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S Goldstein

Publications and source records attributed to S Goldstein.

At least 19 recordsLinked to original sources
PubMed2006

Valganciclovir is safe and effective as pre-emptive therapy for CMV infection in allogeneic hematopoietic stem cell transplantation.

Despite significant advances in prevention and therapy, cytomegalovirus (CMV) infection continues to be an important cause of morbidity and mortality in the hematopoietic stem cell transplant (HSCT) recipient. The standard drug for pre-emptive therapy is intravenous ganciclovir (GCV). Valganciclovir (VGC), the oral pro-drug of GCV, has excellent bioavailability and is ideal for oral therapy. Since March 2002, VGC was adopted in our center for outpatient pre-emptive therapy in all patients undergoing allogeneic HSCT. Fifty-two allogeneic HSCT recipients were followed weekly via Digene hybrid capture assay. Patients with a positive assay were treated with VGC 900 mg p.o. b.i.d. x 14 days followed by 900 mg p.o. QD until at least 7 days after a negative test. Eighteen patients (14 sib, four MUD) had 30 episodes of CMV DNA detection treated with oral VGC. Median duration of therapy was 21 days (range 10-21 days). The rate of response was 93% (28/30) as confirmed by a negative assay within 14 days. No significant toxicity was encountered. Two patients failed oral VGC. One case of CMV enteritis was diagnosed in a patient with acute GVHD. Pre-emptive therapy of CMV infection with oral VGC is safe and effective in allogeneic HSCT recipients.

Administration, Oral↗
PubMed2005

Alvimopan, a peripherally acting mu-opioid receptor antagonist, compared with placebo in postoperative ileus after major abdominal surgery: results of a randomized, double-blind, controlled study.

BACKGROUND: Alvimopan is a peripherally acting mu-opioid receptor (PAM-OR) antagonist for accelerating gastrointestinal recovery after surgery. METHODS: Patients undergoing open laparotomy (bowel resection, n = 418; hysterectomy, n = 197) were randomized to receive alvimopan 6 or 12 mg or placebo orally > or = 2 h before surgery and then b.i.d. until hospital discharge (up to 7 days). The primary efficacy endpoint was time to gastrointestinal (GI) recovery (measured by toleration of solid food and passage of flatus/stool; GI-3). Secondary endpoints included time to GI-2 recovery (toleration of solid food and passage of stool) and hospital discharge order written (DCO). RESULTS: Alvimopan did not significantly accelerate GI-3 compared with placebo [6 mg: hazard ratio (HR) = 1.20, p = 0.080; 12 mg: HR = 1.24, p = 0.038). However, after adjustment for significant covariates (sex/surgical duration), benefits were significant for both doses (6 mg: HR = 1.24, p = 0.037; 12 mg: HR = 1.26, p = 0.028). Alvimopan also significantly accelerated time to GI-2 (6 mg: HR = 1.37, p = 0.008; 12 mg: HR = 1.33, p = 0.018) and DCO (6 mg: HR = 1.31, p = 0.008; 12 mg: HR = 1.28, p = 0.015). Adverse events were similar between groups. CONCLUSIONS: Alvimopan (6 or 12 mg) accelerates GI recovery and is well tolerated in patients undergoing open laparotomy.

Abdomen↗
PubMed2004

Boltzmann entropy for dense fluids not in local equilibrium.

Using computer simulations, we investigate the time evolution of the (Boltzmann) entropy of a dense fluid not in local equilibrium. The macrovariables M describing the system are the (empirical) particle density f=[f(x,v)] and the total energy E. We find that S(f(t),E) is a monotone increasing in time even when its kinetic part is decreasing. We argue that for isolated Hamiltonian systems monotonicity of S(M(t))=S(M(X(t))) should hold generally for "typical" (the overwhelming majority of) initial microstates (phase points) X0 belonging to the initial macrostate M0, satisfying M(X0)=M(0). This is a consequence of Liouville's theorem when M(t) evolves according to an autonomous deterministic law.

Journal Article↗
PubMed2004

The emergence of selective 5-HT 2B antagonists structures, activities and potential therapeutic applications.

5-HT(2) receptors mediate a large array of physiological and behavioral functions in humans via three distinct subtypes: 5-HT(2A), 5-HT(2B)and 5-HT(2C). While selective 5-HT(2A)antagonists have been known for some time, knowledge of the precise role played by the 5-HT(2B)receptor was hampered by the existence of solely 5-HT(2B)5-HT(2C) mixed antagonists. However, selective 5-HT(2B)antagonists began recently to emerge in the literature. Indeed, four structural classes belonging to the piperazine, indole, naphthylpyrimidine and tetrahydro-beta-carboline scaffolds were reported. In this paper, we will briefly review the structural and pharmacological features of selective 5-HT(2B) antagonists, including patent literature of the last five years.

Animals↗
PubMed2002

Evaluation of a video based health education strategy to improve sexually transmitted disease partner notification in South Africa.

OBJECTIVES: To evaluate the feasibility and impact of a health education intervention promoting partner notification for sexually transmitted diseases (STDs). METHODS: The research setting was a busy public health clinic in a rural district in KwaZulu Natal, South Africa. A before/after quantitative study design was used to measure the effect of an audiovisual presentation of a compelling love drama, posters, and pamphlets. Measures collected from all consenting STD index patients during a 6 week pre-intervention (control) phase were compared with those collected during a 6 week intervention phase. A qualitative evaluation assessed whether the intervention accurately portrayed the intended educational messages. RESULTS: 150 index patients (55% female) were interviewed in the control phase and 185 index patients (64% female) in the intervention phase. The intervention phase showed improvements on several measures of self efficacy about notifying casual partners, such as a belief among index patients that a greater proportion of their casual partners would see the importance of seeking treatment as a result of their notification interaction. The rate of contact cards returned per index patient was 0.27 in the intervention phase, compared with 0.20 in the control phase (95% CI for the rate difference: -0.05, 0.17). The qualitative research found that the intervention was thoroughly enjoyed by patients and clinicians, but a fundamental problem with it was that patients received confused messages about the relation between HIV/AIDS and other STDs. This has potentially negative consequences for partner notification. CONCLUSION: The intervention needs further development, and then could provide a highly acceptable, cost effective model for health education in clinics in developing countries.

Adult↗
PubMed2001

ACC/AHA Guidelines for the Evaluation and Management of Chronic Heart Failure in the Adult: Executive Summary A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1995 Guidelines for the Evaluation and Management of Heart Failure): Developed in Collaboration With the International Society for Heart and Lung Transplantation; Endorsed by the Heart Failure Society of America.

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Adult↗
PubMed2001

High-pressure pulse-radiolysis study of the formation and decomposition of complexes with iron-carbon sigma bonds: mechanistic comparison for different metal centers.

Volumes of activation for the formation and homolysis of the transient complexes (hedta)Fe(III)-CO(2)(2-) and (hedta)Fe(III)-CH(3)(-) (HOCH(2)CH(2)N(CH(2)CO(2-))CH(2)CH(2)N(CH(2)CO(2-))(2) = hedta) were determined using high-pressure pulse-radiolysis techniques. A comparison of the results with those for analogous complexes with other central transition-metal cations (M(n+)) and ligands (L) points out that (i) the reaction of M(n)L(m) with aliphatic radicals (R(*)) proceeds via an interchange ligand substitution mechanism, i.e. M(n)L(m) + R(*) --> L(m-1)M(n+1)-R + L, (ii) the homolysis of the metal-carbon bonds naturally follows the same mechanism, and (iii) the volume of activation for the homolysis reaction depends strongly on the nature of the central cation, i.e. larger for M(n+1) = Cr(III), Co(III), Ni(III) and smaller for Fe(III). The volume of activation for the reaction (hedta)Fe(III)-CO(2)(2-) + CO(2)(*-) + 2H(+) --> Fe(II)(hedta)(H(2)O)(-) + CO + CO(2) was measured, and the results enable a tentative proposal for the nature of the transition state of this interesting reaction.

Carbon↗
PubMed2001

Cuban medicine.

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Cardiology↗
PubMed2001

Somatosensory evoked potentials as a marker of disease burden in type 3 Gaucher disease.

The authors compared stretch-evoked somatosensory evoked potentials (SEP) of 18 type 3 Gaucher disease (GD3) patients (two with progressive myoclonus epilepsy [PME]) with 22 age-matched normal controls and six patients with type 1 (nonneuronopathic) Gaucher disease (GD1). The mean P1-N2 SEP amplitude in GD3 patients was significantly larger than the SEP in controls and in GD1 patients, and there was a significant negative correlation between SEP amplitude and the IQ of GD3 patients. The authors conclude that abnormal cortical inhibition is a unifying feature of GD3 patients and correlates with the degree of cognitive deficit.

Adolescent↗
PubMed2001

Decellularized human valve allografts.

BACKGROUND: Variable performance of allograft tissues in children and some adults may be linked to an immune response and could be mitigated by reducing implant antigenicity. METHODS: As endothelial and fibroblast cells are the likely source of valve antigenicity, human (CryoValve SG) and sheep pulmonary valves were decellularized using the SynerGraft treatment process. Treated valves were evaluated in vitro using histochemical, biomechanical, and hydrodynamic methods, and compared with standard cryopreserved valves. Four SynerGraft-treated and two cryopreserved sheep pulmonary valves were implanted as root replacements in the right ventricular outflow tract of growing sheep and monitored echocardiographically and histologically at 3 and 6 months. CryoValve SG human pulmonary valves were implanted in 36 patients. RESULTS: SynerGraft treatment reduced tissue antigen expression but did not alter human valve biomechanics or strength. Decellularized sheep allograft valves were functional during the implantation period, and, they became progressively recellularized with recipient cells. In humans, CryoValve SG pulmonary valves did not provoke a panel reactive antibody response. CONCLUSIONS: SynerGraft decellularization leaves the physical properties of valves unaltered and substantially diminishes antigen content. Reduction in implant cellularity enables host recellularization of the matrix, which should favorably impact long-term graft durability.

Adult↗
PubMed2001

Metoprolol controlled release/extended release in patients with severe heart failure: analysis of the experience in the MERIT-HF study.

OBJECTIVES: This study analyzed the effect of the beta(1)-selective beta-blocker metoprolol succinate controlled release/extended release (CR/XL) once daily on mortality, hospitalizations and tolerability in patients with severe heart failure. BACKGROUND: There continues to be resistance to the incorporation of beta-blockers into clinical care, largely due to concerns about their benefit in patients with more severe heart failure. METHOD: SA subgroup of patients from Metoprolol CR/XL Randomized Intervention Trial in chronic Heart Failure (MERIT-HF) in New York Heart Association (NYHA) functional class III/IV with left ventricular ejection fraction < 0.25 were identified (n = 795). The analysis was by intention-to-treat. RESULTS: The mean ejection fraction at baseline was 0.19, and the yearly placebo mortality during follow-up was 19.1%. Treatment with metoprolol CR/XL compared to placebo resulted in significant reductions in all predefined mortality end points including: total mortality, 45 versus 72 deaths (risk reduction 39%; 95% confidence interval 11% to 58%; p = 0.0086); sudden death, 22 vs. 39 deaths (45% [7% to 67%]; p = 0.024); and death due to worsening heart failure, 13 vs. 28 deaths (55% [13% to 77%]; p = 0.015). Metoprolol CR/XL also reduced the number of hospitalizations for worsening heart failure by 45% compared with placebo (p < 0.0001). The NYHA functional class improved in the metoprolol CR/XL group compared with placebo (p = 0.0031). Metoprolol CR/XL was well tolerated, with 31% fewer patients withdrawn from study medicine (all causes) compared with placebo (p = 0.027). CONCLUSIONS: This subgroup analysis of the MERIT-HF study shows that patients with severe heart failure receive a similar mortality benefit and a similar reduction in hospitalizations for worsening heart failure with metoprolol CR/XL treatment as those patients included in the total study.

Adrenergic beta-Antagonists↗
PubMed2001

Gibbs energy of formation of peroxynitrite--order restored.

In a recent publication [Nauser et al. (2001) Chem. Res. Toxicol. 14, 248-350], the authors estimated a value of 14 +/- 3 kcal/mol for the standard Gibbs energy of formation of ONOO(-) and argued that the experimental value of 16.6 kcal/mol [Merényi, G., and Lind, J. (1998) Chem. Res. Toxicol. 11, 243-246] is in error. The lower value would suggest that the yield of free radicals during decomposition of ONOOH into nitrate is negligibly low, i.e., less than 0.5%, though within the large error limit given, the radical yield might vary between 0.003% and ca. 80%. The experimental value of 16.6 +/- 0.4 kcal/mol was based on the determination of the rate constant of the forward reaction in the equilibrium ONOO(-) <==> (*)NO and O2(*-) by use of C(NO2)4, an efficient scavenger of O2(*-) which yields C(NO2)3(-). Nauser et al. reported that addition of (*)NO has no significant effect on the rate of formation of C(NO2)3(-), and therefore the formation of C(NO2)3(-) is due to a process other then reduction of C(NO2)4 by O2(*-). In addition, they argued that Cu(II) nitrilotriacetate enhances the rate of peroxynitrite decomposition at pH 9.3 without reduction of Cu(II). In the present paper, we show that the formation of C(NO2)3(-) due to the presence peroxynitrite is completely blocked upon addition of (*)NO. Furthermore, the acceleration of the rate of peroxynitrite decomposition at pH 9 in the presence of catalytic concentrations of SOD ([ONOO(-)]/[SOD] > 30) results in the same rate constant as that obtained in the presence of C(NO(2))(4). These results can only be rationalized by assuming that ONOO(-) homolyses into (*)NO and O2(*-) with k = 0.02 s(-1) at 25 degrees C. Thus, the critical experiments suggested by Nauser et al. fully support the currently accepted thermodynamics as well as the mode of decomposition of the ONOOH/ONOO(-) system.

Kinetics↗