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Biomedical subjects

R Jacobson

Publications and source records attributed to R Jacobson.

At least 55 records · Page 3Linked to original sources

A study of the relationship between family interaction and individual symptomology over time.

The study was designed to answer two questions: (a) Can a relationship over time between family interaction and individual symptomatology be demonstrated? (B) Can it be shown that changes in interaction have more influence on changes in the symptom than vice versa. Five interaction dimensions were taped in weekly, three-quarter hour sessions over 20 weeks in five families, each consisting of a mother-father-child triad who met certain criteria and had an encopretic child. The interaction dimension scores were abstracted weekly from these sessions by content analyses relying on various scales. The derived ratio scores were then related to the number of days the child soiled himself in the week preceding and following the interaction measurement. The relationship was assessed by Pearson correlation coefficients and step-wise multiple regression analyses adjusted to account for the possible inflationary effects of taking measures from the same subjects more than once. The results of the analyses answered both questions posed by the study in the affirmative, thus supporting the rationale underlying family therapy.

Family

Histiocytosis and a leukaemoid response. A case report.

A patient with all the clinical signs of Letterer-Siwe disease is reported. The patient was unusual in that he had a severe leukaemoid reaction. To our knowledge, only 2 similar patients with reticulo-endotheliosis, histiocytic skin infiltration and leukaemoid reaction have been reported. It is possible that the disorder may represent a variant of the histiocytic proliferative disorders, characterized by both histiocytic and myeloid hyperplasia, and is thus similar to myelomonocytic leukaemia. However, it differs from the latter condition in that there is proliferation of monocytes and granulocytes in soft tissues rather than in the blood.

Blood Cell Count

Hb Potomac (101 Glu replaced by Asp): speculations on placental oxygen transport in carriers of high-affinity hemoglobins.

Blood from a woman with unexplained erythrocytosis had increased oxygen affinity, but no abnormality could be detected by electrophoresis or chromatography of her hemolysate. Separation of the tryptic peptides of her beta chains disclosed two half-sized peaks in the regions of beta T-11. The faster of these was abnormal, with the structure beta 101 Glu replaced by Asp. The new hemoglobin was called "Potomac." Three of the proband's four surviving siblings and both of her children were carriers. Differences in the ratio of carrier: normal children born to male of female carriers of 23 other high-affinity hemoglobins were not significant. The high proportion of carriers in this kindred was probably due to chance alone, and not because high maternal oxygen affinity interfered with oxygen transport to fetuses with normal hemoglobin.

Adult

Chronic myeloid leukaemia in South African blacks.

A study on 25 South African Black patients with chronic myelogenous leukaemia (CML), who were followed for 3 1/2 years, is reported. The Ph chromosome was found in 19 of 20 patients studied. Males predominated in a ratio of 2,5:1. Several unusual clinical features were encountered: significant lymphadenopathy, congestive cardiac failure and skin lesions. Patients with lymphadenopathy responded to busulphan therapy no differently from patients without lymphadenopathy. Nine patients had congestive cardiac failure, and in 7 of these a cause could not be found. Three untreated patients became pregnant, indicating that CML per se does not cause infertility. The haematological measurements were similar to those of previous reports; however, the marked splenomegaly suggests that South African Black patients present themselves for treatment rather late in the disease. The median survival time of 34 months is similar to that of previous reports of larger series from other parts of the world.

Adult

In vitro reversal of cellular unresponsiveness induced by levamisole.

Mononuclear cells from twenty-one patients with depressed cellular reactivity were assessed for the ability to produce leucocyte inhibitory factor (LIF) and to transform after PHA stimulation, in the presence or absence of levamisole. Cells from nineteen patients failed to produce significant lymphokines when stimulated with PHA alone, but after a prior 1-hr levamisole pulse normal amounts of LIF were produced. Unstimulated mononuclear cell supernatants from six patients showed LIF-like activity, which could be abolished or decreased in five of the six when the cells were initially treated with levamisole. Mononuclear cells from seven of twelve patients which failed to incorporate [3H]thymidine after PHA activation, showed an increased response after a 1-hr levamisole pulse. Unstimulated mononuclear supernatants from six patients inhibited the lymphoproliferative response of normal cells to PHA. After treatment with levamisole, however, the suppressive effect of these supernatants was decreased or abolished. In vitro levamisole treatment, therefore, not only restores cellular responsiveness in anergic patients but also restricts the uncontrolled release of inhibitory factors.

Cells, Cultured

A pilot study of prednisone in Alzheimer's disease.

Preliminary to a multicenter trial, an open-label study was conducted of prednisone treatment in Alzheimer's disease. Prednisone was given at an initial dose of 10 mg (part 1) or 20 mg (part 2) and tapered over 7 weeks. There were no serious adverse events attributed to the medication, and there were no significant changes in either mean cognitive or behavioral assessment scores with treatment during either part. Serum levels of the acute phase proteins alpha-1-antichymotrypsin and C-reactive protein did not change significantly during part 1, but were suppressed by the higher dose given in part 2. Thus, a prednisone regimen with an initial dose of 20 mg is tolerable and results in suppression of the acute phase response in Alzheimer's disease.

Acute-Phase Proteins

Comparison of a urine spot test and blood tests as indicators of patient compliance.

Irregular drug intake has been a concern of leprosy control programmes for many years and various methods have been used to monitor and encourage patient compliance. This study compares the results of a urine spot test for dapsone as proposed by Huikeshoven, with blood levels measured in the same patients by the modified Bratton Marshall method and by high performance liquid chromatography. Two hundred-sixty urine and blood specimens were obtained from subjects who were taking supervised and unsupervised medications as well as from controls who were taking no medications. The results indicate that the urine spot test is simple and easily performed, and for monitoring patient compliance under routine clinical conditions (hospital or field work) it compares favourably with blood levels of dapsone estimated by the Bratton Marshall method or by high performance liquid chromatography. The study also shows that dapsone level is not a good indicator of compliance in patients who are also taking daily rifampicin but the urine spot test remains useful in such patients.

Dapsone