Albert Einstein College of Medicine, Yeshiva University: Open Journal Systems
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Harm Reduction Outreach Services and Engagement of Chemically Dependent Homeless People Living with HIV/AIDS: An Analysis of Service Utilization Data to Evaluate Program Theory
Get PDFThis study examines service utilization patterns among a socially vulnerable population of homeless people living with HIV/AIDS and who have a history of chemical dependence, as they are engaged through outreach services. CitiWide Harm Reduction collaborates with Montefiore Medical Center to connect homeless people with health care through harm reduction outreach and low threshold medical services. Analysis of two cohorts – individuals engaged through harm reduction outreach and individuals who “walk-in” to engage in services at CitiWide Harm Reduction’s drop-in center – assesses the program’s theory that outreach engagement is a mediating variable increasing service utilization. These results demonstrate that low-threshold harm reduction outreach, a brand of outreach designed to reduce barriers to services, does increase access to health care and related services for a socially vulnerable, traditionally “hard-to-reach,” population. Harm reduction outreach is a valuable intervention for increasing service utilization among this highly marginalized group
An Unusual Case of Drug-Induced Acute Pancreatitis
Get PDFWe report a rare case of drug-induced pancreatitis in a patient receiving repaglinide antidiabetic therapy. A patient with type 2 diabetes mellitus presented with severe abdominal cramping, nausea, and vomiting. Three months prior to symptoms, repaglinide was added to the patient’s current regimen of metformin. The patient was diagnosed with acute pancreatitis, treatment was initi- ated, and repaglinide was discontinued. There was no history of pancreatitis or other risk factors such as history of gallstones, alcohol abuse, or hypertriglyceridemia. The patient reported resolution of symptoms following discontinuation of repaglinide. Considering the temporal relationship of his symptoms to the addition of repaglinide to his existing antidiabetic regimen, this case strongly suggests a possible causal link between repaglinide and the etiology of acute pancreatitis in this patient.
Jews of the Sahara
Get PDFMany years ago, my French colleague and collaborator, Dominique Labie, had arranged a scientific trip to Algeria to study hemoglobinopathies in Algiers (Mears et al., 1981; Pagnier et al., 1984). After several days of intense work, Cherif Beldjord, the younger of our hosts, proposed that we take the weekend off and go to Ghardaia. To entice us, he said, “It will be a fun trip to the Sahara desert, and you cannot imagine how beautiful the place is.” Dominique and I rapidly signed up for this great opportunity. Finally, I would see the Sahara desert, the magical and mysterious Sahara desert.
Social Support: A Role for Social Work in the Treatment and Prevention of Hypertension
Get PDFResearchers have long noticed an association between social relationships and health. More recently, a vast and growing literature has developed, linking various forms of social support to hypertension, often even suggestive of a causal relationship. A detailed survey of this literature is presented, followed by a review of possible psychosocial and physiological explanations for the phenomena. Implications for social workers in various settings are emphasized.
Genomic Medicine
Get PDFThe human genome project created the field of genomics – understanding genetic material on a large scale. Scientists are deciphering the information held within the sequence of our genome. By building upon this knowledge, physicians and scientists will create fundamental new technologies to understand the contribution of genetics to diagnosis, prognosis, monitoring, and treatment of human disease. The science of genomic medicine has only begun to affect our understanding of health
The Medical Uses of Monoclonal Antibodies
No full textAlthough antibodies have had many uses in research and medicine, the difficulties of producing high-titer specific antisera have often limited the role of serological reagents. Recently, a technique for fusing cultured myeloma cells to primary immune lymphocytes has made it possible to generate continuous cell lines secreting antibodies of predefined specificity. Because of the immortality and clonal nature of these hybridoma lines, the monoclonal antibodies they produce represent a homogeneous and well-defined reagent that is available indefinitely and in unlimited amounts. Monoclonal antibodies can be generated to a wider range of antigens than can conventional antisera and are uniquely suited to a number of clinical as well as scientific purposes. Because of their interaction with phagocytic cells and components of normal immunoregulatory circuits, however, the use of monoclonal antibodies in vivo could have undesired effects. We have approached this problem by investigating the possibility of generating variant hybrldoma lines secreting antibodies with mutations in the constant region domains responsible for immunoglobulin effector functions. We have generated several such lines with a number of potentially useful functional alterations