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Biomedical subjects

J Katz

Publications and source records attributed to J Katz.

At least 271 records · Page 15Linked to original sources
PubMed1995

Impact of vitamin A supplementation on prevalence and incidence of xerophthalmia in Nepal.

PURPOSE: To assess the impact of vitamin A supplementation at 4-month intervals on the prevalence and incidence of xerophthalmia among preschool-age children. METHODS: A stratified, random sample of 40 wards with 4766 children in Sarlahi district of Nepal was selected to participate in a randomized, controlled, community trial. In the vitamin A group, at 4-month intervals, neonates received 50,000 IU, 1- to 11-month-old infants received 100,000 IU, and children 1 through 4 years of age received 200,000 IU. Children underwent eye examination before the intervention and 16 months later. RESULTS: Before the intervention, 4318 children were examined for xerophthalmia. The prevalence was 2.3% in the vitamin A group and 3.3% in the placebo group. All children with xerophthalmia were treated with vitamin A at the time of the examination. Of those examined at baseline, 38 in the vitamin A group and 48 in the placebo group died in the 16 months after intervention. There were 1871 (84%) surviving children in the vitamin A group and 1711 (85%) in the placebo group examined at follow-up. After adjustment for the baseline prevalence of xerophthalmia, vitamin A reduced the prevalence at follow-up by 63% (95% confidence interval, 21% to 83%). The apparent incidence was 3.2/1000 per year in the vitamin A group and 9.2/1000 per year in the placebo group, an adjusted reduction of 62% (95% confidence interval, 0% to 86%). CONCLUSIONS: Supplementation was effective at reducing the prevalence and incidence of xerophthalmia.

Child, Preschool↗
PubMed1995

Repeatability of the Glaucoma Hemifield Test in automated perimetry.

PURPOSE: To examine the concordance of the Glaucoma Hemifield Test and other global visual field indexes between two consecutive automated visual field tests. METHODS: Normal subjects, subjects with ocular hypertension, and subjects with glaucoma had two automated visual field tests on the Humphrey Field Analyzer. The Glaucoma Hemifield Test results, mean deviation, and corrected pattern standard deviation of the two consecutive visual field tests were compared. RESULTS: Forty-one normal subjects were tested within 1 and 2 years of each other. Four hundred seven subjects with ocular hypertension and 95 subjects with glaucoma were tested 1 year apart. The proportion of normal subjects who met a criterion for abnormality on two consecutive tests was 2.4%. The proportion of subjects with glaucoma with normal results of two tests was 10.5%. The specificity of automated visual field testing was improved from 80.8% to 89.9%, with a modest loss of sensitivity if two rather than one abnormal test result was required for entry into a clinical trial enrolling patients with glaucomatous field loss. Similarly, specificity increased from 84.2% to 89.5% if two normal tests were required for entry into an ocular hypertensive clinical trial. Among subjects with more closely spaced tests, the agreement between consecutive tests was similar for tests spaced 4 versus 12 months apart. CONCLUSIONS: Although there is concordance of Glaucoma hemifield Test results on consecutive testing, there is enough disagreement to result in improved specificity from the use of a second test in a clinical trial setting.

Adult↗
PubMed1995

Interruption of right sided aortic arch. Case report and review of the literature.

Interrupted right sided aortic arch is a very rare anomaly, and to our knowledge only one such case in which the patient underwent complete repair has been recorded in the literature. Twelve additional cases were found on autopsy or underwent palliative surgery. We present the case of a 25-day-old infant with an interrupted right sided aortic arch. The anomaly was repaired by a one-stage surgical approach, and the patient discharged from the hospital. Surgical technique considerations are discussed.

Anastomosis, Surgical↗
PubMed1995

Pre-emptive analgesia: evidence, current status and future directions.

Although some studies of pre-emptive analgesia have reported small reductions in post-operative pain or analgesic consumption in favour of pre-incisional vs. post-incisional or post-operative treatment, most have not demonstrated any benefit at all. This paper reviews recent evidence supporting the effectiveness of pre-emptive analgesia and discusses factors that may be responsible for the lack of consistent results. These factors include problems with the accepted definition of pre-emptive analgesia, the potential pre-emptive analgesic effects of other agents (e.g. opioids, nitrous oxide, pentobarbitone) used routinely as part of the general anaesthetic, the role of post-operative inflammation in initiating and enhancing a state of central sensitization, and the lack of a true placebo control condition. Given the constraints of clinical research and current standards of practice, it is unlikely that studies of pre-emptive analgesia using conventional analgesics or local anaesthetics will yield large reductions in post-operative pain or analgesic consumption. Extending the pre-emptive treatment well into the post-operative period using balanced, multimodal analgesia, may prolong the initial advantage conferred by the pre-operative blockade and possibly interfere with the development of long-lasting pain.

Analgesia↗
PubMed1995

Reorganization of ascending 5-HT axon projections in animals previously exposed to the recreational drug (+/-)3,4-methylenedioxymethamphetamine (MDMA, "ecstasy").

The recreational drug (+/)3,4-methylenedioxymethamphetamine (MDMA, "ecstasy") is a methamphetamine derivative that selectively destroys central 5-HT axons and axon terminals in animals and, possibly, humans. The fate of 5-HT neurons following MDMA injury is uncertain. In particular, while it is known that central 5-HT axons can undergo regenerative sprouting after MDMA injury, it has not been determined whether they reestablish the original innervation pattern. To address this question, the present studies examined 5-HT innervation patterns in animals lesioned with MDMA 12-18 months previously. Both rodents (rats) and nonhuman primates (squirrel monkeys) were examined, since there is indication that serotonergic recovery after MDMA injury may be species dependent. 5-HT axon projections were studied neurochemically, autoradiographically and immunocytochemically. In both rodents and nonhuman primates previously lesioned with MDMA, substantial serotonergic axonal sprouting was observed. However, in a few rats and in most squirrel monkeys, the reinnervation pattern was highly abnormal: distant targets (e.g., dorsal neocortex) remained denervated, while some proximal targets (e.g., amygdala, hypothalamus) were reinnervated or hyperinnervated. Although the specific determinants of axonal recovery after MDMA injury remain to be identified, it appears that axons which initially sustain more severe damage, are longer, or are more highly arborized have low probability of recovering. The observation that some brain regions remain denervated, while others are reinnervated or hyperinnervated suggests that, under some circumstances, MDMA injury can lead to a lasting reorganization of ascending 5-HT axon projections. Such lasting changes in brain innervation, documented here in MDMA-treated animals, may have implications for humans using MDMA recreationally.

Afferent Pathways↗
PubMed1995

Hemophilus influenzae bacteremia in elderly men with Kaposi's sarcoma: two case reports and a review of the literature.

Hemophilus influenzae is a common pathogen responsible for respiratory infections, meningitis, and bacteremia in children, and a rare cause of bacteremia in adults. We report two cases of H. influenzae bacteremia in elderly men with Kaposi's sarcoma. Both of the patients described are elderly men with no other stigmata of the acquired immune deficiency syndrome. Both Kaposi's sarcoma of the elderly and adult H. influenzae bacteremia are relatively uncommon, and the coappearance of these syndromes may suggest a common immune defect predisposing to these syndromes, or Kaposi's sarcoma may provide a portal of entry for this organism. We suggest that patients with Kaposi's sarcoma who may have bacteremia receive appropriate antibiotic treatment for H. influenzae until a causative agent is isolated.

Aged↗
PubMed1995

Excuses, excuses: accounting for the effects of partner violence on marital satisfaction and stability.

For both theoretical and practical reasons, it is important to understand processes that lead to marital dissatisfaction and dissolution among women who are targets of relationship violence. Because attributional tendencies may often forecast marital behavior and because alcohol use is often seen as providing an excuse for deviant behavior, we examine two potential moderators of the associations between husband violence and wife marital outcomes: wife attributional style and husband problem drinking tendencies. A community sample of married couples (N = 66) completed a comprehensive battery of marital assessments. Results suggested that responsibility attributions moderated the association between husband violence and wives' marital dissatisfaction but exerted a direct effect on wives' disposition toward divorce. Husband problem drinking moderated the impact of husband violence only on wives' disposition toward divorce. As would be expected from an "excuse" model of the associations between violence and marital outcomes, violence had less of an impact on marital satisfaction and divorce ideation when wives attributed responsibility for negative spouse behavior as external to their husbands and when husbands were problem drinkers, respectively.

Adult↗
PubMed1994

Pulmonary insufficiency complicating therapy with high dose cytosine arabinoside in five pediatric patients with relapsed acute myelogenous leukemia.

BACKGROUND: The occurrence of fatal or nearly fatal pulmonary insufficiency in 5 of 22 pediatric patients with relapsed acute myelogenous leukemia (AML) treated with high dose cytosine arabinoside (Ara-C) at St. Jude Children's Research Hospital, Memphis, Tennessee, and institutions affiliated with the Pediatric Oncology Group (POG) is reported. METHODS: Cytosine arabinoside (1.0-1.5 g/m2/day) was given as a 5-day continuous infusion to all patients. Four patients with persistent leukemia received a second 3- or 5-day course. The POG protocol included the administration of granulocyte colony stimulating factor for the priming of myeloblasts. Diagnostic criteria for pulmonary insufficiency included noncardiogenic pulmonary edema with exclusion of underlying cardiorespiratory, infectious, or metabolic conditions. Autopsy material also was reviewed. RESULTS: Of the 22 patients 5 died (23%), including 2 who received a second course of Ara-C as a result of pulmonary insufficiency that developed at a median of 8 days (range, 3-38 days) after the first course. Three patients died despite intubation and pressor support. Two patients were managed successfully with colloids, diuresis, and oxygen by face mask; remission was achieved in both. The postmortem examination of one patient disclosed airless lungs, profound pulmonary edema, and subpleural nodules, but no evidence of leukemia. CONCLUSION: Pulmonary insufficiency from high dose Ara-C varies in severity and may be fatal. It may occur during or after treatment. Awareness of this potential complication, careful attention to fluid status, and aggressive supportive care may optimize outcome.

Acute Disease↗
PubMed1994

Glucose-glucose 6-phosphate cycling in hepatocytes determined by incorporation of 3HOH and D2O. Effect of glycosyns and fructose.

The phosphorylation of glucose and recycling between glucose and glucose-6-P was determined in hepatocytes from fasted rats by a novel method. The cells were incubated with [U-14C]glucose as sole substrate in media containing 3HOH and D2O. Recycling was calculated from the yield of protons in glucose and glycogen. Results with 3HOH and D2O were identical. Phosphorylation was obtained as the sum of recycling plus the U-14C yields in products. At 10 mM glucose, more than 4 out of 5 molecules of glucose-6-P were recycled. About 1.2 mumol of glucose min/g of liver was phosphorylated, 1 mumol was recycled, and 0.2 mumol was glycolyzed. The effect of two phenacylimidazolium compounds (designated as glycosyns) and low concentrations of fructose (0.05-0.2 mM) on phosphorylation and recycling were examined. The glycosyns doubled glucose uptake, mainly as glycogen, nearly abolished glycolysis, and decreased recycling from 80 to 50-60%. There was little change in phosphorylation. Fructose doubled the yield of tritium from [2-3H]glucose in short term incubations (20-30 min), confirming the results of Van Schaftingen ((1993) Diabetologia 36, 582-588). The effect was transient, and cells became refractory to fructose. There was no glycogen synthesis and little effect on recycling. A new phenacylimidazolium compound stimulated glycogen synthesis and suppressed glycolysis and recycling, like the compound designated as proglycosyn by Yamanuchi et al. ((1992) Arch. Biochem. Biophys. 294, 609-615). This new compound (glycosyn-2) was fully active at lower concentrations (maximal effect at 0.02 mM).

Acetophenones↗
PubMed1994

Family history and risk of primary open angle glaucoma. The Baltimore Eye Survey.

OBJECTIVE: Primary open angle glaucoma has been previously associated with a positive family history of glaucoma. We used data from the Baltimore Eye Survey to examine this association. DESIGN: A population-based prevalence survey identified 161 cases of primary open angle glaucoma among 5308 black and white residents of east Baltimore, Md, who were 40 years of age or older. Family history was ascertained by interview and included all first-degree relatives (parents, siblings, and children). RESULTS: Age-adjusted associations of primary open angle glaucoma with a history of glaucoma were higher in siblings (odds ratio [OR] = 3.69) than in parents (OR = 2.17) or children (OR = 1.12). Odds ratios were slightly higher in blacks than in whites, and there was evidence of selection bias, with ORs between two and three times higher for those who had prior knowledge of their glaucoma diagnosis than for those who first received their diagnosis by the study examination (history in siblings OR = 4.72 for those with prior knowledge vs 2.77 for those without). CONCLUSION: Family history is an important risk factor for primary open angle glaucoma, although clinic-based studies are likely to overstate its impact.

Adult↗
PubMed1994

The impact of overnight wear on the risk of contact lens-associated ulcerative keratitis.

OBJECTIVE: To assess the relative risk of contact lens-associated ulcerative keratitis by lens type and related lens-wearing behavior. DESIGN: Case-control study. SETTING/PARTICIPANTS: Forty practice-based case patients with contact lens-associated ulcerative keratitis and 180 control patients matched to the case patients' dispensing practitioner and date of contact lens prescription. RESULTS: Compared with users of daily-wear soft lenses, users of disposable soft contact lenses had a 13.33-fold (95% confidence interval [CI], 5.35 to 33.20) excess risk of ulcerative keratitis. However, after adjusting for overnight wear, the excess risk associated with disposable contact lenses is reduced to 3.21 (95% CI, 1.22 to 14.36). Overall, overnight wear of contact lenses conferred an 8.25-fold excess risk (95% CI, 3.33 to 25.58) of ulcerative keratitis after controlling for lens type. No protective effect of standard compared with substandard lens hygiene was found. The risk of ulcerative keratitis attributable to overnight wear was estimated at 49% for users of daily-wear lenses and 74% for users of lenses approved for overnight wear. CONCLUSION: Overnight wear of contact lenses is the overwhelming risk factor for ulcerative keratitis among contact lens users. We estimate that 49% to 74% of cases of contact lens-associated ulcerative keratitis could be prevented by eliminating overnight wear.

Adolescent↗
PubMed1994

Risk factors for the development of glaucomatous visual field loss in ocular hypertension.

OBJECTIVE: To detect characteristics of persons with ocular hypertension that are associated with a higher risk of future glaucomatous field loss. METHODS: Annual examinations of the optic disc, nerve fiber layer, and visual field in 647 persons with bilateral intraocular pressure higher than 21 mmHg and initially normal visual field test results with the Goldmann perimeter. RESULTS: Sixty-eight persons developed a field defect on two consecutive Goldmann visual field tests in at least one eye, while 579 others retained normal fields. Moderate or severe nerve fiber layer atrophy at baseline was associated with a seven to eight times greater risk of development of visual field loss. Attributes that were significantly associated with the incidence of field loss included older age, larger cup-disc ratio, smaller rim-disc area ratio, larger cup asymmetry, presence of disc crescent, and higher intraocular pressure. Characteristics found not to be associated with incidence were gender, race, hypertension, diabetes, refractive error, family history of glaucoma, smoking or alcohol drinking history, and disc area. CONCLUSIONS: Increasing nerve fiber layer atrophy judged by a semiquantitative grading system was associated with increasing risk of development of visual field loss among persons with ocular hypertension. The relationship of the development of field loss to race, myopia, family history of glaucoma, and medical history are more complex than has been presumed.

Adult↗
PubMed1994

Race-, age-, gender-, and refractive error-related differences in the normal optic disc.

OBJECTIVE: To determine race-, age-, gender-, and refractive error-related differences in the size and topography of the optic disc in healthy Americans. DESIGN: Population-based study. SETTING: Eastern and southeastern health districts of Baltimore, Md. PARTICIPANTS: A population-based sample of 4877 non-institutionalized black and white individuals aged 40 years or older without evidence of optic nerve disease. MAIN OUTCOME MEASURE: Race-, age-, gender-, and refractive error-related differences in optic disc measurements: disc area, neural rim area, cup area, cup-to-disc ratio, and neural rim area-to-disc area ratio. RESULTS: We analyzed simultaneous stereoscopic optic disc photographs from 3387 (1534 black and 1853 white) of the 4877 healthy individuals using an image analyzer (Topcon Image Analyzer, Topcon Instrument Corporation, Paramus, NJ). A total of 1490 individuals were excluded owing to the absence of good-quality images from either eye. The image analyzer defined the cup margin 150 microns below the surface of the disc margin. On average, blacks had significantly larger disc areas (blacks, 2.94 mm2; whites, 2.63 mm2), larger cup areas (blacks, 1.04 mm2; whites, 0.71 mm2), larger cup-to-disc ratios (blacks, 0.56; whites, 0.49), similar neural rim areas (blacks, 1.90 mm2; whites, 1.92 mm2), and smaller neural rim area-to-disc area ratios (blacks, 0.66; whites, 0.74) compared with whites. There were no age-related differences in any of the disc measurements. Male subjects had 2% to 3% larger optic discs compared with female subjects. No association between refractive error and any of the optic disc measurements studied was detected. CONCLUSIONS: Racial differences in the normal optic disc are present among urban Americans, and these differences must be considered in evaluation of the optic disc for glaucoma and other optic neuropathies. Among the individuals in our study, all of whom were 40 years of age or older, no progressive age-related decline in neural rim area was detectable. Neither gender nor refractive error were associated with any significant differences in the size and topography of the normal optic disc.

Adult↗