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Biomedical subjects

E Seidman

Publications and source records attributed to E Seidman.

At least 19 recordsLinked to original sources
PubMed1992

The effect of a new calcium channel blocker (TA-3090) on lipoprotein profile and intestinal lipid handling in rodents.

Recent interest has focused on findings that drugs used to lower blood pressure may adversely modify plasma lipids and lipoprotein metabolism. This observation may explain why pharmacologic control of hypertension has failed to reduce the incidence of morbidity and mortality from coronary artery disease. The present study aims to evaluate the effect of TA-3090, a new calcium channel blocker, on fasting plasma lipids and lipoproteins, as well as on processes of intestinal fat absorption. Rats were treated by gavage with TA-3090 (10 mg/kg twice daily) for 4 days and compared with controls (n = 6 per group). Plasma cholesterol was increased in the treated group to (mean +/- SE) 74 +/- 2 vs 60 +/- 4 mg/dl (P less than 0.01), due mainly to an increased high density lipoprotein-cholesterol level (50 +/- 2 vs 37 +/- 3 mg/dl, P less than 0.005). Notably plasma triglycerides (TG) and low density lipoprotein-cholesterol were not significantly affected. Another group of TA-3090-treated animals was given an intraduodenal fat meal, and the rise in plasma TG and chylomicrons followed over 4 hr. Postprandial hypertriglyceridemia and chylomicronemia were significantly lower at 2 hr (P less than 0.05) and 3 hr (P less than 0.01) compared with controls. In a separate group of animals, the addition of TA-3090 to a 2% intralipid infusion intraduodenally was associated with significantly reduced TG and chylomicron-TG transport into lymph (P less than 0.05). Furthermore, experiments in rats pretreated with TA-3090 intraperitoneally and then given 2% intralipid intraduodenally were shown to have a significant decrease in mean flow rate (27%), TG transport (31%) and chylomicron-TG output (37%), when compared with controls. In vitro studies using jejunal organ culture to examine the effect of TA-3090 on intracellular lipid synthesis and secretion revealed that the addition of the drug to the medium resulted in significantly decreased TG synthesis and secretion. These data suggest that TA-3090 could be effective in increasing HDL-cholesterol and reducing postprandial chylomicronemia. Our findings support a role for TA-3090 directly on enterocyte absorption and/or intracellular lipid transport, and thus indicate the importance of intracellular calcium on these processes.

Animals↗
PubMed1991

Growing up the hard way: pathways of urban adolescents.

Presented a description and initial findings from the Adolescent Pathways Project (APP). There is a dearth of developmentally and ecologically anchored knowledge concerning adolescents, particularly poor and ethnically diverse urban adolescents, other than that they are at greater risk for behavioral, emotional, and educational problems. As a result, our ability to develop and implement grounded prevention programs is severely limited. The APP was intended to fill this knowledge gap. Using an accelerated longitudinal design, the APP examines the developmental trajectories of an ethnically diverse sample of 1,333 black, Latino, and white youth from inner-city public schools in Baltimore, Washington, DC, and New York. It involves four interrelated studies: Youth, Parent, School, and Neighborhood. The project's major aim is to identify the critical psychological, developmental, and ecological factors that facilitate positive as well as negative outcomes. This initial description of the APP presents the overarching ecological-developmental framework and guiding questions, as well as initial findings central to the tenets of community psychology.

Adolescent↗
PubMed1991

Expansion strategies of a mutual help organization.

Described a study of the expansion strategies of a successful self- and mutual help organization for persons with mental illness. Resource mobilization and behavior-setting theories were used as conceptual frameworks to guide the investigation. Collaborative methods and a grounded theory approach were used. Archives, reports of contacts outside of the organization, and naturalistic observations were data sources. Of particular interest are the processes used by the organization to mobilize internal and external resources and to start new mutual help groups. Results suggest that the organization mobilizes resources from a variety of sources, displays flexibility in securing resources and defining organizational roles, and creates underpopulated settings to encourage individual involvement. The strategies appear to avoid overtaxing resource pools, reduce role ambiguity, and encourage pluralistic participation. Discussion includes several potential explanations for the successful growth of the organization.

Community Mental Health Services↗
PubMed1991

Charting uncharted terrain: a behavioral observation system for mutual help groups.

Describes the development of a behavioral observation system for mutual help meetings and presents evidence supporting its reliability, validity, and utility. The MHOS-BIC (Mutual Help Observation System-Behavioral Interaction Codes) was used by 10 observers to record the sequential flow of group interaction in 527 meetings. Psychometric analyses indicate that the system performed consistently with measurement objectives. Mean kappas for each of the 12 coding categories ranged from .62 to .87; the system demonstrated sensitivity to setting and time differences; and a predictable pattern of correlations was found among BIC categories and conceptually related participant and observer ratings. Studies using the BIC to address substantive questions about mutual help are reviewed, providing further evidence for its validity and utility. An empirical description of mutual help is presented using BIC data, and the promises and limitations of the system are discussed.

Affective Symptoms↗
PubMed1991

Setting phenotypes in a mutual help organization: expanding behavior setting theory.

Expands Barker's theory of behavior settings by proposing an additional method of classifying settings based on their functional/behavioral aspects--the setting phenotype. Although behavior setting theory has been widely hailed as a revolutionary contribution to behavioral science, it has had limited impact on general psychology. This may be due in part to a reliance on a purely structural method of classifying behavior settings--the setting genotype. Behavioral data were collected from 510 meetings of 13 self-help groups from a mutual help organization for persons with problems in living. A cluster analysis was performed to uncover meaningful behavioral patterns among the groups. Four phenotypes were identified: personal, impersonal, small talk, and advising. Mutual help group phenotype was found to be related to a set of setting characteristics as well as to overall rated change of group members. The results are discussed in light of the significance of the phenotype construct for making behavior setting theory more relevant for social scientists.

Activities of Daily Living↗
PubMed1991

Nutritional issues in pediatric inflammatory bowel disease.

Malnutrition, characterized by weight loss, growth failure and micronutrient depletion, are prominent features of inflammatory bowel disease (IBD) in the pediatric age group. Accurate evaluation of the patient's nutritional status and appropriate nutritional support, whether enteral or parenteral, constitute integral parts of the management of the growing child with IBD. Over the past two decades, a number of studies have supported the potential use of nutritional therapy to induce remission and to control disease activity in symptomatic Crohn's disease. More recently, preliminary studies on the use of dietary supplements of marine-oil-derived omega-3 fatty acids have also indicated a beneficial effect in IBD patients. In parallel with these clinical trials, scientific research has recently focused on the concept that specific dietary alterations can modulate the immune response. Components of the diet that may have particular relevance to mucosal immunity and the pathogenesis of IBD include polyunsaturated fatty acids, nucleotides, and amino acids such as glutamine and arginine. Future research in the interactions between specific nutrients and the immune system will likely increase our understanding of the causes of IBD, as well as enhance the development of novel nutritional therapies for IBD patients.

Child↗
PubMed1990

An unusual histiocytoid proliferation in infancy.

A 2 1/2-month-old female infant was admitted to the Hôpital Ste-Justine for investigation of marked hepatosplenomegaly. The pregnancy and neonatal period were uneventful and the child had exhibited normal growth. There were no skin or osseous lesions. Investigations revealed a coagulopathy with hypoproteinemia, but normal liver enzymes. An open liver biopsy revealed widespread infiltration of portal veins and hepatic sinusoids by large histiocyte-like cells, exhibiting protein S-100 and Ia antigen, but negative for OKT6, peanut agglutinin, and T and B cell and macrophage markers. Ultrastructural examination failed to reveal Birbeck granules. After a 4-month course of chemotherapy, liver and spleen size decreased, the biochemical profile returned to baseline levels, and the child has remained well. A repeat liver biopsy, performed at the end of the therapeutic trial, was normal. This patient presents an unusual pattern of infiltration of liver and spleen not readily classifiable within the present scheme of histiocytic disorders.

Cell Nucleus↗
PubMed1990

In vitro remodelling of plasma lipoproteins in whole plasma by lipoprotein lipase in primary and secondary hypertriglyceridaemia.

In patients with familial lipoprotein lipase deficiency (FLPL-d) and glycogen storage disease type I (GSD-I), hypertriglyceridaemia (1445 +/- 247 and 1082 +/- 312 mg dl-1, n = 5 per group) was associated primarily with reduced extrahepatic lipoprotein lipase (LPL) activity (0.33 +/- 0.33 and 1.69 +/- 0.38 mumol FFA ml-1 h-1) when compared with controls (4.83 +/- 0.90). Hypercholesterolaemia was characterized by elevated LDL cholesterol (191 +/- 30 and 344 +/- 34 vs. 115 +/- 5 mg dl-1 in controls P less than 0.01) and low HDL cholesterol (12 +/- 2 and 22 +/- 2 vs. 56 +/- 3 in controls, P less than 0.001). In order to ascertain the role of LPL in the interconversion and remodelling of lipoproteins in these disorders, we analysed lipid and lipoprotein profiles before and following in vitro incubation of patient plasma with purified milk LPL (EC 3.1.1.34) for 6 h at 37 degrees C. The efficiency of exogenous LPL in vitro was demonstrated by the extent of hydrolysis of chylomicrons and of VLDL-TG in both groups. Concomitant with the disappearance of TG-rich lipoprotein particles, a consistent per cent increment of IDL (99.2 +/- 30.8 and 43.9 +/- 70.5), LDL (152.8 +/- 36.2 and 137.0 +/- 36.1) and of HDL2 (144.8 +/- 29.4 and 99.8 +/- 18.7) was observed in both groups of patients. The enhancement of the latter fractions contrasted with the decline of HDL3 mass concentration (25.4 +/- 7.7 and 51.4 +/- 5.8%), suggesting that a major shift of HDL3----HDL2 occurs following in vitro lipolysis by LDL. Simultaneous compositional and morphological changes of individual lipoprotein particles were noted, confirming the dynamic movement and exchange of neutral lipids and proteins. Specificity of LPL results was demonstrated by experiments in which incubation of the whole plasma at 37 degrees C without exogenous lipolytic enzyme did not cause any substantial changes. The present study, therefore, demonstrates a correction of the major lipoprotein abnormalities associated with FLPL-d and GSD-I by exogenous LPL. No substantial difference was noted between primary (FLPL-d) and secondary (GSD-I) hyperlipidaemias. These studies allow us to conclude that a simple in vitro system, utilizing an exogenous source of LPL and plasma from patients, may serve as a suitable model for the study of the metabolic relationships of lipoproteins. However, in view of the fact that the extent of lipolysis achieved in vitro did not differ between FLPL-d and GSD-I, it may not be able to separate primary from secondary hyperlipaemias.

Adolescent↗
PubMed1989

A preferred route for substantive theorizing.

Wicker (1989) urges the ecologyically-oriented psychologist to be more cognizant of the decision points implicit in the scientific enterprise. He describes what he calls substantive theorizing and urges us to give greater precedence, conceptually and methodologically, to context-specific phenomena. In this rejoinder, I: (1) underscore the thrust of the choices Wicker has clarified and the p references he has recommended; (2) suggest an alternative route for the ecologically-oriented research process, one in which the conceptual and substantive "paths" have coequal and interdependent importance in determining the nature and direction of the research process; and (3) discuss in greater depth the search for universal laws. Though universal laws per se may be fictional goals, I argue that our principles will have greater generalizability to the degree to which we are successful in redirecting the research enterprise to focus upon structural, as opposed to content, principles.

Choice Behavior↗
PubMed1989

Economic predictors of mental health service utilization: a time-series analysis.

This research was designed to understand the relationships between economic indicators and mental health service utilization. Six monthly and three quarterly time-series analyses were done to assess the time-dependent association between three state-level economic indices and two measures of mental health service utilization. Consistent with the existing literature, increases in manufacturing employment were inversely related to both first admissions in state hospitals and case openings in community outpatient facilities. Labor force participation was also inversely related to first admissions to state hospitals. No relationship was found between service employment and either of the mental health service use indices. The specific findings suggest that two processes may be operating in the relationship of labor force participation and manufacturing employment with mental health service utilization. Some of the findings suggest a "crisis" process, in which service use increases rapidly following an economic stressor, whereas other findings suggest a more insidious process, in which economic stressors slowly weaken the mental health of the community and eventually lead to increased mental health service use. These results can be used to better inform social policy and preventive interventions by highlighting the human costs of changes in economic well-being. The need for more ecological research is discussed.

Adaptation, Psychological↗
PubMed1989

The future of schooling.

Distinction is drawn between research on learning processes among children in schools and the impact of schooling on students' academic and socioemotional development. Schooling and the learning environment are considered within an ecological/transactional framework. The research on school effectiveness and teacher effects is summarized. Interventions directed at the social regularities of the schooling environment are proposed as strategies to improve the learning environment of the school and optimize student outcomes.

Child↗
PubMed1989

Nutritional support for pediatric patients with inflammatory bowel disease.

Pediatric patients with ulcerative colitis and Crohn's disease often suffer from malnutrition and growth failure. This is particularly true in pubertal children. Chronic insufficient nutrient intake is most often the cause of growth failure. Both parenteral nutrition and defined enteral formulas are available to rehabilitate patients with malnutrition and growth failure. Assessment of nutritional status and growth and the use of parenteral nutrition and defined enteral formulas to reverse malnutrition, growth failure, and inflammation in pediatric patients with inflammatory bowel disease are discussed.

Adolescent↗
PubMed1989

High incidence of upper gastrointestinal tract involvement in children with Crohn disease.

This retrospective study of Crohn disease in 230 children and adolescents with a mean age of 12.5 years at the time of diagnosis and an average follow-up of 6.6 years showed that 30% had lesions of the esophagus, stomach, and duodenum. Three patients had Crohn disease isolated to the upper gastrointestinal tract. The 169 patients with both small and large bowel disease were at greater risk (33%, P less than .05) of having upper gastrointestinal lesions than the 37 with isolated small bowel disease and the 21 with disease limited to the colon and/or rectum. An aggregate of symptoms and signs more likely present in those with upper gastrointestinal involvement included: dysphagia, pain when eating, nausea and/or vomiting, and aphthous lesions of the mouth. Furthermore, weight loss was more severe and hypoalbuminemia more frequent. Because upper gastrointestinal series x-ray studies failed to detect upper gastrointestinal lesions in 13 patients of 69 of those with upper gastrointestinal disease, endoscopy should be considered in all children and adolescents in whom a diagnosis of Crohn disease is entertained. Endoscopy and biopsy of the upper gastrointestinal tract should be done in any patient with symptoms suggestive of proximal involvement. Finally, in view of the fact that endoscopy established the diagnosis of Crohn disease in five patients previously thought to have chronic ulcerative colitis, the procedure should routinely be performed in all patients with chronic ulcerative colitis or indeterminate colitis before surgery is performed.

Adolescent↗
PubMed1988

Chronic intermittent elemental diet improves growth failure in children with Crohn's disease.

Growth failure often complicates Crohn's disease in pediatric patients and is principally due to inadequate caloric intake. To assess whether intermittent courses of an elemental diet could reestablish growth, 8 children (aged 9.8-14.2 yr) with Crohn's disease and growth failure entered into a prospective trial. Each patient was studied during an observation year on standard therapy, then for an experimental year during which they received enteral elemental diet 1 out of 4 mo. An age- and disease-matched control group of 4 patients was treated by conventional medical therapy during both years. Elemental diet therapy was administered nocturnally, at home, by continuous nasogastric infusion and increased the daily caloric intake by 25% (p less than 0.01). Anthropometric measurements demonstrated significant height and weight gains in the elemental diet group vs. controls (p less than 0.01). Crohn's disease activity index and prednisone intake decreased significantly in patients receiving elemental diet therapy when compared with themselves and with controls on conventional medical therapy (p less than 0.05). In contrast, the rate of pubertal development was similar in both groups irrespective of the treatment modality. This study demonstrates that chronic intermittent elemental diet effectively reverses growth arrest, while decreasing prednisone requirements and Crohn's disease activity index in pediatric Crohn's disease patients prior to puberty.

Adolescent↗