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Biomedical subjects

R W Katz

Publications and source records attributed to R W Katz.

30 records · Page 2Linked to original sources
PubMed1989

IgA rheumatoid factor and IgA containing immune complexes in primary Sjögren's syndrome.

IgA rheumatoid factor (RF) and immune complexes containing IgA-IgG, C3-IgA, and C3-IgG from sera of patients with primary Sjögren's syndrome and controls were quantified by ELISA. Salivary tissue obtained from patients at the same time as serum was scored to simultaneously reflect lymphoplasmocytic infiltrate and fibrosis. Patients had significantly increased amounts of IgA RF and all complexes when compared to controls (p less than 0.0005). IgA-IgG complexes, thought to be IgG-IgA RF complexes, were inversely correlated to tissue pathology (p less than 0.001) and peripheral white blood cell counts. Additionally, IgA RF was inversely correlated to stimulated parotid flow. This suggests immune complex formation precedes tissue destruction or is associated with less destructive pathology in primary Sjögren's syndrome.

Adult↗
PubMed1988

Dissociative extraction and partial purification of osteogenin, a bone inductive protein, from rat tooth matrix by heparin affinity chromatography.

Implantation of demineralized tooth matrix in subcutaneous sites results in new bone formation locally. The osteoinductive activity of the tooth matrix was dissociatively extracted in 4.0 M guanidine hydrochloride and the residue was devoid of biologic activity. The bone inductive protein, osteogenin, was partially purified by heparin affinity chromatography. The heparin binding fraction initiated the bone differentiation cascade when implanted with guanidine extracted, inactive bone or tooth matrices. These results imply a cooperative interaction between the soluble osteogenin and collagenous substratum in bone induction.

Animals↗
PubMed1988

Multicentric reticulohistiocytosis.

A case of multicentric reticulohistiocytosis with prominent oral manifestations is described. The case is presented to emphasize the oral involvement since there appear to be no reports of this entity in the dental literature.

Adult↗
PubMed1988

Improving the outcome and efficiency of intensive care: the impact of an intensivist.

Data from two 3-month time periods before and after the arrival of a pediatric intensivist were collected prospectively and compared to determine the intensivist's impact on ICU mortality, use of monitoring and therapeutic modalities, and efficiency of ICU bed utilization. Severity of illness and care modalities were determined daily for all patients with the Physiologic Stability Index and the Therapeutic Intervention Scoring System. The only major organizational change in the postintensivist period was the organization and implementation of a daytime ICU team. Case mix variables, including sex; medical/surgical, emergency/elective, and diagnostic distributions; and nursing hours/patient day, were equivalent in the pre-intensivist and postintensivist samples. After the intensivist's arrival, there was a significant decrease in admissions with very low severity of illness (Physiologic Stability Index less than 4; 52% vs. 34%; p less than .05) and a significant decrease in bed utilization by patients who received only monitoring services (27% vs. 17% of bed days; p less than .001). The severity of the illness-adjusted ICU mortality rate was significantly higher in the pre-intensivist period than in the postintensivist period (weighted mean mortality difference 5.3 +/- 2.6%; p less than .05). The incidence of both therapeutic and monitoring modalities increased in the postintensivist period. These results indicate that a pediatric intensivist can improve mortality rates and efficiency of bed utilization in the pediatric ICU.

Critical Care↗
PubMed1988

Oral defense mechanisms are impaired early in HIV-1 infected patients.

We have examined the hypothesis that individuals infected with human immune deficiency virus type 1 (HIV-1) experience significant, specific alterations in mechanisms protecting the oral cavity prior to the appearance of AIDS-related systemic opportunistic infections. In a study of 13 early-stage, stable anti-HIV antibody positive patients, parotid salivary function was found to be generally intact. In contrast, several indicators of submandibular gland dysfunction were detected. In particular, stimulated fluid output was decreased and salivary lysozyme levels were increased relative to controls by 50-60% for both resting (p less than 0.05) and stimulated (p less than 0.001) conditions. Also, the frequency of albumin detection in submandibular saliva samples was approximately 65% in HIV-1 infected patients vs. 0% in controls (p less than 0.05). In addition, cytologic evaluation of oral mucosa revealed a fivefold increase in the prevalence of candidal hyphae in HIV-1 infected patients compared to controls (41% vs. 8%, p less than 0.05). We conclude that normal oral defense mechanisms show signs of compromise in HIV-1 infected individuals. We suggest that (a) effects of HIV-1 infection are seen early in the oral cavity, (b) impairment of oral defense mechanisms may facilitate entry of microorganisms with an attendant increased risk of morbidity and mortality, and (c) intensive oral surveillance and prophylactic care should be part of the routine management afforded to AIDS patients soon after HIV-1 infection is recognized.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Efficiency of intensive care. A comparative analysis of eight pediatric intensive care units.

To calculate overall pediatric intensive care unit (PICU) efficiency rates, 1668 patients representing 6962 patient-days were studied in eight PICUs. The contributions to inefficiency by two patient groups--low-risk monitored patients and potential early-discharge patients--were quantified using measures of daily mortality risk and therapeutic assessments. Low-risk monitored patients never received a unique PICU therapy and had daily mortality risks less than 1%. Potential early-discharge patients were similar to the low-risk monitored patients except that their unnecessary PICU use came only on their last consecutive day(s) of PICU stay. Efficiency ratings ranged from 0.894 to 0.547 in the eight PICUs. Low-risk monitored patients constituted from 16% to 58% of the PICU patient populations and used from 5.4% to 34.5% of the total days of care. Potential early-discharge patients constituted from 12% to 29% of the populations and the potential early-discharge days of care ranged from 5.1% to 17.2% of the total days of care. These results indicate that large disparity exists in efficiency among PICUs. Efficiency rates of greater than 0.80 seem to be a reasonable goal.

Child↗
PubMed1987

Mortality associated with multiple organ system failure and sepsis in pediatric intensive care unit.

Seven hundred twenty-six patients from five pediatric intensive care units were studied to determine the association of multiple organ system failure (MOSF) with mortality and to test the hypothesis that MOSF associated with sepsis has a higher mortality rate than MOSF without sepsis. There were 177 (24%) patients with MOSF and 83 (11%) nonsurvivors of MOSF. The mortality rates for two, three, or four or more failed organ systems were 26%, 62%, and 88%, respectively (P less than 0.001). Eighty-four (47%) patients with MOSF had associated sepsis. Sepsis (both bacteremia and clinical sepsis syndrome) did not significantly increase mortality rates in the groups with organ system failure. Mortality rates for patients with sepsis before or within 24 hours of development of MOSF (early sepsis) did not differ from mortality rates for those patients with onset of sepsis more than 24 hours after developing MOSF (late sepsis, 53% vs 33%, P = NS). We conclude that underlying pathophysiologic mechanisms of MOSF other than sepsis are as important as sepsis in critically ill pediatric patients.

Child↗
PubMed1983

Pulmonary artery catheterization in pediatric intensive care.

Pulmonary artery catheterization has become a routine part of pediatric intensive care even for small infants. Measured and derived variables provide clinicians with better understanding of the patient's cardiovascular and pulmonary systems and provide the means by which the results and complications of therapy may be monitored. While significant complications from pulmonary artery catheterization do occur, the risks are acceptable and warranted. Proper patient selection, strict attention to detail in all aspects of catheter use, and prompt removal will help to minimize complications.

Blood Pressure↗
PubMed1978

Aneurysm of azygous anterior cerebral artery. A case report.

This report describes a patient with a fusiform aneurysm of an azygous anterior cerebral artery (ACA) associated with a ruptured saccular aneurysm at its distal end. Gross, microscopic, and radiological documentation of this anomaly is presented. It is suggested that in cases where the question of an unpaired ACA arises, a projection paralleling the radiological baseline be employed during angiographic studies thus affording better visualization of these vessels. Clinically, in patients with pericallosal aneurysms, their frequent association with azygous ACA's should be borne in mind, as injury to this common arterial trunk will affect both hemispheres and the corpus callosum with tragic results.

Cerebral Arteries↗
PubMedDate not supplied

Total financial management.

Total financial management is a program designed by author Robert Katz, M.S., C.P.A., which says that by managing from the top down, the physician/administrator team can regain control of the practice and its major financial centers. His article describes the two-phased approach to total financial management.

Accounts Payable and Receivable↗
PubMedDate not supplied

An analysis of compound and complex odontomas.

Three hundred ninety-six odontomas were included in this study, with each case assigned to one of three categories using commonly accepted histologic criteria for compound and complex forms. Analysis revealed that compound odontomas were the most common type (70 percent of all cases). They were most common in the 11 to 15-year-old age-group and in the maxillary incisor area or the canine regions of either jaw. There was a nearly equal sex distribution. Complex odontomas showed similar age and sex distribution; they had a greater tendency to occur in the molar regions. Complex odontomas were also associated with unerupted teeth more often than compound odontomas. Tooth agenesis in the area of an odontoma or the impaction of a primary tooth by an odontoma occurred infrequently. This study showed that there is a correlation between the site of an odontoma and the age at which it is generally treated.

Adolescent↗