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Shapira A, Chen CW, Volkening LK, Laffel LM. Updated Psychosocial Surveys With Continuous Glucose Monitoring Items for Youth With Type 1 Diabetes and Their Caregivers. J Diabetes Sci Technol 2023:19322968231159411. [PMID: 36912009 DOI: 10.1177/19322968231159411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
AIM We added items relevant to continuous glucose monitoring (CGM) to the Diabetes Family Conflict Scale (DFC), Diabetes Family Responsibility Questionnaire (DFR), and Blood Glucose Monitoring Communication Questionnaire (GMC) and evaluated the psychometric properties of the updated surveys. RESEARCH DESIGN AND METHODS Youth with type 1 diabetes who recently started CGM and their parents completed the updated surveys and additional psychosocial surveys. Medical data were collected from self-reports and review of the medical record. RESULTS Youth (N = 114, 49% adolescent girls) were aged 13.3 ± 2.7 years and had mean glycated hemoglobin (HbA1c) 7.9 ± 0.9%; 87% of them used pump therapy. The updated surveys demonstrated high internal consistency (DFC youth: α = .91, parent: α = .81; DFR youth: α = .88, parent: α = .93; and GMC youth: α = .88, parent: α = .86). Higher youth and parent DFC scores (more diabetes-specific family conflict) and GMC scores (more negative affect related to glucose monitoring) were associated with more youth and parent depressive symptoms (r = 0.28-0.60, P ≤ .003), more diabetes burden (r = 0.31-0.71, P ≤ .0009), more state anxiety (r = 0.24 to r = 0.46, P ≤ .01), and lower youth quality of life (r = -0.29 to -0.50, P ≤ .002). Higher youth and parent DFR scores (more parent involvement in diabetes management) were associated with younger youth age (youth: r = -0.76, P < .0001; parent: r = -0.81, P < .0001) and more frequent blood glucose monitoring (youth: r = 0.27, P = .003; parent: r = 0.35, P = .0002). CONCLUSIONS The updated DFC, DFR, and GMC surveys maintain good psychometric properties. The addition of CGM items expands the relevance of these surveys for youth with type 1 diabetes who are using CGM and other diabetes technologies.
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Affiliation(s)
- Amit Shapira
- Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA
| | - Charlotte W Chen
- Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA
- The Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Lori M Laffel
- Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA
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Shapira A, Volkening LK, Borus JS, Laffel LM. Ecological Momentary Assessment of Positive and Negative Affect and Associations with Blood Glucose in Teens with Type 1 Diabetes. J Diabetes Sci Technol 2023; 17:195-200. [PMID: 34330178 PMCID: PMC9846400 DOI: 10.1177/19322968211035451] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Affect (i.e., emotions) can be associated with diabetes self-care and ambient glucose in teens with type 1 diabetes (T1D). We used momentary sampling to examine associations of daily affectwithblood glucose (BG) monitoring,BG levels,and BG variability in teens with T1D. METHOD Over 2 weeks, 32 teens reported positive and negative affect (Positive and Negative Affect Scale) and BG levels on handheld computers 4x/day, coordinated with planned daily BG checks. BG values were classified as: in-range (70-180 mg/dL); low (<70 mg/dL); severe low (<54 mg/dL); high (>180 mg/dL); severe high (>250 mg/dL). Daily BG variability was derived from BG coefficient of variation (BGCV). To determine associations of positive and negative affect with BG checks, BG levels, and BGCV, separate generalized estimating equations were performed, adjusting for demographic and diabetes-related variables, for the overall sample and stratified by HbA1c (≤8%, >8%). RESULTS Teens (44% male, ages 14-18, 63% pump-treated, HbA1c 8.8 ± 1.4%) reported 51% in-range, 6% low (2% severe low), and 44% high (19% severe high) BG. In teens with HbA1c ≤8%, positive affect was associated with in-range BG (OR = 1.08, 95% CI = 1.04-1.13, P = .0002), reduced odds of very low glucose (OR = 0.35, 95% CI = 0.16-0.74, P = .006), and less daily BGCV (β = -0.9; 95% CI = -1.6, -0.2; P = .01). In teens with HbA1c >8%, negative affect was associated with less likelihood of checking BG (OR = 0.75, 95% CI = 0.64-0.87, P = .0003). CONCLUSIONS Our findings shed light on individual differences in metabolic reactivity based on glycemic levels and the importance of incorporating affect into automated insulin delivery systems.
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Affiliation(s)
- Amit Shapira
- Harvard Medical School, Joslin Diabetes
Center, Boston, MA, USA
| | | | - Joshua S. Borus
- Harvard Medical School, Boston
Children’s Hospital, Boston, MA, USA
| | - Lori M. Laffel
- Harvard Medical School, Joslin Diabetes
Center, Boston, MA, USA
- Harvard Medical School, Boston
Children’s Hospital, Boston, MA, USA
- Lori M. Laffel, MD, MPH, Harvard Medical
School, Joslin Diabetes Center, One Joslin Place, Boston, MA 02215, USA.
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Hermanns N, Ehrmann D, Shapira A, Kulzer B, Schmitt A, Laffel L. Coordination of glucose monitoring, self-care behaviour and mental health: achieving precision monitoring in diabetes. Diabetologia 2022; 65:1883-1894. [PMID: 35380233 PMCID: PMC9522821 DOI: 10.1007/s00125-022-05685-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 01/06/2022] [Indexed: 02/02/2023]
Abstract
Monitoring of glucose plays an essential role in the management of diabetes. However, to fully understand and meaningfully interpret glucose levels, additional information on context is necessary. Important contextual factors include data on behaviours such as eating, exercise, medication-taking and sleep, as well as data on mental health aspects such as stress, affect, diabetes distress and depressive symptoms. This narrative review provides an overview of the current state and future directions of precision monitoring in diabetes. Precision monitoring of glucose has made great progress over the last 5 years with the emergence of continuous glucose monitoring (CGM), automated analysis of new glucose variables and visualisation of CGM data via the ambulatory glucose profile. Interestingly, there has been little progress in the identification of subgroups of people with diabetes based on their glycaemic profile. The integration of behavioural and mental health data could enrich such identification of subgroups to stimulate precision medicine. There are a handful of studies that have used innovative methodology such as ecological momentary assessment to monitor behaviour and mental health in people's everyday life. These studies indicate the importance of the interplay between behaviour, mental health and glucose. However, automated integration and intelligent interpretation of these data sources are currently not available. Automated integration of behaviour, mental health and glucose could lead to the identification of certain subgroups that, for example, show a strong association between mental health and glucose in contrast to subgroups that show independence of mental health and glucose. This could inform precision diagnostics and precision therapeutics. We identified just-in-time adaptive interventions as a potential means by which precision monitoring could lead to precision therapeutics. Just-in-time adaptive interventions consist of micro-interventions that are triggered in people's everyday lives when a certain problem is identified using monitored behaviour, mental health and glucose variables. Thus, these micro-interventions are responsive to real-life circumstances and are adaptive to the specific needs of an individual with diabetes. We conclude that, with current developments in big data analysis, there is a huge potential for precision monitoring in diabetes.
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Affiliation(s)
- Norbert Hermanns
- Research Institute Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany.
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany.
- German Center for Diabetes Research (DZD), Muenchen-Neuherberg, Germany.
| | - Dominic Ehrmann
- Research Institute Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany
- German Center for Diabetes Research (DZD), Muenchen-Neuherberg, Germany
| | - Amit Shapira
- Harvard Medical School, Joslin Diabetes Center, Boston, MA, USA
| | - Bernhard Kulzer
- Research Institute Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany
- German Center for Diabetes Research (DZD), Muenchen-Neuherberg, Germany
| | - Andreas Schmitt
- Research Institute Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
- German Center for Diabetes Research (DZD), Muenchen-Neuherberg, Germany
| | - Lori Laffel
- Harvard Medical School, Joslin Diabetes Center, Boston, MA, USA
- Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
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Shapira A, Kane NS, Tanenbaum ML, Hoogendoorn CJ, Gonzalez JS. Memory complaints moderate the concordance between self-report and electronically monitored adherence in adults with type 2 diabetes. J Diabetes Complications 2022; 36:108205. [PMID: 35667963 DOI: 10.1016/j.jdiacomp.2022.108205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 04/22/2022] [Accepted: 04/22/2022] [Indexed: 02/02/2023]
Abstract
AIMS We examined the impact of memory complaints on the concordance between self-report (SR) and electronically monitored (EM) medication adherence, independent of depression symptoms, among adults with type 2 diabetes (T2D). METHODS Adults (N = 104, age = 56.6 ± 9.2; 64% female) completed a prospective and retrospective memory questionnaire (PRMQ) and a depression symptom interview at baseline. EM was tracked over 3 months and participants rated adherence using SR. Multiple linear regression evaluated PRMQ as a moderator of the relationship between EM and SR, adjusting for depression and other covariates. RESULTS PRMQ was correlated with lower SR (r = -0.31, p = 0.001), but not with EM. PRMQ moderated the relationship between SR and EM, independent of depression symptoms. At low levels of PRMQ, SR and EM were closely related (β = 0.76, p < 0.001); at high levels of PRMQ the relationship was weaker (β = 0.28, p = 0.02). Participants who under-reported their adherence (SR < EM) had higher PRMQ scores than more concordant reporters (p = 0.016). CONCLUSIONS SR and EM measures were less concordant among adults with T2D who endorsed higher PRMQ scores. Memory complaints may contribute to under-reporting of medication adherence in adults with T2D.
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Affiliation(s)
- Amit Shapira
- Joslin Diabetes Center, Harvard Medical School, Boston, MA
| | - Naomi S Kane
- VA Ann Arbor Healthcare System, Michigan Medicine, Department of Psychiatry, Ann Arbor, MI
| | - Molly L Tanenbaum
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA
| | | | - Jeffrey S Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY; Departments of Medicine (Endocrinology) and Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY.
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Shapira A, Harrington KR, Goethals ER, Volkening LK, Laffel LM. Health-related quality of life in youth with type 1 diabetes: Associations with multiple comorbidities and mental health conditions. Diabet Med 2021; 38:e14617. [PMID: 34060668 PMCID: PMC8429188 DOI: 10.1111/dme.14617] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/28/2021] [Indexed: 01/09/2023]
Abstract
AIM This cross-sectional study examined the associations of comorbid conditions on health-related quality of life (HRQOL) in 601 youth with type 1 diabetes. We evaluated associations between number of comorbid conditions (0, 1, ≥2) and particular comorbid conditions and youth HRQOL by self-report and parent proxy-report. RESEARCH DESIGN AND METHODS Youth with type 1 diabetes, aged 5-18 years, and their parents completed the PedsQL 4.0 Generic Core Scales self-report and parent proxy-report, respectively; they also reported youths' comorbid medical and mental health conditions. Separate linear regression models tested the relationship between number of comorbid conditions and specific comorbid conditions with youth-reported and parent proxy-reported HRQOL. RESULTS Youth with ≥2 comorbid conditions had significantly lower HRQOL by both self- and parent proxy-reports compared with youth with 0 or 1 comorbid condition (youth self-report: 0: 85 ± 12, 1: 85 ± 13, 2+: 78 ± 16, p = <0.0001; parent proxy-report: 0: 83 ± 12, 1: 81 ± 13, 2+: 74 ± 15, p = <0.0001). Amongst the comorbid conditions, only a mental health comorbidity was associated with lower HRQOL. For youth and parent proxy-reports, both the number of comorbidities (≥2) and the presence of a mental health comorbidity were significantly associated with lower HRQOL. CONCLUSIONS Health-related quality of life seems to be preserved in youth with type 1 diabetes unless confronted by multiple comorbidities as reported by youth and their parents. Our findings highlight the importance of tracking the presence of multiple comorbid conditions, possibly by reviewing problem and medication lists in the medical record, as well as screening for and addressing mental health conditions in routine diabetes care.
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Affiliation(s)
- Amit Shapira
- Section on Clinical, Behavioral, and Outcomes Research, Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA
| | - Kara R. Harrington
- Section on Clinical, Behavioral, and Outcomes Research, Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA
| | - Eveline R. Goethals
- Section on Clinical, Behavioral, and Outcomes Research, Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA
- Vanderbilt University Medical Center, Nashville, TN
- KU Leuven, Leuven, Belgium
| | - Lisa K. Volkening
- Section on Clinical, Behavioral, and Outcomes Research, Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA
| | - Lori M. Laffel
- Section on Clinical, Behavioral, and Outcomes Research, Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA
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Harrington KR, Shapira A, Volkening LK, Butler DA, Anderson BJ, Wasserman RM, Laffel LM. Associations of diabetes self-management characteristics, HbA1c, and psychosocial outcomes with depressive symptoms in a contemporary sample of adolescents with type 1 diabetes. J Diabetes Complications 2021; 35:107838. [PMID: 33431226 PMCID: PMC7870579 DOI: 10.1016/j.jdiacomp.2020.107838] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/05/2020] [Accepted: 12/06/2020] [Indexed: 11/20/2022]
Abstract
AIMS We sought to examine the associations between diabetes self-management, HbA1c, and psychosocial outcomes with the frequency of depressive symptoms. METHODS We surveyed 301 teens (50% male, 22% non-white), mean age of 15.0±1.3 years, diabetes duration of 6.5±3.7 years. Biomedical variables: daily frequency of blood glucose monitoring of 4.5±1.9, 63% insulin pump use, mean HbA1c 8.5±1.1% (69±12 mmol/mol); 15% of the sample achieved the target HbA1c of <7.5% (<58 mmol/mol). RESULTS Nearly 1 in 5 (18%, n=54) adolescents reported significant depressive symptoms and, of those participants, slightly under half reported moderate/severe depressive symptoms. Teens with moderate/severe depressive symptoms (CES-D scores ≥24) were more likely to be female, have parents without a college education, and not utilize insulin pumps. Teens with more depressive symptoms reported higher diabetes family conflict, higher diabetes burden, and lower quality of life. In the group reporting no depressive symptoms (10%), scores on psychosocial variables and diabetes treatment variables were the most favorable. CONCLUSION In our sample, the presence of depressive symptoms appears to relate to both diabetes treatment and quality of life. In addition, studying teens without depressive symptoms can help us learn more about protective factors that potentially buffer against depressive symptoms and that are associated with better outcomes.
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Affiliation(s)
- Kara R Harrington
- Section on Clinical, Behavioral, and Outcomes Research, Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA, United States of America
| | - Amit Shapira
- Section on Clinical, Behavioral, and Outcomes Research, Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA, United States of America
| | - Lisa K Volkening
- Section on Clinical, Behavioral, and Outcomes Research, Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA, United States of America
| | - Deborah A Butler
- Section on Clinical, Behavioral, and Outcomes Research, Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA, United States of America
| | | | | | - Lori M Laffel
- Section on Clinical, Behavioral, and Outcomes Research, Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA, United States of America.
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Shapira A, Volkening LK, Markowitz JT, Butler DA, Laffel LM. Mental Health Providers' Assessment of Parents' Reactions to their Children's Elevated Depressive Symptoms. Pediatr Diabetes 2021; 22:354-359. [PMID: 33030293 PMCID: PMC8988090 DOI: 10.1111/pedi.13138] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/18/2020] [Accepted: 10/04/2020] [Indexed: 11/30/2022] Open
Abstract
This study assessed parental reactions to the report of elevated depressive symptoms in a sample of 29 youth with type 1 diabetes (ages 8-17 years; 48% female) who scored ≥15 on the Center for Epidemiologic Studies Depression Scale for Children (CES-DC). We also assessed parental depressive symptoms and how the presence of such symptoms was linked to parental reactions to the report of a positive screening score in their children and subsequent acceptance of a mental health referral. Mental health professionals contacted parents to discuss elevated scores and offer a mental health referral. Two coders reviewed the documentation of phone contacts made by mental health professionals and categorized parental responses to their child's elevated CES-DC score and the disposition plan. Youth and parent depressive symptoms were modestly correlated (r = 0.21, P = .01). About half (55%, 16/29) of parents were unaware of their child's depressive symptoms. Only 14% (4/29) of youth were already receiving mental health care while 28% (8/29) of parents accepted a referral. Parents with depressive symptoms were frequently unaware of their child's symptoms. Findings provide insight into parental reactions to learning of their child's depressive symptoms and highlight the need for more research on parental mood and reactions to their child's positive screen for depressive symptoms, as a potential barrier to mental health referral acceptance.
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Affiliation(s)
- Amit Shapira
- Joslin Diabetes Center, Harvard Medical School, Boston, MA
| | | | | | | | - Lori M. Laffel
- Joslin Diabetes Center, Harvard Medical School, Boston, MA
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Hoogendoorn CJ, Shapira A, Roy JF, Walker EA, Cohen HW, Gonzalez JS. Depressive symptom dimensions and medication non-adherence in suboptimally controlled type 2 diabetes. J Diabetes Complications 2019; 33:217-222. [PMID: 30598369 PMCID: PMC6662178 DOI: 10.1016/j.jdiacomp.2018.12.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 11/02/2018] [Accepted: 12/01/2018] [Indexed: 11/25/2022]
Abstract
AIMS Research suggests differential effects for somatic and cognitive-affective depressive symptoms in predicting health outcomes. This study evaluated differential relations with medication non-adherence among disadvantaged, and predominantly immigrant adults with sub-optimally controlled type 2 diabetes (T2D). METHODS Health plan members taking oral diabetes medication and who had A1c ≥ 7.5% were recruited for a trial of telephonic self-management support. A subset (n = 376; age, M = 55.6 ± 7.2 years; A1c M = 9.1% ± 1.6) completed the Patient Health Questionnaire-8 (PHQ-8). Diabetes medication adherence was measured by self-report and claims-based records. Multivariable logistic regression modeled depressive symptoms and odds of non-adherence using pre-intervention data. RESULTS A positive PHQ-8 screen (OR = 2.72 [95%CI: 1.56-4.73]) and each standard deviation increase in PHQ-8 score (OR = 1.40 [95%CI: 1.11-1.75]) were associated with non-adherence, with no independent effects for somatic versus cognitive-affective symptoms. Exploration of individual symptoms identified three significantly associated with non-adherence in covariate-adjusted models; after adjustment for likely presence of clinical depression, only fatigue was independently associated with non-adherence (OR = 1.71 [95%CI: 1.06-2.77]). CONCLUSIONS Findings support depression symptom severity as a significant correlate of medication non-adherence among disadvantaged adults with T2D. Support was limited for differential associations for symptom dimensions, but findings suggest that fatigue may be associated with non-adherence independent of the likely presence of depression.
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Affiliation(s)
| | - Amit Shapira
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Juan F Roy
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Elizabeth A Walker
- Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA
| | - Hillel W Cohen
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jeffrey S Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA; Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA; The Fleischer Institute for Diabetes and Metabolism, Albert Einstein College of Medicine, Bronx, NY, USA
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Gonzalez JS, Kane NS, Binko DH, Shapira A, Hoogendoorn CJ. Tangled Up in Blue: Unraveling the Links Between Emotional Distress and Treatment Adherence in Type 2 Diabetes. Diabetes Care 2016; 39:2182-2189. [PMID: 27797932 PMCID: PMC5127225 DOI: 10.2337/dc16-1657] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 09/16/2016] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We conducted comprehensive assessments of emotional distress to examine relations with diabetes medication adherence over time. RESEARCH DESIGN AND METHODS Ethnically and socioeconomically diverse adults treated for type 2 diabetes completed validated self-reports (SRs) for diabetes distress and depression, were administered semistructured depression interviews, and provided blood samples for A1C. Medication adherence among 104 participants was electronically monitored (EM) over the subsequent 3 months; validated SRs of medication adherence were also obtained. Hierarchical linear regression evaluated independent effects of diabetes distress and depression on adherence. RESULTS Mean ± SD 3-month medication adherence was 76.1% ± 25.7% for EM and 83.7% ± 21.9% for SR. Higher levels of SR (P < 0.001) and interview-based (P < 0.05) depressive symptom severity (P < 0.05) and diabetes-related distress (P < 0.01) showed a significant bivariate association with EM and SR nonadherence. Regression models showed baseline diabetes distress was a significant independent predictor of EM (β = -0.29; P = 0.001) and SR adherence (β = -0.24; P < 0.02) at follow-up. SR depression was an independent predictor of EM and SR adherence and reduced the effects of diabetes distress to nonsignificance. Subsequent models indicated this effect was driven by somatic rather than cognitive-affective symptoms of depression. Results were consistent but weaker for interview-based depressive symptoms. CONCLUSIONS Findings support diabetes-related distress and depression symptom severity as risk factors for type 2 diabetes medication nonadherence. Somatic symptoms captured by depression measures, but not cognitive-affective symptoms, independently predict nonadherence and should be further investigated as a potential link between emotional distress and nonadherence.
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Affiliation(s)
- Jeffrey S Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY .,Departments of Medicine (Endocrinology) and Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Naomi S Kane
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
| | - Deborah H Binko
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
| | - Amit Shapira
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
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Gonzalez JS, Shapira A. What can screening measures tell us about risk for depression in patients with diabetes? Rev Clin Esp 2015; 215:169-70. [PMID: 25697495 DOI: 10.1016/j.rce.2015.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 01/11/2015] [Indexed: 10/24/2022]
Affiliation(s)
- J S Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States; Diabetes Research Center, Albert Einstein College of Medicine, Bronx, NY, United States.
| | - A Shapira
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States
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Bachmetov L, Gal-Tanamy M, Shapira A, Vorobeychik M, Giterman-Galam T, Sathiyamoorthy P, Golan-Goldhirsh A, Benhar I, Tur-Kaspa R, Zemel R. Suppression of hepatitis C virus by the flavonoid quercetin is mediated by inhibition of NS3 protease activity. J Viral Hepat 2012; 19:e81-8. [PMID: 22239530 DOI: 10.1111/j.1365-2893.2011.01507.x] [Citation(s) in RCA: 116] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Phytochemicals exert antiviral activity and may play a potential therapeutic role in hepatitis C virus (HCV) infection. In this work, we aimed to isolate NS3 inhibitors from traditional Indian medicinal plants that were found, in our earlier study, to inhibit HCV NS3 protease activity and to evaluate their potential to inhibit HCV replication. A potent inhibitory effect of NS3 catalytic activity was obtained with Embelia ribes plant extracts. Quercetin, a ubiquitous plant flavonoid, was identified as the active substance in the fractioned extract. It was found to inhibit NS3 activity in a specific dose-dependent manner in an in vitro catalysis assay. Quercetin inhibited HCV RNA replication as analysed in the subgenomic HCV RNA replicon system. It also inhibited HCV infectious virus production in the HCV infectious cell culture system (HCVcc), as analysed by the focus-forming unit reduction assay and HCV RNA real-time PCR. The inhibitory effect of quercetin was also obtained when using a model system in which NS3 engineered substrates were introduced in NS3-expressing cells, providing evidence that inhibition in vivo could be directed to the NS3 and do not involve other HCV proteins. Our work demonstrates that quercetin has a direct inhibitory effect on the HCV NS3 protease. These results point to the potential of quercetin as a natural nontoxic anti-HCV agent reducing viral production by inhibiting both NS3 and heat shock proteins essential for HCV replication.
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Affiliation(s)
- L Bachmetov
- Molecular Hepatology Research Laboratory, Felsenstein Medical Research Center, Sackler School of Medicine, Tel-Aviv University, Petah Tikva, Israel
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Leesar M, Varma J, Shapira A. Prediction of Hypertension Improvement After Stenting of Renal Artery Stenosis: Comparative Accuracy of Translesional Pressure Gradients, Intravascular Ultrasound, and Angiography. J Vasc Surg 2010. [DOI: 10.1016/j.jvs.2009.12.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Patonay G, Shapira A, Diamond P, Warner IM. A systematic study of pyrene inclusion complexes with .alpha.-, .beta.-, and .gamma.-cyclodextrins. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100400a045] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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15
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Affiliation(s)
- A Shapira
- Tel Aviv University, The Buchman Faculty of Law, Ramat Aviv, Tel Aviv 69978, Israel
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16
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Luntz M, Brodsky A, Nusem S, Kronenberg J, Keren G, Migirov L, Cohen D, Zohar S, Shapira A, Ophir D, Fishman G, Rosen G, Kisilevsky V, Magamse I, Zaaroura S, Joachims HZ, Goldenberg D. Acute mastoiditis--the antibiotic era: a multicenter study. Int J Pediatr Otorhinolaryngol 2001; 57:1-9. [PMID: 11165635 DOI: 10.1016/s0165-5876(00)00425-0] [Citation(s) in RCA: 147] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To evaluate the clinical course and identify the causative organisms of acute mastoiditis in a community where most of the patients who develop acute otitis media are treated with antibiotics. METHODS A multicenter retrospective review of a series of 223 consecutive cases of acute mastoiditis. SETTING Nine secondary or tertiary academic or non-academic referral centers. RESULTS Prior to the diagnosis of acute mastoiditis, 121 of the patients (54.3%) had been receiving oral antibiotic treatment for acute otitis media for periods ranging from 1 to 21 days (mean 5.3 days). Samples for bacterial culture were obtained from 152 patients. Cultures were negative in 60 patients. The organisms isolated in the 92 positive cultures were: Streptococcus pneumoniae (15 patients), Streptococcus pyogenes (14 patients), Staphylococcus aureus (13 patients), Staphylococcus coagulase negative (three patients), Pseudomonas aeruginosa (eight patients), Haemophilus influenzae (four patients), Proteus mirabilis (two patients), Escherichia coli (two patients), Klebsiella pneumoniae (one patient), Enterobacter (one patient), Acinetobacter (one patient), anaerobic gram-negative bacilli (one patient), and fungi (two patients). Ten patients had mixed flora. Sixteen patients presented with complications (cerebellar abscess, perisinus empyema, subdural abscess or empyema, extradural abscess, cavernous sinus thrombosis, lateral sinus thrombosis, bacterial meningitis, labyrinthitis, petrositis, or facial nerve palsy). CONCLUSIONS Antibiotic treatment cannot be considered an absolute safeguard against the development of acute mastoiditis. Early myringotomy for acute otitis media seems to decrease the incidence of complications. The distribution of causative organisms in acute mastoiditis differs from that in acute otitis media. Intracranial complications in acute mastoiditis are not rare. Because of the diversity of causative organisms in acute mastoiditis and the growing resistance of bacteria to the various antibiotics, all means to obtain a sample for culture prior to antibiotic treatment, including general anesthesia.
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Affiliation(s)
- M Luntz
- Department of Otolaryngology, Head and Neck Surgery, Bnai Zion Medical Center, PO Box 4940, 31048 Haifa, Israel.
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17
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Sikuler E, Shapira A, Mor-Yosef S, Shlaeffer P, Slovik D, Brutin M, Gurman G. [Rational use of albumin]. Harefuah 2000; 139:190-3, 246. [PMID: 11062949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
The use of albumin has been a matter of debate since its introduction in the 1940's. Albumin is not only expensive but may also be harmful when administered inappropriately. Until recently our use of albumin was controlled by a number of authorized physicians who signed all albumin prescriptions. In August 1998, a multidisciplinary team reviewed the indications for albumin use and introduced simple guidelines for its supply and administration. As a result, the use of albumin has decreased by almost 70%. This indicates that rational use of albumin can be achieved by appropriate guidelines, without requiring administrative limitations. We believe that this conclusion holds true for other diagnostic and therapeutic procedures as well.
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Affiliation(s)
- E Sikuler
- Division of Medicine, Soroka Medical Center, Beer Sheba
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18
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Lustig JP, Schwartz-Arad D, Shapira A. Odontogenic cysts related to pulpotomized deciduous molars: clinical features and treatment outcome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 87:499-503. [PMID: 10225634 DOI: 10.1016/s1079-2104(99)70251-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the morbidity and outcomes associated with large cysts that developed in conjunction with pulpotomized deciduous molars. STUDY DESIGN This retrospective study was based on the files of 18 patients who were referred to 2 oral surgery departments during a 10-year period (1986-1996). The inclusion criteria were large cyst lesions (>1 cm in diameter) and complete documentation. Data regarding symptoms at presentation, histologic and radiologic features, treatment modalities, morbidity, and outcomes were analyzed. RESULTS An equal gender distribution of patients was found, as were a later development in males (12+/-2 years in boys, 9+/-2 years in girls) and a 5:1 ratio favoring the mandible over the maxilla. Treatment included enucleation (12 patients) and marsupialization (6 patients). The morbidity was high and included loss of permanent teeth (3 patients), extensive loss of alveolar bone (3 patients), use of flaps (2 patients), and adjuvant orthodontic treatment (9 patients). CONCLUSION Failure of early detection and treatment of cysts that develop in conjunction with pulpotomized deciduous molars can cause considerable morbidity. Therefore, periodic clinical and radiologic follow-up until the eruption of succedaneous teeth is recommended.
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Affiliation(s)
- J P Lustig
- Department of Oral and Maxillofacial Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Barzilai Medical Center, Israel
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19
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Abstract
A "wrongful life" suit is based on the purported tortious liability of a genetic counsellor towards an infant with hereditary defects, with the latter asserting that he or she would not have been born at all if not for the counsellor's negligence. This negligence allegedly lies in the failure on the part of the defendant adequately to advice the parents or to conduct properly the relevant testing and thereby prevent the child's conception or birth (where unimpaired life was not possible). This paper will offer support for the thesis that it would be both feasible and desirable to endorse "wrongful life" compensation actions. The genetic counsellor owed a duty of due professional care to the impaired newborn who now claims that but for the counsellor's negligence, he or she would not have been born at all. The plaintiff's defective life (where healthy life was never an option) constitutes a compensable injury. A sufficient causal link may exist between the plaintiff's injury and the defendant's breach of duty of due professional care and an appropriate measure of damages can be allocated to the disabled newborn. Sanctioning a "wrongful life" cause of action does not necessarily entail abandoning valuable constraints with regard to abortion and euthanasia. Nor does it inevitably lead to an uncontrolled slide down a "slippery slope".
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Abstract
We determined the levels of antineurofilament antibodies in 29 patients with postpolio syndrome (PPS), 26 stable postpolio (PP) patients, 22 patients with ALS, and 20 normal controls (NCs). Patients with PPS had higher antibody levels to cholinergic neurofilaments than did all other groups. PP patients and those with ALS had antibody levels similar to those of NCs. The antibody binding level showed no relation to the age of the patients, duration of disease, or motor score.
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Affiliation(s)
- V E Drory
- Department of Neurology, Sourasky Medical Center, Tel-Aviv, Israel
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21
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Shapira A, Yaacov T, Harness D. [Skeletal muscle damage syndrome due to overuse]. Harefuah 1998; 134:212-6. [PMID: 9662916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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22
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Gottfried M, Yelin A, Shapira A, Burillon J, Martinez A, Rozenman Y, Brenner H. 101 Navelbine (N) ifosfamide (I) cisplatin (P) combination in the management of locally advanced non-small cell lung cancer (NSCLC). Lung Cancer 1997. [DOI: 10.1016/s0169-5002(97)89380-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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23
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Lustig J, Shapira A, London D. Clinical identification and measurement of blood supply to the chin: A preliminary study. Int J Oral Maxillofac Surg 1997. [DOI: 10.1016/s0901-5027(97)81433-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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24
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Abstract
We conducted a prospective cohort study of the possible ototoxic effect of vincristine among patients treated for lymphoproliferative malignancies. No deleterious effect of moderate doses of vincristine on pure tone audiometry for air and bone conduction and on speech audiometry could be found. Nevertheless, the isolated finding of sensorineural hearing loss in the only patient who received a high dose of vincristine raises the issue of ototoxicity as a possible dose-related and dose-limiting side effect of vincristine.
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Affiliation(s)
- G Lugassy
- Institute of Hematology, Head and Neck Surgery, Barzilai Medical Center, Ashkelon, Israel
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25
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Abstract
The JDC-Brookdale Institute of Gerontology, in collaboration with Israel's Ministry of Labor and Social Affairs and Ministry of Health, has developed a program to improve government regulation of long-term care institutions for the elderly, and thus the quality of institutional care. The aim of the program was to introduce greater uniformity and objectivity into the existing surveillance system, increase the participation of institution residents, and ensure public access to instruments and criteria. The tracer methodology was used and tracers representing the medical, nursing, psychosocial and environmental-operational areas were developed in consultation with specialists in each field. The program was welcomed by surveillance personnel, and implemented on a nation-wide basis. Although there have been difficulties with its implementation, these have largely been resolved through discussion, workshops and supplementary training for surveyors. Due to the program's success, new programs are being developed to improve the regulation of other kinds of institution.
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Affiliation(s)
- R Fleishman
- JDC-Brookdale Institute of Gerontology and Human Development, Jerusalem, Israel
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26
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Shapira A, Laufer A. Evolution of involvement and effort in construction planning throughout project life. International Journal of Project Management 1993. [DOI: 10.1016/0263-7863(93)90048-r] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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27
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Akrawy MZ, Alexander G, Allison J, Allport PP, Anderson KJ, Armitage JC, Arnison GTJ, Ashton P, Azuelos G, Baines JTM, Ball AH, Banks J, Barker GJ, Barlow RJ, Batley JR, Beck A, Becker J, Behnke T, Bell KW, Bella G, Bethke S, Biebel O, Binder U, Bloodworth IJ, Bock P, Breuker H, Brown RM, Brun R, Buijs A, Burckhart HJ, Capiluppi P, Carnegie RK, Carter AA, Carter JR, Chang CY, Charlton DG, Chrin JTM, Clarke PEL, Cohen I, Collins WJ, Conboy JE, Couch M, Coupland M, Cuffiani M, Dado S, Dallavalle GM, Debu P, Deninno MM, Dieckmann A, Dittmar M, Dixit MS, Duchovni E, Duerdoth IP, Dumas DJP, Elcombe PA, Estabrooks PG, Etzion E, Fabbri F, Farthouat P, Fischer HM, Fong DG, French MT, Fukunaga C, Gaidot A, Ganel O, Gary JW, Gascon J, Geddes NI, Gee CNP, Geich-Gimbel C, Gensler SW, Gentit FX, Giacomelli G, Gibson V, Gibson WR, Gillies JD, Goldberg J, Goodrick MJ, Gorn W, Granite D, Gross E, Grunhaus J, Hagedorn H, Hagemann J, Hansroul M, Hargrove CK, Harrus I, Hart J, Hattersley PM, Hauschild M, Hawkes CM, Heflin E, Hemingway RJ, Heuer RD, Hill JC, Hillier SJ, Ho C, Hobbs JD, Hobson PR, Hochman D, Holl B, Homer RJ, Hou SR, Howarth CP, Hughes-Jones RE, Humbert R, Igo-Kemenes P, Ihssen H, Imrie DC, Janissen L, Jawahery A, Jeffreys PW, Jeremie H, Jimack M, Jobes M, Jones RWL, Jovanovic P, Karlen D, Kawagoe K, Kawamoto T, Kellogg RG, Kennedy BW, Kleinwort C, Klem DE, Knop G, Kobayashi T, Kokott TP, K�pke L, Kowalewski R, Kreutzmann H, Kroll J, Kuwano M, Kyberd P, Lafferty GD, Lamarche F, Larson WJ, Layter JG, Du P, Leblanc P, Lee AM, Lehto MH, Lellouch D, Lennert P, Lessard L, Levinson L, Lloyd SL, Loebinger FK, Lorah JM, Lorazo B, Losty MJ, Ludwig J, Ma J, Macbeth AA, Mannelli M, Marcellini S, Maringer G, Martin AJ, Martin JP, Mashimo T, M�ttig P, Maur U, McMahon TJ, McNutt JR, Meijers F, Menszner D, Merritt FS, Mes H, Michelini A, Middleton RP, Mikenberg G, Mildenberger J, Miller DJ, Milstene C, Minowa M, Mohr W, Montanari A, Mori T, Moss MW, Murphy PG, Murray WJ, Nellen B, Nguyen HH, Nozaki M, O'Dowd AJP, O'Neale SW, O'Neill BP, Oakham FG, Odorici F, Ogg M, Oh H, Oreglia MJ, Orito S, Pansart JP, Patrick GN, Pawley SJ, Pfister P, Pilcher JE, Pinfold JL, Plane DE, Poli B, Pouladdej A, Prebys E, Pritchard TW, Quast G, Raab J, Redmond MW, Rees DL, Regimbald M, Riles K, Roach CM, Robins SA, Rollnik A, Roney JM, Rossberg S, Rossi AM, Routenburg P, Runge K, Runolfsson O, Sanghera S, Sansum RA, Sasaki M, Saunders BJ, Schaile AD, Schaile O, Schappert W, Scharff-Hansen P, Schreiber S, Schwarz J, Shapira A, Shen BC, Sherwood P, Simon A, Singh P, Siroli GP, Skuja A, Smith AM, Smith TJ, Snow GA, Springer RW, Sproston M, Stephens K, Stier HE, Stroehmer R, Strom D, Takeda H, Takeshita T, Taras P, Thackray NJ, Tsukamoto T, Turner MF, Tysarczyk-Niemeyer G, plas D, VanDalen GJ, Vasseur G, Virtue CJ, Schmitt H, Krogh J, Wagner A, Wahl C, Walker JP, Ward CP, Ward DR, Watkins PM, Watson AT, Watson NK, Weber M, Weisz S, Wells PS, Wermes N, Weymann M, Wilson GW, Wilson JA, Wingerter I, Winterer VH, Wood NC, Wotton S, Wuensch B, Wyatt TR, Yaari R, Yang Y, Yekutieli G, Yoshida T, Zeuner W, Zorn GT. A study of the recombination scheme dependence of jet production rates and of ? s ( $$M_{Z^0 } $$ ) in hadronicZ 0 decays. ACTA ACUST UNITED AC 1991. [DOI: 10.1007/bf01549689] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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28
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Valevski A, Modai I, Shapira A, Weizman A. [Clozapine--a novel antipsychotic drug?]. Harefuah 1991; 121:47-51. [PMID: 1684169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Lugassy G, Shapira A, Dukatch E, Berrebi A. Chronic lymphocytic leukemia in 2 young adults. Eur J Cancer 1991; 27:812. [PMID: 1829935 DOI: 10.1016/0277-5379(91)90202-o] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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30
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Melamed E, Achiron A, Shapira A, Davidovicz S. Persistent and progressive parkinsonism after discontinuation of chronic neuroleptic therapy: an additional tardive syndrome? Clin Neuropharmacol 1991; 14:273-8. [PMID: 1676933 DOI: 10.1097/00002826-199106000-00013] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Drug-induced parkinsonism is usually reversible, except in a small percentage of elderly patients. We describe two relatively young patients, who developed drug-induced parkinsonism during chronic treatment with neuroleptics for a psychotic disorder. Parkinsonism persisted, and markedly and progressively deteriorated after discontinuation of neuroleptic drugs. One patient had tremor as the most prominent sign and the other had mainly an akinetic-rigid syndrome. Neither had ever developed tardive dyskinesia. Both responded to levodopa therapy. Persistent drug-induced parkinsonism in our, and other reported on, elderly patients may be due to unmasking of preexisting subclinical idiopathic Parkinson's disease by neuroleptics. Theoretically, these drugs may precipitate degeneration of vulnerable, nigrostriatal neurons by generating cytotoxic free radicals or by attrition, due to accelerated neuronal firing rates.
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Affiliation(s)
- E Melamed
- Department of Neurology, Beilinson Medical Center, Petah Tiqva, Israel
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31
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Katz G, Landau EH, Lancovsky Z, Pode D, Shapira A, Pfau A. [Extracorporeal shock wave lithotripsy for cystine urolithiasis]. Harefuah 1991; 120:182-4. [PMID: 2066017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We present 31 patients with cystine urolithiasis referred to our extracorporeal shock wave lithotripsy (ESWL) center since 1985. This group differed statistically from the other 3000 patients treated by us for urolithiasis with regard to age, stone burden, number of previous operations, and known duration of urolithiasis. The average known duration in those with cystine stones was 15 years. Of 26 patients with such a history, 22 had an average of 2 operations each. At referral, 14 had bilateral stones and among the others there were 5 nonfunctioning kidneys. Of 26 referred with a diagnosis of cystine nephrolithiasis, only 11 were being treated medically. At presentation, 31 had no stones and 1 was being treated medically. In the other 29 patients, 44 renal-ureteral units had urolithiasis. During follow-up 2 ureteral stones were discharged spontaneously and the other units were treated by ESWL, surgery and/or ureteroscopy, and percutaneous irrigation. 36/42 units were free of significant stone residue, but in 4 there were large gravel remains; 1 kidney was removed primarily and 1 kidney lost its function following prolonged obstruction after ESWL. During follow-up, of 11 patients unable to tolerate D-penicillamine and treated by urinary alkalinization alone, 3 have already formed new stones.
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Affiliation(s)
- G Katz
- Dept. of Urology, Hadassah-University Hospital, Jerusalem
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32
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Kornreich L, Shapira A, Horev G, Danziger Y, Tyano S, Mimouni M. CT and MR evaluation of the brain in patients with anorexia nervosa. AJNR Am J Neuroradiol 1991; 12:1213-6. [PMID: 1763756 PMCID: PMC8331453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Thirteen adolescent girls with anorexia nervosa had MR imaging of the brain; 11 were also examined by CT. Fifteen children, ages 10-12 years, served as a control group. The CT and MR studies were evaluated qualitatively for cortical and central atrophic changes. CT detected sulcal and ventricular enlargement in 5/11 patients. On the MR images, enlarged sulci were seen in 10/13 and dilated ventricles in 5/13. In the anorectic patients, the range of the width of the third ventricle was 1-5 mm (mean, 3.2 mm) and the maximal distance between the anterior horns was 22.5-39.0 mm (mean, 30.0 mm). Anterior horns at their minimal width measured 11-30 mm (mean, 16.5 mm). The corresponding measurements in the control group were 1.5-3.5 mm (mean, 2.3 mm) for the third ventricle, 21-35 mm (mean, 28.5 mm) for the distance between the anterior horns, and 10-16 mm (mean, 12.8 mm) for their minimal width. Overall, the patient group had larger ventricles than the control group; however, the difference between the two groups was not significant. Measurement of the number of visible cortical sulci at one cut below the vertex yielded 2-11 sulci in the anorectic girls (mean, 6.6) versus 0-6 sulci (mean, 3.3) in the controls. These results are statistically significant (p = .0009), indicating peripheral volume loss in the anorectic patients. The MR examination did not reveal any additional structural or parenchymal changes when compared with the results of the CT studies. However, the pituitary glands of these patients did not have the expected normal pubertal hypertrophy on the MR examinations.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- L Kornreich
- Department of Pediatric Radiology, Beilinson Medical Center, Petah Tiqva, Israel
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33
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Akrawy MZ, Alexander G, Allison J, Allport PP, Anderson KJ, Armitage JC, Arnison GTJ, Ashton P, Azuelos G, Baines JTM, Ball AH, Banks J, Barker GJ, Barlow RJ, Batley JR, Becker J, Behnke T, Bell KW, Bella G, Bethke S, Biebel O, Binder U, Bloodworth LJ, Bock P, Breuker H, Brown RM, Brun R, Buijs A, Burckhart HJ, Capiluppi P, Carnegie RK, Carter AA, Carter JR, Chang CY, Charlton DG, Chrin JTM, Cohen I, Collins WJ, Conboy JE, Couch M, Coupland M, Cuffiani M, Dado S, Dallavalle GM, Debu P, Deninno MM, Dieckmann A, Dittmar M, Dixit MS, Duchovni E, Duerdoth IP, Dumas D, Mamouni H, Elcombe PA, Estabrooks PG, Etzion E, Fabbri F, Farthouat P, Fischer HM, Fong DG, French MT, Fukunaga C, Gaidot A, Ganel O, Gary JW, Gascon J, Geddes NI, Gee CNP, Geich-Gimbel C, Gensler SW, Gentit FX, Giacomelli G, Gibson V, Gibson WR, Gillies JD, Goldberg J, Goodrick MJ, Gorn W, Granite D, Gross E, Grosse-Wiesmann P, Grunhaus J, Hagedorn H, Hagemann J, Hansroul M, Hargrove CK, Hart J, Hattersley PM, Hauschild M, Hawkes CM, Heflin E, Hemingway RJ, Heuer RD, Hill JC, Hillier SJ, Ho C, Hobbs JD, Hobson PR, Hochman D, Holl B, Homer RJ, Hou SR, Howarth CP, Hughes-Jones RE, Igo-Kemenes P, Ihssen H, Imrie DC, Jawahery A, Jeffreys PW, Jeremie H, Jimack M, Jobes M, Jones RWL, Jovanovic P, Karlen D, Kawagoe K, Kawamoto T, Kellogg RG, Kennedy BW, Kleinwort C, Klem DE, Knop G, Kobayashi T, Kokott TP, K�pke L, Kowalewski R, Kreutzmann H, Krogh J, Kroll J, Kuwano M, Kyberd P, Lafferty GD, Lamarche F, Larson WJ, Lasota MMB, Layter JG, Du P, Leblanc P, Lee AM, Lellouch D, Lennert P, Lessard L, Levinson L, Lloyd SL, Loebinger FK, Lorah JM, Lorazo B, Losty MJ, Ludwig J, Lupu N, Ma J, Macbeth AA, Mannelli M, Marcellini S, Maringer G, Martin AJ, Martin JP, Mashimo T, M�ttig P, Maur U, McMahon TJ, McPherson AC, Meijers F, Menszner D, Merritt FS, Mes H, Michelini A, Middleton RP, Mikenberg G, Miller DJ, Milstene C, Minowa M, Mohr W, Montanari A, Mori T, Moss MW, Murphy PG, Murray WJ, Nellen B, Nguyen HH, Nozaki M, O'Dowd AJP, O'Neale SW, O'Neill BP, Oakham FG, Odorici F, Ogg M, Oh H, Oreglia MJ, Orito S, Pansart JP, Patrick GN, Pawley SJ, Pfister P, Pilcher JE, Pinfold JL, Plane DE, Poli B, Pouladdej A, Pritchard PW, Quast G, Raab J, Redmond MW, Rees DL, Regimbald M, Riles K, Roach CM, Robins SA, Rollnik A, Roney JM, Rossberg S, Rossi AM, Routenburg P, Runge K, Runolfsson O, Sanghera S, Sansum RA, Sasaki M, Saunders BJ, Schaile AD, Schaile O, Schappert W, Scharff-Hansen P, Schmitt H, Schreiber S, Schwarz J, Shapira A, Shen BC, Sherwood P, Simon A, Siroli GP, Skuja A, Smith AM, Smith TJ, Snow GA, Spreadbury EJ, Springer RW, Sproston M, Stephens K, Stier HE, Str�hmer R, Strom D, Takeda H, Takeshita T, Tsukamoto T, Turner MF, Tysarczyk-Niemeyer G, plas D, VanDalen GJ, Vasseur G, Virtue CJ, Wagner A, Wahl C, Ward CP, Ward DR, Waterhouse J, Watkins PM, Watson AT, Watson NK, Weber M, Weisz S, Wermes N, Weymann M, Wilson GW, Wilson JA, Wingerter I, Winterer VH, Wood NC, Wotton S, Wuensch B, Wyatt TR, Yaari R, Yang Y, Yekutieli G, Yoshida T, Zeuner W, Zorn GT. A measurement of global event shape distributions in the hadronic decays of theZ 0. ACTA ACUST UNITED AC 1990. [DOI: 10.1007/bf01552315] [Citation(s) in RCA: 138] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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34
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Abstract
We describe a 64-year-old patient with multiple myeloma who developed a sudden sensorineural hearing loss shortly after receiving chemotherapy with vincristine. Ototoxicity is not a known side effect of this drug. It would be of interest to perform repeated audiograms on patients receiving vincristine, in order to appreciate the actual ototoxicity of this drug.
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Affiliation(s)
- G Lugassy
- Institute of Hematology, Barzilai Medical Center, Ashkelon, Israel
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Braunschweig W, Gerhards R, Kirschfink FJ, Martyn HU, Bock B, Fischer HM, Hartmann H, Hartmann J, Hilger E, Jocksch A, Wedemeyer R, Foster B, Martin AJ, Sephton AJ, Barreiro F, Bernardi E, Chwastowski J, Eskreys A, Gather K, Genser K, Hultschig H, Joos P, Kowalski H, Ladage A, L�hr B, L�ke D, M�ttig P, Notz D, Pawlak JM, P�snecker KU, Ros E, Trines D, Walczak R, Wolf G, Kolanoski H, Kracht T, Kr�ger J, Lohrmann E, Poelz G, Zeuner W, Belk A, Binnie DM, Hassard J, Shulman J, Su D, Leites A, Peso J, Balkwill C, Bowler MG, Burrows PN, Cashmore RJ, Heath GP, Ratoff PN, Silvester IM, Tomalin IR, Veitch ME, Forden GE, Hart JC, Saxon DH, Brandt S, Holder M, Labarga L, Eisenberg Y, Karshon U, Mikenberg G, Montag A, Revel D, Ronat E, Shapira A, Wainer N, Yekutieli G, Caldwell A, Muller D, Ritz S, Strom D, Takashima M, Wu SL, Zobernig G. Measurement of the average lifetime ofB hadrons. ACTA ACUST UNITED AC 1989. [DOI: 10.1007/bf01548581] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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36
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Shapira A, Porat M, Ophir D. [Thyroglossal duct cyst]. Harefuah 1989; 116:138-9. [PMID: 2714693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Thyroglossal duct cysts are embryologic anomalies arising from epithelial remnants of the duct left after the descent of the developing thyroid. Clinical, operative and pathological findings in 124 patients operated on in the past 14 years were analyzed. There were 60 males and 64 females. 69 (56%) were under 10 years of age and the youngest was 6 months old. 26 (21%) were over the age of 30, and the oldest was 72 years old. All excisions were performed in accordance with the Sistrunk procedure, which includes removal of the body of the hyoid bone. Overall recurrence was 6.4%, but in infected cysts or cysts with a fistula to the skin, it was 3.5 times greater. In 20% the cyst was located off the midline. The lining of the cysts was cuboidal, columnar, pseudostratified or stratified squamous epithelium, and varied according to the location of the cyst. There were no malignant changes.
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Shapira A, Peshin J, Lin E, Gordin A, Mendel F, Herness D. Bilateral Baker's cyst as the presenting symptom of paraneoplastic syndrome. Arch Orthop Trauma Surg (1978) 1988; 107:385-7. [PMID: 3240082 DOI: 10.1007/bf00381068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Paraneoplastic syndrome is defined as a systemic malignancy producing prostaglandins or other substances that lead to various manifestations, syndromes or diseases. In the following report we present a case of a young patient complaining of bilateral Baker's cysts who ultimately was diagnosed as suffering from gastric lymphoma. Following subtotal gastrectomy the Baker's cysts disappeared with no specific treatment.
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Affiliation(s)
- A Shapira
- Department of Orthopaedic Surgery B, Assaf-Harofeh Medical Center, Zerifin, Israel
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38
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Shapira A, Wagner JG, Wollner IS, Maybaum J, Stetson PL, Ensminger WD, Carey TE. Dynamics of bromodeoxyuridine incorporation into DNA of squamous carcinoma cells during mid and late logarithmic growth. Pharm Res 1988; 5:518-22. [PMID: 3244661 DOI: 10.1023/a:1015925509778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Head and neck squamous carcinoma cell lines, UM-SCC 1, 5, 9, 11B, and 14B, were exposed in vitro to bromodeoxyuridine (BUdR) during logarithmic growth to determine the effects of drug concentration (0.01 to 10 microM) and duration of exposure (3, 7, and 10 days) on cell growth and on incorporation of BUdR into DNA. Concentrations of less than 1.0 microM were not growth inhibitory except with UM-SCC-11B. After 10 days of exposure to 5 microM BUdR, survival fractions for all lines ranged from 2 to 65% of controls. Replacement of thymidine by BUdR in DNA was assessed by gas chromatography/mass spectroscopy. Percentage replacement (% R) was described by the equation % R = 100 (C/t)s/[(C/t)50s + (C/t)s], where C is the concentration of BUdR (microM), t is the time in days, s is a constant, and (C/t)50 is a constant corresponding to % R = 50%. BUdR incorporation reached a time- and concentration-dependent maximum that, after 3 to 7 days of culture in 10 microM BUdR, ranged from 30 to 60% R. Subsequently, % R declined with time even though the cells were fed daily with fresh BUdR-containing medium.
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Affiliation(s)
- A Shapira
- Department of Otolaryngology, University of Michigan Medical School, Ann Arbor 48109
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39
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Abstract
The effect of tamoxifen, a nonsteroidal antiestrogenic drug, on the in vitro growth of three cell lines derived from carcinoma of the uterine cervix (HeLa, CaSki, ME-180) was studied using the breast cancer cell line MCF-7 as a tamoxifen-sensitive control. Logarithmically growing cells were fed daily with medium containing 5% dextran-charcoal-treated fetal bovine serum (D5) and 0, 1, 2.5, 5, 7.5, or 10 microM tamoxifen. The cell number in replicate cultures was assessed every other day by cell counts. Growth inhibition was expressed as the percentage of the cell number in control cultures fed with D5. At a concentration of 5 microM tamoxifen, a clear decrease in cell proliferation, resulting in 66-74% inhibition of growth, was observed with MCF-7, HeLa, and ME-180 after 6 days of exposure to tamoxifen. Doses greater than 5 microM resulted in cytotoxicity and progressive cell loss. With the CaSki cell line, 2.5 microM tamoxifen induced more than 60% growth inhibition and 5 microM tamoxifen was cytotoxic. Tamoxifen-induced growth inhibition was reversed by removing tamoxifen from the cell cultures, and the cells resumed logarithmic growth after a lag period of 24-48 hr. MCF-7, but not the cervical carcinoma, lines required estradiol for complete and rapid recovery of logarithmic growth. Our results indicate that tamoxifen inhibits cell growth of these cervical carcinoma cell lines by a mechanism different from that in MCF-7.
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Affiliation(s)
- S Grenman
- Department of Otolaryngology/Head and Neck Surgery, University of Michigan, Ann Arbor 48109
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Affiliation(s)
- I G Gorodeski
- Department of Obstetrics and Gynecology "B", Meir General Hospital, Kfar Saba, Israel
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41
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Kramer MR, Shapira A, Bar-On Z. [Brachial plexus injuries in Israeli soldiers]. Harefuah 1988; 114:173-5. [PMID: 3356391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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42
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Abstract
Three cases of heterotopic pregnancy, i.e. combined intra-uterine and extra-uterine pregnancy are reported. The complexities of diagnosis and management are presented.
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Affiliation(s)
- I G Gorodeski
- Department of Obstetrics and Gynecology B, Meir Hospital, Sapir Medical Center, Kfar Saba, Israel
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43
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Patonay G, Fowler K, Shapira A, Nelson G, Warner IM. Cyclodextrin complexes of polyaromatic hydrocarbons in the presence of aliphatic alcohols. ACTA ACUST UNITED AC 1987. [DOI: 10.1007/bf00656591] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Hereditary protein C, a primary hypercoagulable state, has not been previously associated with preeclamptic toxemia. A woman with previous preeclamptic toxemia and fetal deaths presented with recurrent deep vein thrombosis during her third pregnancy. Hereditary protein C was diagnosed but full heparinization followed by low-dose heparin failed to prevent preeclamptic toxemia.
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Affiliation(s)
- B Brenner
- Institute of Hematology, Ichilov Hospital, Tel-Aviv, Israel
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45
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Shapira A. [Anti-estrogen therapy in laryngeal cancer--novel modality of treatment]. Harefuah 1987; 112:601-4. [PMID: 3322967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Grenman R, Virolainen E, Shapira A, Carey T. In vitro effects of tamoxifen on UM-SCC head and neck cancer cell lines: correlation with the estrogen and progesterone receptor content. Int J Cancer 1987; 39:77-81. [PMID: 3793272 DOI: 10.1002/ijc.2910390114] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Eleven squamous-cell carcinoma (SCC) cell lines derived from patients with head and neck cancer were tested together with the MCF-7 breast carcinoma cell line for in vitro growth inhibition by tamoxifen. MCF-7 is known to contain cytosolic receptors for estrogen (ER), progesterone (PgR), androgen (AR) and glucocorticoid. We have previously reported the ER, PgR and AR contents of these 11 head-and-neck SCC cancer lines. Starting from day 3 or 4 after passage, cultures were fed daily with medium containing 5% dextran-charcoal-treated fetal bovine serum (D5) and 0, 1, 2.5, 5, 7.5 or 10 microM tamoxifen. Eight of the 11 SCC lines and MCF-7 showed more than 60% growth inhibition when fed with 5 microM tamoxifen. Of these 8 SCC cell lines, 3 contained both ER and PgR, 4 contained only PgR, and one contained neither receptor. The 3 cell lines that were not inhibited by tamoxifen failed to express either ER or PgR. The action of tamoxifen on the cell lines was further investigated by examining the reversibility and the rate of recovery from tamoxifen-induced growth inhibition in the presence or absence of estrogen. MCF-7 and two ER- and PgR-positive SCC cell lines, UM-SCC-12 and UM-SCC-9, recovered more rapidly when the tamoxifen was replaced with medium containing 17-beta estradiol (E2) than when it was replaced with D5 medium alone. However, of the other tamoxifen-inhibited cell lines studied, each recovered equally well whether the tamoxifen was replaced with D5 medium or with D5 medium containing E2. Furthermore, some cell lines spontaneously resumed growth within 4 to 5 days in the presence of tamoxifen if no new tamoxifen was added to the culture dish. This ability is specific for some cell lines, and further study is required to determine its significance.
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Althoff M, Braunschweig W, Gerhards R, Kirschfink FJ, Martyn HU, Rosskamp P, Wallraff W, Bock B, Eisenmann J, Fischer HM, Hartmann H, Jocksch A, Kolanoski H, K�ck H, Mertens V, Wedemeyer R, Foster B, Bernardi E, Eisenberg Y, Eskreys A, Gather K, Hultschig H, Joos P, Klima B, Kowalski H, Ladage A, L�hr B, L�ke D, M�ttig P, Notz D, Revel D, Ronat E, Trines D, Tymieniecka T, Walczak R, Wolf G, Zeuner W, Hilger E, Kracht T, Krasemann HL, Kr�ger J, Lohrmann E, Poelz G, P�snecker KU, Binnie DM, Dornan PJ, Garbutt DA, Jenkins C, Jones WG, Sedgbeer JK, Su D, Thomas J, Wan Abdullah WAT, Barreiro F, Ros E, Bowler MG, Bull P, Cashmore RJ, Dauncey P, Devenish R, Heath G, Mellor D, Ratoff P, Lloyd SL, Forden GE, Hart JC, Hasell DK, Saxon DH, Brandt S, Holder M, Labarga L, Neumann B, Karshon U, Mikenberg G, Mir R, Montag A, Shapira A, Yekutieli G, Baranko G, Caldwell A, Cherney M, Izen JM, Ritz S, Strom D, Takashima M, Wicklund E, Wu SL, Zonering G. Measurement of the radiative width of theA 2(1320) in two-photon interactions. ACTA ACUST UNITED AC 1986. [DOI: 10.1007/bf01551074] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Shapira A, Virolainen E, Jameson JJ, Ossakow SJ, Carey TE. Growth inhibition of laryngeal UM-SCC cell lines by tamoxifen. Comparison with effects on the MCF-7 breast cancer cell line. Arch Otolaryngol Head Neck Surg 1986; 112:1151-8. [PMID: 3755989 DOI: 10.1001/archotol.1986.03780110027002] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Six laryngeal squamous cell carcinoma (SCC) cell lines and the MCF-7 breast cancer line, all of which contain estrogen and progesterone receptors, were tested for in vitro growth inhibition by the antiestrogen tamoxifen citrate. Cell line MCF-7 was more sensitive to growth retardation at 1 mumol/L of tamoxifen citrate, but SCC lines showed higher sensitivity than MCF-7 to cytotoxic effects at higher drug concentrations (7 to 10 mumol/L). A cytostatic level of growth inhibition was produced by 5 mumol/L tamoxifen citrate for both types of cell lines. When tamoxifen and estradiol were added to cultures simultaneously, partial reversal of growth inhibition was observed with MCF-7 but not with UM-SCC-5. All of the cell lines recovered from inhibition when tamoxifen was replaced with 0.1 mumol/L estradiol, but laryngeal SCC lines recovered equally well in estradiol-free medium, whereas MCF-7 recovered only partially in the absence of estradiol. These findings indicate that there are at least two tamoxifen receptor sites--one for which estradiol is a competitor and one for which it is not--and that tamoxifen reversibly blocks growth and may synchronize SCC cells.
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Chen Z, Pace U, Heldman J, Shapira A, Lancet D. Isolated frog olfactory cilia: a preparation of dendritic membranes from chemosensory neurons. J Neurosci 1986; 6:2146-54. [PMID: 3091781 PMCID: PMC6568744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The recently introduced frog olfactory cilia preparation (Chen and Lancet, 1984; Pace et al., 1985) has been useful for studies of molecular chemosensory mechanisms. Here we describe in detail the properties of this cilia preparation. The "calcium shock" procedure leads to a complete removal of the cilia from the olfactory epithelial surface. Isolated cilia constitute segments of proximal regions with 9 X 2 + 2 microtubular arrangement and a large proportion of membrane vesicles, probably derived from the ciliary distal segments. Polypeptides unique to the olfactory cilia preparation, compared to a control preparation of palate respiratory cilia, are identified by Coomassie brilliant blue staining, silver staining, and radiolabeled lectin overlays, as well as by biosynthetic labeling with 35S-methionine in epithelial explants and protein phosphorylation in isolated cilia. The olfactory cilia preparation contains odorant-sensitive adenylate cyclase, which is absent in control membranes from deciliated epithelium. High activities of tyrosine and serine/threonine protein kinases are also present. The olfactory cilia preparation described should be instrumental in the further elucidation of the biochemistry and molecular biology of vertebrate olfaction.
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50
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Abstract
A retrospective study of 240 stapedectomies for otosclerosis performed in a teaching department during the last 10 years was done. The results and complications in patients operated on by residents and faculty were compared. Strict criteria for evaluating the surgical outcome were used. "Satisfactory" results obtained by residents during their entire training (79 per cent) were significantly poorer (P greater than 0.05) than those achieved by the faculty (90 per cent). In the second period of residency, however, the residents' success rate (89 per cent) was equal to that of the faculty. There was no statistically significant difference in the complication rate between residents and faculty. Two essential conditions are responsible for good stapedectomy results by residents: experience with sufficient numbers of patients requiring middle-ear surgery (including otosclerosis and chronic middle-ear disease) and close supervision by the faculty in the operating room.
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