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Biomedical subjects

J Friedland

Publications and source records attributed to J Friedland.

At least 19 recordsLinked to original sources
PubMed2005

[Use of biological microchips in the determination of drug-resistance of Mycobacterium tuberculosis to rifampicin].

The present-day problems in tuberculosis control are associated with a difficulty in detecting Mycobacterium tuberculosis (MBT) in due time and in determining its drug sensitivity by conventional microbiological assays. The determination of the drug sensitivity of MBT takes much time from 2 weeks to 3 months, which fails to initiate and perform specific therapy timely. Molecular genetic techniques, including biochip analysis, yield results in 24-48 hours, which solves the problem of choosing and initiating adequate antibacterial therapy in the shortest possible time after tuberculosis is diagnosed. To assess the situation associated with the prevalence of rifampicin-resistant tuberculosis, by using the biochip analysis, the authors have examined 501 patients with tuberculosis who live in the Kyrghyz Republic. Drug resistance has been found in 40.3% of the examinees. At the same time, their primary and secondary drug resistance is 25.7 and 61.8%, respectively. In tuberculosis patients living in Kyrghyzstan, rifampicin resistance of MBT is more frequently due to mutations in 531 (59.2%), 526 (20.8%), and 516 (8.0%) codons in the rpoB gene.

Antibiotics, Antitubercular↗
PubMed2001

Randomized prospective evaluation of a novel technique for biopsy or lumpectomy of nonpalpable breast lesions: radioactive seed versus wire localization.

BACKGROUND: Standard wire localization (WL) and excision of nonpalpable breast lesions has several shortcomings. METHODS: Ninety-seven women with nonpalpable breast lesions were prospectively randomized to radioactive seed localization (RSL) or WL. For RSL, a titanium seed containing 125I was placed at the site of the lesion by using radiographical guidance. The surgeon used a handheld gamma detector to locate and excise the seed and lesion. RESULTS: Both techniques resulted in 100% retrieval of the lesions. Fewer RSL patients required resection of additional margins than WL patients (26% vs. 57%, respectively, P = .02). There were no significant differences in mean times for operative excision (5.4 vs. 6.1 minutes) or radiographical localization (13.9 vs. 13.2 minutes). There were also no significant differences in the subjective ease of the procedures as rated by surgeons, radiologists, and patients. All WLs were carried out on the same day as the excision, whereas RSL was performed up to 5 days before the operative procedure. CONCLUSIONS: RSL is as effective as WL for the excision of nonpalpable breast lesions and reduces the incidence of pathologically involved margins of excision. RSL also reduces scheduling conflicts and may allow elimination of intraoperative specimen mammography. RSL is an attractive alternative to WL.

Biopsy↗
PubMed2001

Knowing from whence we came: reflecting on return-to-work and interpersonal relationships.

Much as the medical reformers of the early 1900s believed that occupational therapists could assist patients in their efforts to rejoin society as contributing members, we believe that we can help people to lead satisfying and productive lives. Work (or productivity) and the notion of the spirit, have been entwined within occupational therapy since its inception. The connection was apparent in the badge worn by ward aides in World War I, which was described as emblematic of "the nobility of work lighting up mind, body and spirit". As in war-time, when the spirit can so readily be broken, much of our work today requires us to help mend broken spirits. It is here that we use our interpersonal skills to understand our clients' view of the world, and to enter into an alliance with them; it is here that we draw upon our own sense of compassion. As we evolve in our approach to clients, and move from therapy to enabling, from being a helping profession to a service provider, let us take care to preserve the sense of compassion with which our profession came into being. That compassion will influence what we do as practitioners and how we do it.

Humans↗
PubMed2001

Expanding the boundaries of occupational therapy practice through student fieldwork experiences: description of a provincially-funded community development project.

The numbers of occupational therapists in community practice are not yet large enough to provide fieldwork placements to accommodate all students. This article describes a project designed to educate community agencies that do not employ occupational therapists, about our service while at the same time securing new fieldwork placements. We used on-site different discipline and offsite same discipline supervision to provide students to selected agencies without cost. Funding for one year from the Ontario Ministry of Health to the Ontario University Programs in Rehabilitation Science enabled us to initiate and evaluate the project. Students in the project developed their ability to work independently and to see their potential role in health promotion and prevention. Despite the lack of ongoing government funding, four years later, community sites are not only being maintained, but the number of sites has increased from 28 to 39, providing a total of 75 student placements. By educating a growing number of community agencies about the work of occupational therapists, the project has also expanded the boundaries of practice.

Community Health Services↗
PubMed2000

Serum organochlorine levels and breast cancer: a nested case-control study of Norwegian women.

This study investigated the potential association between organochlorine exposure and breast cancer using stored sera collected from 1973 through 1991 from the Janus Serum Bank in Norway. Breast cancer cases were ascertained prospectively from among 25,431 female serum bank donors. A total of 150 controls were matched to cases by birth dates and dates of sample collection. One g of serum per subject was analyzed for a total of 71 organochlorine compounds. For 6 pesticides [B-hexachlorocyclohexane, heptachlor epoxide, oxychlordane, trans-nonachlor, p, p'-1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene, and p, p'-2,2-bis(p-chlorophenyl)-1,1,1-trichloroethane] and 26 individual polychlorinated biphenyl (PCB) congeners there were >90% of samples over the limit of detection. There was no evidence for higher mean serum levels among cases for any of these compounds, nor any trend of increasing risk associated with higher quartiles of exposure. The remaining compounds (including dieldrin) were analyzed with respect to the proportion of cancer cases and controls having detectable levels; no positive associations were noted in these analyses. Our study did not confirm the recent findings of a Danish study of increased concentrations of dieldrin in the serum of breast cancer cases. The evidence to date on the association between serum organochlorines is not entirely consistent, but there is accumulating evidence that serum levels of p, p'-1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene and total PCBs are not important predictors for breast cancer in the general population. Studies to date have not been able to evaluate whether exposure to highly estrogenic, short-lived PCB congeners increases breast cancer risk, nor have they fully evaluated the risk associated with organochlorine exposure in susceptible subgroups or at levels above general population exposure, including women with occupational exposure.

Adenocarcinoma↗
PubMed1999

American Brachytherapy Society (ABS) recommendations for transperineal permanent brachytherapy of prostate cancer.

PURPOSE/OBJECTIVE: To develop and disseminate the American Brachytherapy Society (ABS) recommendations for the clinical quality assurance and guidelines of permanent transperineal prostate brachytherapy with 125I or 103Pd. METHODS AND MATERIALS: The ABS formed a committee of experts in prostate brachytherapy to develop consensus guidelines through a critical analysis of published data supplemented by their clinical experience. The recommendations of the panels were reviewed and approved by the Board of Directors of the ABS. RESULTS: Patients with high probability of organ-confined disease are appropriately treated with brachytherapy alone. Brachytherapy candidates with a significant risk of extraprostatic extension should be treated with supplemental external beam radiation therapy (EBRT). Patient selection guidelines were developed. Dosimetric planning of the implant should be carried out for all patients before seed insertion. A modified peripheral loading is preferred. The AAPM TG-43 recommendations requiring a change in prescription dose for 125I sources should be universally implemented. The recommended prescription doses for monotherapy are 145 Gy for 125I and 115-120 Gy for 103Pd. The corresponding boost doses (after 40-50 Gy EBRT) are 100-110 Gy and 80-90 Gy, respectively. Clinical evidence to guide selection of radionuclide (103Pd or 125I) is lacking. Post implant dosimetry and evaluation must be performed on all patients. It is suggested that the dose that covers 90% (D90) and 100% (D100) of the prostate volume and the percentage of the prostate volume receiving the prescribed dose (V100) be obtained from a dose-volume histogram (DVH) and reported. CONCLUSION: Guidelines for appropriate patient selection, dose reporting, and improved quality of permanent prostate brachytherapy are presented. These broad recommendations are intended to be technical and advisory in nature, but the ultimate responsibility for the medical decisions rests with the treating physician. This is a constantly evolving field, and the recommendations are subject to modifications as new data becomes available.

Biopsy↗
PubMed1999

Local and systemic radiation for palliation of metastatic disease.

Many radiotherapeutic treatment options are available for the palliation of patients with metastatic prostate cancer. These include local field radiotherapy to symptomatic sites of metastasis and the use of radioisotope therapy either alone or in combination with local field radiotherapy. To date, the majority of patients treated with radioisotope therapy have been treated with 89Sr. Other agents, such as 153Sm-EDTMP are available now, also. Combined radioisotope therapy, cytotoxic chemotherapy, and biphosphonates hold great promise.

Bone Neoplasms↗
PubMed1999

The Caregiver Quality of Life Index-Cancer (CQOLC) scale: development and validation of an instrument to measure quality of life of the family caregiver of patients with cancer.

Family caregivers have become increasingly responsible for providing home care for cancer patients. Research has documented the distress of family caregivers; however, little has been done to evaluate the broader impact of caregiving on quality of life (QoL). The objectives of this study were to evaluate the reliability and validity of the Caregiver Quality of Life Index-Cancer (CQOLC), a new self-report instrument. Two hundred and sixty-three family caregivers of patients with lung, breast or prostate neoplasms participated. Test-retest reliability was 0.95 and internal consistency was 0.91. As expected, there were moderate correlations with overall mental health (r = 0.64), emotional distress (r = -0.50 to -0.52), burden (r = -0.65) and patient's performance status (r = -0.47) and low correlations with overall physical health (r = 0.13), social support (r = 0.22) and social desirability (r = 0.08). These results show that increased overall mental health is associated with better QoL, while more emotional distress and worsening patient performance status are associated with poorer QoL. Thus, the CQOLC appears to possess adequate validity, test-retest reliability and internal consistency. Future directions include further evaluation of sensitivity to change and factor analysis to determine the principal health-related QoL domains evaluated by the CQOLC.

Activities of Daily Living↗
PubMed1999

Description and validation of a measure of received support specific to HIV.

Validation data are described for the Social Support Inventory for People who are HIV Positive or Have AIDS. This inventory was developed specifically for use with individuals who are HIV-positive to assess three types of received support (instrumental, informational, emotional) for each of four dimensions: whether support is received or wanted, satisfaction with support, and source of the support. It was validated in the context of a larger cross-sectional study of 120 adults with HIV who completed a set of questionnaires. Descriptive statistics, internal consistency coefficients, and evidence of construct validity for the original inventory are presented. An improved, revised version based on the validation data for the original one is also briefly described, but not tested.

Adult↗
PubMed1998

Occupational therapy and rehabilitation: an awkward alliance.

This article argues that although occupational therapy and rehabilitation are often considered synonymous, the latter is but one aspect of the former. Early influences on occupational therapy are briefly reviewed, and some philosophical ideas about activity are described. The rationale for the use of occupations as treatment in the early part of this century, both in Canada and in the United States, is examined and contrasted with the development of physical medicine and rehabilitation after World War II. This discussion demonstrates that the origins of occupational therapy and rehabilitation in North America had little in common. As occupational therapy became incorporated into rehabilitation, the profession's core values eroded, and although current definitions of rehabilitation offer a more appropriate fit for occupational therapy, rehabilitation continues to see engagement in occupations as a separate and subsequent step. The article concludes by considering future directions and the tasks that lie ahead.

Canada↗
PubMed1997

Prostate cancer.

Prostate cancer is the most common cancer in American men and the second leading cause of death in men aged 65 years or older. This article reviews the epidemiology and the principles of screening and management of prostate cancer.

Aged↗
PubMed1996

Coping and social support as determinants of quality of life in HIV/AIDS.

Coping, social support and quality of life (QOL) were examined in 120 HIV+ people (mean age = 37). The sample came from ambulatory clinics and drop-in centres in Toronto: 29% had AIDS, 35% were HIV symptomatic, and 35% were asymptomatic. Information was gathered from self-administered questionnaires. Respondents had good levels of social support and used a variety of coping strategies. Their scores on the behavioural and subjective measures of QOL were somewhat below average. The illness-related measure indicated that their diagnosis had an almost neutral effect on QOL and showed several areas where QOL had been positively affected. Data from male subjects only (n = 107) were analysed using a hierarchical block regression for each QOL measure. Income, emotional social support, and problem-oriented and perception-oriented coping were positively related to QOL. Tangible social support and emotion-oriented coping were negatively related and symptom severity was not related at all. Close friends provided most types of support. Although respondents indicated high levels of satisfaction with support generally, they expressed a need for more emotional support. Unemployment was high despite participants being relatively healthy and well-educated.

Adaptation, Psychological↗
PubMed1995

Workers' response to risk notification.

Since 1988, the National Institute for Occupational Safety and Health (NIOSH) has notified workers who were subjects in occupational epidemiology studies of the study findings ("worker notification"). This paper describes seven notifications and the worker's reactions to them. The chemicals of interest in the studies were: carbon monoxide, o-toluidine, bis-chloromethyl ether, polychlorinated biphenyls, cadmium, acid mist, and dioxin. Materials describing the study results were sent to 15,958 subjects who were notified of their increased risk of arteriosclerotic heart disease, bladder cancer, lung cancer, melanoma, kidney dysfunction, laryngeal cancer, all cancers combined, or soft tissue sarcoma. Workers provided feedback via telephone calls, and for three notifications, by postcards containing workers' comments and ratings of the notification materials. The percentage of telephone calls received from notified workers ranged from 0.3% to 3.8%, and the percentage returning postcards ranged from 8.8% to 17.6%. The two largest categories of callers were those with questions about their disease risk (30%) or who reported on their health status (25%). Most of the comments on postcards (26%) were complimentary or expressed appreciation for receiving the letters; reports of ill health were second (20%). A majority (66%) rated the notification materials well done. Few of the callers (5%) requested information on legal issues. Most (85%) did not find the materials, which ranged in reading level from sixth to ninth grade, too hard to read, although 15% reported difficulty reading them. Although this response system was effective in producing some input from workers, its limitation is that respondents may not be representative of all notified workers. However, such information is useful because there are few data on the effects of notifications on workers.

Carcinogens↗
PubMed1994

Morphology and pathology of radiation-induced esophagitis. Double-blind study of naproxen vs placebo for prevention of radiation injury.

Radiation-induced esophagitis can cause substantial morbidity. Experiments in lab animals have shown that pretreatment with indomethacin protects the esophagus from radiation damage. We conducted a prospective, double-blind, randomized trial of naproxen vs placebo in patients undergoing thoracic radiation therapy for lung cancer. Twenty-eight patients were enrolled, of which 26 completed the study. Sixteen patients were given a short course of radiation (30 Gy/10 fractions/2 weeks), and 10 patients were given a longer course and a larger dose (40-50 Gy/25 fractions/5 weeks). Half of the irradiated patients were treated with naproxen, 375 mg, taken orally twice a day, and half were given an identical placebo. All patients were given ranitidine 300 mg, taken orally once a day. Study drugs were taken throughout the course of radiation. Endoscopy with esophageal biopsies and brushings was performed before and on the last day of treatment. Patients kept a daily diary for symptom scoring. Symptoms such as chest pain, dysphagia, odynophagia, and/or heartburn were reported in 15 patients from both subgroups, resulting in diet restriction to liquids only in eight patients and requiring temporary discontinuation of radiation therapy in one of them. Approximately half the patients in each subgroup developed esophagitis, usually mild and usually limited to the proximal esophagus. Severity of symptoms was not proportional to the severity of esophagitis. Candidiasis was documented in eight patients, but only four had symptoms that were severe in one. We conclude that acute radiation injury to the esophagus is observed in approximately half the patients receiving radiation therapy and can result in substantial morbidity.(ABSTRACT TRUNCATED AT 250 WORDS)

Double-Blind Method↗