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Biomedical subjects

L Weinstein

Publications and source records attributed to L Weinstein.

At least 37 records · Page 2Linked to original sources
PubMed1995

The process of resident selection: a view from the residency director's desk.

In 1992, the Executive Council of the Association of American Medical Colleges recommended that a computerized application system be investigated. Under this system, the application package would include: 1) a standardized application form, 2) a personal statement, 3) a dean's letter, 4) transcripts, 5) a chairman's letter, and 6) United States Medical Licensing Examination (USMLE) scores. To investigate the value residency directors placed on these items, all directors from Accreditation Council for Graduate Medical Education--approved residency programs in obstetrics and gynecology and family practice residency programs were surveyed. The directors were asked to prioritize the usefulness of the proposed components of the Electronic Residency Application Service application package. Transcripts, the dean's letter, and USMLE scores ranked highest (in descending order) for the obstetrics and gynecology residency directors for making decisions about "inviting a student for an interview," whereas the dean's letter, personal statement, and transcripts ranked highest for the family practice residency directors. Both ranked the interview as most valuable in ranking a student in the residency match. Although these two disciplines do not represent all fields, our study indicates that residency programs are not homogeneous in their value systems and that certain characteristics may predict those values.

Decision Making↗
PubMed1995

Developing a research unit within a hospital social work department.

This article describes the establishment of a research unit as an integral part of a hospital social work department on the basis of the authors' experience in a cancer center over a 13-year period. Methods are described for building support within the institution, for the process of initiating the unit, for deciding on study topics, and finally for bridging the gap between clinical and research staff. The evolution of the relationship between clinical and research staff was characterized by four different phases: curiosity, competitiveness, cooperation, and collaboration. A childhood bereavement project is used to exemplify the developmental processes and the ongoing interaction of research and clinical staff. The professional practice of all staff benefited from the increased academic rigor and productivity, although some staff remained unconvinced of the value of such a major research effort. The benefits and costs of the unit are also discussed.

Adolescent↗
PubMed1995

Effect of postmenopausal hormonal replacement therapy on mammographic density and parenchymal pattern.

PURPOSE: To measure changes and predictors of change in mammograms obtained in postmenopausal women undergoing continuous combined hormonal replacement therapy (HRT). MATERIALS AND METHODS: Mammograms of 41 postmenopausal women obtained before and 1 year after the initiation of HRT were evaluated blindly according to the quantitative density percentage method and the Wolfe classification system. RESULTS: Mammographic densities increased compared with baseline values in 73% of subjects (mean increase, 6.7%; 95% confidence interval, 2.5%, 11.0%; P = .003). A shift in Wolfe classification from lower to greater parenchymal density was noted in 24% of subjects (P = .016). Multivariate analysis results indicated that the lower the tissue density percentage before treatment, the greater the increase in density percentage after treatment. CONCLUSION: An increase in mammographic density was demonstrated in most subjects undergoing continuous combined HRT and was most pronounced in subjects with a lower baseline density percentage.

Breast↗
PubMed1995

Purpose in life, boredom, and volunteerism in a group of retirees.

In a pilot study of 40 retirees, those who volunteered more than 10 hours per week scored significantly higher on the Purpose In Life test than those who volunteered 10 or fewer hours per week. A significant negative correlation of -.75 was obtained between scores on purpose in life and boredom proneness.

Aged↗
PubMed1994

The manganese superoxide dismutase of Escherichia coli K-12 associates with DNA.

Superoxide dismutases (SODs) are vital components in the resistance of aerobic organisms to the toxicity of oxygen. Escherichia coli contains two highly homologous cytoplasmic SODs, a manganese- and an iron-containing enzyme (MnSOD, FeSOD). We previously demonstrated that MnSOD and FeSOD have different physiological functions and that MnSOD is more effective in preventing oxidative damage to DNA. In this report, purified E. coli MnSOD was shown to bind nonspecifically to DNA by electrophoretic mobility shift assay and nitrocellulose-filter binding methodologies. From electrophoretic mobility shift assay, the equilibrium dissociation constants for interaction with a variety of double-stranded and single-stranded oligonucleotides ranged from 1.5 +/- 0.2 to 8.4 +/- 1.3 microM at 20 degrees C. This range of concentrations corresponds to MnSOD concentrations in aerobically grown E. coli. In vivo binding of MnSOD to DNA was supported by colocalization of MnSOD and the E. coli nucleoid in immunoelectron microscopy. Both MnSOD and DNA were inhomogeneously distributed in the cytosol, the concentration of each being higher in the center of the cell and relatively low near the inner membrane. In contrast, there was no evidence for physiologically relevant interaction of FeSOD with DNA. Binding to DNA in vitro was weak, Kd > 40-220 microM, concentrations 7-40 times higher than found in vivo. In addition, the cytoplasmic distribution of FeSOD did not correlate with DNA. FeSOD concentration was higher near the inner membrane and lower in the center of the cytosol. These results demonstrate that E. coli MnSOD associates with DNA in vitro and in vivo. Combined with prior data demonstrating that MnSOD preferentially protects DNA in vivo while an equal enzymatic activity of FeSOD does not (Hopkin, K. A., Papazian, M. A., and Steinman, H. M. (1992) J. Biol. Chem. 267, 24253-24258), our data suggest that E. coli MnSOD acts as a "tethered antioxidant"; association of MnSOD with DNA localizes dismutase activity near a target of oxidative stress and increases protection of DNA from oxidative damage. This model has implications for the therapeutic use of SODs as antioxidants.

Antibodies↗
PubMed1994

Residency directors' responses to the concept of a proposed electronic residency application service.

BACKGROUND: In 1992, the Executive Council of the Association of American Medical Colleges (AAMC) recommended that the feasibility of the proposed Electronic Residency Application Service (ERAS) be investigated. This action was based on concerns that the current system was inefficient, costly, and disruptive to students, medical schools, and residency programs. The purpose of this study was to explore residency directors' opinions about the benefits and barriers to the introduction of such a system. METHOD: All directors from family practice and obstetrics-gynecology residency programs were surveyed in early 1993. Three forced-choice and three open-ended questions elicited opinions concerning benefits and potential barriers to the implementation of ERAS. T-tests and chi-square tests for independence were used to examine differences for continuous and categorical variables. RESULTS: Overall, 544 residency directors (81%) responded to the questionnaire: 339 (86%) in family practice, and 205 (75%) in obstetrics-gynecology. Eighty percent of the respondents in family practice and 75% of those in obstetrics-gynecology were in favor of the initiation of ERAS. Perceived benefits included increased "efficiency," "simplicity," "standardization," and "completeness." Concerns included "technical problems," "loss of flexibility," "lack of a personal touch," "costs," and "lack of security." CONCLUSIONS: It is appropriate for the AAMC to take the lead in investigating the computerization of this important process. It is essential, however, to gather data from all three consumers of this potentially valuable service as an important step in the project's development.

Administrative Personnel↗
PubMed1994

A case study: massage, relaxation, and reward for treatment of alopecia areata.

Alopecia areata, a common cause of hair loss, is generally considered the consequence of an autoimmune process. Both physiological and psychological factors have been implicated. Previous studies have not incorporated behavior modification in their treatment designs. In this study, three treatment techniques (hair massage, relaxation procedures, and monetary reward) were applied to a 16-year-old male with a five-year history of alopecia areata. Comparison for seven months without treatment versus seven months with treatment showed that loss of hair was markedly reduced after three months of treatment. During the last four months of the study, new hair growth was evidenced.

Adolescent↗
PubMed1994

LIFENET/INTERNET and the health science librarian.

The Medical Library Center of New York, a cooperative library agency for the health sciences, developed a program to offer an electronic communications system (LIFENET) with access to the Internet for its members. Information on documentation and training as well as statistics on the subsequent use of the system and of the Internet are discussed in the article. Specific examples of how health science librarians are using the system include bibliographic verification, reference, research on integrated library systems, production of duplicate journal lists, and professional activities such as electronic mail and discussion groups (listservs).

Computer Communication Networks↗
PubMed1993

Particle digestibility is required for induction of the phosphatidylserine recognition mechanism used by murine macrophages to phagocytose apoptotic cells.

One of the characteristic features of programmed cell death in vivo is the rapid recognition and removal of apoptotic cells by macrophages. Although there are several potential mechanisms by which the macrophage can identify a cell as apoptotic, it has been shown recently that murine-elicited macrophages stereospecifically recognize phosphatidylserine (PS) exposed on the surface of apoptotic cells. The particulate stimulus, beta-1, 3-glucan, stimulates bone marrow-derived macrophages to express several characteristics of inflammatory macrophages, and induced these cells to recognize PS on apoptotic cells; this activity was correlated with the ability to form rosettes with PS-expressing RBC. Induction of PS recognition in bone marrow-derived macrophages was associated with digestibility of the stimulus, because L, but not D amino acid particles or latex, were able to stimulate macrophage recognition of PS. The requirement for digestibility could be bypassed by the addition of exogenous TGF-beta, which induced macrophage recognition of PS after stimulation with either latex or D amino acid particles. That endogenously produced TGF-beta played a role in the glucan-stimulated response was indicated by the ability of anti-TGF-beta antibodies to inhibit digestible particle-induced recognition of PS. The induction of the PS recognition mechanism correlated well with the expression of other markers for the inflammatory phenotype. These studies indicate that the PS receptor may be a marker for the inflammatory phenotype, which appears to be induced by the phagocytosis of particulate digestible stimuli. Endogenously produced TGF-beta is suggested to play an autocrine or paracrine priming role in the induction of the PS receptor.

Animals↗
PubMed1993

The PROEF diet--a new postoperative regimen for oral early feeding.

OBJECTIVE: The purpose of this study was to determine if immediate postoperative feeding of a new oral elemental diet (PROEF diet) would be tolerated by patients and to determine its effect on gastrointestinal function after cesarean section. STUDY DESIGN: One hundred eighteen patients undergoing cesarean section were randomly assigned by a computer-generated list of numbers to receive either the PROEF diet (60 patients) or routine postoperative dietary management (58 patients). Gastrointestinal morbidity was analyzed by an independent-samples t test. RESULTS: The PROEF diet group has a more rapid return of normal bowel sounds, 10.3 versus 14.5 hours (p = 0.001), and earlier acceptance of a regular diet, 2.0 versus 2.3 days (p = 0.008). CONCLUSION: The PROEF diet was well tolerated in cesarean section patients with no increase in gastrointestinal morbidity when compared with a control group of patients. This dispels the classic teaching that postoperative patients may not have oral intake until the return of normal bowel function. Further study is necessary to support the theoretic benefits that may accrue from early feeding of an elemental diet.

Cesarean Section↗
PubMed1993

Impact of parental terminal cancer on latency-age children.

The underlying psychological and emotional components of distress were examined in 87 children with a parent in the terminal phase of cancer. Common fears, concerns, misperceptions, and behavioral consequences are analyzed, as are more severe psychological and behavioral reactions. Implications for psychoeducational parent-guidance intervention are discussed.

Adaptation, Psychological↗
PubMed1993

Pulmonary sporotrichosis treated with itraconazole.

A 62-year-old woman had chronic cavitary pulmonary sporotrichosis refractory to medical management over an 8-year period. She was treated with oral itraconazole and had an apparent microbiologic and clinical response; however, the patient succumbed to progressive pulmonary hypertension. The early use of oral itraconazole for treatment of pulmonary sporotrichosis is advocated.

Amphotericin B↗
PubMed1993

Development of functional diversity in mouse macrophages. Mutual exclusion of two phenotypic states.

The objective of this study was to investigate the mechanisms that contribute to the generation of macrophage functional diversity. Exposure of mouse bone marrow-derived macrophages to beta-1,3-glucan, a particulate inflammatory stimulus, or polyinosinate-polycytidylate (poly[I:C]), a stimulus of macrophage cytocidal activation, induced distinct and stimulus-specific patterns of gene expression. These changes were characterized by an up-regulation of the expression of the acid hydrolase beta-glucuronidase and platelet-derived growth factor B following incubation with beta-1,3-glucan and a stimulation of the expression of the complement component Bf, beta-interferon, and the reactive nitrogen intermediates NO2/NO3 during incubation with poly[I:C]. The induction of Bf expression by poly[I:C] could not be explained on the basis of distinct subpopulations of cells since in situ hybridization with a mouse Bf cRNA probe revealed a uniform and substantial increase in Bf expression by the entire population of cells. Incubation of macrophages with beta-1,3-glucan before stimulation with poly[I:C] was found to strongly attenuate the expression of Bf and beta-interferon. Conversely, incubation with poly[I:C] prior to exposure to beta-1,3-glucan substantially blocked the stimulation of beta-glucuronidase and platelet-derived growth factor B expression, indicating that these two responses were expressed in a mutually antagonistic fashion. However, after removal of either stimulus and following a period in which the primary response was allowed to decay, the cells regained their capacity to subsequently respond to either the same stimulus or to a different stimulus. Collectively, these findings indicate, first, that the heterogeneity of gene expression seen in response to poly[I:C] represents an adaptive response of the entire macrophage population rather than the restricted responses of distinct subpopulations of cells. Second, macrophages respond to these stimuli in a sequential fashion. These findings thus have a significant bearing on our understanding of the regulation of macrophage heterogeneity in host defense.

Animals↗