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Biomedical subjects

S Wexler

Publications and source records attributed to S Wexler.

At least 19 recordsLinked to original sources
PubMed2001

Psychiatric co-morbidity in caregivers and children involved in maltreatment: a pilot research study with policy implications.

OBJECTIVE: The purpose of this study was to determine the lifetime incidence of mental disorders in caregivers involved in maltreatment and in their maltreated child. METHODS: Lifetime DSM-III-R and IV psychiatric diagnoses were obtained for 53 maltreating families, including at least one primary caregiver and one proband maltreated child or adolescent subject (28 males, 25 females), and for a comparison group of 46 sociodemographically, similar nonmaltreating families, including one proband healthy child and adolescent subject (22 males, 22 females). RESULTS: Mothers of maltreated children exhibited a significantly greater lifetime incidence of anxiety disorders (especially post-traumatic stress disorder), mood disorders, alcohol and/or substance abuse or dependence disorder, suicide attempts, and comorbidity of two or more psychiatric disorders, compared to control mothers. Natural fathers or mothers' live-in mates involved in maltreatment exhibited a significantly greater lifetime incidence of an alcohol and/or substance abuse or dependence disorder compared to controls. The majority of maltreated children and adolescents reported anxiety disorders, especially post-traumatic stress disorder (from witnessing domestic violence and/or sexual abuse), mood disorders, suicidal ideation and attempts, and disruptive disorders. Most maltreated children (72%) suffered from comorbidity involving both emotional and behavioral regulation disorders. CONCLUSIONS: Families involved in maltreatment manifest significant histories of psychiatric comorbidity. Policies which target identification and treatment of comorbidity may contribute to breaking the intergenerational transmission of maltreatment.

Adolescent↗
PubMed2001

Pseudotumour in von Willebrand disease.

Pseudotumour is a rare complication of haemophilia; it has previously been reported in patients with moderate or severe haemophilia and rarely in mild disease. We report a case of a proximal pseudotumour occurring in a 36-year-old patient with mild von Willebrand disease (vWD) who made a good recovery with conservative management. Surgery has been advocated as the optimal treatment for proximal pseudotumours due to the risk of continued bleeding and progression. However, in mild haemophilia or vWD, where the risk of spontaneous bleeds is low, conservative management may be an appropriate alternative.

Adult↗
PubMed2000

EPSDT in the Commonwealth of Pennsylvania, 1967-1991: a case study of a federally-sponsored, state-administered program.

Understanding the state-level processes that can shape the operations of health and welfare programs is of particular importance today. This article describes the process by which the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program was implemented in the Commonwealth of Pennsylvania. The case study highlights the factors that facilitated and hindered the transformation of this federal policy into a local program. Implications for children's health programming are identified.

Child↗
PubMed1992

Obstetric outcome in women with congenital uterine malformations.

Ninety-eight cases of congenital uterine malformations were diagnosed with hysterosalpingography (HSG). Symmetric uterine malformations, composed of bicornuate uterus, uterus didelphys and septate uterus, constituted 80% of the cases. Of them, 75% were of the bicornuate type. Infertility (55%) and a suggestion of cervical incompetence (24%) were the main indication for HSG. Premature deliveries (29%), spontaneous first-trimester abortions (24%), ectopic pregnancies (3%), abnormal fetal presentations (23%) and a high cesarean section rate (27.5%) occurred in those patients. The highest rate of first-trimester abortions (47%) and the lowest rate of term deliveries (21%) occurred in the group with T-shaped uteri as compared to a 7% rate of early abortions (P less than .05) and 61% rate of term deliveries (P less than .03) in the unicornuate uterus group. In 30% of the patients with uterine malformations, cervical incompetence was diagnosed. Improved obstetric outcomes occurred in patients treated with cervical cerclage. There was a statistically significant difference between the number of premature deliveries and spontaneous late abortions in the group without cerclage (50%) and that with cerclage (21%) (P less than .001).

Abortion, Spontaneous↗
PubMed1991

The effect of prostaglandins and aspirin--an inhibitor of prostaglandin synthesis--on adhesion formation in rats.

The effect of intraperitoneal application of prostaglandins E2 and F2 alpha and of aspirin, a non-steroidal anti-inflammatory drug, on the formation of intraperitoneal adhesions was investigated in rats, in view of the main role of the body's reaction in adhesion formation. Intraperitoneal adhesions were induced by inflicting uniform trauma to the uterine serosa. It was demonstrated that prostaglandin E2 may increase adhesion formation and that intraperitoneal aspirin is able to inhibit its formation.

Animals↗
PubMed1990

Prostaglandins--a role in adhesion formation. An experimental study.

The effect of intraperitoneal application of prostaglandins F2 alpha and E2 on adhesion formation was studied in the rat after traumatizing to the uterine serosa. Prostaglandins applied locally were found to increase intraperitoneal adhesion formation at the injury site, in comparison with controls. The effect of intraperitoneal application of prostaglandins F2 alpha and E2 on fibroblastic proliferation was examined in vitro, by fibroblastic cell culture of rat kidney, human kidney and human prepuce. No direct effect of prostaglandins on fibroblast proliferation could be demonstrated. It is concluded that prostaglandins play an important role in the process of adhesion formation. This effect is not related to fibroblast proliferation.

Animals↗
PubMed1989

Asymptomatic bacteriuria in normal and high-risk pregnancy.

A routine urine culture was performed in 1130 normal pregnant women and in 211 high-risk pregnancies (136 diabetics and 75 women with a previous urinary tract infection). Asymptomatic bacteriuria was found in 5.9% of the normal pregnancies, 12.5% among the diabetics and in 18.5% of the previous urinary tract infection patients. The higher incidence of a clinical urinary tract infection among patients with asymptomatic bacteriuria was found statistically significant (p less than 0.001) in all three groups. A high correlation was found between a negative urine culture in early pregnancy and the absence of development of cystitis and pyelonephritis in later pregnancy. The incidence of asymptomatic bacteriuria in normal pregnant women who developed cystitis later in pregnancy was 33.3% and in those developing pyelonephritis, 66%. In the two high-risk pregnancy groups, the incidence of asymptomatic bacteriuria among those developing clinical infection was even higher, 58.3 and 85.7%, respectively, among the diabetics, and 60 and 66.6% respectively, among the previous urinary tract infection patients.

Bacteriuria↗
PubMed1989

Calcium antagonist. Effect on adhesion formation.

In view of the role of the calcium ion in the inflammatory process, the effect of Diltiazem--a calcium antagonist--on the formation of intraperitoneal adhesions was studied in rats after induced trauma to the uterine serosa. It was found that intraperitoneal application of diltiazem inhibited adhesion formation to some extent, whereas intramuscularly administered Diltiazem did not. A dual effect of calcium antagonists on the formation of adhesions is suggested.

Animals↗
PubMed1987

Advanced ultrasonic placental maturation in twin pregnancies.

The mean length of twin pregnancies is shorter than that of singleton pregnancies. The possibility that the shorter gestation of twins is associated with advanced fetal maturational changes was studied in relation to placental maturation. For this purpose, the sonographically determined placental gradings of 158 twin pregnancies and 474 singleton pregnancies were compared at different gestational ages. The percent distributions of placental grades, from I to III, were significantly different throughout the third trimester, with a preponderance of Grade III placentas in the twin group (p less than 0.001). Considering the reported association of Grade III placentas with advanced gestation as well as fetal lung maturity, the present study suggests earlier maturational changes in twin fetuses compared with singleton fetuses.

Female↗
PubMed1987

Crime at home and in the streets: the relationship between family and stranger violence.

Research and theory on violent behavior have treated aggression between intimates and aggression between strangers as separate phenomena. Major criminological works on violence and aggression have generally overlooked violence in the home. As a result, independent and distinct bodies of theoretical and practical knowledge exist regarding family violence and aggression toward strangers, and the relationship between family violence and violence directed against strangers is little understood. Estimates of the intersection of these behaviors vary extensively. Severity of domestic violence is associated with violence outside the home. Exposure to violence as a child consistently emerges as a strong explanatory factor for both domestic violence and the behavior of "generally" violent men. Behavior patterns appear to shift over time, from domestic violence only to violence toward both strangers and family members. However, an integrated theory of violent behavior by males provides explanations of both stranger and family violence. Early childhood socialization toward violence, modified by social and cultural supports during adolescence and adulthood, suggests a social learning paradigm. Hypotheses are developed that integrate and unify theories of stranger and family violence.

Adult↗
PubMed1986

Tolerance intervals for standards in ultrasound measurements: determination of BPD standards.

Standards for the relationship between BPD and gestational age are used for the assessment of fetal size. We measured the BPD in 310 women with exact gestational age in a cross-sectional study. Two types of BPD charts were constructed based on tolerance intervals: directly from measurements and after model fitting. We found that the tolerance intervals based on the model are smoother and narrower than those achieved by direct determinations. The fit, advantages, and prospects of the model are discussed.

Body Constitution↗
PubMed1986

The accuracy of hysterosalpingography versus laparoscopy in evaluation of infertile women.

Two hundred fifteen infertile women underwent hysterosalpingography (HSG) and laparoscopy. One hundred twenty-eight patients had bilaterally patent tubes on hysterosalpingography. Thirty-one percent of these women had pelvic adhesions diagnosed by laparoscopy. Eighty-seven women had either occluded tubes or suspected pelvic adhesions on hysterosalpingography. Thirty-nine percent of these women had patent tubes without any pelvic pathology on laparoscopy. Inaccurate diagnoses limit the value of hysterosalpingography in evaluation of tubal and peritubal pathology.

Adult↗
PubMed1985

Human chorionic gonadotropin in the ectopic gestation.

The ectopic pregnancy is a relatively common condition in the south African black patients. The beta-specific subunit radioimmunoassay for human chorionic gonadotrophin (HCG) was utilized in procuring information in our series of 30 patients. Levels of the hormone were significantly lower when compared to normal gestation of similar duration, never exceeding 2000 mIU/ml. The clearance rate of HCG following normal vaginal delivery was about 24 h and less variable than that of ectopic gestation. The half-life clearance rate of HCG in the ectopics could be divided into three phases, suggestive of HCG compartmentalization. The possible buffering effect of this hormone in the maintenance of the receptor-saturated pregnancy is discussed. The possibility that the HCG produced by the normal pregnancy is dissimilar to that of ectopic is speculated upon.

Chorionic Gonadotropin↗
PubMed1985

Personality characteristics of drug addicts and alcoholics on the Millon Clinical Multiaxial Inventory.

The Million Clinical Multiaxial Inventory (MCMI) was administered to 106 alcoholics and 100 addicts in separate VA inpatient rehabilitation treatment programs. The alcoholics scored higher on the personality style scales of Avoidant, Passive-Aggressive, Schizotypal, Borderline and Paranoid, while the opiate addicts scored higher on the Narcissistic personality disorder scale. Separate cluster analyses for both groups further revealed common personality styles among both groups. Several MCMI scales showed significant correlations with age, but in no case were the effects attributed to age larger than 5% of the total variance. The MCMI may alert clinicians to subtle similarities and differences between and among alcoholics and opiate addicts.

Adult↗
PubMed1984

Pseudogestational sac in ectopic pregnancy.

A case of tubal pregnancy demonstrated by sonography is presented. In addition to the true ectopic gestational sac, an intra-uterine structure closely resembling a gestational sac was detected simultaneously. Such a finding of a pseudogestational sac in the uterine cavity may mislead to the diagnosis of an intra-uterine gestation. Thus, this sonographic finding is not sufficient to exclude the diagnosis of ectopic pregnancy. Clinicians should be aware of the possible finding of a pseudogestational sac in cases of ectopic pregnancy and the pathophysiological basis of this phenomenon is discussed.

Adult↗