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Biomedical subjects

N Blum

Publications and source records attributed to N Blum.

At least 19 recordsLinked to original sources
PubMed2006

Counterfeit and substandard antimalarial drugs in Cambodia.

Counterfeit and substandard antimalarial drugs can cause death and contribute to the growing malaria drug resistance problem, particularly in Southeast Asia. Since 2003 in Cambodia the quality of antimalarial drugs both in the public and private health sector is regularly monitored in sentinel sites. We surveyed 34% of all 498 known facilities and drug outlets in four provinces. We collected 451 drug samples; 79% of these were not registered at the Cambodia Department of Drugs and Food (DDF). Twenty-seven percent of the samples failed the thin layer chromatography and disintegration tests; all of them were unregistered products. Immediate action against counterfeit drugs was taken by the National Malaria Control Program (NMCP) and the DDF. They communicated with the Provincial Health Department about the presence of counterfeit antimalarial drugs through alert letters, a manual, annual malaria conferencing and other training occasions. Television campaigns to alert the population about counterfeit drugs were conducted. Moreover, the NMCP has been promoting the use of good quality antimalarial drugs of a blister co-packaged combination of artesunate and mefloquine in public and private sectors. Appropriate strategies need to be developed and implemented by relevant government agencies and stakeholders to strengthen drug quality assurance and control systems in the country.

Antimalarials↗
PubMed2001

Synthesis, reactivity, and structure of strictly homologous 18 and 19 valence electron iron nitrosyl complexes.

The 18 and 19 valence electron (VE) nitrosyl complexes [Fe(NO)('pyS4')]BF4 ([1]BF4) and [Fe(NO)('pyS4')] (2) have been synthesized from [Fe('pyS4')]x ('pyS4'(2-) = 2,6-bis(2-mercaptophenylthiomethyl)pyridine(2-)) and either NOBF4 or NO gas. Complex [1]BF4 was also obtained from [Fe(CO)('pyS4')] and NOBF4. The cation [1]+ is reversibly reduced to give 2. Oxidation of 2 by [Cp2Fe]PF6 afforded [Fe(NO)('pyS4')]PF6 ([1]PF6). The molecular structures of [1]PF6 and 2 were determined by X-ray crystallography. They demonstrate that addition of one electron to [1]+ causes a significant elongation of the Fe-donor atom bonds and a bending of the FeNO angle. Density functional calculations show that the unpaired electron in 2 occupies an orbital, which is antibonding with respect to all Fe-ligand interactions. As expected from qualitative Molecular Orbital (MO) theory, it has a large contribution from a pi* type NO orbital. The nu(NO) frequency decreases from 1893 cm(-1) in [1]BF4 to 1648 cm(-1) in 2 (in KBr). The antibonding character of the unpaired electron explains the ready reaction of 2 with excess NO to give [Fe(NO)2('pyS4')] (3), the facile NO/CO exchange of 2 to afford [Fe(CO)('pyS4')], and the easy oxidation of 2 to [1]+.

Journal Article↗
PubMed2000

Improving HIV/AIDS services through palliative care: an HRSA perspective. Health Resources and Services Administration.

There has been a dramatic shift of the human immunodeficiency virus/ acquired immunodeficiency syndrome (HIV/AIDS) epidemic into poor, marginalized, and minority communities in the US. At the same time, the availability of new highly active antiretroviral treatments has made it possible for a large number of individuals to live for a much longer time with their disease. A net result is that the US is faced with an increasing number of people who are living with HIV/AIDS and are dependent on publicly supported health care services. In this paper, we review the palliative care efforts of the federal agency, the Health Resources and Services Administration (HRSA), responsible for providing Ryan White CARE Act HIV/AIDS care to medically underserved populations. In addition to supporting traditional hospice care, HRSA's HIV/AIDS Bureau has begun a series of initiatives that apply a broader concept of palliative care to its HIV programs in hospital- and community-based settings. Our interest is not to substitute palliation for access to new HIV therapies, such as highly active antiretroviral treatments, but to ensure that our health delivery systems attend to the alleviation of symptoms and suffering along with the provision of antiretroviral and other necessary treatments. HRSA's HIV/AIDS Bureau is organizing a broader provision of palliative care for its clients and actively contributing to improving care for the disenfranchised internationally.

Delivery of Health Care↗
PubMed2000

Therapy-related changes of CD20+ and CD45RO+ lymphocyte subsets in chronic myeloid leukemia (CML): an immunohistochemical and morphometric study on sequential trephine biopsies of the bone marrow.

Little information exists about the amount of CD45RO+-T- and CD20+-B-lymphocytes in the bone marrow of patients with Philadelphia chromosome-positive chronic myelogenous leukemia (Ph1+-CML) at presentation or regarding corresponding changes during therapy. On the other hand, quantification of this cell compartment seems to be imperative for two reasons: first, the presumed association of immunocompetent lymphocyte subsets in the expansion of the leukemic cell clone; and second, a speculated relationship with the complex generation of myelofibrosis. Therefore, an immunohistological and morphometric study was performed on 219 representative trephine biopsies of the bone marrow derived from 70 patients with repeated examinations during the course of Ph1+-CML. For the identification of the different lymphocyte populations, the monoclonal antibodies UCHL-1 (CD45RO) and L26 (CD20) were applied on formaldehyde-fixed and decalcified specimens. In comparison to a control group and calculated per hematopoietic cells, the CML bone marrow showed about a 50% decrease in the total amount of lymphocytes. Determination of CD45RO+ and CD20+ subsets revealed a significant enhancement during treatment. Because of the different intervals (range, 10 to 25 mo) between first and last biopsy in the various therapeutic groups, results had to be modified by considering dynamic features. This calculation included changes of the lymphocyte subpopulations related to time. Contrasting the CD45RO+ lymphocytes, a relevant increase in the CD20+ subset could be observed after interferon-a treatment or corresponding combination regimens. No significant correlations were found between fiber density at onset (first biopsy) or development of fibrosis and lymphocyte proliferations in the course of CML. Our results are in keeping with the finding that a proper immune response consistent with an increased lymphocyte growth seems to be associated with a regression of the clonally-transformed cell population. Opposed to a repeatedly discussed pathomechanism, we failed to demonstrate any quantitative relationships between the extent of lymphocyte proliferations and occurrence or progression of myelofibrosis.

Adult↗
PubMed1999

The bedtime pass: an approach to bedtime crying and leaving the room.

OBJECTIVE: To evaluate a novel intervention for bedtime problems. DESIGN: We used an ABAB withdrawal-type experimental design. SETTING: The intervention was prescribed in an outpatient primary health care context and evaluated in the home setting. PARTICIPANTS: Two normally developing boys aged 3 and 10 years were the primary participants. Twenty parents and 23 practicing pediatricians rated the acceptability of the intervention. INTERVENTION: A bedtime pass, exchangeable for 1 excused departure from the bedroom after bedtime. MAIN OUTCOME MEASURES: For both primary participants, instances of crying and/or coming out from the bedroom after bedtime; for the 20 parents and 23 pediatricians, comparative ratings of acceptability for the pass and 2 other commonly used approaches to bedtime problems (ignoring crying and letting children sleep with their parents). RESULTS: Crying and coming out from the bedroom reduced to zero rates in both children. Pediatricians rated using the pass as significantly more acceptable than letting children sleep with parents and equivalent to ignoring. Parents rated the pass as more acceptable than either alternative. CONCLUSION: The bedtime pass provides pediatricians with a readily usable, potentially effective, and highly acceptable novel intervention for bedtime problems, one of the most common complaints in outpatient pediatrics.

Adult↗
PubMed1998

Hoarding and treatment response in 38 nondepressed subjects with obsessive-compulsive disorder.

OBJECTIVE: The authors studied factors associated with short-term treatment response in 38 nondepressed subjects with DSM-III-R obsessive-compulsive disorder (OCD). METHOD: The subjects completed 12 weeks of treatment with paroxetine (N = 20), placebo (N = 8), or cognitive-behavioral therapy (N = 10). Clinician and self-rated measures were gathered at baseline, during treatment, and after treatment. RESULTS: Seventeen (45%) subjects had "much" or "very much" improvement and achieved at least a 40% decrease in their total Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score. Responders had lower obsessive-compulsive scores on the Symptom Checklist 90-Revised, had a lower checking score on the Maudsley Obsessive-Compulsive Inventory, were less likely to have had prior drug therapy, and in general suffered more obsessive-compulsive symptoms. They were significantly less likely to have hoarding obsessions and corresponding compulsions. The latter finding was confirmed using multiple regression analysis. CONCLUSION: Hoarding is an important symptom that predicts poor treatment response in patients with OCD.

Age Factors↗
PubMed1996

Preliminary confirmation of the proposed link between reward-dependence traits and norepinephrine.

The tridimensional theory of personality posits that traits belonging to a personality spectrum called 'reward dependence' are determined in part by the neurotransmitter norepinephrine (NE). We hypothesized that urinary levels of the NE metabolite 3-methoxy-4-hydroxyphenylglycol (MHPG) would be significantly correlated to the reward dependence score on the Tridimensional Personality Questionnaire (TPQ). Twenty-seven never psychiatrically ill subjects collected urine for MHPG measurements and completed the TPQ. There was a significant correlation between the reward dependence score and the level of MHPG. MHPG levels was not associated with the other two personality dimensions, novelty seeking and harm avoidance. This preliminary study supports the hypothesis that reward-dependence traits are in part determined by NE.

Adult↗
PubMed1996

Sign stimulus activates a peptidergic neural system controlling reproductive behavior in Aplysia.

1. In the marine mollusk Aplysia, egg laying is a complex behavior that lasts for up to several hours. We used behavioral and electrophysiological methods to determine how egg laying occurs in groups of animals and how it is related to other aspects of reproductive behavior. 2. Prolonged contact with an existing egg mass by the lips and tentacles of an animal is a sign stimulus for release of egg-laying behavior and two other fixed action patterns in the same individual, mating as a female during egg laying and mating as a male after egg laying. 3. Prolonged contact with the egg mass initiated repetitive spike activity in bag cell neurons, which are part of a peptidergic neural system that modulates neuronal activity in the CNS for up to several hours. The sign stimulus thus activates the neuromodulatory system, which may serve as an innate releasing mechanism, and an associated internal drive, for control of the behavioral sequence.

Animals↗
PubMed1995

Psychiatric disorders in relatives of probands with obsessive-compulsive disorder and co-morbid major depression or generalized anxiety.

The authors report findings from a blind, controlled study of obsessive-compulsive disorder (OCD). Prevalence rates of generalized anxiety disorder (GAD) and major depressive disorder (MDD) were compared among first-degree relatives of probands with OCD and co-morbid GAD or MDD, respectively. Rates of MDD were not increased in relatives of probands with OCD and MDD; neither were rates of GAD increased in relatives of probands with OCD and GAD, although rates of GAD were increased among relatives of probands with OCD compared to relatives of healthy controls. The authors explore the implications of the findings.

Adolescent↗
PubMed1994

The demography, phenomenology, and family history of 22 persons with compulsive hair pulling.

This study reports on the demographics, phenomenology, and family history of 22 compulsive hair pullers. Subjects were recruited through a psychiatric outpatient clinic as well as newspaper advertisements. Subjects completed a semistructured interview focused on hair-pulling behavior and demographics, the Diagnostic Interview Schedule to assess major (Axis I) mental disorders, and the Structured Interview for DSM-III-R Personality Disorders to assess Axis II disorders. The typical subject was a 33-year-old woman who had completed 1 or more years of college and had been pulling her hair for 19 years. Nearly two-thirds met the criteria for a major mental disorder (particularly anxiety and mood disorders), and more than one-half met the criteria for a personality disorder. Nearly three-quarters of first-degree relatives were reported to have a psychiatric disorder, and about 5% were reported to be hair pullers.

Adolescent↗
PubMed1993

Personality disorder in obsessive-compulsive volunteers, well comparison subjects, and their first-degree relatives.

OBJECTIVE: The authors sought to determine the frequency of DSM-III personality disorders in subjects with obsessive-compulsive disorder, well comparison subjects, and their first-degree relatives. METHOD: Thirty-two subjects with obsessive-compulsive disorder and 33 age-(within 5 years) and gender-matched well comparison subjects were assessed with the Structured Interview for DSM-III Personality Disorder and several self-report instruments. Their first-degree relatives were assessed in a blind manner with the same instruments. RESULTS: Subjects with obsessive-compulsive disorder were more likely than well comparison subjects to have a personality disorder, but compulsive personality was not the most frequent. No significant differences were found in the prevalence of personality disorders among first-degree relatives, including compulsive personality, or in obsessional, hysterical, or oral character traits. CONCLUSIONS: Personality disorders are highly prevalent among patients with obsessive-compulsive disorder, but the data do not support a relationship between obsessive-compulsive disorder and compulsive personality.

Adult↗
PubMed1992

A family study of obsessive-compulsive disorder.

First-degree relatives of probands with obsessive-compulsive disorder (OCD) (n = 32) and psychiatrically normal controls (n = 33) were blindly interviewed with the use of the Diagnostic Interview Schedule. The morbidity risk for anxiety disorders was increased among the relatives of obsessional subjects compared with that for the relatives of controls, but the risk for OCD was not. Risk for a more broadly defined OCD (including relatives with obsessions and compulsions not meeting criteria for OCD) was increased among the parents of obsessional subjects but not among the parents of controls (16% vs 3%). The findings suggest that an anxiety disorder diathesis is transmitted in families with OCD, but that its expression within these families is variable. The findings also support the current practice of classifying OCD as an anxiety disorder.

Adolescent↗
PubMed1992

Depression and other mental disorders in the relatives of morbidly obese patients.

The authors systematically interviewed 88 bariatric clinic patients presenting for vertical banded gastroplasty. The typical subject was middle-aged, female and of low socioeconomic status as indicated by his or her method of payment. Morbidly obese subjects were more likely than a comparison group to have first-degree relatives with a history of depression, bipolar disorder, antisocial personality, and other psychiatric disorders. These data indicate that relatives of morbidly obese subjects are frequently emotionally disturbed. Reasons for the findings are discussed.

Adult↗
PubMed1990

A test of the tridimensional personality theory: association with diagnosis and platelet imipramine binding in obsessive-compulsive disorder.

We administered the Tridimensional Personality Questionnaire (TPQ) to a sample of 25 individuals with obsessive-compulsive disorder (OCD) and 35 normal controls. As predicted, OCD cases scored much higher on the harm avoidance dimension than normal controls. Findings for the novelty seeking and reward dependence dimensions were less dramatic, although compatible with the underlying theory. Despite a theoretical link between the harm avoidance dimension and serotonin-mediated neuropathways, we failed to find an association between this dimension and platelet imipramine binding in either OCD cases or controls.

Arousal↗
PubMed1986

Repeat visitors in the psychiatric emergency service: a critical review of the data.

Repeat visitors to psychiatric emergency services constitute 7 to 18 percent of the total patients and account for up to a third of the visits. This frequently difficult-to-treat group has been described in six controlled and two uncontrolled studies. In a critical review of findings and methodology, the authors interpret and compare the available data about repeaters. Their major conclusions are that repeaters are more likely to lack social supports, to be currently in psychiatric treatment, and to have a chronic illness. Research approaches to further elucidate these patients' characteristics are suggested.

Adult↗
PubMed1985

Defensive projection. An investigation of its role in paranoid conditions.

This paper reports two studies bearing upon the role of defensive projection in paranoid conditions. The first study considered a proposal explaining the mechanics of projection. People who use their social environment for standards of comparison in making self-evaluations may distort the social comparison process in the case of a threatening characteristic. False attribution or selective perception may allow a social standard to be shifted toward the negative attribute. Given the modified standard, the characteristic can be minimized or denied. Evidence supporting this hypothesis was found when high projectors (among normals) reported greater use of social comparison in reaching self-evaluation judgments concerning negative qualities. The second study considered the clinical implications of the proposition that defensive projection, defined this way, would be found among those who are more heavily invested in their social environment. It was predicted that reactive paranoid schizophrenics, identified by greater premorbid commitment to their social environment, would use projection; process paranoid schizophrenics, having a greater premorbid history of social withdrawal, would not. This prediction was confirmed. Process paranoids demonstrated the most idiosyncratic free associations to verbal cues, suggesting the autistic (self-preoccupied) quality of their thinking and delusions.

Adult↗