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Biomedical subjects

S Fink

Publications and source records attributed to S Fink.

At least 19 recordsLinked to original sources
PubMed1995

Every-other-week methotrexate in patients with rheumatoid arthritis. A double-blind, placebo-controlled prospective study.

OBJECTIVE: To determine if patients with rheumatoid arthritis (RA) that is stable with weekly methotrexate (MTX) therapy could be switched to an every-other-week regimen of MTX. METHODS: Forty-seven patients with classic or definite RA who had received MTX for at least 8 months were studied. Clinical measurements consisted of the number of tender and swollen joints, physician and patient global evaluation of disease activity on a 5-point scale, grip strength, patient evaluation of pain, morning stiffness, and the interval to onset of fatigue from time of awakening. Laboratory measures included the erythrocyte sedimentation rate (ESR), rheumatoid factor, C-reactive protein (CRP), and baseline serum folate levels. Uptake of MTX was measured with tritiated thymidine from peripheral blood mononuclear cells (PBMC) from patients ex vivo. Serum measures of interleukin-1 beta (IL-1 beta), IL-6, and tumor necrosis factor alpha (TNF alpha) were performed in sera, and TNF alpha was also measured on PBMC supernatants. RESULTS: Twelve of the 23 patients receiving every-other-week MTX (52%) were able to complete 6 months of this treatment without experiencing a disease flare. Eleven of the 23 patients receiving every-other-week MTX (48%) withdrew from the study before completing 6 months of treatment, because of a flare. No significant differences in clinical or laboratory parameters were seen when the 24 patients receiving weekly MTX were compared with the 12 patients in the every-other-week MTX group who successfully completed 6 months of the study. None of the changes in serum cytokine levels were significantly different between the patients receiving MTX weekly versus those receiving it every other week, and changes in ESR and CRP did not differ between groups. Age, sex, RA disease duration, MTX weekly dose or duration, baseline joint counts, or serum folate status did not predict a flare. Tritiated MTX uptake did not differ between groups. CONCLUSION: Some patients with RA that is stable on weekly dosing are able to change to every-other-week dosing without experiencing a flare in their disease activity.

Aged↗
PubMed1995

Medical characteristics of 61 unwarranted malpractice claims.

We describe malpractice claims closed by plaintiff attorneys after initial medical expert (ME) review. This retrospective study includes 61 cases, of which 33 originated in hospitals, 18 in physicians' offices, and 10 in nursing homes. No claims were against state or federal agencies. The reviews were done between 1987 and 1994 for 29 attorneys from 11 states. The cases fell into 12 diagnostic groups, and leading causes for action were late diagnosis (13 cases), drug administration (11 cases), sepsis (6 cases), and strokes (5 cases). We conclude that internists are particularly liable to unwarranted malpractice claims when unexpected complications occur and when treatment fails to cure infectious disease. However, such claims may be terminated following the initial ME review.

Accidental Falls↗
PubMed1995

Lack of cytotoxic activity against Mycobacterium leprae 65-kD heat shock protein (hsp) in multibacillary leprosy patients.

Cytotoxic T cells play an important role in host defence mechanisms, as well as in the immunopathology of leprosy. In this study, we evaluated whether Mycobacterium leprae hsp18, hsp65 and Myco. tuberculosis hsp71 could induce cytotoxic T cell activity against autologous macrophages pulsed with these hsp. Paucibacillary (PB) patients and normal controls generated more effector cells than multibacillary (MB) patients with all three hsp tested. There was no cross-reactivity between any of the hsp tested. Mycobacterium leprae hsp65 induced cytotoxic responses only in those MB patients undergoing an erythema nodosum leprosum (ENL) episode. Although hsp65 and hsp18 induced similar proliferation in MB patients, a high proportion of these patients did not generate cytotoxic effector cells in response to hsp65. Hence, those T cells reacting to hsp65 may play an important role in the control of Myco. leprae infection.

Adolescent↗
PubMed1994

The evaluation of a new intravascular blood gas monitoring system in the pig.

OBJECTIVE: Our objective was to investigate the accuracy of a new intravascular blood gas sensor, the Paratrend 7 (P7) (Biomedical Sensors Ltd, Pfizer Hospital Products Group, High Wycombe, England) in a porcine model. METHODS: A total of 12 sensors were inserted into 10 animals under total intravenous anesthesia. Changes in blood gas chemistry were produced over a wide range by manipulating the inspired oxygen and carbon dioxide concentrations and by adjustments in minute ventilation. Blood gas samples (BGA) were taken and analyzed during periods of stability; the results obtained were compared with the readings from the intravascular sensor. RESULTS: A total of 292 blood gas samples were taken and analyzed for pHa, PaCO2, and Po2; the results were compared with the readings from the intravascular sensor. Correlation coefficients of r = 0.98 for PCO2 and r = 0.99 for PO2 were obtained. Analysis of bias and precision as mean +/- SD of the difference (P7 - BGA) gave the following results: pH bias = -0.03, precision = +/- 0.04; PCO2 bias = 0.65 mm Hg, precision = +/- 3.1 mm Hg; and PO2 bias = -6.50 mm Hg, precision = +/- 0.6 mm Hg. No problems with clot formation on the sensor were seen, and the sensors did not appear to show the "wall effect" seen with other systems. CONCLUSIONS: The results obtained were well within the requirements for a clinically useful blood gas monitoring system.

Animals↗
PubMed1994

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PubMed1993

Colocalization of D1 and D2 dopamine receptor mRNAs in striatal neurons.

There is evidence that D1 and D2 dopamine receptor subtypes coexist at the cellular level in the striatum and act synergistically to mediate the effects of dopamine. Other data suggest that these receptor subtypes are largely segregated in different striatal projection pathways. We used in situ hybridization in serial adjacent 4 microns sections to determine the extent of colocalization of D1 and D2 receptor mRNAs in rat striatal neurons. Cellular localization of D1 and D2 receptor mRNA was performed on section pairs that were hybridized with 35S-labeled cDNA or oligonucleotide probes directed against non-homologous regions of D1 and D2 receptor mRNAs. We found that 26-27% of striatal cells containing one receptor subtype also contained the other subtype. Thus, although D1 and D2 receptors are segregated in the majority of striatal neurons, a substantial number of striatal neurons coexpress both dopamine receptor mRNA subtypes. Our findings provide anatomic support for many of the functional interactions that have been described for D1 and D2 receptors.

Animals↗
PubMed1993

IFN-gamma, IL-6 and IL-4 modulate M. leprae- or PPD-specific cytotoxic T cells in leprosy patients.

Specific cytotoxic T cells against intracellular pathogens may be generated in vitro. On the other hand it is well known that cytokines can regulate almost every aspect of immune function. The aim of this study was to evaluate the effect of some cytokines on the generation of cytotoxic T cells with specificity for Mycobacterium leprae- or PPD-pulsed autologous macrophages from leprosy patients and normal controls. Peripheral blood mononuclear cells from M. bovis BCG-immunized controls or from leprosy patients were stimulated with antigen, in the presence or absence of cytokines, for 7 days. These were used as effector cells in a 4-h [51Cr]-release assay. Our results show that development of cytotoxic T cells may be enhanced by gamma-IFN, IL-6 or the combination of IL-6 and IL-2. Addition of IL-2 or TNF-alpha alone did not modify the generation of cytotoxic activity. IL-4 down-regulated the cytotoxic response and gamma-IFN was able to counteract this effect. Hence, the generation of specific cytotoxic T cells can be modulated by cytokines. Whether this cytotoxic mechanism contributes to protection or tissue damage in M. leprae infection remains to be determined.

Adult↗
PubMed1992

A solvent-free coating-procedure for the improved preparation of cryostat sections in light microscope histochemistry.

A new technique is presented for the external stabilization of cryostat sections by spraying the specimen surfaces with an aqueous solution of poly(vinyl alcohol) before each sectioning stroke. The spray freezes upon the surface and forms a tough coating which facilitates subsequent sectioning and handling especially of difficult material. The sections are affixed upon cold glass slides covered with an improved formulation of pressure-sensitive adhesive. During further processing of the affixed sections, the PVA-coating and any surrounding supporting medium dissolve without traces in the first aqueous incubation or staining solution.

Animals↗
PubMed1992

Prognostic implication of gastroparesis in patients with diabetes mellitus.

The prognosis and survival in 13 patients with Type II diabetes mellitus who had delayed gastric emptying as shown by radionuclide tests performed between August 1985 and August 1987 was determined in July 1990. The two patients that were over 80 years of age died within 18 months of the diagnosis of diabetic gastroparesis, but ten of the remaining eleven patients survived. The clinical data on these patients suggest that despite the usual presence of significant co-existent pathology, gastroparesis diabeticorum carries a less ominous prognosis than currently believed.

Adult↗
PubMed1992

Ex vivo investigation of blood monocyte and platelet behaviour in pigs maintained on an atherogenic diet.

Domestic pigs aged 4 months were fed for 16 weeks an atherogenic diet rich in cholesterol and saturated fatty acid. The increase of plasma cholesterol and triacylglycerol levels was found to be accompanied by a significant increase in the number of blood monocytes and platelets when compared to control animals. Furthermore, the atherogenic diet produced a small but significant reduction in the blood monocyte phagocytic capacity and adhesion to plastic surface. No significant differences between both groups were found when spontaneous platelet aggregation in whole blood was studied. However, platelets from pigs fed the atherogenic diet had a smaller mean cell volume compared to controls. The results indicate than an atherogenic diet may affect blood monocytes and platelets in pigs.

Animals↗
PubMed1991

Correlation of radionuclide urodynamometric and clinical data in 20 men with urinary symptoms.

Radionuclide uroflowmetry was performed in 20 patients. These data were correlated with other urologic data, the treatment decision, and the patient's clinical status five to twelve months after testing. In 19 patients the follow-up period confirmed the expectations of the therapeutic plan. We conclude that the radionuclide uroflowmetry technique provides the urologist with objective data which can assist in the decision to perform surgery.

Adult↗