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Biomedical subjects

M Katz

Publications and source records attributed to M Katz.

At least 703 records · Page 39Linked to original sources
PubMedDate not supplied

Medicinal marijuana: a comprehensive review.

Considerable controversy exists regarding the role of marijuana as a therapeutic agent; however, many practitioners are taught very little about existing marijuana data. The authors therefore undertook a comprehensive literature review of the topic. References were identified using textbooks, review and opinion articles, and a primary literature review in MEDLINE. Sources were included in this review based primarily on the quality of the data. Some data exists that lends credence to many of the claims about marijuana's properties. In general, however, the body of literature about marijuana is extremely poor in quality. Marijuana and/or its components may help alleviate suffering in patients with a variety of serious illnesses. Health care providers can best minimize short term adverse consequences and drug interactions for terminally ill patients by having a thorough understanding of the pharmacology of marijuana, potential adverse reactions, infection risks, and drug interactions (along with on-going monitoring of the patient). For chronic conditions, the significance and risk of short and long term adverse effects must be weighed against the desired benefit. Patients who are best suited to medicinal marijuana will be those who will gain substantial benefit to offset these risks, and who have failed a well-documented, compliant and comprehensive approach to standard therapies.

Cannabis↗
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Adverse metabolic effects of antiparasitic drugs.

Several drugs are available for mass campaigns against enteric helminths. Mebendazole and pyrantel pamoate are quite effective against ascariasis and reasonably effective against the hookworms. Only mebendazole is effective against trichuriasis. Two drugs have recently been introduced for mass therapy of schistosomiasis, but they remain experimental, pending further evaluation. Other drugs are mentioned, and possible adverse metabolic effects are discussed. The fundamental question remaining is whether the eradication of certain parasites will improve the nutritional status of the infected populations.

Animals↗
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Spiral CT and 3D image reconstruction of vascular rings and associated tracheobronchial anomalies.

OBJECTIVE: Spiral CT (SCT) angiography and three-dimensional (3D) reconstruction methods represent noninvasive tools in diagnosis of vascular rings and associated tracheobronchial anomalies in the pediatric age group. MATERIALS AND METHODS: Three patients suspected on clinical and conventional radiological grounds of having vascular and tracheobronchial anomalies were examined using SCT. Three-dimensional images were reconstructed using a surface rendering technique. RESULTS: In one case the diagnosis of complete double aortic arch was confirmed by angiography. In the other two patients the SCT and 3D reconstruction established the diagnosis of pulmonary sling and right aortic arch associated with left aberrant subclavian artery and angiography could be avoided. CONCLUSION: Spiral CT and color-coded 3D reconstruction represent important additional tools and perhaps alternatives to angiography or other noninvasive techniques used in evaluation of vascular anomalies of the thoracic aorta and pulmonary arteries in infants and children.

Aorta, Thoracic↗
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Babesiosis.

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Animals↗
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Praziquantel.

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Animals↗
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Issues in implementing prenatal screening for cystic fibrosis: results of a working conference.

PURPOSE: To summarize a conference convened to examine how cystic fibrosis screening might appropriately be introduced into routine prenatal practice. METHODS: Participants included experts from various relevant disciplines. Systematic reviews and data from individual trials were presented; issues were identified and discussed. RESULTS: Judged by published criteria, prenatal cystic fibrosis screening is suitable for introduction. Screening can be performed cost-effectively by identifying racial/ethnic groups at sufficient risk and then using either of two models for delivering laboratory services. Validated educational materials exist. Ethical issues are not unique. CONCLUSIONS: Once adequate facilities for patient and provider education, testing, counseling, quality control, and monitoring are in place, individual programs can begin prenatal screening for cystic fibrosis.

Clinical Trials as Topic↗
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Epilepsy in children with mental retardation: a cohort study.

The cumulative risk of seizures and epilepsy was investigated in a prospectively identified cohort of 221 children with mental retardation (MR) born between 1951 and 1955 in Aberdeen, Scotland. By age 22 years, 33 (15%) had epilepsy. An additional 16 (7%) had had at least one seizure, but did not meet the criteria for epilepsy. The cumulative risk of epilepsy was 9, 11, 13, and 15% at 5, 10, 15, and 22 years, respectively. In children with MR and no associated disabilities, the cumulative risk of epilepsy was only 2.6, 3.2, 3.9, and 5.2% at 5, 10, 15, and 22 years. In children with MR and cerebral palsy (CP), the cumulative risk was 28, 31, and 38% at 5, 10, and 22 years. Children with a postnatal injury associated with MR had a cumulative risk of epilepsy of 53, 66, and 66% at 5, 10, and 15 years after the injury. By age 22 years, 39% had achieved 5-year seizure-free remission, including 56% of children with MR without associated disability, 47% of children with MR and CP, and 11% of children with a postnatal injury. We conclude that, in the absence of associated disability or postnatal injury, the risk of epilepsy in the retarded population is low. Epilepsy in this population also will frequently enter remission in later life.

Adolescent↗
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Early detection of preterm labor: ambulatory home monitoring of uterine activity.

Most women who experience preterm labor cannot receive long-term tocolysis mainly because of belated diagnosis. To detect excessive uterine contractions, an ambulatory tocodynamometer was developed. Sixty-two women, at high risk for preterm labor, monitored uterine activity between 20 and 36 weeks' gestation daily for a total of 200 minutes per day. Twenty-nine women (47%) had episodes of preterm labor. All the episodes were diagnosed by the device, and tocolysis was begun. The mean gestational age at which diagnosis was made was 28 +/- 2 (mean +/- SD) weeks, and the mean time gained in utero was 7.5 +/- 2.6 weeks. The data indicate that ambulatory home monitoring may represent a new and effective means for accurate and early diagnosis of preterm labor.

Female↗
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Congenital hemangiopericytoma/infantile myofibromatosis: radical surgery versus a conservative "wait and see" approach.

Infantile/congenital hemangiopericytoma, although sharing many similar histological features with adult hemangiopericytoma, has a much better prognosis. Nevertheless, most cases described in the literature were pursued by radical surgery with or without adjuvant chemotherapy. We describe a neonate who presented with a huge mass in the right gluteus, 6 x 5 x 4 cm, and a small ventral abdominal mass. The masses were confirmed on biopsy according to light microscopy, immunohistochemistry, and electron microscopy as congenital hemangiopericytoma. They shrank spontaneously within 2 weeks and vanished within 2 months. We present a hypothesis that masses appearing in the neonatal period with this histology and with no life-endangering pressure on vital organs should routinely be dealt with conservatively.

Adult↗
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Intracellular proteolysis of pancreatic zymogens.

Activation of pancreatic digestive zymogens within the pancreatic acinar cell may be an early event in the development of pancreatitis. To detect such activation, an immunoblot assay has been developed that measures the relative amounts of inactive zymogens and their respective active enzyme forms. Using this assay, high doses of cholecystokinin or carbachol were found to stimulate the intracellular conversion of at least three zymogens (procarboxypeptidase A1, procarboxypeptidase B, and chymotrypsinogen 2) to their active forms. Thus, this conversion may be a generalized phenomenon of pancreatic zymogens. The conversion is detected within ten minutes of treatment and is not associated with changes in acinar cell morphology; it has been predicted that the lysosomal thiol protease, cathepsin B, may initiate this conversion. Small amounts of cathepsin B are found in the secretory pathway, and cathepsin B can activate trypsinogen in vitro; however, exposure of acini to a thiol protease inhibitor (E64) did not block this conversion. Conversion was inhibited by the serine protease inhibitor, benzamidine, and by raising the intracellular pH, using chloroquine or monensin. This limited proteolytic conversion appears to require a low pH compartment and a serine protease activity. After long periods of treatment (60 minutes), the amounts of the active enzyme forms began to decrease; this observation suggested that the active enzyme forms were being degraded. Treatment of acini with E64 reduced this late decrease in active enzyme forms, suggesting that thiol proteases, including lysosomal hydrolases, may be involved in the degradation of the active enzyme forms. These findings indicate that pathways for zymogen activation as well as degradation of active enzyme forms are present within the pancreatic acinar cell.

Animals↗
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Hypercholesterolemia in long-term survivors of heart transplantation: an early marker of accelerated coronary artery disease.

Coronary artery disease remains a significant long-term problem for survival after heart transplantation. Hyperlipidemia is a known risk factor for coronary artery disease in the general population, but the role of hyperlipidemia in cardiac allograft recipients has not been elucidated. To study this problem, we retrospectively reviewed 38 heart transplant recipients who survived more than 3 years after surgery and looked at age, development of diabetes, drug protocol, and development of hypercholesterolemia for a possible correlative or predictive value to the development of early coronary artery disease after heart transplantation. Eleven patients were identified as having coronary disease by the third year after transplantation. High-risk cholesterol values (in milligrams per deciliter) at 6 months after heart transplantation were defined as follows: for ages 10 to 20, 190; 20 to 30, 220; 30 to 40, 240; 40+, 260. We found a strong predictive value with high-risk lipid profiles (p less than 0.01) for the development of coronary artery disease by the third year. No significance was found for a low-risk value, the development of diabetes, or hypertension. All patients below the age of 20 years had coronary artery disease by the third year after transplantation. We conclude that a high-risk cholesterol value at 6 months after transplantation is a strong predictor for development of accelerated coronary artery disease and early graft failure. This has major implications for management of hyperlipidemia in the cardiac allograft recipient.

Adult↗