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Biomedical subjects

J R Weinberg

Publications and source records attributed to J R Weinberg.

9 recordsLinked to original sources
PubMed1992

Lipopolysaccharide, tumor necrosis factor, and interleukin-1 interact to cause hypotension.

Lipopolysaccharide (LPS) causes the syndrome of septic shock by initiating the release of endogenous mediators such as tumor necrosis factor (TNF) and interleukin-1 (IL-1) from macrophages. Hypotension is one of the important clinical features of septic shock; however, TNF is only hypotensive in high doses. Therefore we have investigated the interactions of low, nonhypotensive doses of LPS, IL-1, and TNF in the restrained unanesthetized rabbit. Combinations of nonhypotensive doses of TNF, IL-1, and LPS produced significant (p less than 0.05) decreases in blood pressure as compared with doses of each of the substances alone. TNF bioactivity in animals that were made hypotensive with combinations of TNF, IL-1, and LPS was lower than in animals that were made hypotensive with TNF alone. This suggests that TNF release that is stimulated by LPS is not the sole cause of the hypotension that is seen in this model of endotoxic shock. In this model, interactions of LPS, IL-1, and TNF occur and may explain hypotension during some episodes of sepsis.

Animals↗
PubMed1992

Fever, cytokines and shock.

Septic shock is a complex event with activation of many inflammatory pathways. Recent advances have begun to make some sense of the pathophysiological events. This review describes the historical background to the contemporary concepts and outlines the important role that cytokines probably have in the pathophysiology of septic shock. A consequence of the changing understanding of septic shock is that new therapeutic interventions are becoming available.

Cytokines↗
PubMed1991

Hypothermia and infection in elderly patients admitted to hospital.

Twenty-five consecutive elderly patients with hypothermia were studied. Data were gathered regarding their home conditions, the circumstances in which they had been found, and their recent medical history. Clinical and laboratory examinations were performed to establish accurate diagnoses of underlying illnesses present at the time of arrival in hospital. Patients were followed up until the completion of the study. Evidence of an underlying cause was found in all cases. Twenty-two patients had evidence of definite or probable infection at the time of admission. Drugs may have contributed in seven cases. There were multiple significant causes for hypothermia in nine cases. Only 12 patients survived the index admission, and six of these had previous or subsequent admissions with hypothermia.

Age Factors↗
PubMed1991

The increase in body temperature of elderly patients in the first twenty-four hours following admission to hospital.

In 76 unselected patients aged 70 years or over, the mean increase in rectal temperature in the 24 hours following admission to hospital was 0.4 degrees C. In those who did not receive antibiotics on admission, the mean increase in rectal temperature was 0.6 degrees C, with increases of up to 2.3 degrees C recorded. There were no significant changes in C-reactive protein, white cell count or erythrocyte sedimentation rate over that period, suggesting that the changes were due to passive warming rather than to progression of the underlying disease. Infected patients may have low or normal body temperatures on admission. Within 24 hours, nearly all infected patients (excluding a few with low or normal temperatures on admission, who receive antibiotics) have a raised body temperature. The most sensitive test for a raised body temperature is the rectal temperature measured at least 24 hours after admission. A patient who has a low or normal body temperature on admission has a 61% chance of having a raised body temperature the next day. At least 55% of patients admitted with a febrile illness have low or normal body temperatures on admission.

Aged↗
PubMed1991

Normal rectal, auditory canal, sublingual and axillary temperatures in elderly afebrile patients in a warm environment.

Fifty hospital inpatients were selected, who, on the basis of their history and on clinical and laboratory findings, were believed not to have a febrile illness. Body temperature was measured simultaneously at four sites, in order to compile a normal range of temperature at each site for patients under these conditions. The observed range of rectal temperature was 36.7-37.5 degrees C, auditory canal temperature 36.4-37.2 degrees C, sublingual temperature 36.2-37.0 degrees C, and axillary temperature 35.5-37.0 degrees C.

Aged↗
PubMed1991

Capillary blood cell velocity is reduced in fever without hypotension.

Capillary blood cell velocity was measured in a group of normotensive febrile patients as a basis for further study into the microvascular physiology of febrile hypotensive patients with sepsis. Television videomicroscopy was used to record the capillary blood cell movement in the finger nailfold. Analysis of all moving gaps in the red cell column seen during a minimum of 2 minutes was done by the frame-by-frame technique and mean blood cell velocity derived. Core (external auditory meatus) and skin (finger) temperature were also measured. Subjects (n = 6) were sex and skin temperature matched to controls. Although the mean skin temperature of subjects [28.73 degrees C, SD = 0.28] was not significantly different to controls [30.63 degrees C, SD = 3.11; p less than 0.05] the mean velocity was significantly reduced in the febrile subject group [0.28 mm/sec, SD = 0.17] as compared with controls [0.56 mm/sec, SD = 0.22; p less than 0.05]. It is likely therefore that these skin vessels vasoconstrict as part of the integrated response to reduce heat loss.

Adolescent↗
PubMed1977

Toward classifying psychoactive chemical use.

A classification scheme is proposed based on description of consequences of psychoactive chemical use. It is an alternative to current labels (e.g., alcoholic, drug abuser, chemically dependent) which are often controversial or pejorative, as well as being imprecise and limited to pathology. The categories are: Helpful, Low Risk Potential Harm, High Risk Potential Harm, and Harmful. These are briefly defined and illustrative examples are cited. The appropriate treatment responses for the four categories are, respectively: Encouragement, Accurate Information, Persuasive Education, and Active Intervention. The basic rationale and procedure for each is discussed. The system incorporates prevention as well as remediation.

Barbiturates↗
PubMed1976

Assessing drinking problems by history.

Patients with alcohol problems can be categorized as either medical alcoholics, who have medical problems caused by high levels of alcohol consumption, or behavioral alcoholics, whose drinking results in adverse changes in their behavior. Behavioral alcoholics pose a diagnostic problem to the physician because of their highly developed denial systems. A detailed, accurate drinking history is necessary for diagnostic assessment, and the physician must employ several key strategies in order to circumvent the denial system and elicit relevant information. Additional information can be obtained from a member of the problem drinker's family. Family members should also be involved in the treatment process.

Alcoholism↗