PubMed Health⌕ Search

Biomedical subjects

N Shapiro

Publications and source records attributed to N Shapiro.

At least 19 recordsLinked to original sources
PubMed1999

Targeting the replication of adenoviral gene therapy vectors to lung cancer cells: the importance of the adenoviral E1b-55kD gene.

It has been proposed that an adenovirus with the E1b-55kD gene deleted has a selective advantage in replicating in cancer cells that have mutations in the p53 gene (Bischoff et al., 1996). We have explored this hypothesis in several lung cancer cell lines, and evaluated potential mechanisms that might regulate the replication of Ad338, an E1b-55kD-deleted virus, with the objective of developing a rational approach for targeting gene therapy to lung tumors. Our data show that Ad338 replicates poorly in three lung cancer cell lines with various p53 mutations (H441, H446, and Calu1), yet this virus replicates to a high level in a lung cancer cell line with wild-type p53 (A549) and in a normal lung fibroblast line (IMR90). Viral DNA replication, expression of viral proteins, and shutoff of host cell proteins were not important variables in limiting the replication of the E1b-55kD-deleted virus. However, the cell lines resistant to host cell protein shutoff were also the most resistant to the cytopathic effect induced by mutant and wild-type virus and the only cells to survive for 8 days following infection. The E1b-55kD protein clearly has an important role in viral replication beyond its interaction with p53. Thus, an E1b-55kD-deleted virus cannot be used to specifically target viral replication to p53-mutated lung cancer cells.

Adenoviridae↗
PubMed1999

Self-reported health status of low-income mothers.

PURPOSE: To determine the self-reported health status of low-income mothers before major health and welfare policy reform in the state of Ohio, to compare the health status of this group with the general population age-based norms, and to examine differences in health status among insurance and racial subgroups. Policy makers and others have a need for key health-status information about low-income mothers, a topic for which little empirical data currently exist. DESIGN: Descriptive using a cross-sectional survey with convenience sampling; 502 women were interviewed at intake sites in four countries in central Ohio, 1995 to 1996. METHODS: Health status was measured using the general health status index developed by J. E. Ware and colleagues (1995). Two summary measures, one indicating physical health and one indicating mental health, were used and compared with published norms. Multivariate logistic models were examined for depression and physical health status. FINDINGS: A significant level of depression in the population of low-income mothers was found as were differences in physical health scores by insurance group. People insured privately had the highest physical health scores, while those enrolled in fee-for-service Medicaid had scores indicating the poorest health. No significant difference was found between racial groups in self-reported health status. CONCLUSIONS: Self-reported mental health status is low among some low-income female populations. Physical health is worse for the Medicaid-enrolled group compared to both uninsured and privately insured groups. This poor state of health will likely diminish the success of welfare reform to improve the economic self-sufficiency of these women unless comprehensive health services are available.

Adult↗
PubMed1999

Demonstration of high-fidelity simulation team training for emergency medicine.

Emergency medicine (EM) presents many cognitive, social, and systems challenges to practitioners. Coordination and communication under stress between and among individuals and teams representing a number of disciplines are critical for optimal care of the patient. The specialty is characterized by uncertainty, complexity, rapidly shifting priorities, a dependence on teamwork, and elements common to other risky domains such as perioperative medicine and aviation. High-fidelity simulators have had a long tradition in aviation, and in the past few years have begun to have a significant impact in anesthesiology. A national, multicenter research program to document the costs of teamwork failures in EM and provide a remedy in the form of an Emergency Team Coordination Course has developed to the point that high-fidelity medical simulators will be added to the hands-on training portion of the course. This paper describes an evolving collaborative effort by members of the Center for Medical Simulation, the Harvard Emergency Medicine Division, and the MedTeams program to design, demonstrate, and refine a high-fidelity EM simulation course to improve EM clinician performance, increase patient safety, and decrease liability. The main objectives of the paper are: 1) to present detailed specifications of tools and techniques for high-fidelity medical simulation; 2) to share the results of a proof-of-concept EM simulation workshop introducing multiple mannequin/ three-patient scenarios; and 3) to focus on teamwork applications. The authors hope to engage the EM community in a wide-ranging discussion and handson exploration of these methods.

Clinical Competence↗
PubMed1998

Are emotions frightening? II: An analogue study of fear of emotion, interpersonal conflict, and panic onset.

Two studies with college students were conducted to further explore the reliability and construct validity of fear of emotion, as assessed by the Affective Control Scale (ACS), a measure of fear of anxiety, depressed mood, anger, and strong positive emotion. The ACS fared well in tests of internal consistency and of convergent and divergent validity. In an analogue study of panic onset with college students with no history of panic, the predictive and incremental validity of the ACS was demonstrated: the ACS predicted students' fear of induced panic-like bodily sensations even once trait and state anxiety were statistically controlled. A second aspect of the investigation was an analogue test of the hypothesis that stress from interpersonal conflict (induced via remembrance of conflictual interactions with an important person) would moderate the ACS's effects on anxiety and fear of induced bodily sensations. This hypothesis was not confirmed.

Adolescent↗
PubMed1998

Preventive health counseling reported by uninsured women with limited access to care.

Low-income women in the childbearing years are at an increasing risk of becoming uninsured as welfare reforms are enacted and women enter minimum-wage jobs without insurance benefits. This study contrasts preventive counseling reported by low-income uninsured mothers and mothers insured through Medicaid. Low-income women attending Women, Infant, and Children (WIC) clinics and human services offices who had received health care during the previous 12 months (N = 406) were asked if they had received counseling from a health provider regarding any of seven types of preventive health behaviors. Uninsured women were less than half as likely to receive counseling on three or more preventive topics (OR = 0.42) as were mothers on Medicaid. Risk estimates were stable on bivariate analyses and logistic regression models. Findings indicate that opportunities for preventive health counseling need to be maximized for this group already experiencing compromised access to care.

Adult↗
PubMed1996

The recA gene and cadmium toxicity in Escherichia coli K12.

The influence of the recA gene on cadmium toxicity was studied in Escherichia coli K12 strains. Those strains mutant in the recA gene showed a 1,000-fold loss of viability upon exposure to cadmium, but recovered and started growing approximately 16-20 h following the initial exposure to cadmium. In contrast to previous studies with E. coli B strains, the E. coli K12 strains carrying a functional recA gene showed little or no loss of viability upon exposure to cadmium. The cells also exhibited a significant lag period in which no net growth occurred and then began growing 16-20 h after initial exposure to cadmium. These results indicate the importance of the recA gene to cell survival during exposure to metals, and also support the hypothesis that cadmium causes DNA damage.

Cadmium↗
PubMed1994

Retaining periodontally "hopeless" teeth.

A case of advanced periodontitis with many hopeless teeth, treated and maintained for 8-1/2 years, is presented. This case suggests a successful departure from traditional treatment.

Adult↗
PubMed1988

Severe gingival damage after polysiloxane impression procedures. A case report.

This is a report of a 38-year-old white female who developed severe gingival damage after impression for a full crown with vinyl polysiloxane material. Treatment of the lesion consisted of a gingival graft placed directly on bone. A one-year follow-up showed significant re-establishment of a healthy gingival complex.

Adult↗
PubMed1981

Duodenal infarction after therapeutic Gelfoam embolization of a bleeding duodenal ulcer.

A patient is presented who sustained a duodenal infarction after therapeutic Gelfoam embolization of the gastroduodenal artery for hemorrhage from a duodenal ulcer. Factors that may have contributed to this previously unreported complication included underlying vascular disease, recent surgery, and an associated arteritis possibly related to the Gelfoam. Although ischemic injury of the duodenum has been considered unlikely because of its dual vascular supply, our case suggests that the technique of therapeutic embolization may carry an increased risk in patients with underlying vascular disease or previous surgery within the area of the vascular bed to be embolized.

Aged↗
PubMed1978

Conservation, choice, and the concurrent fixed-ratio schedule.

Five rats got all of their water in daily 60-minute sessions. Two levers and a water spout were freely available throughout baseline sessions. Contingency sessions offered a choice between two alternative fixed-ratio components, in the form of a choice between the two levers. Each component required a specified number of lever presses for access to the spout, and then a specified number of licks for another choice between components. Given the observed relative frequency, the absolute frequency of selecting each component was predicted accurately by assuming that the subject conserved between baseline and contingency the total amount of a dimension attributable to lever pressing and licking. Several quantitative models for predicting relative frequency were examined. The best of these assumed that the subject would show a nonexclusive preference for the component requiring fewer lever presses.

Journal Article↗
PubMed1978

Epinephrine absorption from retraction cord: a study in dogs.

This report re-opens the question of epinephrine absorption from gingival retraction cord during fixed prosthodontic impression procedures. The conflicting evidence exposed by this and other studies is probably related to the experimental models utilized. Some suggestions for further investigation are given.

Absorption↗
PubMed1978

Choledochoduodenostomy as an adjunct to choledocholithotomy.

Choledochoduodenostomy was performed in 100 patients for calculus related disease of the common bile duct. There were no significant early or late complications of the anastomotic procedure. The 3 per cent mortality was related to antecedent advanced liver disease in two instances and, in one instance, to intra-abdominal sepsis. The surgical bypass has the advantage of circumventing the retained stone problem or the sequelae of benign obstructive disease in the distal part of the choledochus. It permits postoperative roentgenographic and endoscopic evaluation of the anastomotic site. Cholangitis, blind segment disability and malfunction have not been seen with these indications and this technique. When the common bile duct is at least 1.4 centimeters wide, primary or secondary choledochoduodenostomy with a wide anastomosis has significant advantages over T-tube intubation in the therapeutic and prophylactic management of choledocholithiasis.

Adult↗
PubMed1977

Administrative receivership and troika management.

The authors describe the use of troika management and administrative receivership to upgrade a unit in a state mental hospital. The experiment included a three person unit chief, transitional leadership, and collective decision making.

Administrative Personnel↗