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Biomedical subjects

J Rubinstein

Publications and source records attributed to J Rubinstein.

At least 19 recordsLinked to original sources
PubMed1996

Drug detection in a suburban psychiatric emergency room.

This study evaluated the yield and utility of urine toxicological screening (UTS) in psychiatric emergency room patients. We also assessed the effect of race, gender, and cocaine and/or alcohol detection on clinical symptoms and diagnoses. The study's null hypothesis is that recent use of cocaine and/or alcohol in psychiatric emergency patients does not change rates of psychiatric symptoms at evaluation. We did a retrospective chart review of 325 consecutive psychiatric emergency room patients and of 112 consecutive patients with benzoylecgonine (BE; major metabolite of cocaine) on UTS. At assessment clinicians were blind to the results of UTS in most cases. UTS was positive in about one-fourth of cases who submitted urine for toxicological testing. Alcohol, cocaine, and cannabis accounted for the majority of positive cases, and simultaneous detection of these drugs was common. Very few patients with BE on UTS were younger than 18 and none was older than 45. In patients with BE on UTS, substance use was missed in about one out of seven cases, and cocaine use in about one out of four cases. Patients with BE on UTS showed decreased rates of aggressive and bizarre behavior. Cocaine use increased rates of suicidality in males and rates of paranoia in black male patients. Black patients had more hallucinatory experiences than white patients, regardless of cocaine use. Principal diagnoses of psychotic disorders were frequently assigned to black patients with cocaine use, and principal diagnoses of affective disorders rarely. Patients with both BE and alcohol on UTS and patients with only BE on UTS had low rates of aggression, but patients with only alcohol on UTS were frequently aggressive. This study's findings show distinct clinical effects of cocaine and/or alcohol use on psychiatric emergency room patients, contrary to the null hypothesis. These effects differed according to race and gender. We conclude that there is little support to advocate routine toxicological testing in the psychiatric emergency room. Instead, selective testing based on empirical evaluation of risk factors might be more profitable to improve detection rates of cocaine and alcohol.

Adjustment Disorders↗
PubMed1995

Marker chromosome 21 identified by microdissection and FISH.

A child without Down syndrome but with developmental delay, short stature, and autistic behavior was found to be mosaic 46,XX/47,XX,+mar(21) de novo. The marker was a small ring or dot-like chromosome. Microdissection of the marker was performed. The dissected fragments were biotinylated with sequence-independent PCR as a probe pool for fluorescence in situ hybridization (FISH). FISH results suggested an acrocentric origin of the marker. Subsequent FISH with alpha-satellite DNA probes for acrocentric chromosomes, and chromosome-specific 21 and 22 painting probes confirmed its origin from chromosome 21.

Child, Preschool↗
PubMed1995

Interrater and observer/self-report correlation of psychopathology in routine clinical practice.

Interrater (attending vs resident) and observer/patient self-report correlations were assessed for 17 and 9 symptom factors, respectively, in a consecutive sample of psychiatric outpatients at the time of intake evaluation in a university based clinic using the Hopkins Psychiatric Rating Scale (HPRS) and the SCL-90R. Highly significant interrater reliability was obtained for most items on the HPRS but observer/self-report correlations were more variable, ranging from good (r = .60 to .75) for depression and phobic anxiety, to poor (r < .40) for obsessive-compulsive, paranoia, and psychoticism symptoms. Results also varied by patient sex. The findings suggest a role for both observer and, for specific symptoms, self-report symptom scales in routine clinical practice.

Ambulatory Care↗
PubMed1994

Similarity and property effects in inductive reasoning.

Three experiments investigated the proposal that inductive inferences about different properties depend on different measures of similarity. In Experiments 1 and 2, Ss were given the premise that a category of animals has some property and judged the probability that another category of animals also has that property. Ss made the strongest inferences when the kind of property (anatomical or behavioral) corresponded to the kind of similarity between the animal categories (anatomical or behavioral). These results cannot be explained in terms of a single measure of similarity underlying induction. In Experiment 3, Ss rated the similarity of animal pairs with respect to anatomy or behavior. Regression analyses showed that both behavioral and anatomical similarity influenced behavioral inferences, but only anatomical similarity influenced anatomical inferences.

Adult↗
PubMed1994

Six-month stability of psychiatric diagnoses in first-admission patients with psychosis.

OBJECTIVE: The short-term diagnostic stability of schizophrenic and other psychotic disorders was examined in first-admission patients, with attention to the principal reasons for diagnostic change. METHOD: Hospitalized first-admission patients (N = 278) participating in an epidemiologic study were interviewed at baseline and after 6 months with the Structured Clinical Interview for DSM-III-R. A best estimate diagnosis was made at both time points with the use of all available sources of information. Reasons for changes in diagnosis were determined by two psychiatrists. RESULTS: Affective psychosis and schizophrenic disorders were relatively stable broad diagnostic categories over the 6-month period, with 86.5%-88.9% of the patients remaining in the same category, although findings for specific diagnoses within these categories ranged from 61.5% to 85.7%. The groups with unknown and nonspecific diagnoses showed less stability; the diagnoses of more than one-third of these patients remained unknown or nonspecific at the 6-month evaluation. If the 6-month diagnoses are used as the research standard, somewhat lower percentages of patients received the same diagnoses at baseline. Forty-three percent of the changes in diagnosis were attributed to the clinical course of illness; the rest were attributed to the diagnostic process itself. CONCLUSIONS: A longitudinal diagnostic assessment based on multiple sources of information is crucial for categorizing first-admission psychotic patients, particularly those who do not initially fit into a DSM-III-R category. The short-term stability of a diagnosis is a function of multiple factors, including the changing clinical picture, additional sources of information, and new interpretations of original data.

Adolescent↗
PubMed1988

Renal metabolic/excretory coupling.

Renal metabolic/excretory coupling is the enhancement of urinary excretion dependent upon renal metabolism. The nitrofurothiazoles, N-[4-(5-nitro-2-furyl)-2-thiazolyl]formamide (FANFT) and 2-amino-4-(5-nitro-2-furyl)thiazole (ANFT), are model compounds used to study metabolic/excretory coupling. FANFT is deformylated to ANFT by renal deformylase enhancing ANFT excretion. In the rat, ANFT excretion after oral FANFT administration was 100-fold greater than ANFT excretion when ANFT was administered. FANFT and ANFT uptake into purified proximal tubules achieved equilibrium within 60 s and was demonstrated in nonviable tubules. FANFT partitioned into oil better than ANFT. Albumin inhibited FANFT and ANFT uptake into oil and decreased tubular uptake by 65%. Tubular FANFT uptake was threefold or greater than that of ANFT uptake with or without albumin. Renal deformylase was predominantly cytosolic and yielded apparent Km and Vmax of 6.7 microM and 6.1 nmol ANFT.min-1.mg protein-1, respectively. Deformylase activity was abolished by boiling, was specific for N-formylated compound, and was not altered by dinitrophenol treatment. Renal metabolic/excretory coupling for FANFT/ANFT combines energy-independent uptake with metabolism (deformylation), resulting in enhanced urinary ANFT excretion.

Animals↗
PubMed1985

Rectal administration of tenoxicam for the treatment of rheumatoid arthritis and arthrosis.

Seventy-nine patients with arthrosis (40) or rheumatoid arthritis (39) were included in an open, non-comparative multicentric study. All the patients were treated by rectal route with a suppository form of tenoxicam (20 mg/day) during 6 weeks (in the first 3 days the dose was increased to 40 mg). The drug was administered once daily at evening. Clinical evaluation was performed before treatment and thereafter every 2 weeks. In the patients with arthrosis the parameters evaluated for efficacy were: pain on movement, pain at rest, tenderness, spontaneous pain, pain after 1 day of normal activity, flexion, functional status, and time to walk 10 metres. For patients with rheumatoid arthritis the parameters were: articular index, duration of morning stiffness, functional status, spontaneous pain and pain when moving. Efficacy was considered excellent or good in 22 patients with rheumatoid arthritis and moderate or poor in 17. In the group of patients with arthrosis the results were excellent or good in 28 and moderate or poor in 12. Side effects occurred in five cases.

Administration, Rectal↗
PubMed1982

Mercuric reductase enzyme from a mercury-volatilizing strain of Thiobacillus ferrooxidans.

Cell-free mercury volatilization activity (mercuric reductase) was obtained from a mercury-volatilizing Thiobacillus ferrooxidans strain, and the properties of intact-cell and cell-free activities were compared with those determined by plasmid R100 in Escherichia coli. Intact cells of T. ferrooxidans volatilized mercury at pH 2.5, whereas cells of E. coli did not. Cell-free enzyme preparations from both bacteria functioned best at or above neutral pH and not at all at pH 2.5. The T. ferrooxidans mercuric reductase was a soluble enzyme that was dependent upon added NAD(P)H. The enzyme activity was stable at 80 degrees C, required an added thiol compound, and was stimulated by EDTA. Antisera against purified mercuric reductases from transposon Tn501 and plasmid R831 (which inactivated mercuric reductases from a wide range of enteric and pseudomonad strains) did not inactivate the enzyme from T. ferrooxidans.

DNA Transposable Elements↗
PubMed1979

Lysozyme content of tears in patients with Sjögren's syndrome and rheumatoid arthritis.

In 37 patients and 143 control patients we estimated tear fluid lysozyme content by the Micrococcus lysodeikticus agar diffusion assay. We found no correlation between the titer of lysozyme in tear fluid and the rate of tear flow. Decrease in lysozyme production was found to be a sensitive indicator of the involvement of the lacrimal system in Sjögren's syndrome.

Adult↗
PubMed1977

[Studies on the facial muscles in the aged].

The dissection of the facial musculature in the elderly made on 2 bodies, confirmed the mode of evolution noted earlier in the Primates. The reduction in the m. platysma myoides was confirmed; this muscle showed only two parts: a rudimentary pars buccalis and a relatively developed pars mentalis. This reduction was accompanied by fundamental transformations since the m. quadratus of the chin appeared at the anterior part of the pars mentalis of the platysma myoides. The derivatives of the deep m. sphincter coli showed an arrangement very similar to that of the Simians. However some modifications already observed became stronger, particularly the verticilisation of the m. caninus and the separation of the two m. zygomaticus. Curiously, the extrinsic ear musculature persisted and remained well developed despite its absence of activity.

Aged↗