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Biomedical subjects

J M Silverman

Publications and source records attributed to J M Silverman.

At least 73 records · Page 4Linked to original sources
PubMed1993

Radiologic evaluation of multichannel intracochlear implant insertion depth.

Postoperative plain film x-rays are necessary in all multichannel cochlear implant patients to confirm intracochlear position, detect possible electrode kinking, and provide a reference if postoperative slippage occurs. In addition, precise documentation of multichannel intracochlear electrode insertion depths is necessary for comparison of speech recognition results among patients and may be of use for future speech processing strategies. In the present study, a method has been devised, using a modified Stenver's view, to more accurately document insertion depths of the electrode array and location of individual electrodes on 50 multichannel cochlear implant patients. Surgical estimates of insertion depth are shown to have great variability in regard to distance along the basilar membrane when compared with x-ray documentation. Additionally, there is preliminary evidence that insertion depth, as determined by x-ray studies, has a strong correlation with open-set speech discrimination.

Basilar Membrane↗
PubMed1992

Deterioration on the Blessed test in Alzheimer's disease: longitudinal data and their implications for clinical trials and identification of subtypes.

One hundred eleven patients with probable Alzheimer's disease (AD) were given the Blessed test (BT) of information, memory, and concentration (scored 0-33) at 6-month intervals over periods of 6-96 months. For each patient, the change in the total BT score between pairs of visits at 6- and 12-month intervals was measured. Mean deterioration scores over 6 and 12 months were 2.2 (SD = 3.2) and 4.1 (SD = 4.1) points, respectively. There was no significant correlation between degree of dementia on the BT and the rate of deterioration. Gender, age of onset, and family history had no significant effect on the rate of deterioration. The implications of the results for treatment trials and investigations of clinical heterogeneity are discussed.

Adult↗
PubMed1992

A cross-cultural family history study of primary progressive dementia in relatives of nondemented elderly Chinese, Italians, Jews and Puerto Ricans.

Very few studies have directly compared the risk for Alzheimer's disease in different ethnic groups. This may be due in part to the costs and methodological difficulties associated with conducting traditional epidemiological studies. The family history method, in which information is collected on the dementia status of relatives of normal elderly members of ethnic groups of interest, offers a less costly and more practical preliminary approach. In the present study, 6866 first-degree relatives of 924 elderly, nondemented index subjects (305 Chinese, 212 Jewish, 215 Italian and 192 Puerto Rican, living in New York City) were assessed through family history interview for progressive primary and other dementias using previously published family history criteria. Both the Jewish and Italian groups had significantly increased cumulative risk for progressive primary dementia compared with both the Chinese and Puerto Rican groups. Although possible methodological biases cannot be discounted, these results appear to reflect differences between ethnic groups in the degree of risk for dementia.

Aged↗
PubMed1992

A case-control study of Alzheimer's disease in China.

We conducted a case-control study to assess possible factors associated with Alzheimer's disease (AD) with 70 clinically diagnosed AD patients and 140 age- and sex-matched nondemented neighborhood controls in China. Factors significantly associated with AD cases were family history of dementia in first-degree relatives, family history of psychotic disorders in first-degree relatives, and left-handedness/ambidexterity. A history of arthritis showed a significantly negative association with AD. Neither a family history for Down's syndrome, history of head trauma, nor other conditions that might support immune or viral hypotheses in AD were significantly associated with AD cases. These data support the role of familial/genetic factors in AD.

Aged↗
PubMed1991

Case report 659: Metastatic osteoblastic carcinoid tumor (primary in pancreas or gallbladder).

The only plain radiographic skeletal features in this 71-year-old man were those of a solitary sclerotic lumbar vertebral body which grossly underestimated the extent of metastatic carcinoid involvement of the lumbar spine and elsewhere described in the text. The primary focus in this case was either the pancreas or gallbladder resulting in disseminated metastases to the skeleton and many visceral areas. It was emphasized that these skeletal metastases are principally blastic and that those carcinoids arising in the bronchi and foregut-related structures (e.g., stomach) most often metastasize to the skeleton.

Aged↗
PubMed1991

Affective and impulsive personality disorder traits in the relatives of patients with borderline personality disorder.

OBJECTIVE: This study tested the hypothesis that the risk for affective and impulsive personality disorder traits commonly found in patients with borderline personality disorder would be greater in the first-degree relatives of probands with borderline personality disorder than in two comparison groups. METHOD: Blind family history interviews were conducted with family informants to assess the extent to which first-degree relatives of 29 probands with borderline personality disorder, 22 probands with other personality disorders who met three or fewer of the criteria for borderline personality disorder, and 43 probands with schizophrenia fulfilled operationalized criteria for the two kinds of personality disorder traits and for other diagnostic categories. The crude proportions of adult relatives with each diagnosis, as well as the age-adjusted morbid risks, were assessed in the three groups of relatives. RESULTS: The risks for affective and impulsive personality disorder traits were independently greater in the 129 relatives of the borderline probands than in the 105 relatives of the probands with other personality disorders and the 218 relatives of the schizophrenic probands. There was no similarly greater risk for any other psychiatric disorder assessed, including major affective disorder. In addition, the relatives of borderline probands with current or past major depressive disorder showed a greater risk for major affective disorders than the relatives of never-depressed probands with other personality disorders but not the relatives of never-depressed borderline probands. CONCLUSIONS: These results suggest familial transmission of the hallmark borderline-related personality characteristics and raise the possibility that these familial traits may be partially independent.

Adult↗
PubMed1991

Clinical genetic studies of Alzheimer's disease.

In this article, the authors review the genetic investigations in Alzheimer's disease employing epidemiologic study techniques--mainly case-control, twin, and cumulative risk studies--as well as pedigree and genetic linkage studies and discuss the implications these studies have for identifying and characterizing a possible genetic etiology of Alzheimer's disease. Some of the methodologic issues associated with each of these techniques and the more general problems associated with identifying genetic factors in Alzheimer's disease are discussed, and some directions and prospects for future research in this area are indicated.

Aged↗
PubMed1990

Increased morbid risk for schizophrenia-related disorders in relatives of schizotypal personality disordered patients.

To evaluate whether probands from a clinical sample diagnosed as having DSM-III schizotypal and/or paranoid personality disorder have a familial relationship to the schizophrenia-related disorders, the morbid risk for schizophrenia-related disorders and other psychiatric disorders were evaluated in the first-degree relatives of patients with schizotypal and/or paranoid personality disorder and compared with the corresponding risk for these disorders in the first-degree relatives of patients with other non-schizophrenia-related personality disorders. The morbid risk for all schizophrenia-related disorders, and specifically for schizophrenia-related personality disorders, was significantly greater among the relatives of the probands with schizotypal and/or paranoid personality disorder than among the relatives of probands with other personality disorder. The morbid risk for other psychiatric disorders did not differ significantly between the first-degree relatives of the schizotypal/paranoid personality disorder and the other personality disorder control proband samples. These results suggest a specific familial association between schizophrenia-related disorders, particularly schizophrenia-related personality disorders, and clinically diagnosed schizotypal patients.

Adolescent↗
PubMed1989

Large melanoma metastases to the gastrointestinal tract.

It is well known that malignant melanoma can metastasize widely. Although these metastases in the gastrointestinal tract usually appear as small 'bull's-eye' or 'target' lesions, there are a few reports of relatively large melanoma metastases. We report five cases of large melanoma lesions metastatic to the alimentary canal. We also emphasise the consideration of a thorough gastrointestinal tract evaluation in patients with malignant melanoma especially if they are symptomatic.

Aged↗
PubMed1989

Discoid menisci of the knee: MR imaging appearance.

Discoid menisci of the knee are not uncommon, and the criteria for arthrographic diagnosis and the clinical symptoms are well known. Although enlarged menisci have been recognized at magnetic resonance (MR) imaging, there are no criteria for the MR imaging diagnosis. The authors describe 29 discoid menisci imaged by means of MR. A discoid meniscus was said to be present if three or more 5-mm-thick contiguous sagittal images demonstrated continuity of the meniscus between the anterior and posterior horns. High-resolution coronal images allowed more graphic depiction of the abnormally wide meniscus. In approximately one-third of the cases in which coronal images were obtained, the measurable height difference between the discoid and the opposite meniscus was greater than or equal to 2 mm. Arthroscopic correlation (obtained in 10 cases) revealed that six cases of discoid meniscus were diagnosed correctly with MR imaging, although one meniscus was considered discoid at MR imaging but was not considered discoid at arthroscopy. Of three discoid menisci seen to be torn at arthroscopy, two were seen to be torn at MR imaging.

Adult↗
PubMed1989

Premorbid sociosexual functioning and long-term outcome in schizophrenia.

Chronic schizophrenic patients with the most severe social deterioration have been shown to differ from other chronic schizophrenic patients with respect to measures of left-to-right ventricular asymmetry, negative symptoms, and response to haloperidol treatment. In the current study, the authors investigated the social antecedents of these characteristics of very poor outcome schizophrenia in 69 chronic schizophrenic patients. Poor premorbid sociosexual functioning was associated with more severe left-to-right ventricular asymmetry, greater severity of negative symptoms, fewer positive symptoms, and worse current social functioning. These data suggest that factors associated with severe social deterioration in the end stage of schizophrenia are also associated with premorbid sociosexual impairment.

Adult↗
PubMed1989

A study of the reliability of the family history method in genetic studies of Alzheimer disease.

The reliability between 2 raters conducting independent family history interviews for Alzheimer disease-like and other dementias was investigated. The interviews were conducted at least 1 year apart with the second rater blind to the data collected by the first rater. Raters agreed on the presence and type of dementia in 153 relatives age 45 or older of 30 AD probands, the age at onset in secondary cases, and the age of nonaffected relatives.

Aged↗
PubMed1988

Age-dependent expression of familial risk in Alzheimer's disease.

There is growing evidence for genetic causes of Alzheimer's disease; therefore, consideration of its age at onset among genetically predisposed individuals is timely. The authors studied the onset of Alzheimer-like dementia in families of 79 probands ascertained clinically for the Bronx Veterans Administration/Mt. Sinai School of Medicine longitudinal studies of Alzheimer's disease. Analyses among their 379 first-degree relatives, living and decreased, suggested that 1) early onsets form a distribution that is distinct from that of later onsets, and thus, different causes or mechanisms may operate in early- and late-appearing disease; 2) age at onset varies as a familial characteristic; 3) with present population survival, only one third of the theoretical predisposition to Alzheimer's disease will become manifest during the lifetime of relatives at risk; and 4) a stable annual incidence of 1.5 per cent in the early ninth decade, reported by others, can be explained by the operation of a dominant gene with a population allele frequency of 0.13. The authors conclude that different (possibly genetic) causes of Alzheimer's disease may operate in different families or individuals, although much of its predisposition remains latent during the lifetime of those at risk.

Age Factors↗
PubMed1988

Familial aggregation in Alzheimer's disease: comparison of risk among relatives of early-and late-onset cases, and among male and female relatives in successive generations.

Although the morbid risk of Alzheimer's disease (AD) is increased among relatives of AD index cases, it is not yet clear whether the extent of familial aggregation is similar for probands of all ages, or for male and female relatives. The present study investigated the incidence of AD-like illness among 379 first-degree relatives of 79 probands in a continuing longitudinal study of AD. Cumulative incidence among relatives increased strikingly with age to 49% by age 87, and the risks observed did not differ appreciably among relatives of presenile-onset versus senile-onset probands. Risks were also similar among parents and sibs. Female relatives appeared to develop the disease earlier than males, but the age-specific risk curves for the two sexes did not differ significantly. These results should not be viewed as direct evidence for dominant genetic transmission of late-onset AD, but they suggest a rationale for formal genetic studies in late-onset (often apparently "sporadic") disease as well as earlier-onset ("familial") cases.

Adult↗
PubMed1987

Alzheimer's disease. Morbid risk among first-degree relatives approximates 50% by 90 years of age.

The morbid risk of Alzheimer's disease was studied in first-degree relatives of 50 patients who met contemporary clinical research diagnostic criteria and 45 matched controls. Relatives of patients showed a 46% cumulative incidence of probable Alzheimer's disease by 86 years of age. The risk, which was four times the control value, is consistent with other recent reports using similar, modern methods. Although not conclusive, the data suggest the operation of a relatively common, dominant autosomal gene for Alzheimer's disease, the expression of which is delayed until late old age but is largely complete by 90 years of age.

Actuarial Analysis↗
PubMed1987

Familial schizophrenia and treatment response.

Thirty-nine patients with chronic schizophrenia for whom hospitalization was clinically indicated received haloperidol for 4 to 6 weeks in a standardized dose schedule. Responders were compared with nonresponders for family history, baseline symptom factors, and ventricle-brain ratio (VBR). The lifetime risk for schizophrenia spectrum disorders was higher among first-degree relatives of nonresponders than among first-degree relatives of responders. Treatment responders had higher baseline scores on the factors of activation and hostile-suspiciousness, but the groups did not differ in any other baseline symptom factor or in VBR. The authors suggest that there is an association between failure to respond to drugs and genetic loading for schizophrenia spectrum disorders.

Adolescent↗
PubMed1987

Characteristics of very poor outcome schizophrenia.

The authors compared 21 "Kraepelinian" schizophrenic patients who had been ill and dependent on others for the past 5 years with 76 chronic schizophrenic patients in remission or with exacerbations requiring hospitalization. The Kraepelinian patients met the criteria for schizophrenia by more diagnostic systems than the exacerbated patients, were less responsive to haloperidol, had more severe negative symptoms, and had similarly severe positive symptoms. They had cerebral ventricles that were more asymmetrical and a greater family history of schizophrenia spectrum disorders than the other chronic patients. These data suggest that patients with 5 years of illness and complete dependency on others may represent a subgroup of schizophrenia.

Adult↗