Search PubMed⌕ Search

Biomedical subjects

P Katz

Publications and source records attributed to P Katz.

At least 37 records · Page 2Linked to original sources
PubMed1994

Magnesium deficiency in the eosinophilia-myalgia syndrome. Report of clinical and biochemical improvement with repletion.

We describe a patient with the eosinophilia-myalgia syndrome (EMS) with persistent myalgias, cramping, and weakness that were not responsive to treatment. Despite a normal serum magnesium level, a loading study was performed, and the results suggested low tissue levels of magnesium. He was given parenteral magnesium and had dramatic improvement in symptoms as well as in muscle intracellular levels of this cation. After cessation of magnesium therapy the symptoms recurred, and magnesium repletion again led to an improvement in symptoms and ATP levels. Low tissue levels of magnesium, even in the setting of normal serum levels, may lead to the neuromuscular symptoms in EMS and related disorders.

Adenosine Triphosphate↗
PubMed1994

Exercise and the immune response.

The data presented here document that exercise is associated with changes in immunological activity as assessed by a variety of in vitro assays. In general, these changes appear to be temporally associated with activity and are not persistent. In fact, most alterations are probably secondary to exercise-induced hormonal changes, with resultant effects on the intravascular composition of immunocompetent cells. Thus, changes in lymphocyte trafficking induced by hormonal effects lead to relative and absolute differences in cell numbers, which may be reflected in in vitro functional assays. These data argue against any profound impact of exercise on the immune system, which might impact on overall health. Furthermore, there is little information about exercise decreasing the number of infectious illnesses or diminishing the likelihood of immunologically mediated conditions or malignancies. Nevertheless, these results should not be construed as an argument against the tangible health benefits of exercise. The changes in life-style which often accompany exercise programmes, as well as the documented benefits for cardiovascular health, are reasons enough to support these activities.

Antibody Formation↗
PubMed1994

Eosinophilia-myalgia syndrome not associated with the ingestion of nutritional supplements.

The eosinophilia-myalgia syndrome (EMS) is a recently recognized illness characterized by peripheral eosinophilia, myalgias, and a variety of neurologic, cutaneous, and pulmonary features. Most of those afflicted with this disorder consumed L-tryptophan, but some cases have occurred in association with the ingestion of other nutritional supplements. We describe someone who developed EMS in 1986 without the ingestion of any nutritional supplements. He was also found to have slowed P450 metabolism, in a pattern seen in other patients with EMS. We postulate that EMS can occur in association with the ingestion of multiple substances that share minute quantities of a common, as yet unidentified, toxin(s), and that metabolic host factors may contribute to disease susceptibility.

Adult↗
PubMed1994

Approach to the patient with rheumatoid arthritis.

RA remains a therapeutic challenge. Despite substantial data from therapeutic trials, the precise therapy of this often debilitating disease remains controversial. A variety of agents are available to the clinician for the treatment of this disease, yet the precise timing of their use and the determination of situations in which efficacy is most likely to be observed is still unclear. However, it is obvious that earlier intervention and more aggressive forms of therapy are currently advocated by most rheumatologists. Given the rapidity with which this disease can induce substantial morbidity, the use of second-line agents early in the course of this process is warranted. Whether or not combination therapy provides any benefit is still unproved. As our understanding of the pathogenic mechanisms involved in the development of RA evolve, and with the development of newer immunomodulatory agents, it is likely that more specific forms of therapy can be developed. It is hoped that these protocols will permit more precise treatment of the abnormalities leading to this disease without global suppression of the immune system or other unacceptable side effects.

Anti-Inflammatory Agents↗
PubMed1994

P-31 magnetic resonance spectroscopy of skeletal muscle in the eosinophilia-myalgia syndrome: a preliminary study.

OBJECTIVE: To determine the pathogenesis of muscular symptomatology in the eosinophilia-myalgia syndrome (EMS). METHODS: P31-nuclear magnetic resonance spectroscopy (MRS) was performed on 7 patients with EMS and 10 age matched controls to determine the relative concentrations of phosphocreatine (PCr), inorganic phosphate (Pi), and adenosine triphosphate (ATP) in calf muscle. RESULTS: Patients with EMS had statistically lower ATP/PCr ratios and higher Pi/ATP ratios than controls, indicating a preferential and unique decrease in ATP levels at rest in skeletal muscle. CONCLUSION: Skeletal muscle is metabolically abnormal in patients with EMS. This abnormality may contribute to the myalgia, spasm, and weakness seen in this disorder.

Adenosine Triphosphate↗
PubMed1993

Bronchiolitis obliterans organizing pneumonia associated with essential mixed cryoglobulinemia.

Bronchiolitis obliterans organizing pneumonia (BOOP) is an uncommon and underrecognized pathologic finding observed in a variety of syndromes including connective tissue diseases. Although lung involvement in essential mixed cryoglobulinemia (EMC) has been reported, there are no previous reports of BOOP in EMC. We report herein a case of longstanding EMC associated with interstitial and cavitary lung disease histologically consistent with BOOP. A theory of a possible etiologic basis for the development of BOOP in patients with connective tissue diseases is discussed.

Biopsy↗
PubMed1993

Work disability among adults with asthma.

OBJECTIVE: To estimate the incidence of work disability among adults with asthma and to evaluate a clinically based illness severity score as a predictor of such disability. DESIGN: Baseline and follow-up telephone interviews and medical record review. SETTING: University-based outpatient pulmonary specialty practice. PATIENTS: Fifty-six patients interviewed at baseline; 42 reinterviewed 2 years later. MEASUREMENTS: Work disability ascertained by interview report and defined as change in job duties, reduction in pay, or change in job or employment status attributed to asthma. Severity of asthma score derived from medical records and based on respiratory symptom frequency, asthma history, and prescribed medications. Pulmonary function by routine testing. Logistic regression analysis of the 5-year incidence of work disability on severity score and forced expiratory volume in 1 s (FEV1). RESULTS: The 5-year work disability cumulative incidence was 19 percent for change in duties, 17 percent for reduction in pay, 20 percent for change in job or work status, and 36 percent for any of these measures. The median asthma score was 10 (range, 2 to 26). The mean FEV1 as a percent predicted (FEV1 percent) was 88 +/- 25 percent. Score and FEV1 percent were statistically correlated (r = -0.6, p < 0.0001). Severity of asthma score statistically predicted each measure of work disability (p < 0.01). Addition of FEV1 percent added little additional explanatory power to the logistic regression model (maximum chi 2 = 1.3, p > 0.2). CONCLUSIONS: Work disability is common among adults with asthma. A severity of asthma score based on clinical variables is statistically correlated with lung function but appears to be a stronger predictor of disability than airflow measured at one point in time.

Adolescent↗
PubMed1993

[New treatment method for salivary lithiasis].

The author developed a new original method of exploration and treatment of salivary glands: ultrafine fibroscopy. After having briefly described the material, as well as the method and indications, he shows how lithiases can now be extracted through natural pathways thanks to the manufacture of a miniaturized basket probe, avoiding major surgery.

Endoscopy↗
PubMed1993

Ectopic pregnancy in the United States: economic consequences and payment source trends.

OBJECTIVE: To estimate the annual direct and indirect costs of ectopic pregnancy in the United States and to examine trends in payment source. METHODS: We analyzed hospital discharge data for 1982-1989 from a San Francisco hospital and California statewide data for 1983-1987 to estimate direct medical care costs and to determine payment sources. Examination of national labor data was used to compute indirect cost. RESULTS: The total cost of ectopic pregnancy in 1990 was estimated to be nearly $1.1 billion. Direct costs of hospitalization and other medical treatment contributed 77% of the total costs, with average hospital costs estimated to be $6079, hospitalization-related physician fees $3254, and average outpatient costs $149, for a total direct cost-per-case of $9482. Of the total indirect costs ($250.5 million), 67% was attributed to the value of lost wages and the remainder to the lost value of household management. Public payment sources covered the largest portion of ectopic pregnancy-related direct costs among women aged 19 and younger (35%), but private insurance covered the largest portion among women aged 20-29 (32%) and women aged 30 and older (43%). In general, the proportion of payments made by private insurance has decreased, while the proportion of payments made by public pay sources and health maintenance organizations and preferred provider organizations has increased. CONCLUSIONS: Ectopic pregnancy results in a substantial economic burden, with an increasing share of direct costs being borne by public pay sources. Appropriate use of cost-effective management approaches can reduce costs, while preventive measures that decrease the risk of ectopic pregnancy can both save resources and, more important, spare human suffering.

Adolescent↗
PubMed1992

Dyspnea and pulmonary function in the L-tryptophan-associated eosinophilia-myalgia syndrome.

We reviewed the pulmonary history, dyspnea ratings, and pulmonary function test results in 16 patients with L-tryptophan-induced eosinophilia myalgia syndrome to determine the correlation between reported pulmonary complaints and pulmonary function abnormalities. All patients reported pulmonary symptoms. Dyspnea, seen in 14 of 16 (87 percent) patients, was the most common symptom. The severity of dyspnea was graded by the baseline dyspnea index and the oxygen cost diagram. Pulmonary function testing including maximal static inspiratory and expiratory pressures were measured. The DCO was diminished in 12 of 16 (75 percent) patients. The MSIP was decreased in seven out of ten (70 percent) and the MSEP was decreased in nine out of ten (90 percent) of those patients tested. There was a statistically significant correlation between the severity of dyspnea as graded by the BDI and OCD, and the decrease in DCO. These results and a review of the literature of the pulmonary manifestations of EMS lead us to conclude that patients with EMS have a high prevalence of dyspnea, and it appears to be caused by both lung parenchymal involvement, as well as respiratory muscle weakness.

Adult↗
PubMed1991

Cost of and payment source for pelvic inflammatory disease. Trends and projections, 1983 through 2000.

Pelvic inflammatory disease (PID) and its sequelae affect millions of women in the United States at substantial costs. To estimate these total costs annually and to determine payment sources, we analyzed data from local, state, and national sources. Direct costs for PID and PID-associated ectopic pregnancy and infertility were estimated to be $2.7 billion, and indirect costs were estimated to be $1.5 billion, for a total cost of $4.2 billion in 1990. Overall, private insurance covered the largest portion of the direct costs of PID (41%), followed by public payment sources (30%). However, the proportion of payments made by private insurance appears to be decreasing, while that by public payment sources is increasing. In the year 2000, costs associated with PID are projected to approach $10 billion if the current PID incidence persists, with an increasing proportion of this expense burdening public institutions. Prevention of PID is needed both to reduce human suffering and to contain rising costs.

Adult↗