, particularly in clinical trials. Active treatment usually is expected to benefit patients. The healthy adherer effect, the association or greater adherence to all health-promoting behaviors, including medication and overall concern for health, explains the improved survival of more adherent patients in both active and placebo medication groups of several clinical trials. The Cardiac Arrhythmia Suppression Trial (CAST), a placebo-controlled double-blind clinical trial of post-myocardial infarction (MI) patients with asymptomatic ventricular arrhythmias, in which active medication (encainide or flecainide) led to increased mortality, provided an opportunity to examine the relationship of adherence to survival from a different perspective. We consider whether adherence to active treatment was related to arrhythmic mortality and whether a healthy adherer effect might counteract the effect of treatment on mortality among patients taking active medication. Adherence (average pill count) at the first follow-up visit did not differ in the active treatment (92.2%, standard deviation (SD) = 11.97, n = 574) and placebo (90.8%, SD = 13.66, n = 579) groups. In a Cox proportional hazard regression model, medication adherence predicted arrhythmic mortality among the active (P < 0.0062) but not the placebo medication group. The effect of adherence on arrhythmic mortality was significant beyond the effects of ejection fraction, race, spouse, smoking status, diuretic medication, and history of MI. A 10% increase in adherence led to more than a threefold increase of risk of arrhythmic death. The design of the CAST, which included a titration phase, may have tended to select relatively adherent patients since only those whose arrhythmias were suppressed with active medication were randomized into the trial. The data do not support a strong healthy adherer effect in the CAST. There was no evidence in this study that a healthy adherer effect counterbalanced the effect of the active medication.

Anti-Arrhythmia Agents↗
PubMed1996

Coitus and menstruation in perimenopausal women.

The objective of the study was to determine whether coitus during menstruation in perimenopausal women is associated with increased menstrual flow defined as either heavier flow, more days of flow, or both. Initial interviews for the Stanford Menopause Study were conducted locally with 160 perimenopausal women. Six weeks later, additional data were gathered from 121 women. At a third interview, 6-10 weeks later at Stanford University, 56 of 57 subjects (mean age 48.8 +/- 3.9 SD) provided data on menstrual flow and coital behavior. At both the first and third interview, more than half of the women reported a pattern of increased menstrual flow. At the third interview, 83% of those reporting increased menstrual flow also reported a behavioral pattern of coitus during menses. Only 10% with diminished flow acknowledged such a pattern. Women who abstained from sex during menses were not less regular in coital activity at other times nor did the data reveal them to be less orgasmic than women who did not abstain. Our data reveal an association between coitus during menstruation and longer and/or heavier menstrual flow. The etiology of such increased flow is usually believed to be hormonal, but coitus during menstruation may be another important variable.

Coitus↗
PubMed1995

Pet ownership, social support, and one-year survival after acute myocardial infarction in the Cardiac Arrhythmia Suppression Trial (CAST).

Social support and pet ownership, a nonhuman form of social support, have both been associated with increased coronary artery disease survival. The independent effects of pet ownership, social support, disease severity, and other psychosocial factors on 1-year survival after acute myocardial infarction are examined prospectively. The Cardiac Arrhythmia Suppression Trial provided physiologic data on a group of post-myocardial infarction patients with asymptomatic ventricular arrhythmias. An ancillary study provided psychosocial data, including pet ownership, social support, recent life events, future life events, anxiety, depression, coronary prone behavior, and expression of anger. Subjects (n = 424) were randomly selected from patients attending participating Cardiac Arrhythmia Suppression Trial sites and completed baseline psychosocial questionnaires. One year survival data were obtained from 369 patients (87%), of whom 112 (30.4%) owned pets and 20 (5.4%) died. Logistic regression indicates that high social support (p < 0.068) and owning a pet (p = 0.085) tend to predict survival independent of physiologic severity and demographic and other psychosocial factors. Dog owners (n = 87, 1 died) are significantly less likely to die within 1 year than those who did not own dogs (n = 282, 19 died; p < 0.05); amount of social support is also an independent predictor of survival (p = 0.065). Both pet ownership and social support are significant predictors of survival, independent of the effects of the other psychosocial factors and physiologic status. These data confirm and extend previous findings relating pet ownership and social support to survival among patients with coronary artery disease.

Adult↗
PubMed1994

Older patient satisfaction with communication during an initial medical encounter.

There has been extensive research on the factors associated with patient satisfaction with communication during medical encounters, however, little attention has been paid to satisfaction among subgroups of patients, including the elderly. It is inappropriate to assume that all patients have the same physician-patient relationship needs, and thus, they will all be satisfied with the same communication approaches during medical visits. In this study, we examine the interactional correlates of older patient satisfaction with an initial visit with a general internist. A multidisciplinary team composed of social scientists and physicians used the Multi-dimensional Interaction Analysis system to code audiotapes. Patients and physicians completed post-visit satisfaction questionnaires. Older patient satisfaction was positively correlated with the following variables: physician questioning and supportiveness on patient-raised topics; patient information-giving on patient-raised topics; the length of the visit; the physician's use of questions worded in the negative; shared laughter between the physician and the patient; and physician satisfaction. These findings suggest that older patients prefer encounters in which: (1) there is physician supportiveness and shared laughter; (2) they are questioned about and given an opportunity to provide information on their own agenda items; and (3) physicians provide some structure for the first meeting through their use of questions worded in the negative. The authors caution that although this sample of older patients appears to be satisfied with a communication style usually considered characteristic of the traditional model of the physician-patient relationship (i.e. a warm interpersonal style and physician-generated structure for the visit), older patients in other settings and future cohorts of elderly patients may prefer other communication approaches. It is also suggested that aspects of communication which provide satisfaction to patients in first visits may be different than aspects of communication associated with patient satisfaction in follow-up visits.

Adult↗
PubMed1994

The cardiovascular effects of rate of verbal communication.

This study was designed to evaluate the effect of modifying rate of speech on the cardiovascular responses of type A and type B cardiac patients during verbalization. Blood pressure and heart rate were recorded in 111 cardiac patients every minute during two series: rapid and slow verbalization. Cardiovascular responses were significantly greater during rapid than during slow verbalization, independent of type A behavior pattern. This study demonstrates that reducing rate of speech can decrease cardiovascular reactivity during verbalization.

Analysis of Variance↗
PubMed1993

Prevalence of kyphosis in a healthy sample of pre- and postmenopausal women.

Kyphosis, initially modest, progresses to the well recognized dowager's hump of the postmenopausal osteoporotic woman. Kyphosis is not only associated with relatively altered vertebral body shape (anterior wedging), but also with reduced bone density and fitness, as well as decreased muscle strength, and is associated with reduced survival. We found an unexpectedly high (35%) incidence of kyphosis in a healthy sample of well women 20 to 64 years of age. The correlation between normal postural index of kyphosis (I/K) and upright postural I/K was substantial (r = 0.799). Among the postmenopausal women, normal postural I/K was inversely correlated with age. Upright postural kyphosis was not related to age, nor was normal postural I/K in the premenopausal woman. There was no direct relationship demonstrated between current calcium consumption and I/K. Similarly, neither estrogen levels nor follicle-stimulating hormone levels were related to current posture. Women with satisfactory exercise habits had significantly lower I/K. Because the capacity to stand up straight was consistently higher than the normal postural score, yet closely correlated to it, there may be a role for postural kyphosis in changing the architecture of the vertebral column. As normal posture becomes kyphotic, an individual can no longer straighten the vertebral column. The surveyor's flexicurve, which we employed for this study, provided a simple and inexpensive method for assessing postural index. This measurement can be routinely included in the comprehensive health examination. Assessment of bone health in women should be made within the context of a fixed postural kyphosis.

Adult↗
PubMed1993

Nursing blood pressure research, 1980-1990: a bio-psycho-social perspective.

The purpose of this review is to examine nursing research on blood pressure (BP) from 1980 to 1990 from a bio-psycho-social perspective. Nursing research articles (N = 50) from three journals were reviewed. The inclusion of subject descriptions, environmental factors, dynamic and interpersonal aspects were tabulated. This review provides a basis for designing nursing research on BP with a broader perspective.

Adult↗
PubMed1993

Clinical and biochemical characteristics of acromegalic patients harboring gsp-positive and gsp-negative pituitary tumors.

A subgroup of growth hormone (GH)-secreting pituitary tumors carries somatic mutations within the gene coding for the alpha subunit of the stimulatory heterotrimeric guanosine 5'-triphosphate-binding protein, Gs alpha. These so-called gsp mutations result in constitutively activated Gs alpha and the signal transduction cascade downstream of it, with eventual markedly and continuously elevated cyclic adenosine monophosphate levels as a result of constitutive adenylyl cyclase activity. It is this elevation of intracellular cyclic adenosine monophosphate that is thought to be the cause of excessive GH secretion and somatotroph proliferation. We examined the clinical and biochemical characteristics of acromegalics harboring gsp-positive and gsp-negative pituitary tumors. Of 19 tumors studied, 8 (42%) were gsp positive. There was a slight tendency for basal GH levels in serum to be lower and to be further reduced by an oral glucose tolerance test in gsp-positive patients. However, there was no difference between the two groups in terms of clinical features, tumor size, mitotic activity (as assessed by cytosolic deoxyribonucleic acid polymerase and KI-67 staining), and in vitro GH response to GH releasing factor. We conclude that there is, in general, little difference in the clinical and biochemical characteristics between gsp-positive and gsp-negative human pituitary GH-secreting tumors.

Acromegaly↗
PubMed1992

Cardiovascular responses of patients with cardiac disease to talking and exercise stress testing.

The blood pressure (BP), heart rate (HR), and premature ventricular contraction responses of patients with cardiac disease during talking were compared with those during exercise stress testing (EST). BPs, HR, and heart rhythm were recorded in 52 patients with cardiac disease before and during talking about an intentionally neutral topic and compared with changes during EST. The systolic and diastolic BP and HR increased significantly during talking. Diastolic BP increased significantly more during talking than during EST stages 1 and 2. The increase in diastolic BP during EST stage 3 did not differ from the increase during talking. HR and systolic BP increased more during EST than during talking. Nine patients had premature ventricular contractions during both EST and talking, two during EST only, and one while talking only. The verbalization protocol provides information about changes in diastolic BP that are not seen with EST. It also may be of value for evaluating heart rhythm, HR, and systolic BP changes for patients whose disabilities preclude EST.

Adult↗
PubMed1990

[Recurrent hypoglycemia in the insulin autoimmune syndrome].

A 72-year-old man with recurrent hypoglycaemia was suspected of having an insulinoma. But several diagnostic methods (computed tomography; mesenteric and coeliac angiography; sella imaging) did not reveal any tumour. 72-hour hunger test did not precipitate any spontaneous hypoglycaemia. A falling insulin-glucose ratio spoke against an insulin-producing tumour. Reactive symptomatic hypoglycaemia occurred 4.5 hours after an oral glucose test. Measurement of insulin concentration demonstrated a slow but pronounced increase (3500 microU) over an already raised initial value (816 microU/ml), typical of prediabetic metabolic regulation. Demonstration of insulin autoantibodies confirmed the diagnosis of an insulin autoimmune syndrome, which has a good prognosis. The patient became free of symptoms on a regimen of frequent small, carbohydrate-poor but fat and bulk-rich meals. Hypoglycaemia recurred when the diet was not observed.

Aged↗
PubMed1989

Concordance between physicians and their older and younger patients in the primary care medical encounter.

To test the hypothesis that less concordance exists between older patients and their physicians than between younger patients and their physicians, we examined agreements between physicians and patients on the major goals and topics discussed during an outpatient medical encounter. Using coded audiotapes of the medical visit, patient postvisit interviews, and physician questionnaires, concordance was found to be significantly greater for younger patients and their physicians than for older patients and their physician on the major goals and major medical topics discussed during the primary care interview. This paper explores possible explanations for these findings.

Age Factors↗
PubMed1989

Blood pressure, heart rate, and heart rhythm changes in patients with heart disease during talking.

Blood pressure and heart rate were recorded in 37 patients with cardiac disease while they were resting quietly and talking. Heart rate, systolic blood pressure, and diastolic blood pressure were all significantly greater while the patients were speaking than while they were resting silently. In addition, ventricular and atrial arrhythmias were more frequent while they were talking than while they were quiet. Higher resting systolic blood pressure levels also were associated with larger blood pressure increases while the patients were speaking. Older patients exhibited significantly greater systolic pressure increases while talking than younger patients. Therapeutic doses of antihypertensive medications, including beta-blockers, calcium channel blockers, and diuretics did not block the heart rate and blood pressure increases while the patients were talking. These findings suggest that more attention needs to be paid to the hemodynamic consequences of communication in patients with coronary heart disease. Coupled with previous research findings, these data also suggest that clinicians need to attend to verbal communications during routine diagnostic procedures for evaluating cardiovascular function.

Adult↗
PubMed1987

Parathyroid hormone stimulation of renal adenylate cyclase in various vertebrate species: evidence for an effect in the frog.

The effect of [Nle8,18,Tyr34]bPTH-(1-34)amide on renal plasma membrane adenylate cyclase, in the presence of 0.1 mM guanylylimidodiphosphate was measured in rat, chicken, frog and trout. All species showed an enrichment of at least 8-fold (relative to homogenate) in the marker enzyme Na+,K+-ATPase. A significant dose-dependent adenylate cyclase stimulation was found in frog, with affinity values similar to those of rat and chicken (ED50=8, 10 and 3 nM, respectively), but not in trout. The frog response was specific since [Nle8,18,Tyr34]bPTH-(3-34)amide strongly inhibited the agonist-stimulated enzyme. These results suggest the existence of a PTH-like substance in anurans acting via cyclic AMP formation in the kidney.

Adenylyl Cyclases↗
PubMed1986

The effect of touch on nutritional intake of chronic organic brain syndrome patients.

Inadequate nutrition, a major cause of illness and complications among elderly adults, is of particular import for those who cannot provide for themselves. We evaluated the effect of gentle touch during eating on nutritional intake (NI) of 42 institutionalized chronic organic brain syndrome (COBS) patients. Patients were randomly assigned to experimental or control groups. NI was evaluated for 3 consecutive weeks. During Weeks 1 and 3 all patients were encouraged verbally to eat. In the treatment week experimental group members were touched gently during this verbal encouragement. Repeated measures analyses of variance were used to evaluate the effect of touch on NI. In the first week NI for the groups did not differ. NI was significantly greater in the experimental than in the control group (p less than .01) during the other 2 weeks. Tactile stimulation, a simple intervention, may be an important adjunct to verbal encouragement to improve NI in COBS patients.

Aged↗
PubMed1984

Changes in nurses' blood pressure and heart rate while communicating.

Cardiovascular responses of nurses were measured during two communication tasks. In the first experiment 40 nurses' blood pressures and heart rates were taken pre, during, and post change-of-shift report. In the second experiment, 30 nurses spoke to an individual nurse and to a group of nurses. Blood pressures and heart rates were recorded pre, during, and post speech in both conditions. Analyses of variances showed that speaking levels of all cardiovascular parameters were higher (p less than .001) than resting levels in both experiments. Blood pressures and heart rates were higher (p less than .0001) in front of a group than in front of an individual. These findings extend previous work that has shown communication alters blood pressure.

Adult↗