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Biomedical subjects

W M Goldberg

Publications and source records attributed to W M Goldberg.

At least 19 recordsLinked to original sources
PubMed1998

An evaluation of multidisciplinary intervention for chronic fatigue syndrome with long-term follow-up, and a comparison with untreated controls.

Individuals meeting the Fukuda et al definition for chronic fatigue syndrome completed a multidisciplinary assessment that included medical, psychiatric, behavioral, and psychological evaluations. Patients were then offered a comprehensive multidisciplinary intervention that included (1) bringing the patient under optimal medical management; (2) treating any ongoing affective or anxiety disorder pharmacologically; and (3) implementing a comprehensive cognitive-behavioral treatment program. Fifty-one patients proceeded to treatment. The cognitive-behavioral component was carried out through the use of a therapist working with the patients in their own environments. The program was individually tailored to patients, but included (1) structured physical exercise and activation; (2) sleep management strategies; (3) careful activity management; (4) regulation of stimulant intake and reductions in use of symptomatic medications; (5) cognitive intervention designed to deal with patients' beliefs concerning the nature of their disorder; (6) participation of patients' family; and (7) efforts to establish specific vocational and avocational goals. Third parties were encouraged to collaborate cooperatively. Employers were urged to provide employment opportunities and facilitate a graduated but time-targeted return to work. Disability carriers were encouraged to provide interim financial support in the form of disability benefits, support therapeutic intervention, but also to establish a clear time-frame to access to benefits. Of 51 treated patients, 31 returned to gainful employment, 14 were functioning at a level equivalent to employment, and 6 remained significantly disabled. Twenty of the original 71 patients were contacted an average of 33 months later. Patients who had been treated showed good maintenance of gains. Untreated patients showed improvement in only a minority of cases.

Adult↗
PubMed1992

Comparison of black coral skeleton and insect cuticle by a combination of carbon-13 NMR and chemical analyses.

Cross-polarization, magic-angle spinning 13C NMR spectra of skeletal components of individual colonies of the New Zealand black coral, Antipathes fiordensis, have a marked similarity to spectra of the sclerotized exoskeleton of the adult tobacco hornworm, Manduca sexta. NMR analysis estimates the organic content of the load-bearing skeletal base of A. fiordensis as 70% protein, 10% chitin, 15% diphenol, and 5% lipid by weight, and that of M. Sexta moth cuticle as 60% protein, 20% chitin, 15% diphenol, and 5% lipid. The younger pinnules or tips of A. fiordensis are less than 3% diphenol by weight. The only diphenols extracted from coral skeleton by hydrochloric acid are 3-(3,4-dihydroxyphenyl)-DL-alanine (DOPA) and 3,4-dihydroxybenzaldehyde (DOBAL), while the predominant diphenols in acid extracts of insect cuticles are N-acyldopamines. More DOPA is found in the base than in the tips of A. fiordensis and it appears to be a peptidyl component of coral skeletal protein. The oxidation of DOPA and DOBAL to quinones may provide mechanical stabilization of the coral skeleton by cross-linking of structural proteins to other proteins or to chitin.

Amino Acids↗
PubMed1992

Interdisciplinary treatment of morbidity in benign chest pain.

This study tested the hypothesis that functional morbidity in benign chest pain can be modified independently of symptoms through interdisciplinary medical and cognitive-behavioral intervention. Analyses used data collected in a sixteen-week trial of interdisciplinary treatment for disability in benign chest pain. One hundred four chest pain patients having normal coronary arteriograms (NCA) (n = 14) or mitral valve prolapse (MVP) with no other known cardiac or arterial disease (n = 90) were assigned to individual treatment, group treatment, self-monitoring attention control, or a wait-list control group. Results indicate that interdisciplinary intervention, in group or individualized format, was successful for improving short-term and long-term (follow-up range = six to sixteen months) functional status, in both MVP and NCA patients. Correlation analysis indicated that functional improvements were not dependent on reductions in the frequency of symptoms. In fact, significant reductions in disability were obtained in those treated patients (13 of 43) who reported no reduction, or an actual increase, in the frequency of chest symptoms. These data indicate that disability in benign chest pain may be modified independently of symptoms by an integration of medical and cognitive-behavioral strategies.

Analysis of Variance↗
PubMed1988

Chemistry, histochemistry and microscopy of the organic matrix of spicules from a gorgonian coral. Relationship to alcian blue staining and calcium binding.

Alcian blue dye normally binds to polyanionic, polymeric substances. Such structures are often associated with calcium binding portions of the organic matrix in calcifying tissues. The organic matrix of spicules prepared from the gorgonian Pseudoplexaura flagellosa (Houttuyn) is alcianophilic. The dye is very tightly bound to the lipoid portion of the insoluble spicule matrix. No acidic substances (sulfated or acidic polysaccharides or phospholipids) were demonstrable in this material, suggesting an unusual but unknown interaction between dye and substrate. On a microscopical basis, inclusion of Alcian blue (or Ruthenium red) is an essential co-requisite to glutaraldehyde fixation. Without the dye the morphological integrity of the spicule is lost on decalcification. The fragmented matrix is still alcianophilic suggesting that the dye may substitute for material solubilized by the decalcifying agents. Examination of post-decalcification supernatants demonstrate that approximately 13% of the matrix is solubilized on demineralization, releasing 93% of the carbohydrate but less than 20% of the protein. Liberated protein takes the form of peptides ranging from 1100-1500 daltons. The composition of these peptides is a function of the demineralizing agent. Acidic demineralizers produce peptides proportionately high in acidic amino acids, that do not bind calcium. Peptides produced by chelator decalcification appear to bind calcium but other evidence strongly suggests that the binding is due to adsorbed chelator rather than by soluble matrix.

Alcian Blue↗
PubMed1979

Emotional disturbance and cognitive deficits in hyperthyroidism.

Assessment of cognitive and emotional variables in 19 females with hyperthyroidism was made pretreatment, at 3 weeks, and after euthyroidism was established. A matched group of normal controls was similarly tested. Group differences on cognitive measures did not reach statistical significance, but cognitive deficits and symptoms of emotional disorder were significantly associated with the severity of thyroid toxicity previous to treatment. Measures of cognitive function and personality features moved towards control group values as euthyroidism was established. The implication of these findings is discussed in the context of a review of previous literature. The observed cognitive disturbance and emotional distress appear to be reflections of thyroid toxicity.

Age Factors↗
PubMed1974

Evidence for reversible motoneurone dysfunction in thyrotoxicosis.

Motor unit estimating techniques have been employed as part of a comprehensive electrophysiological survey of peripheral nerve and muscle in 20 patients with thyrotoxicosis. In all patients there was evidence of a loss of operational motor units; the selective nature of this involvement suggested that the motoneurone soma was the site of the primary lesion. The reversible nature of the postulated motoneurone dysfunction was demonstrated by the increased motor unit counts in six patients who were studied again after treatment of their thyrotoxicosis.

Adult↗
PubMed1972

Medical audit.

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Accreditation↗
PubMed1969

Hyperthyroidism with periodic paralysis.

Hyperthyroidism may be associated with hypokalemic periodic paralysis. Two cases are presented demonstrating intermittent attacks of flaccid paralysis associated with clinical symptoms, signs and laboratory findings of hyperthyroidism. During an attack, one patient had a serum potassium of 2.1 mEq. per litre.Various factors such as trauma, exposure to cold, excessive carbohydrate ingestion and certain medications have been stated to precipitate an episode of paralysis. Attacks may range from mild weakness to generalized flaccid paralysis with loss of deep tendon reflexes. Several reported patients have died owing to cardiac arrest or respiratory paralysis.During attacks, the serum potassium is usually in the range of 2.2 to 3.2 mEq. per litre. It is postulated that a metabolic abnormality affecting the muscle-cell membrane can occur in the hyperthyroid state resulting in a shift of potassium to the intracellular position, thus producing a situation of hyperpolarization of the muscle-cell membrane which in turn alters the muscle contractibility.The importance of recognizing the unusual association of hypokalemic periodic paralysis with hyperthyroidism is stressed because, with successful treatment of the hyperthyroidism, the episodes of paralysis disappear.

Adult↗