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Biomedical subjects

L Moses

Publications and source records attributed to L Moses.

At least 19 recordsLinked to original sources
PubMed1990

Using the patient's history to estimate the probability of coronary artery disease: a comparison of primary care and referral practices.

PURPOSE: According to probability theory, the interpretation of new information should depend on the prior probability of disease. We asked if this principle applies to interpreting the history in patients with chest pain. We compared the prevalence of coronary artery disease (CAD) in patients who had similar histories but who came from populations with different disease prevalence. PATIENTS AND METHODS: We studied two high-disease-prevalence populations (patients referred for coronary arteriography) and two low-disease-prevalence populations (patients from primary care practices). We used clinical characteristics of one arteriography population to develop a logistic rule for estimating the probability of coronary artery narrowing. The number of clinical findings determined the logistic score, which was proportional to the prevalence of CAD. RESULTS: The prevalence of CAD was much lower in the primary care population than in the arteriography population, even when patients with similar logistic scores, and thus similar clinical histories, were compared. CONCLUSION: A clinician must take account of the overall prevalence of disease in the clinical setting when using the patient's history to estimate the probability of disease. Failure to observe this caution may lead to errors in test selection and interpretation.

Adult↗
PubMed1990

Calcium activated neutral protease in blood cells from patients & carriers of Duchenne muscular dystrophy.

As blood cells such as platelets, lymphocytes and erythrocytes from patients with Duchenne muscular dystrophy show evidence of membrane alterations and elevation of intra-cellular calcium, one of the calcium related changes i.e., the activity of calcium activated neutral protease (CANP) was monitored and found to be elevated in erythrocytes, lymphocytes and platelets. As similar changes were observed in platelets of carriers of this disease, CANP in platelets may serve as a useful index for carrier detection.

Adult↗
PubMed1989

The effect of dexamethasone on chronic pulmonary oxygen toxicity in infant mice.

The effect of dexamethasone (0.1, 1, and 5 mg/kg/d given subcutaneously from d 14-18) was tested in infant mice continuously exposed from birth to either humidified air or 80% oxygen. Dexamethasone significantly decreased lung wet wt (p less than 0.01), lung water (p less than 0.021), lung dry wt, protein, and DNA (p less than 0.001) in both air- and oxygen-exposed animals. Dexamethasone, however, had no effect on lung compliance measured after animals were killed on d 18. It also had no effect on the increase in the blood-air barrier thickness or decrease in the blood-air exchange surface area seen in the 80% oxygen-exposed mice. Dexamethasone decreased thymus gland wt (p less than 0.001), body wt gain (p less than 0.001), brain wt (p less than 0.001), and lung lymphocytes (p less than 0.05) in both air- and oxygen-exposed animals. The effect of 1 mg/kg and 5 mg/kg of the drug could not be differentiated. During the 4 d of drug administration, one air- and one oxygen-exposed animal died; both received 5 mg/kg/d of dexamethasone; microscopic and culture evidence of infection was not found. If dexamethasone causes similar effects in human infants with bronchopulmonary dysplasia, it should be used with great caution even for short-term clinical management.

Animals↗
PubMed1987

Calcium-activated neutral protease and its endogenous inhibitor in tissues of dystrophic and normal mice.

Calcium-activated neutral protease (milli-CANP) and its endogenous inhibitor are elevated in muscle tissues, primarily the skeletal muscle and heart, of dystrophic mice (C57BL/6J dy/dy) as compared to the control strain (C57BL/10J). Tissues showing relative increase of CANP also show significant loss of enzymes such as CK, LDH in comparison to plasma, where these enzymes register a significant increase. PK is lost minimally from these tissues, probably showing a "sparing effect." Absence of any significant change in CANP activity in the liver points to a specific role of CANP in the dystrophic process. In the skeletal muscle the endogenous CANP inhibitor registers a concomitant increase with CANP without altering the enzyme/inhibitor ratio.

Animals↗
PubMed1984

Calcium-activated neutral protease from muscle and platelets of Duchenne muscular dystrophy cases.

Calcium-activated neutral protease (CANP) has been purified from its endogenous inhibitor and its activity is monitored in the muscle of Duchenne Muscular Dystrophy (DMD) patients. The specific activity of the enzyme is found to be significantly higher as compared to normal. CANP from platelets of DMD patients is significantly higher as compared to activities in other myopathies and controls. Platelet CANP, therefore, may prove to be an index of pathological condition in DMD, since other myopathies do not show such a significant change.

Adolescent↗
PubMed1984

Complications of rigid anterior chamber implants.

Despite accurate lens sizing, 100 eyes with rigid anterior chamber implants showed a high incidence of lens-related trauma postoperatively: pigment dispersion (pseudoguttata), angle recession, peripheral anterior synechiae, iris erosion/atrophy, iris holes from stretching, angle fibrosis, haptic tip erosion into sclera and iris, neovascularization of peripheral iris and angle, lens rotation through iridectomy and into ciliary body, lens tilting with corneal endothelial touch, high refractive cylinder with long intraocular lenses, pigment proliferation onto iris surface, partial slippage of the intraocular lens into vitreous following intracapsular procedure, and pupillary-block glaucoma. Vision results were good. Glaucoma and cystoid macular edema rates were low. Bullous keratopathy and retinal detachment didn't occur. High endothelial cell loss was associated with those lenses that "propellered" and those that tilted and touched endothelium. The adverse findings may be static or may represent a continuing process of tissue damage.

Adult↗
PubMed1979

Continuing medical education before audit.

Patient-care-assessment systems have failed to demonstrate efficiency in detecting continuing education needs or in influencing clinical practice. We believe that one of the weaknesses in retrospective audit systems is their tendency to result in the ratification of criteria which match past practices rather than criteria which incorporate new, science-based information. This is in spite of the fact that for many years guidelines for medical audit processes have encouraged physicians to develop science-based criteria. This study was undertaken to determine whether continuing education programs preceding patient care audits can induce physicians to choose criteria beyond their own experience. A highly significant difference was found between audit criteria developed after education programs and those which were developed without such programs. The results indicate that educational efforts can have a striking effect on the criteria ratified by audit committees.

California↗
PubMed1979

Astigmatism and the Flieringa ring.

Routine use of a Flieringa ring in conjunction with a large corneal section for intracapsular or extracapsular surgery facilitates more accurate wound closure and can significantly decrease the amount of postoperative astigmatism.

Astigmatism↗
PubMed1978

Kelman anterior chamber lens: a preliminary report.

The Kelman anterior chamber lens is thin and lightweight. Its design is unique for introduction through a small limbal incision following phacoemulsification or as a secondary implant. It can be used easily in conjunction with intracapsular or extra-capsular surgery. The postoperative course is quiet and short, and the patient has rapid visual rehabilitation with a comfortable eye.

Aged↗