Conceptualizing a geriatric core curriculum for the health professions: a skills-based approach.
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Clinical Competence↗
Biomedical subjects
P Fishman
Publications and source records attributed to P Fishman.
The iron content of finger-nails in iron deficient patients.
The content of S, Ca, Fe, Cu and Zn in the finger-nails of 17 women with iron deficiency was examined by X-ray microanalysis and compared with that of 17 healthy women. The values for all these elements were similar in both groups. The distribution curve for iron was also similar in both patients and controls. There was no correlation between the iron content of the finger-nails and the serum iron or haemoglobin levels. It is suggested that the iron content of the finger-nails in iron deficient patients does not reflect their iron status.
Adult↗
Intravitreal ceftazidime in a rabbit model: dose- and time-dependent toxicity and pharmacokinetic analysis.
We delineated the dose-and time-dependent retinal toxicity of intravitreal ceftazidime using electroretinography (ERG) in phakic rabbit eyes. Toxicity was evaluated following intravitreal doses ranging from 0.5 to 50 mg/0.1 ml. Eyes were examined prior to injection, at one day, and at seven days after injection. ERG patterns at one and seven days indicated a toxic response to doses of 20 to 50 mg. Doses of 10 mg or less gave a transient depression of the B-wave at one day, but a return to normal was observed at the seven-day evaluation. Pharmacokinetic analysis following intravitreal injection of 2 mg of ceftazidime into uninfected phakic rabbit eyes disclosed vitreous levels of: 1711 micrograms/ml at 0 hr; 1340 micrograms/ml at 8 hr; 451 micrograms/ml at 24 hr; 270 micrograms/ml at 48 hr and 67 micrograms/ml at 72 hr. Peak aqueous humor level was 139 micrograms/ml 8 hr post-injection. Potentially therapeutic drug levels were obtained in the aqueous and vitreous humors following a nontoxic intravitreal dose of ceftazidime in a rabbit model.
Animals↗
X-ray microanalysis of the fingernails in cirrhotic patients.
The element content of clipped nails of 13 patients with liver cirrhosis was examined by X-ray microanalysis, and compared with that of 50 healthy subjects. The results showed a statistically significant increase in the percentage of Na, Mg and P and a slight, but statistically significant decrease in S and Cl. The percentage of K, Ca, Fe, Cu and Zn did not show any difference from that of the controls. The findings indicate that X-ray microanalysis may be a valuable tool for the simultaneous examination of a large number of elements in the fingernails.
Aged↗
Subconjunctival administration of ceftazidime in pigmented rabbit eyes.
The ocular kinetics of ceftazidime, a third-generation cephalosporin, were examined in phakic and aphakic pigmented eyes of rabbits following subconjunctival injection (100 mg). Peak ceftazidime concentrations (mean +/- SE, n = three to five rabbits per determination) were as follows: phakic eyes, 40.2 +/- 7.3 mg/L in aqueous humor and 11.2 +/- 0.6 mg/L in vitreous humor at one hour; aphakic eyes, 30.5 +/- 4.8 mg/L in aqueous humor and 15.8 +/- 2.4 mg/L in vitreous humor at one hour. The ability of ceftazidime to eliminate an incipient bacterial infection was also studied. Ten aphakic rabbits received intravitreal injections of 50 colony-forming units (cfu) of Pseudomonas aeruginosa. Six of the ten immediately received a subconjunctival injection of ceftazidime (100 mg). At 48 hours following injections, four of four control eyes yielded bacterial counts greater than 6.2 X 10(6) cfu/mL. Of the six that received ceftazidime, five were sterile and one yielded 10 cfu/mL.
Animals↗
The effect of nifedipine on protein synthesis and surface morphology of peripheral blood cells.
Peripheral blood polymorphonuclear cells, lymphocytes, and platelets, incubated with nifedipine, showed a marked dose-dependent inhibition of the cell capacity to synthesize proteins. The possible role of the drug as a Ca2+ blocker for the explanation of this finding is discussed. In addition, the drug induced surface alterations in all three cell types, the most prominent being observed on the platelets which showed elongation of their pseudopodia. This phenomenon, accompanied by an increase in the negative membranal electric charge, may explain the previously reported inhibition of platelet aggregation caused by nifedipine.
Blood Platelets↗
The effect of propranolol on protein synthesis and phagocytosis by polymorphonuclear leukocytes from newborn, children and elderly individuals.
The effect of propranolol on protein synthesis by polymorphonuclear (PMN) leukocytes was assessed in subjects from four age categories: elderly individuals, grown-up children, small children and newborn babies. This function was inhibited in PMN cells from individuals of all age groups, but inversely proportional to the age of the individual, i.e. the younger the subject, the more inhibited was the protein synthesis by his PMN leukocytes. The phagocytic capacity of the PMN cells of elderly subjects was decreased in comparison with that of individuals from the younger age groups. Propranolol inhibited this cell function in cells from subjects of all categories, although the inhibition was more pronounced in the cells of the younger groups. The difference in the degree of inhibition of the cell function observed in the various age groups may indicate different functional properties of the cell membrane.
Aged↗
Reduced phagocytosis promoting activity of saliva from patients with chronic lymphocytic leukemia.
Patients with chronic lymphocytic leukemia (CLL) have an increased susceptibility to oral and other infections. In a previous study we have shown that normal human saliva contains phagocytosis promoting factor(s). Saliva from healthy subjects enhanced in vitro phagocytosis of latex particles by polymorphonuclear leukocytes (PMNL) and monocytes. Therefore, it was of interest to examine the phagocytosis promoting activity of saliva from patients with CLL. Homologous PMNL and monocytes from healthy subjects supplemented by saliva from patients with CLL demonstrated in vitro a decreased phagocytosis of latex particles, in comparison with cells supplemented by saliva from healthy subjects. This observation suggests that saliva from CLL patients has a reduced phagocytosis promoting ability. This finding may contribute to a further clarification of the increased susceptibility of CLL patients to oral infections.
Blood Proteins↗
Platelet X-ray microanalysis in patients with chronic renal failure.
The platelet element content was determined by semiquantitative X-ray microanalysis in 6 patients with chronic renal failure. The patients showed a different degree of thrombocytopathy expressed by impaired adhesiveness, epinephrine-induced aggregation and platelet factor 3 availability. The microanalysis indicated significantly increased quantities of phosphorus and copper in patients' platelets. Sodium and zinc showed a decrease in about half of the patients, whereas iron was significantly increased in at least 50% of the patients. Magnesium and potassium did not show any difference from the control. The results of sulfur, chlorine and calcium did not reveal a consistent pattern.
Arachidonic Acid↗
X-ray microanalysis of normal human neutrophils, lymphocytes, monocytes and platelets.
Elemental X-ray microanalysis of normal peripheral blood neutrophils, lymphocytes, monocytes and platelets was carried out with a scanning electron microscope fitted with an X-ray analytical system. Each cell type was characterized by its own spectrum. Nucleus containing cells displayed a high phosphorus level, while platelets showed a low peak of this element. The elevated level of sulfur observed in platelets, neutrophils and monocytes may result from their cytoplasmic granules which contain sulfur-rich substances. The highest amount of calcium was detected in the platelets. The results indicate that X-ray microanalysis may be applied for the detection of the elemental content of blood cells.
Blood Platelets↗
Severe alterations of red blood cells from the vessels of colorectal tumors.
The RBCs from vessels supplying the tumors of 14 patients with colorectal carcinoma were examined with the scanning electron microscope. In all of them a great variety of alterations in the shape and the cell membrane were found. Erythrocytes from the vessels of healthy colonic tissue of the patients were found to have a normal appearance. Since fibrin thrombi were present in a few vessels of only six patients, the possibility that the alterations were due to mechanical trauma was not likely. This observation may serve as an additional explanation for the anemia observed in patients with colorectal carcinoma.
Adenocarcinoma↗
Growth of human basophil lines derived from chronic myelocytic leukaemia cells in vitro: ultrastructure and X-ray microanalysis studies.
Mononuclear cells from the peripheral blood of patients with chronic myelocytic leukaemia were grown and expanded in liquid culture in the presence of Con A-conditioned medium. An accelerated development of cells of the basophilic lineage was observed and resulted in the appearance of 85% mature basophils after 14 days of incubation. Transmission electron microscopy of developing basophils showed changes in the nucleus and active granule formation in the cytoplasm. By scanning electron microscopy, the immature cells were relatively smooth in comparison with the mature basophils which showed membranous microvilli. The chemical content of the cells at different days of culture was detected by X-ray microanalysis. Immature cells were characterized by a high level of phosphorus with a low level of sulphur. As maturation progressed, the amount of phosphorus decreased, while the level of the sulphur increased, reaching its highest peak in the mature basophils. The different amount of sulphur found in the cells during the maturational process most probably represents the amount of heparin located in the cell granules. This finding may be useful for studying the influence of growth factors on the development and differentiation of human basophils.
Basophils↗
Transformation of erythrocytes to spherocytes following incubation with malignant cells.
Incubation of erythrocytes from controls and patients with colorectal carcinoma with tumor cells, or their metabolites, caused transformation of the normally-shaped cells to spherocytes. It is assumed that abnormal metabolites produced by malignant cells affect the cell membrane inducing the subsequent appearance of spherocytes. The increased destruction of these cells by the reticuloendothelial system may serve as an additional factor for the explanation of anemia accompanying malignant diseases.
Colonic Neoplasms↗
Effect of cimetidine on granulocyte-macrophage colony formation by normal and chronic renal failure bone marrow cells.
The effect of cimetidine, an antihistaminic blocker of the H2 receptors, on the development of granulocyte-macrophage colonies (GMC) was examined in vitro on bone marrow cells from healthy individuals and chronic renal failure (CRF) patients. The drug caused a dose-dependent decrease in the number of GMC from bone marrow samples in both healthy subjects and patients, being much more expressed in the latter group. The addition of urea to bone marrow cultures of healthy subjects increased the inhibition of colony formation caused by cimetidine alone. CRF or control serum added to normal bone marrow cells enhanced the colony growth which was significantly more expressed when using a CRF serum sample.
Adult↗
Generation of superoxide anions during phagocytosis by monocytes of uremic patients.
The phagocytic activity of monocytes from 15 uremic patients was estimated by the superoxide anion test. There was a significant decrease in the ability of monocytes from these patients to produce superoxide anions in comparison with monocytes obtained from healthy subjects. Addition of urea to monocytes from healthy subjects caused a marked reduction in their ability to produce superoxide anions, while addition of creatinine did not cause any effect. Monocytes from patients with renal failure of glomerular origin were found to produce less superoxide anions than those from patients with other types of renal diseases.
Creatinine↗
In vitro colony-forming cells in embryonic mouse liver, spleen and peripheral blood.
The number of in vitro colony-forming cells (CFC) was examined in embryonic livers, spleens, and peripheral blood of C57B1/6J mice from the 12th to the 19th day of gestation. Peaks of CFC in the liver and spleen were noted on days 13, and 15, respectively, whereas the number of CFC in the peripheral blood remained almost constant. The possibility that CFC in the embryonic mouse are produced both in the yolk sac and in other hemopoietic sites is discussed.
Animals↗
Effect of human saliva on the phagocytotic activity of polymorphonuclear leukocytes and monocytes.
Saliva of healthy subjects was found to enhance phagocytosis of polymorphonuclear leukocytes and monocytes in vitro. Autologous and homologous polymorphonuclear leukocytes and monocytes, separated from heparinized venous blood samples and treated with two concentrations of saliva, demonstrated increased phagocytotic activity for latex particles. The phagocytotic pattern was similar for the two types of cells, and for the two concentrations of saliva used. There was no significant difference between phagocytosis by cells treated by homologous and autologous saliva.
Humans↗
Psychoactive drug use by young and future physicians.
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Adult↗