PubMed Health⌕ Search

Biomedical subjects

L Eisenberg

Publications and source records attributed to L Eisenberg.

At least 19 recordsLinked to original sources
PubMed1999

Does social medicine still matter in an era of molecular medicine?

To ask whether social medicine still matters may seem to be in poor taste at a symposium to honor Martin Cherkasky, but social medicine has always had the courage to take on difficult questions. There is all the more reason to do so when its legitimacy is challenged. The extraordinary findings emerging from the human genome project will revolutionize diagnostic and therapeutic methods in medicine. The power of medical interventions, for good and for harm, will increase enormously. However, in the next millennium, as in this one, social factors will continue to be decisive for health status. The distribution of health and disease in human populations reflects where people live, what they eat, the work they do, the air and the water they consume, their activity, their interconnectedness with others, and the status they occupy in the social order. Virchow's aphorism is as true today as it was in 1848: "If disease is an expression of individual life under unfavorable conditions, then epidemics must be indicative of mass disturbances of mass life." Increasing longevity resulting from major economic transformations has made ours the age of chronic disease. Changes in diet and behavior transform genes that once conferred selective biologic advantage into health hazards. Although disease risk varies with social status, medical care makes an important difference for health outcomes. Access to care and the quality of care received are functions of social organization, the way care is financed, and political beliefs about the "deserving" and the "underserving" poor. It is a moral indictment of the US that ours is the only industrialized society without universal health care coverage. In educating the American public about the social determinants of health, a goal Martin Cherkasky championed, the very power of the new molecular biology will help make our case. Social medicine is alive and well.

Adolescent↗
PubMed1999

Amplification for infants: selection and verification.

Hearing aid fittings for children under the age of 1 year provide many challenges to the audiologist. This article offers guidelines for assessment, hearing aid selection, verification, and follow-up for infants with hearing loss. The importance of early intervention and the consideration of new technologies are emphasized in this article. Case studies illustrate various aspects of infant hearing aid fittings.

Correction of Hearing Impairment↗
PubMed1999

Experience, brain, and behavior: the importance of a head start.

Nature and nurture stand in reciprocity, not opposition. All children inherit-along with their parents' genes-their parents, their peers, and the communities they live in. Development unfolds in an ecologic and a social setting which, just like the genes, is decisive in shaping the organism. The social niche is a crucial link between parents and offspring, an envelope of life chances. It is high time to replace the false dichotomy between nature versus nurture by a more inclusive trio: nature, niche, and nurture. Major brain pathways are specified in the genome, but the learned connections between brain and behavior are fashioned by social experience. The luxuriant overgrowth of neurons and their processes in embryonic and early life provides the substrate for environmentally induced structural change. Activity selects out the synapses that will persist; inactivity results in regression and apoptosis. Learning begins in utero and accelerates after birth. Responsive interactions between infants, their parents, and other caretakers is crucial to biological no less than psychosocial development. Comprehensive pediatric care can help provide a head start to enhance brain development and put the mind on the road to adaptive maturity.

Adult↗
PubMed1999

Sonographically guided compression repair of pseudoaneurysms: further experience from a single institution.

OBJECTIVE: Our purpose was to perform a comprehensive review of our experience with compression of postcatheterization groin pseudoaneurysms. MATERIALS AND METHODS: Two hundred eighty-one patients underwent 306 sonographically guided compression procedures on 297 groin pseudoaneurysms after femoral artery catheterization. The medical records, cardiac catheterization reports, and sonographic images were reviewed to determine patient demographics, type of catheterization procedure performed, sheath size, access site, interval from sheath removal to compression, anticoagulation status, pseudoaneurysm dimensions, complications, and follow-up information. Statistical analysis was performed using Pearson's chi-square and Kendall tau tests. RESULTS: The success rate for the initial compression attempt was 72.1%. Of the 83 failed compression attempts, 12 patients underwent a second attempt, of which seven attempts were successful. Therefore, counting both first and second attempts, the success rate was 74.4%. A strong negative correlation existed between anticoagulation status and success, with a 70% failure rate in patients with anticoagulated blood. Smaller pseudoaneurysm size was strongly correlated with success. Of the 83 failed cases, 49 ultimately underwent surgical repair. Eleven complications (3.6%) occurred, including three patients with rupture during compression. No deaths occurred as a result of compression repair. CONCLUSION: We conclude that sonographically guided pseudoaneurysm compression repair is an effective alternative to surgical repair, though nearly one third of compression attempts will fail and most of those patients will ultimately require surgery. The procedure is less effective when the patient's blood is anticoagulated and when the pseudoaneurysm is large. The procedure carries an overall complication rate of 3.6% and a risk for rupture of 1%.

Aged↗
PubMed1998

Siblings of children with mental retardation living at home or in residential placement.

Severe retardation in a child surely has an effect on all family members. Studies of non-disabled siblings in these families have indicated both emotional risks and perceived benefits. Little is known about how out-of-home placement of the child with retardation affects the siblings. Adolescent siblings of children with retardation living at home (N = 25) or in residential placement (N = 20) were contrasted with siblings of children without retardation (N = 28), on measures obtained from their mothers and themselves. Despite their different situations, these siblings were highly similar on measures of psychological adjustment, self-esteem, and family environment. Sibling relationships, however, were less intense, with less warmth but also lower conflict, in families where the child lived out of the home. Most siblings of children with retardation reported positive personal growth experiences while also expressing realistic concerns about the future. Siblings of children with retardation had beliefs and attitudes about placement that were highly consistent with the child's current living situation.

Adolescent↗