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Biomedical subjects

M Robbins

Publications and source records attributed to M Robbins.

At least 55 records · Page 3Linked to original sources
PubMed1991

Magnetic resonance imaging of central nervous system lesions in patients with lupus erythematosus. Correlation with clinical remission and antineurofilament and anticardiolipin antibody titers.

Clinical, magnetic resonance imaging (MRI), and serologic studies were performed on 11 patients with diffuse central nervous system (CNS) systemic lupus erythematosus and 8 patients with focal CNS lupus. MRI of patients with diffuse clinical disease showed symmetrically distributed areas of increased signal intensity in the subcortical white matter; these resolved after treatment with high-dose methylprednisolone. These patients' sera contained elevated levels of antineurofilament antibodies. Patients with focal CNS lupus had areas of increased signal intensity and atrophic changes in regions corresponding to the major cerebral vessels. These MRI abnormalities did not improve after treatment with high-dose steroids. The sera of patients with focal CNS lupus had elevated levels of cardiolipin and lupus anticoagulant but normal levels of antineurofilament antibody. Our findings suggest that results of a combined clinical, MRI, and serologic evaluation of patients with CNS lupus may predict the response of patients to high-dose steroid therapy.

Adult↗
PubMed1991

A comparative clinical trial of the TCu 380A, Lippes Loop D and Multiload Cu 375 IUDs in Indonesia.

The Copper T 380A (TCu 380A), Lippes Loop D (LLD) and the Multiload Cu 375 (MLCu 375) IUDs were evaluated for safety and efficacy in a multicenter randomized clinical trial in Indonesia. A total of 2992 women were enrolled into the study and data for 2845 women were analyzed (147 cases did not meet protocol criteria). Although study IUDs were randomly assigned, LLD users in this study were older and of higher parity than TCu 380A and MLCu 375 users. The 24-month gross cumulative life-table pregnancy rates for TCu 380A, LLD and MLCu 375 users were 1.2, 2.2 and 2.7, respectively. The 24-month expulsion rates for TCu 380A, LLD and MLCu 375 users were 6.7, 7.5 and 5.3, respectively. Overall, 24-month continuation rates were 85.5%, 85.0% and 85.4% for the respective device groups. Differences in both gross and age- and parity-adjusted life-tables rates for the major outcome variables were not statistically significant at 24 months postinsertion. The study suggests that the TCu 380A, LLD and MLCu 375 IUDs seem to be safe and effective contraceptive options for Indonesian women.

Adolescent↗
PubMed1991

Use of red blood cells older than five days for neonatal transfusion.

Sick neonates often require periodic small volume transfusions (10 mL/kg) to replace blood drawn for laboratory monitoring during their hospital stay. We use red blood cells (RBCs), stored as CPDA-1 whole blood, up to their expiration date, and are unaware of any clinical problems with this practice. We proceeded to confirm our clinical impression by reviewing the hospital records of 22 transfused neonates who received a median of 2.5 RBC transfusions (range 1 to 11) with a volume of 16 mL (range 5 to 38) each, and total volume of 60 mL (range 16 to 152). The RBCs were stored a median of 7 days (range 2 to 27). Following transfusion, there was an increase (P less than .05) in hemoglobin (mean 2.8 +/- 1.6 gm/dL [SD]) and hematocrit (9.0% +/- 4.7%). The bilirubin also rose (0.6 +/- 1.5 mg/dL, P less than .05), but this was not considered clinically significant. No significant change occurred in pH or bicarbonate. Paradoxically, RBCs over 10 days of age resulted in a fall in potassium (-0.9 +/- 0.8 mEq/L, P less than .01), but not below 3.4 mEq/L. We could find no evidence by clinical observation or laboratory indexes that small volume transfusion of RBCs more than 5 days old was deleterious to the newborns studied. By using RBCs up to their expiration date, the number of donor exposures and the potential risk of transfusion-transmitted diseases can be decreased.

Blood Preservation↗
PubMed1990

The measurement of skin lymph flow by isotope clearance--reliability, reproducibility, injection dynamics, and the effect of massage.

The measurement of skin lymph flow was investigated using an isotope clearance technique (ICT). Multiple lymph flow determinations were undertaken in the skin of anaesthetized large white pigs to test for reproducibility, ascertain the most suitable tracer, study the influence of injection dynamics, and observe the effect of massage as a stimulus to lymph flow. Blood clearance of tracer was also investigated. Results demonstrated that lymphatic clearance is a monoexponential function with good reproducibility under controlled laboratory conditions. 99mTc-colloid (TCK17 Cis) compared favorably with 131I-human serum albumin as a tracer and both performed better than colloid gold (198Au). Lymph flow was significantly faster in one pig than in the other. No difference existed between left and right sides or between caudal and rostral sites on each flank, but clearance was significantly slower in thigh than flank skin. Sub-epidermal injections cleared faster and more consistently than either deep or subcutaneous injections. Neither injection volume nor needle tract backflow of tracer influenced results, but local massage significantly enhanced clearance. Escape of 99mTc-colloid by the blood was negligible. These results indicate that skin lymph flow can be reliably measured when conditions are controlled. Extrinsic factors such as massage strongly influence lymph flow. Greater sensitivity in detecting degrees of lymphatic insufficiency may be achieved if a standardized stimulus to lymph flow is administered during isotope clearance measurement.

Animals↗
PubMed1989

Primitive personality organization as an interpersonally adaptive modification of cognition and affect.

I have attempted a new description of the salient clinical phenomenology of the primitive personality disorders (borderline, narcissistic, paranoid and schizoid), focusing in particular on absence of personality integration, sensori-motor-affective thinking, and an inability to recognize and to own significant emotional predispositions and institute appropriate behavioral adaptations. I conclude that these phenomena cannot adequately be comprehended either from the classical intrapsychic perspective and the cognitive and affective capabilities assumed to exist in normal and neurotic individuals, or from the perspective of self psychology. I propose an alternative model in which pathology of cognition and affect is postulated to be both the contemporary cause and the historical result of pathological adaptation. For these individuals, analysis of cognition and affect must occupy the central position that analysis of conflict and defence occupies in the treatment of the neurotic.

Affect↗
PubMed1988

Identification of Corynebacterium jeikeium and Corynebacterium CDC group D2 with the API 20 Strep system.

A total of 170 strains of Corynebacterium jeikeium and 23 strains of Corynebacterium group D2 were examined in three British laboratories using the API 20 Strep identification system and three supplementary tests (catalase production, urease production and nitrate reduction). The isolates were collected from clinical specimens in various laboratories over a three-year period. The two species produced consistent reactions in these tests after 24 h. Two tests were highly discriminatory, with positive reactions for ribose fermentation seen for Corynebacterium jeikeium while urease production was observed with Corynebacterium group D2. This method allows routine clinical laboratories to rapidly identify these emerging pathogens.

Corynebacterium↗
PubMed1988

Use of audiotape recording in impasses with severely disturbed patients.

The psychoanalytically oriented treatment of patients with severe personality disorders is characterized by impasses and by efforts to resolve them. Patient audiotape recording and review of sessions can be a particularly useful technical parameter in such situations. When judiciously employed, it is unusual, if not unique, in that it selectively amplifies the power of traditional elements of technique as well as some of the constructive elements of the analytic process itself, while reducing the power of some of the destructive elements of the transference. Indications for using this parameter are discussed, case illustrations presented, and hypotheses advanced about its mode of action. No single element of technique is responsible for the success or failure of analysis. The most that can be expected of tape recording is that it help break up the treatment log jam and facilitate further work.

Adult↗
PubMed1988

The adaptive significance of destructiveness in primitive personalities.

Destructiveness in primitive personalities is not restricted to a segment of the person as it is in the case of neurotics, but is global and pervasive. This destructiveness is meaningfully configured in a manner which cannot fully be accounted for by constitutional factors or be comprehended from the individual, intrapsychic, conflictual viewpoint of classical psychoanalysis. It follows an interpersonally meaningful pattern and therefore has adaptive significance in the contemporary life of the individual. The adaptive model I propose does not violate essential canons of psychoanalytic theory, for it can simultaneously be conceptualized in terms of intrapsychic structure and dynamics. This model holds out the possibility for a therapeutic approach to primitive personality organization which differs in some but by no means all respects from classical analysis.

Adaptation, Psychological↗
PubMed1987

The in-vitro activity of doxycycline and minocycline against anaerobic bacteria.

The likelihood of bacterial resistance now prevents the use of oxytetracycline in the empirical therapy of anaerobic infections. This study investigates the in-vitro activity of two semi-synthetic derivatives, doxycycline and minocycline, against a range of anaerobic bacteria. MICs for each antibiotic were determined by an agar incorporation technique. Doxycycline and minocycline were four to eight times more active against the majority of strains than oxytetracycline. With the exception of Bacteroides bivius, almost 90% of strains were inhibited by 4 mg/l of doxycycline or minocycline, but resistance to the same concentration of oxytetracycline was present in 60% of the B. fragilis group, 30% of Peptostreptococcus spp. and 24% of Clostridium perfringens. Doxycycline and minocycline represent an alternative therapy for anaerobic infections where bacterial sensitivities are known.

Bacteria, Anaerobic↗
PubMed1983

Anaerobiospirillum species isolated from humans with diarrhoea.

Flagellated anaerobic motile spiral bacteria were isolated from the faeces of two patients with diarrhoea. They were recovered by the microaerophilic culture method used to detect campylobacters but demanded anaerobic conditions for subculture. Electron microscopy and other investigations showed them to be closely related to Anaerobiospirillum succiniproducens first described in beagle dogs and subsequently in three humans with bacteraemia.

Adult↗
PubMed1982

Narcissistic personality as a symbiotic character disorder.

I have attempted to integrate our theoretical understanding of a particular group of borderline and narcissistic personalities and to relate their development to mother-infant failure to form a normal symbiotic bond, and pathological efforts to compensate. I have attempted to preserve and to integrate some of the valuable contributions of Kernberg and Kohut while, hopefully, avoiding the pitfalls of each theoretical system. The result is a theory of dissociated possession configurations and their actualization in relationships. This is neither a theory of nature (innate rage) nor of nurture (maternal failure) but of the pathological form of adaptation in which objects are used as possessions in order to compensate for absent structures. Whereas the primary introject of the borderline personalities is unmitigatedly self-destructive, the narcissistic personalities have formed a more complex introject including a conditional symbiotic representation, the maintenance of which involves active dissociation of object related needs. The conditional symbiotic relationship, in turn, is a stabilizing and constructive force in his relationships.

Depressive Disorder↗
PubMed1980

A radioimmunoassay for immunologic phenomena in pneumococcal disease and for the antibody response to pneumococcal vaccines. I. Method for the radioimmunoassay of anticapsular antibodies and comparison with other techniques.

A radioimmunossay is described which uses a 14C biosynthetically internally labeled antigen. This modified Farr technique has been standardized by quantitative precipitation and compared with hemagglutination and mouse protection. Specificity was established by use of heterologous hyperimmune sera and by use of unlabeled pneumococcal polysaccharides for inhibition. Reproducibility has been evaluated for different preparations of antigens and varying storage conditions of sera. The system has been applied to a wide variety of studies requiring analysis of human and animal sera.

Animals↗