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Biomedical subjects

J Fine

Publications and source records attributed to J Fine.

At least 37 records · Page 2Linked to original sources
PubMed1996

Malignant melanoma risk factors by anatomic site: a case-control study and polychotomous logistic regression analysis.

This population-based case-control study systematically examined reported malignant melanoma risk factors by anatomic site. Study subjects consisted of 548 invasive melanoma cases diagnosed in Connecticut during 1987-1989 and 494 randomly selected controls. Multivariate polychotomous logistic regression was used to determine whether risk factors differed across anatomic sites. Risk factors examined included demographic and pigmentary characteristics, sun exposure-related factors, anatomic site-specific sunburn, recreational water activity clothing habits and number of nevi. A pattern of site-specificity was observed for sunburn. A history of sunburn at an anatomic site was specifically related to the development of malignant melanoma at that site more so than at other sites. This site-specificity was consistent with a direct role for intense, intermittent sun exposure in the development of melanoma. Age and gender were the only risk factors that differed significantly in effect across anatomic sites. The age difference was explained by differences in histologic subtype across sites. The gender difference could not be explained by sex differences in anatomic site-specific sunburns or in recreational water activity clothing habits. Alternative explanations include sex differences in behavioral patterns of sun exposure that we did not measure and as yet unelucidated differences in susceptibility to melanoma according to sex and anatomic site.

Adult↗
PubMed1996

Fine et al. Reply.

Explore the source record for details and available documents.

Journal Article↗
PubMed1996

Cerebellar hemorrhagic infarction.

We investigated 17 patients with 26 cerebellar hemorrhagic infarcts for their vascular anatomy, stroke mechanisms, and clinical course. Sixteen infarcts involved the superior cerebellar artery, nine the posterior inferior cerebellar artery, and one the anterior inferior cerebellar artery territories. The infarcts involved the full territory of the supplying arteries in 19 of 26 infarcts (73%). Sixteen of 17 patients were stable or improving when the hemorrhagic infarction was detected. All but one patient had an imaging study at the time of presentation that was negative for blood; hemorrhagic infarction was detected on routine serial scans performed during the first 15 days. Nine of the 17 patients were on anticoagulants when the cerebellar hemorrhagic infarct was detected; anticoagulation was maintained in eight of them with no clinical worsening. The stroke mechanism in all patients was considered embolic from cardiac and intra-arterial sources. The causes, imaging findings, and consequences of hemorrhagic infarcts in the posterior circulation are similar to those in the anterior circulation.

Anticoagulants↗
PubMed1996

The impact of co-morbidity on life expectancy among men with localized prostate cancer.

PURPOSE: We evaluated 3 indexes used to assess patient co-morbidities to determine whether they could predict mortality among men with clinically localized prostate cancer. MATERIALS AND METHODS: We measured the impact of co-morbidity classifications on all cause mortality using a parametric proportional hazards model based on a retrospective cohort analysis. RESULTS: Each index tested is a highly significant predictor of mortality for patients dying of nonprostate cancer related causes after adjusting for age and Gleason score. CONCLUSIONS: Each co-morbidity index provides significant, independent predictive information concerning patient mortality beyond that provided by age, Gleason score and clinical stage alone.

Aged↗
PubMed1995

Tumor vascularity is not a prognostic factor for malignant melanoma of the skin.

Tumor vascularity has been proposed as a prognostic indicator for a number of solid tumors. Although a correlation between microvessel number and metastatic behavior has also been suggested for cutaneous melanoma, the small number of cases studied to date allows one to draw only preliminary conclusions. In this study, we have assessed tumor vascularity in cutaneous melanoma by comparing 60 cases of metastasizing and non-metastasizing tumors matched for tumor thickness, age, sex, and anatomic site. Ulex europaeus agglutinin I appeared to be the most suitable vascular marker for this study. Our results indicate that there was no statistically significant difference between the two groups with regard to tumor vascularity. Even after identifying 15 cases of thin ( < 1.0 mm thick) melanoma, there was no significant difference in the number of microvessels between metastasizing and non-metastasizing tumors. Comparison of patterns of vascular microarchitecture also failed to discriminate between the two groups. Thus, our results indicate that tumor vascularity may not be an independent prognostic factor for cutaneous melanoma.

Adolescent↗
PubMed1994

Cohesive discourse in pervasive developmental disorders.

Investigated the use of cohesive links to create a reciprocal conversation in individuals with autism, Asperger syndrome, and a control group of children and adolescents with nonspecific social problems. All subjects engaged in a 10-minute conversation with an examiner that touched on various topics. The conversation was audiotaped, transcribed, and coded blindly for several types of cohesive links. Compared to controls, the higher functioning autistic group referred less to a previous stretch of the conversation and more to an aspect of the physical environment. The Asperger group, on the other hand, was very similar to the controls except they made more unclear references that were difficult to interpret. Implications of these findings for understanding the communicative failure of subjects with pervasive developmental disorder are discussed.

Adolescent↗
PubMed1994

Quantitation of hepatitis C viral RNA in sera of hemodialysis patients: gender-related differences in viral load.

Hepatitis C virus (HCV) infection is common in hemodialysis patients, as determined by antibody assays and qualitative polymerase chain reaction (PCR) analysis of serum HCV RNA. To further characterize HCV infection in this population, we measured the viral load in infected hemodialysis patients by a quantitative, competitive PCR assay (QC-PCR) for HCV RNA. Hepatitis C virus RNA levels were correlated with serologic, biochemical, and demographic features of a cohort of hemodialysis patients. Sera from 208 hemodialysis patients were screened for HCV RNA (5' conserved region) by reverse transcriptase PCR (RT-PCR) and HCV-specific antibody. Forty-four patients were antibody positive (21%); among these patients, 34 (77%) were HCV RNA positive. No viremic, seronegative patients were identified. Hepatitis C virus RNA levels quantitated by QC-PCR ranged from 3 x 10(5) to 10(8) molecules of HCV RNA/mL. Male patients had significantly higher mean and median HCV RNA levels (10(7) molecules/mL) compared with female patients (3.6 x 10(6) molecules/mL and 3 x 10(6) molecules/mL, respectfully; P = 0.02). No other demographic or clinical feature of this cohort correlated with HCV RNA levels. Intravenous drug abuse was the most frequently identified risk factor (29% of seropositive patients) for infection with HCV in this population. No association between HCV RNA levels and hepatic enzyme levels (alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, alkaline phosphatase) was apparent. Hepatitis C virus infection is highly prevalent in our hemodialysis population, and hemodialysis patients, particularly males, have high levels of HCV in serum.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Cardiac and respiratory activity in panic disorder: effects of sleep and sleep lactate infusions.

OBJECTIVE: This study examined cardiac and respiratory activity in panic disorder patients and healthy comparison subjects during sleep, when the effects of anxious cognition and expectancy set are minimized. METHOD: Heart rate, respiratory rate, end-tidal PCO2, and oxygen saturation were recorded for 11 panic disorder patients and 12 comparison subjects before and during sleep and before and after infusions of sodium lactate and a saline control. RESULTS: Panic disorder patients had higher oxygen saturations than comparison subjects before sleep onset and during sleep stages 0 and 2 before any infusions. The two groups did not differ on other respiratory variables and heart rate. Panic disorder patients responded to lactate infusions during stage 3-4 sleep with greater increases in heart rate and oxygen saturation, and possibly in respiratory rate and end-tidal PCO2, than comparison subjects. The saline control infusion had little effect. CONCLUSIONS: These findings suggest that panic disorder patients have greater cardiac and respiratory reactivity than healthy comparison subjects during sleep, when the influence of cognitive factors is minimal or absent.

Adolescent↗
PubMed1993

Evaluation and acute management of psychotic symptomatology in alcohol and drug addictions.

The practical clinical evaluation of patients manifesting psychotic symptomatology and addictive illness is approached in diverse and contradictory ways. While addiction specialists may not recognize the existence of Axis I disorders that prevent the utilization of treatment in the system, trained mental health professionals are traditionally prone to deny or minimize the addictive process and its capacity to produce psychiatric symptoms. This may result in premature diagnosis, and in a poor response to psychiatric treatment. The purpose of this paper is to describe a pragmatic model, based on clinically observable conditions, for the evaluation and acute management of major psychiatric symptomatology associated with diagnosed drug and alcohol addiction. Before describing the model, psychotic illness and symptoms in the general population versus the drug and alcohol addicted will be examined. The model will be applied to a few discrete syndromes based on common clinical presentations.

Female↗
PubMed1993

Current epidemiology of comorbidity of psychiatric and addictive disorders.

Some major epidemiologic studies have assumed that treatment of the psychiatric symptoms will result in a lowered morbidity and mortality from the addictive disorders or, more specifically, that the addictive disorders are dependent on the psychiatric disorders and etiologically linked to them as an effect or secondary consequence. There is little systematic evidence beyond anecdotal and intuitive supposition to support this popular and only hypothetic position. The consequence is that to insist on the priority of the psychiatric disorder in diagnosis and treatment is to perpetuate artifactual prevalence rates for psychiatric comorbidity in addictive disorders, and to preclude the definitive treatment to reduce the psychiatric morbidity and mortality caused by addictive disorders.

Comorbidity↗
PubMed1992

Histologic evaluation of pigmented lesions in Connecticut and its influence on the reporting of melanoma.

BACKGROUND: Underreporting of melanoma to state tumor registries has been identified as a problem in gathering accurate statistics on melanoma incidence. OBJECTIVE: Our purpose was to examine two factors that could influence the reporting of melanoma to the Connecticut Tumor Registry: histologic diagnosis of melanoma in the private offices of dermatologists and histologic diagnosis of melanoma in out-of-state laboratories. METHODS: From December 1990 to April 1991, questionnaires were sent to all known practicing dermatologists in the state of Connecticut (N = 149). Of the 127 dermatologists who were eligible, 124 (97.6%) completed the survey. RESULTS: The estimated number of melanomas diagnosed in private offices during 1990 was 9 to 18; this was based on the number of dermatologists who officially read their own slides (n = 19), the estimated number of melanomas diagnosed by these 19 dermatologists (n = 91), and the percentage of melanomas and uncertain pigmented lesion cases sent for consultation (80% to 90%). According to the estimates of Connecticut dermatologists, out-of-state laboratories diagnosed 84 of 523 melanomas (16%) in Connecticut residents. CONCLUSION: The diagnosis of melanoma in private offices did not appear to be a significant factor in underreporting whereas the diagnosis of melanoma in out-of-state laboratories did appear to be more significant. However, the possibility exists that some of these latter melanomas would eventually be reported at the time of reexcision.

Biopsy↗