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Biomedical subjects

J Marcus

Publications and source records attributed to J Marcus.

At least 19 recordsLinked to original sources
PubMed1992

Infants at risk for schizophrenia: sequelae of a genetic neurointegrative defect. A review and replication analysis of pandysmaturation in the Jerusalem Infant Development Study.

A 1975 report stated that a schizophrenic genotype may be manifested in infants by a neurointegrative defect called pandysmaturation. Recent evidence supports this: (1) 12 studies found delayed development in schizophrenics' infants and in preschizophrenics; (2) "blind" psychometric evaluations favored an adult schizotypal disorder in four to six of seven high-risk subjects with pandysmaturation in the New York study; and (3) finally, in a partial replication of this method using the Jerusalem data, blind diagnoses of "probable" and "possible" pandysmaturation were significantly related to a parental diagnosis of schizophrenia and to cognitive and motor neurointegrative deficits at 10 years. Obstetrical complications were unrelated to diagnosis, pandysmaturation, or outcome in the overall sample. However, we found a small subgroup of schizophrenic offspring in whom the most severe motor deficits at follow-up were related to obstetrical complications, pandysmaturation, and low birth weight.

Adult↗
PubMed1992

Disseminated candidiasis, Candida arthritis, and unilateral skin lesions.

Candida species are the most common cause of systemic fungal infections in patients with hematologic malignancies. These infections are aggressive with rapid dissemination to various organs. Cutaneous lesions occur in 10% to 13% of cases, whereas Candida arthritis occurs infrequently. This report describes the first case of disseminated candidiasis in a patient with both Candida arthritis and unilateral cutaneous lesions.

Acute Disease↗
PubMed1992

Interpersonal behavior of children at risk for schizophrenia.

Investigations of the childhood antecedents of adult schizophrenia may clarify our understanding of the etiology of the disease, provide guidelines for meaningful classification of subtypes of schizophrenic illness, point to strategies for identifying those individuals in need for early intervention, and suggest appropriate techniques for early intervention. Among the more salient characteristics of schizophrenic illness are disturbances in interpersonal relations, especially withdrawal from normal social interaction.

Child↗
PubMed1992

Tissue expansion in a patient with extensive nevus comedonicus.

Nevus comedonicus is a rare developmental abnormality of the pilosebaceous apparatus that presents as an aggregation of dilated follicular orifices filled with pigmented keratinous material. Occurrence of extensive or giant lesions is even more rare. Indications for treatment include recurrent infections and cosmetic reasons. Therapeutic approaches include topical keratolytic agents, manual extraction of comedones, dermabrasion, and excision of smaller lesions. Increasing clinical experience with tissue expansion has suggested that it might be used effectively in the definitive treatment of an extensive nevus comedonicus previously considered too large to excise without the use of a skin graft, despite the potential risk of infection within the lesion during the course of expansion. We report the first patient with giant nevus comedonicus to be treated using tissue expansion. This patient demonstrates that prompt treatment of cellulitis and abscesses within the lesion will keep this process isolated from the adjacent expanders and will not compromise a planned excision and reconstruction.

Buttocks↗
PubMed1990

Tissue expansion: past, present, and future.

The history of tissue expansion, technique, indications, and complications are reviewed. A detailed review of delayed tissue expansion's histologic, biochemical, biomechanical, and physiologic changes in the skin is given. There is a net gain in epidermal tissue during delayed expansion. Recent experimental and clinical experience suggests that expansion for 1 to 2 weeks is just as effective as longer delayed expansion for 6 to 8 weeks. A new deviation from standard technique, intraoperative tissue expansion, may have significant implications for dermatologic surgery. Intraoperative tissue expansion is explored in relation to other commonly used techniques of intraoperative load cycling.

Animals↗
PubMed1989

Prosthetic rehabilitation of elderly bilateral amputees.

A retrospective evaluation of vascular amputees, all over 55 years of age, found that 18 underwent bilateral lower limb amputation. The ages of patients ranged from 55 to 83 years, mean age at the time of second amputation was 65.9 years, 13 men and 5 women. Out of the 18 patients, 12 underwent bilateral below knee amputation (BK-BK), 3 below knee and above knee (BK-AK), and 3 bilateral above knee (AK-AK). Six patients (50%) of the 12 with BK-BK were fitted with prostheses. They therefore became users of two prostheses and have achieved a high functional level of rehabilitation despite a high mean age of 67.8 years. Five of these patients had been successful prosthetic users after the first leg amputation. The sixth patient underwent double BK amputation almost at the same time. He was fitted and rehabilitated with two prostheses simultaneously. Patients with BK-AK and AK-AK amputations had not been fitted with two prostheses. Deciding about prosthetic prescription and type of rehabilitation of elderly bilateral amputees is very difficult. Age alone is not a factor in success or failure of prosthetic rehabilitation. The type of rehabilitation for these patients is related mainly to the level of amputation, associated diseases and successful prosthetic use after the first leg amputation. Careful evaluation by a multidisciplinary team is the key for the right treatment decision and successful rehabilitation of this group of patients.

Activities of Daily Living↗
PubMed1988

Age-of-onset heterogeneity in hereditary breast cancer: minimal clues for diagnosis.

Knowledge of the family history of cancer may significantly influence diagnosis and surgical management. Hereditary breast cancer (HBC) is common and accounts for approximately 9% of the total breast cancer burden. The pattern of HBC's natural history, including age of onset, increased incidence of bilaterality, integral tumor combinations in certain kindreds, and vertical transmission consonant with an autosomal dominantly inherited factor, when observed in context with the family history, enables pattern recognition so that the diagnosis might be facilitated. We describe seven families from our Hereditary Cancer Consultation Center (HCCC) and the Creighton Oncology Clinic which are noteworthy for extraordinarily early age of onset. This appears to be an additional example of heterogeneity in HBC and may represent the first account of this remarkable subset. The manner in which age of onset can be incorporated with other aspects of natural history for expediting diagnosis is discussed.

Age Factors↗
PubMed1988

Natural history of colorectal cancer in hereditary nonpolyposis colorectal cancer (Lynch syndromes I and II).

Approximately 5 to 6 percent of the total colorectal cancer burden is accounted for by hereditary nonpolyposis colorectal cancer (HNPCC). Because clinical premonitory signs such as those seen in familial polyposis coli (FPC) are lacking, the clinician must recognize clinical findings and family history typical of HNPCC. The authors have described colorectal cancer expression from a survey of ten HNPCC kindreds. Kindred members with colorectal cancer differed significantly (P less than .05) from patients with sporadic colorectal cancer: 1) mean age of initial colon cancer diagnosis was 44.6 years; 2) 72.3 percent of first colon cancers were located in the right colon, and only 25 percent were in the sigmoid colon and rectum; 3) 18.1 percent had synchronous colon cancers; and 4) 24.2 percent developed metachronous colon cancer, with a risk for metachronous lesions in ten years of 40 percent. Affecteds and their first-degree relatives should undergo early intensive education and surveillance. In families with an early age of onset, colonoscopy should begin at age 25, and biannually thereafter, with fecal occult blood testing of the stool semiannually. Third-party carriers must become more responsive to the costly surveillance measures required for these otherwise healthy patients.

Adult↗
PubMed1988

Differential diagnosis of hereditary nonpolyposis colorectal cancer (Lynch syndrome I and Lynch syndrome II).

Increasing recognition of the statistical burden posed by HNPCC (5 to 6 percent of all colorectal cancer) mandates that physicians have a better understanding of the genetics, natural history, and distinction between the hereditary site-specific variant (Lynch syndrome I) and the Cancer Family Syndrome (Lynch syndrome II). The authors report detailed cancer (all sites) family histories on two prototype families with Lynch syndrome I (Family R) and Lynch syndrome II (Family N), which have been under investigation for more than two decades. Emphasis is placed on shared clinicogenetic features; namely, early age of onset of colonic cancer (approximately age 44), multiple primary colonic cancer (24 percent of cases showed metachronous colonic cancer), predominance of proximal colonic cancer location (approximately 65 percent in the proximal colon), and vertical transmission consonant with an autosomal dominantly inherited factor. An increased predilection for extracolonic cancer, particularly endometrial carcinoma, occurs in Lynch syndrome II and is the primary basis for distinction from Lynch syndrome I. Surveillance and management programs must be wholly responsive to these natural history features.

Adult↗
PubMed1987

A process model for the development of schizophrenia.

Less than two decades ago scientists interested in the etiology of schizophrenia were still vigorously debating the nature-nurture controversy, with many adhering to the view that the illness grew either out of a constitutional deficit or a pathological family environment. Today, virtually all researchers adopt interactional models that include both constitutional and environmental factors. Interactional models are most often expressed in diathesis-stress terms: Development of schizophrenia requires both a biological vulnerability (diathesis) and stressful life circumstances that facilitate expression of the illness. Modern debate within the field now primarily focuses on understanding the characteristics of the biological diathesis, the stressful environment, and their interaction. Scientists using diathesis-stress theories have employed several research strategies (Rosenthal 1970): (1) consanguinity studies exploring the distribution of illness among the relatives of schizophrenics, (2) twin studies comparing the concordance of schizophrenic illness in monozygotic and dizygotic twin pairs reared together or apart, (3) retrospective studies examining the premorbid behavior and development of schizophrenic parents, and (4) prospective studies of children at high risk for schizophrenia. The population most frequently followed in prospective high-risk studies has been offspring of schizophrenics. Biological offspring of schizophrenics who are reared by their parents are at extremely high risk for becoming schizophrenic themselves, approximately ten times greater risk than the general population. The present paper will make use of the Israeli High-Risk Study to test a diathesis-stress model for the transmission of schizophrenia. The goodness of fit of this model to the data will be explored using a simple decision tree data analytic approach.

Child↗
PubMed1978

Agranulocytosis and chlorpromazine.

A case of death associated with chlorpromazine agranulocytosis and the pertinent literature is reviewed. The authors conclude that the condition is cumulative dose related. Elderly, sickly Caucasian females are the population at high risk. Daily evaluation of the need for medication, the cumulative dose, and signs of infection and fever can reduce the incidence.

Age Factors↗
PubMed1976

Nursing consultation: a clinical specialty.

In summary, the Mental Health Nurse Consultant is committed to the belief that nursing staff are competent to implement appropriate mental health care. Because of this the consultant utilizes both resource and process consultation to assist staff in determining care plans and to support a realistic method for delivery. The Mental Health Nurse Consultant interviews clients in order to assess dynamics of behavior and uses this information for care plan development. The direct interview also enables the consultant to investigate client perceptions of Psychiatric Mental Health Intervention and support the utilization of direct involvement by a member of the Consultation and Liaison Team. The Mental Health Nurse Consultant acts as a facilitator for ongoing utilization of existing resources through resource and process consultation to members of the Department of Nursing. Thus, consultation as a clinical specialty offers an additional opportunity for nurses to utilize individual skills and refocus the tasks of nursing within the general hospital.

Hospitals, General↗