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Biomedical subjects

R Horowitz

Publications and source records attributed to R Horowitz.

17 recordsLinked to original sources

Reflections on the casework relationship: beyond empiricism.

This article examines the dynamics of the casework relationship from a holistic perspective. The significance of the interplay between caseworker and client often evades efforts at objective evaluation. Too often emphasis is placed on concrete indications of progress. Staff who look solely at these measures may become frustrated and lose sight of internal change not easily revealed in empirical studies. This article looks at how long-term casework relationships revolve around existential issues that lie at the heart of psychiatric rehabilitation. These relationships, however resistant to stringent measurement, enjoy value apart from specific achievements and merit recognition in their own right. The ordeal of change that both parties endure leaves them heir to a legacy of struggle and renewal.

Attitude of Health Personnel

Iliofemoral venous obstruction without thrombosis.

Nonthrombotic iliofemoral venous obstruction, masquerading as deep vein thrombosis, was diagnosed in four patients. In each instance the patient was hospitalized and intravenous heparin therapy was started. Phlebography demonstrated venous outflow obstruction without thrombosis; subsequent CT scanning revealed an obstructing lesion in each case. At surgical exploration, (1) endoaneurysmorrhaphy of a hypogastric artery aneurysm decompressed an obstructed right iliac vein; (2) a primary iliac vein leiomyosarcoma was extirpated; (3) a synovial cyst arising from the right hip joint, which obstructed the femoral vein, was excised; and, (4) a postherniorrhaphy inflammatory mass obstructing the left iliofemoral vein junction was confirmed with biopsy results. Improved diagnostic accuracy with its attendant specific therapy is achieved in suspected cases of iliofemoral vein thrombosis if, in addition to noninvasive venous studies or phlebography, CT scanning of the abdomen and pelvis is performed.

Adult

Injury patterns in motor vehicle fatalities.

A retrospective pilot study of motor vehicle incident fatalities was conducted to determine what relationships exist between injuries received by deceased drivers, passengers, and a control population of pedestrians, and some of the environmental factors existing at the time of the incident. A number of correlations were established between the types and locations of injuries received, seat belt use, position of the injured party, and so forth. A study of this type, if performed on a large enough population, could lead to predictive models for the determination of position of the victims within a motor vehicle at the time of a fatal crash, based on a unique clustering of injuries.

Abdominal Injuries

Left atrial myxoma in the elderly. Report of four patients over the age of 70 and review of the literature.

Myxoma of the atrium presents distinctive clinical profile, yet precise diagnosis of the tumor on the basis of clinical findings is often not made in the elderly patient as the symptoms are often attributed to "generalized arteriosclerosis of the elderly." The authors report the clinical findings in four elderly patients with left atrial myxoma in whom the diagnosis had not been clinically suspected before echocardiographic evaluation.

Aged

Effect of human syncytiotrophoblast extract on in vitro proliferative responses.

The authors studied the effects of soluble syncytiotrophoblast extract (STE) on the proliferative responses of lymphocytes to different lectins (PHA and Con A) and to allogeneic cells in one-way mixed lymphocyte cultures. STE suppressed lymphocyte reactivity to lectins and to allogeneic cell cultures. The inhibitory effect was dose dependent. Increased concentrations of lectins failed to overcome the inhibitory effect of STE. Lymphocytes preincubated with STE for 18 hr, then washed and exposed to lectins still exhibited an inhibition of cellular proliferation. STE added to lymphocyte cultures at various times in the presence of both mitogens or of allogeneic cells continued to inhibit lymphoproliferative responses even when it was added after 43 hr of cell culture. Furthermore, STE was able to reduce the spontaneous proliferation of tumor cell lines K562 and LHN13 maintained in vitro culture prior to testing. In all cases, the inhibition observed was not due to lymphocytotoxicity or to tumor cell mortality. The inhibitory effect of STE on the proliferative responses of lymphocytes to stimulants may be due to a cytostatic effect that may represent a contributing factor in the nonrejection of the fetus by a competent immune system.

Cell Survival

Correlation of plasma hormone levels and peripheral circulating lymphocyte subpopulations during human pregnancy.

Using monoclonal antibodies (OKT3, OKT4, OKT8) peripheral blood lymphocyte subsets were determined in 40 normal primiparous pregnant women and compared with those of 31 nonpregnant controls. In pregnant women plasma concentrations of estradiol, progesterone, human placental lactogen (HPL), beta subunit of human chorionic gonadotropin (beta HCG), and alpha-fetoprotein were measured by means of radioimmunoassay. We studied if correlations between peripheral lymphocyte subsets and plasma hormone levels might exist. We observed in pregnant women from 10 to 40 wk of amenorrhea a decrease in the percentage of OKT3 and OKT8 cells, and during the course of pregnancy an increase in the percentage of OKT4 cells. This increase inversely correlated with plasma beta HCG levels and directly correlated with plasma HPL levels.

Adult

D-I-A-B-E-T-E-S.

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Diabetes Mellitus, Type 1

Use of the lactose-ethanol tolerance test in diabetes.

The standard lactose tolerance test involves measuring a patient's blood glucose after the ingestion of lactose. If the patient has lactase deficiency and is unable to hydrolyze lactose and absorb its monosaccharides, glucose and galactose, the blood glucose does not usually increase greater than 20 mg/100 ml. Since factors other than the absorption of glucose can cause an increase in the blood glucose of greater than 20 mg/100 ml in a diabetic, this test could be unreliable when it is performed on a diabetic. The present study was performed to determine whether the lactose-ethanol tolerance test could be used to diagnose lactoase deficiency in diabetics. This test involves measuring the blood galactase level, instead of the blood glucose, and the administration of ethyl alcohol to a subject prior to the test to delay the clearance of galactose from the circulation. The results indicate that the standard lactose tolerance test in which the blood glucose is measured is unreliable when performed on insulin-dependent diabetics, but that it can be reliable when performed on non-insulin-dependent diabetics. The lactose-ethanol tolerance test gave results in each type of diabetic which were qualitatively similar to those of nondiabetics. It was concluded that the latter test is a useful screening test for lactase deficiency in diabetics.

Adult

Tribal differences in diabetes: prevalence among American Indians in New Mexico.

The prevalence of diagnosed diabetes among American Indians in New Mexico with varied genetic and cultural backgrounds is reported. Utilizing community-based registries, the prevalence in persons ages 35 years and older ranged from 9.8 percent among Jicarilla Apache Indians to 28.2 percent among Zuni Indians. All rates were significantly higher than the U.S. rate of 5.3 percent for the same age group. In addition, in three of the five tribal groups examined, the rates of diagnosed diabetes in Indians less than 35 years of age (range from 0.5 percent to 1.3 percent) were significantly higher than the U.S. rate of 0.4 percent for the same age group. The prevalence rates of diagnosed diabetes found in this study of American Indians in New Mexico were intermediate between those for the United States as a whole and the Pima Indians of southern Arizona. Reasons for the variations and the relative contribution of obesity, fitness, or genetic risk in the development of diabetes need further study.

Adult