Biomedical subjects

M Wiener

Publications and source records attributed to M Wiener.

At least 19 recordsLinked to original sources

PubMed1992

Psychiatric implications of missile attacks on a civilian population. Israeli lessons from the Persian Gulf War.

OBJECTIVE: To determine the proportion of hospitalized patients who had stress reactions as a result of missile attacks during the Persian Gulf War and evaluate the factors that influenced their evacuation. DESIGN: Review of medical records of patients hospitalized as a result of missile attacks. SETTING: During the Persian Gulf War in the winter of 1991, Israel received 18 missile attacks involving 39 surface-to-surface Scud missiles. The uncertainty in time, place, and type of warhead, conventional or chemical, was a source of chronic stress and the immediate cause for many traumatic stress reactions at or near the missile attack sites. PARTICIPANTS: Data from victims who were injured after each missile attack were available through a central hookup between 12 local hospitals and the Medical Corps of the Israeli Defence Force. MAIN OUTCOME MEASURE: The number of persons diagnosed in the hospital as psychological casualties after each missile attack. RESULTS: Approximately 43% of the 773 casualties evacuated to hospitals were diagnosed as psychological casualties, and an additional 27% had mistakenly injected themselves with atropine. Data also indicated that triage of psychological casualties to hospitals was more a function of the rescue team's training and preparation than the severity or extent of injury or damage. CONCLUSIONS: Optimal treatment during events that cause mass casualties requires proper preparation of rescue teams as well as reorganization of the hospital's psychiatric services. The threat of chemical warfare affected the number and nature of stress reactions.

Atropine↗

PubMed1991

Trauma anesthesia for disasters. Anything, anytime, anywhere.

Field anesthesia can be practiced safely and effectively but requires special training to acquire familiarity with the techniques. Because field anesthesia may be required even in sophisticated countries for entrapment situations, skill should be maintained by practicing the appropriate techniques on a regular basis. Field anesthetic techniques are not second rate methods; they are just different. Although improvisation in the disaster situation has merit, it is not the place for experimenting with new and untried techniques.

Anesthesia↗

PubMed1990

[Crush injuries].

Explore the source record for details and available documents.

Crush Syndrome↗

PubMed1990

A measure of semantic complexity among predications.

A scale for assessing the complexity or density of utterances was developed using 10 categories of semantic relations (e.g., temporal ordering, causality). The categories are inferable from the particular "meanings" of the words (e.g., connectives, particular tense variations) used in an utterance. The scale was applied to three samples of subjects to assess its interjudge reliability and to compare the utterances of fourth-, sixth-, and eighth-grade children from middle- and working-class neighborhoods. It was also used to compare the complexity of utterances for different types of visual stimuli (used to elicit language samples). Interjudge reliabilities were more than acceptable for each of the samples, and significant differences in semantic density were found across grade, between children from working-class and middle-class neighborhoods, and for the stimuli used to elicit the utterances. When two of the three types of eliciting visual stimuli were equated for content and exposure conditions, the differences in verbal density between eliciting conditions were not replicated. The usefulness of the scale for assessing utterance density and by implication, comprehension difficulty of utterances and of texts, is discussed.

Attention↗

PubMed1990

The nursing home as a site for teaching medical students.

The nursing home was evaluated as a site for introductory teaching of the interview and physical examination to medical students. Using questionnaires, the authors compared the 1986-1988 experiences of 106 students in nursing homes with those of 171 students in hospitals and found that carefully selected patients in the two settings were equally able to cooperate; patient availability was better in the nursing homes. Although fewer nursing home patients had a traditional "present illness," most students interviewing them were able to identify a predominant illness to characterize. The authors conclude that the nursing home is an appropriate alternative site for teaching the medical interview and physical diagnosis.

Aged↗

PubMed1990

Military medicine: trauma anesthesia and critical care on the battlefield.

This article presents a few of the basic guidelines that must be considered once a decision is made to provide anesthesia and advanced surgical care in the battlefield--or in civilian catastrophes (for example, terrorist incidents, and man-made or natural disasters) that resemble the battlefield. However, it must be stressed that the most central consideration in battlefield anesthesia is the selection, training, and experience of the battlefield anesthesiologist. There are strict guidelines for providing safe anesthesia under the dire circumstances of war or similar civilian circumstances; the properly trained and experienced TA/CCS, however, will be best able to deliver battlefield anesthesia and to improvise equipment and agents for its safest delivery in those circumstances.

Anesthesia↗

PubMed1989

Anorexia nervosa reconceptualized from a psychosocial transactional perspective.

Anorexia nervosa is conceptualized as a number of very different instrumental actions that occur within particular family contexts. Six psychosocial transactional patterns--negativistic, attention centering, distracting, childlike, attractive, and self-punishing--are identified. This psychosocial transactional perspective is proposed as an alternative to approaches that focus on the "psychopathology" of young female anorexics.

Anorexia Nervosa↗

PubMed1989

[Casualties of the Peace for Galilee operation].

Most casualties of the Peace for Galilee operation were hospitalized at the Rambam Medical Center. Data from the medical records of 864 casualties of the first 15 weeks of the conflict were analyzed. 75% of them were battle casualties, and the rest were injured in accidents. Since this is the major central hospital of northern Israel, most of the severe, and about a third of the minor casualties were hospitalized here. Half of the cases reached hospital within 3 hours and 20 minutes of the time of injury. The overall mortality of all casualties, battle and accident, was 2.9%. The mortality among battle casualties who arrived at the hospital alive, was 3.4%.

Accidents↗

PubMed1988

Variations in aphasic language behaviors.

This study reports intraindividual variations in the semantic and syntactic complexity of language and in the linguistic errors produced by mildly and moderately impaired aphasic and nonneurologically impaired control subjects in different communication contexts. Aphasic patients, compared to control subjects, evidenced as many, if not more, linguistic variations in response to changing communication requirements. In conditions that restricted visual contact between speaker and listener, aphasic patients produced fewer communicative gestures and more complex verbalizations. Verbal complexity and language errors also varied significantly with different contents of communication. Measures of verbal complexity and errors in verbal communications were found to vary independently across different communication contexts, contents, and tasks. These findings demonstrate that despite their linguistic impairments, aphasic patients show appropriate and predictable linguistic changes in response to nonlinguistic social contextual variables.

Adult↗

PubMed1987

Fat metabolism in injury and stress.

Fat metabolism is a complex mechanism involving energy production as well as various physiological and biochemical effects involved in a large spectrum of both normal and pathological phenomena. Many different paths are currently being investigated by different medical and basic science disciplines. These include lipoproteins, prostaglandins, leukotrienes, and more. This chapter is limited to the energy related facets of fat metabolism, though in the future interrelations may be found between the different fields of fat research and serve not only for better understanding of the human organism, but also better treatment in hypermetabolic states. Much has been learned about fat metabolism both in normal and stressed man. The finding that, in most hypermetabolic states, fat is being oxidized and used as the main caloric source is definitely a cornerstone in improving nutritional therapy in such cases. The development of safe fat solutions, together with the studies showing that exogenous fat is efficiently utilized, has led to increased use of fat in TPN regimens as well as in enteral nutrition. The possibility of tilting the energy source in nutritional therapy from a 50:50 ratio of carbohydrates:fat to a fat-dominant regimen in the steady flow state (thus approaching the actual metabolic preference in stress) requires further studies and may prove to be beneficial. On the other hand, an increasing number of observations show that in late severe stress states--the so-called multi-organ failure syndrome--significant alterations in fat metabolism occur both in liver and in muscle. Recognizing the situations in which fat oxidation is decreased, leading to liver failure with fat accumulation, necessitates a different mode of treatment. Providing glucose or amino acids, and possibly more BCAA, is one method of treatment to be pursued. On the other hand, the prospect of new fat solutions containing medium chain triglycerides, may lead to improved nutritional support and decreased complications in these extreme situations. Other treatment modalities, like carnitine, need further research as well. Furthermore, if and when the relationship between fatty acids used in nutritional support and the various mediators involved in trauma and sepsis can be elucidated, better treatment of critically ill patients may be possible and offered in a more comprehensive way.

Critical Care↗

PubMed1986

Communicative gestures in aphasia.

Gestural communications of 10 mild and moderate aphasics and five controls were examined in two conditions: Face-to-face informal dyadic conversation and restricted visual access between speaker and listener. Gestural production was significantly reduced with restriction of visual access, supporting the posited communicative function of the hand and arm gestures investigated in this study. No differences were found between aphasic and control subjects in the rate of gestural communication in the natural condition of face-to-face interaction. Moderate aphasics, however, were found to produce proportionally fewer of the complex semantic modifying and relational communicative gestures and more nonspecific, nonconsensually shared, unclear gestures. Gestural complexity was significantly negatively correlated with measures of linguistic impairment for the aphasics. The relationship between the frequency and complexity of communicative gestures and concurrent verbalizations was also examined. The findings of this study provide confirmation for the view that there is an identifiable class of gestures utilized by aphasics for communication, aphasics are impaired in their gestural communicative competence in natural conditions of communication, and the quality of aphasics' gestural communications parallels changes in their verbal communication patterns.

Adult↗

PubMed1986

Studies on the lysosomal binding of 141Ce, 239Np, 239Pu and 241Am in rat and Syrian hamster liver using carrier-free electrophoresis.

The binding of 141Ce, 239Np, 239Pu and 241Am in the liver of rats and Syrian hamsters, following injection in essentially monomeric form, was analyzed by carrier-free electrophoresis at 4-9 days and several months after radionuclide injection. In contrast to density gradient methods lysosomes can be clearly separated from other cell organelles by carrier-free electrophoresis. These, and previous results from this and other laboratories confirm that lysosomes are the main initial binding site for these four radionuclides in the livers of rats and Syrian or Chinese hamster. Light microscopic autoradiography showed that at all the time intervals studied 241Am was more or less uniformly distributed in the liver of all three species. Thus, the changes in the electrophoretic pattern of the nuclides, observed at later time periods in hamsters, cannot be explained by gross redistribution phenomena such as accumulation in macrophages.

Americium↗

PubMed1985

ASHP members' concepts of institutional pharmacy in the year 2000.

Trends in institutional pharmacy practice were identified, and ASHP members' views of these trends were evaluated in a futures study. A list of statements concerning the practice of institutional pharmacy in the year 2000 was developed using a modified Delphi method. A random sample of 3000 active ASHP members received the questionnaire and were asked to estimate the probability that each of the 42 statements would occur by the year 2000. The responses were analyzed to reduce the number of variables to common factors. A total of 1276 of the returned questionnaires were usable. Six factors were identified: pharmacy-medicine linkage, advanced training or degree, drug administration, quality assurance and accreditation, supportive personnel, and pharmacy-nursing conflict. There were differences in the mean values of responses of items related to various factors when they were compared by sex, age, position held, degree held, and residency training. The key trends predicted were that advanced training or degrees will be necessities in the year 2000, institutional practice will be composed of multiple tracks, postgraduate education will be required of clinicians and administrators, turf conflict with nurses will increase, and accreditation standards and other safeguards for quality health care will continue to be required and will increase. The trends in how ASHP members conceptualized the future of their profession can provide insight for individuals developing programs in pharmacy education, health-care administration, institutional practice, and the pharmaceutical industry.

Adult↗

PubMed1985

Species differences in the handling of lysosomotropic metals and Triton WR 1339 by rat and Chinese hamster liver.

The study was undertaken in order to understand the reasons for the distinct differences in the elimination rate of lanthanides and transuranium elements from the liver of different mammalian species. The binding of monomeric 239Pu in livers of rats and Chinese hamsters was analyzed by density gradient centrifugation and electrophoresis. It was concluded that this nuclide is initially bound to lysosomes in liver of rats and Chinese hamsters. The influence of Triton WR 1339 (TWR) on the density of lysosomal marker enzymes from rat and Chinese hamster liver at day 4 was very similar for both animal species but the TWR induced shift persisted in Chinese hamsters up to day 60 whereas in rat liver the lysosomal density increased again with time. Electron microscopic inspection confirmed the similarity of the initial reaction of hepatocyte lysosomes. However, after 60 to 70 days typical TWR induced "tritosomes" were absent from rat hepatocytes but could be found regularly in hepatocytes from Chinese hamsters. The elimination rate of 3H-activity from liver injection of 3H-TWR was lower in Chinese hamsters than in rats. It was concluded that the differences in elimination rate of lanthanides and transuranium elements from liver of various mammalian species and the differences observed after TWR injection might reflect differences in the composition or function of the lysosomal system in the livers of different mammalian species. With respect to the transport of certain heavy metals the rat liver is not a reliable model for human liver.

Acid Phosphatase↗

PubMed1985

Association of 239Pu with lysosomes in rat, Syrian hamster, and Chinese hamster liver as studied by carrier-free electrophoresis and electron microscopic autoradiography with 241Pu.

The binding of injected monomeric plutonium in the liver of rats, Syrian hamsters, and Chinese hamsters (species which show profound differences in their ability to eliminate 239Pu from the liver) was investigated by carrier-free electrophoresis using 239Pu and electron microscopic autoradiography with 241Pu. These studies are part of a program designed to obtain a better understanding of the mechanisms of the clearance of transuranium elements from liver of different mammals and man. Between 4 and 9 days after nuclide injection, a clear correlation between the majority of the 239Pu and lysosomal enzymes was observed when the mitochondrial-lysosomal (ML) fraction of the livers was analyzed by carrier-free electrophoresis. In the two hamster species, a second 239Pu peak exists from the beginning and increases with time to comprise 50% of the total radioactivity at later times. During electron microscopic examination 4 days after 241Pu injection, beta tracks were frequently observed over globular structures resembling dense bodies in Chinese hamster liver. They were also observed frequently over chromatin-rich portions of the cell nuclei. These results, together with those from previous density gradient studies, show that lysosomes are the primary deposition site for 239Pu in the liver cytoplasm of these three rodent species. The hypothesis of a morphologic transformation of these lysosomes with time in hamster liver and of rapid bulk exocytosis of the lysosomes in rats are still possible explanations for the extreme differences in the elimination among the three species.

Animals↗

PubMed1984

Simultaneous occurrence of adenocarcinoma and transitional cell carcinoma as two separate primary tumors in the bladder.

We report on a 56-year-old man who had two distinct and separate primary tumors of the bladder simultaneously: one mucin-producing adenocarcinoma and the other a transitional cell carcinoma. Despite local extension of the adenocarcinoma beyond the bladder wall, surgical resection has resulted in a 6-year recurrence-free survival of the patient.

Adenocarcinoma, Mucinous↗

PubMed1984

Renal cell carcinoma in a horseshoe kidney.

A case of renal cell carcinoma arising in a horseshoe kidney and presenting with a pathologic fracture of humerus is reported. Relevant literature is discussed.

Adenocarcinoma↗

PubMed1984

Fibromyxomatous pseudotumor of the scrotum.

An unusual scrotal mass occurring in a 72-year-old man is described. Clinically and grossly, the lesion appeared to be a neoplasm. However, microscopically the mass was composed of fibromyxomatous tissue that appeared to be degenerative rather than neoplastic in nature.

Aged↗