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Biomedical subjects

A Moskowitz

Publications and source records attributed to A Moskowitz.

At least 19 recordsLinked to original sources
PubMed2001

High vegetable and fruit diet intervention in premenopausal women with cervical intraepithelial neoplasia.

OBJECTIVE: To examine whether diet intervention can promote increased vegetable and fruit intake, as reflected in increased plasma carotenoid and decreased plasma total homocysteine concentrations, in premenopausal women with cervical intraepithelial neoplasia, a precancerous condition. DESIGN: Randomized controlled diet intervention study. SUBJECTS: Fifty-three free-living premenopausal women who had been diagnosed with cervical intraepithelial neoplasia, were randomly assigned to an intervention (n = 27) or a control (n = 26) group. INTERVENTION: Individualized dietary counseling to increase vegetable and fruit intake. MAIN OUTCOME MEASURES: Diet was assessed by food frequency questionnaire. Plasma carotenoids and total homocysteine were measured at enrollment and at 6 months follow up. ANALYSIS: Associations between baseline plasma concentrations of carotenoids and homocysteine and influencing factors were examined with multiple regression analysis. Repeated measures analysis of variance was used to test for group by time effects in these plasma concentrations. Plasma carotenoids at baseline and 6 months in the study groups, and differences in homocysteine concentrations from baseline to 6 months, were compared with independent sample t tests. RESULTS: Repeated measures analysis of variance showed significant group by time effects (P<.01) in plasma carotenoid and homocysteine concentrations. In the intervention group, total plasma carotenoids increased by an average of 91%, from 2.04+/-0.13 (mean+/-standard error of the mean) to 3.90+/-0.56 micromol/L and plasma total homocysteine was reduced by 11%, from 9.01+/-0.40 to 8.10+/-0.44 micromol/L (P<.003). Neither changed significantly in the control group. APPLICATIONS: Individualized dietary counseling can effectively promote increased vegetable and fruit intake in premenopausal women. This dietary pattern may reduce risk for cancer and other chronic diseases and also promote an improvement in folate status.

Adult↗
PubMed2001

The contribution of early traumatic events to schizophrenia in some patients: a traumagenic neurodevelopmental model.

The current diathesis-stress model of schizophrenia proposes that a genetic deficit creates a predisposing vulnerability in the form of oversenstivity to stress. This model positions all psychosocial events on the stress side of the diathesis-stress equation. As an example of hypotheses that emerge when consideration is given to repositioning adverse life events as potential contributors to the diathesis, this article examines one possible explanation for the high prevalence of child abuse found in adults diagnosed schizophrenic. A traumagenic neurodevelopmental (TN) model of schizophrenia is presented, documenting the similarities between the effects of traumatic events on the developing brain and the biological abnormalities found in persons diagnosed with schizophrenia, including overreactivity of the hypothalamic-pituitary-adrenal (HPA) axis; dopamine, norepinephrine, and serotonin abnormalities; and structural changes to the brain such as hippocampal damage, cerebral atrophy, ventricular enlargement, and reversed cerebral asymmetry. The TN model offers potential explanations for other findings in schizophrenia research beyond oversensitivity to stress, including cognitive impairment, pathways to positive and negative symptoms, and the relationship between psychotic and dissociative symptomatology. It is recommended that clinicians and researchers explore the presence of early adverse life events in adults with psychotic symptoms in order to ensure comprehensive formulations and appropriate treatment plans, and to further investigate the hypotheses generated by the TN model.

Adult↗
PubMed1998

Diabetes care for Medicare beneficiaries. Attitudes and behaviors of primary care physicians.

OBJECTIVE: To obtain information related to primary care physician (PCP) attitudes, knowledge, and practice patterns, as well as perceptions about barriers to care and the use of materials to assist in the delivery of diabetes care for elderly patients in the office setting. RESEARCH DESIGN AND METHODS: A survey was mailed to a random sample (n = 900) of PCPs (internal medicine, family practice, and general practice physicians and endocrinologists) from the states of Alabama, Iowa, and Maryland who met selection criteria and provided diabetes care to > or = 25 Medicare beneficiaries during calendar year 1993. RESULTS: Respondents provided self-reported information regarding diabetes care for elderly patients. PCP respondents (n = 370) considered blood glucose control to be the most important treatment goal. Most respondents (92%) considered acceptable GHb values to be those < 8%. Blood pressure measurement and foot inspections for the detection of ulcers and infection were the most commonly reported routine procedures performed as part of an office visit. Laboratory tests reported to be frequently ordered included GHb, serum creatinine, and proteinuria tests. Patient nonadherence to the treatment regimen was reported to be the most common barrier to care. The majority of respondents reported using two treatment aids in caring for patients with diabetes. CONCLUSIONS: The results of this study provide some evidence that PCP self-reported attitudes, knowledge, and practice patterns in delivering diabetes care for elderly patients in the office setting more closely reflect current recommended practice than reported in previous physician surveys. Opportunities for improvement still exist.

Alabama↗
PubMed1997

An international comparison of cancer survival: Toronto, Ontario, and Detroit, Michigan, metropolitan areas.

OBJECTIVES: This study examined whether socioeconomic status has a differential effect on the survival of adults diagnosed with cancer in Canada and the United States. METHODS: The Ontario Cancer Registry and the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program provided a total of 58,202 and 76,055 population-based primary malignant cancer cases for Toronto, Ontario, and Detroit, Mich, respectively. Socioeconomic data for each person's residence at time of diagnosis were taken from population censuses. RESULTS: In the US cohort, there was a significant association between socioeconomic status and survival for 12 of the 15 most common cancer sites; in the Canadian cohort, there was no such association for 12 of the 15 sites. Among residents of low-income areas, persons in Toronto experienced a survival advantage for 13 of 15 cancer sites at 1- and 5-year follow-up. No such between-country differentials were observed in the middle- or high-income groups. CONCLUSIONS: The consistent pattern of a survival advantage in Canada observed across various cancer sites and follow-up periods suggests that Canada's more equitable access to preventive and therapeutic health care services is responsible for the difference.

Health Services Accessibility↗
PubMed1995

Expression of quinone reductase activity in embryonal and adult porcine tissues.

Quinone reductase (QR; EC 1.6.99.2) is recognized as a major antimutagenic/anticarcinogenic enzyme in the organism. Our recent studies demonstrated the presence of significant QR activity in the early human placenta; whether this enzyme is expressed by the mammalian embryo is not known at present. In the investigation reported here, we sought to determine whether or not QR activity is detected in porcine embryonal tissues and if so, how early this expression takes place. In addition, the enzyme activity in the embryo was compared to that present in adult porcine tissue. Enzyme activity was determined by a colorimetric method with menadione as substrate in the presence of tetrazolium salt (MTT). NADH was a preferable cofactor in the embryo, whereas in the adult tissues NADPH was a better cofactor. Results show that the enzyme is present in all the embryonal organs tested from a very early age (30 days of gestation). Among the organs tested, activity was highest in the porcine embryo liver, and the specific activity remained unchanged until Day 70. Activity in the embryonal kidney increased with advancing gestation. The enzyme activity in embryonal tissues was much lower than that measured in the adult liver (30-40-fold). These findings suggest that the embryo has the potential for inactivating carcinogens/mutagens that will subsequently be eliminated by the maternal organism, thus protecting against adverse environmental impacts during the most critical period of development.

Animals↗
PubMed1993

Surgical and clinical results of scoliosis surgery using Zielke instrumentation.

All patients with idiopathic thoracolumbar or lumbar scoliosis treated by a single surgeon with a single-stage fusion with Zielke instrumentation and a minimum 2-year follow-up were reviewed. Thirty-two patients were reviewed (94% follow-up), 13 adolescents and 19 adults. All patients were evaluated clinically and radiographically, as well as psychosocially. There were no major complications. The average curve correction was 73%. The instrumentation was kyphogenic, but this did not affect the overall sagittal contour or the clinical results. Back pain was significantly improved, as was cosmesis. The Zielke device was found to be an effective device for the correction of thoracolumbar and lumbar curves in selected adolescents and adults.

Adolescent↗
PubMed1992

Development of lateral interactions in the infant visual system.

The development of lateral inhibitory interactions in the infant visual system, as reflected by the visual-evoked potential (VEP), was studied using a radial, asymmetrical windmill-dartboard stimulus. This contrast-reversing stimulus generates VEP responses with a strong fundamental frequency component and an attenuated second harmonic component (relative to that obtained using a symmetrical stimulus). These two harmonic components reflect distinct phenomena, and appear to be the result of short-range (the fundamental) and long-range (attenuated second harmonic) lateral inhibitory interactions elicited by differential luminance-modulation of contiguous spatial regions. We studied the development of the short- and long-range interactions at 100% and 30% contrast in human infants using both VEP amplitude and phase measures. Attenuation of the second harmonic (long-range interactions) was adult-like by 8 weeks of age while the strength of the fundamental (short-range interactions) was adult-like by 20 weeks suggesting a differential development of long-range and short-range interactions. In contrast, corresponding phase data indicated significant immaturities at 20 weeks of age for both the short- and long-range components.

Contrast Sensitivity↗
PubMed1992

Infant VEP and preferential looking acuity measured with phase alternating gratings.

Previously, infants' grating acuity was found to be temporally tuned, but adults' grating acuity was not. In infants, acuity was higher for gratings phase alternating at 7.5 and 14 reversals/sec than for stationary gratings and gratings alternating at 2.5 or 23 reversals/sec. Also, when preferential looking (PL) and visually evoked potential (VEP) acuity were estimated with phase alternating gratings (14 reversals/sec), the acuity difference between the two techniques was smaller than that obtained when phase alternating gratings were used to estimate VEP acuity and stationary gratings were used to estimate PL acuity. In the present study, it was determined if PL grating acuity was tuned in older children and if the smaller difference between VEP and PL acuity found when infants were tested with phase alternating gratings was independent of temporal rate. Grating acuity in infants older than 2 yr was found to be not tuned, and the smaller difference between VEP and PL grating acuity in infants when both were measured with phase-alternating gratings was not rate dependent. VEP acuity and PL acuity for phase alternating gratings developed at different rates, converging to nearly equivalent levels by 12 mo of age.

Aging↗
PubMed1990

Surface electrical stimulation versus brace in treatment of idiopathic scoliosis.

Surface electrical stimulation using the ScoliTron device was applied to 40 adolescent patients for treatment of idiopathic scoliosis. Adequate follow-up was available for 30 of these patients. The overall failure rate was 15 of 30 or 50%. Due to curve progression while using the ScoliTron, these patients either went on to a fusion (9 of 15) or were changed to a brace (6 of 15). The remaining 15 patients were considered successes with no curve progression (10 of 30 or 33%) or successful/failures with slight curve progression not requiring a change in treatment (5 of 30 or 17%). None of the various parameters analyzed were found to be useful indicators of successful treatment using the ScoliTron device. Electrical stimulation was found to be ineffective in preventing curve progression for idiopathic scoliosis.

Adolescent↗
PubMed1989

Evoked potential and preferential looking correlates of the oblique effect in 3-month-old infants.

Sensitivity for vertical and horizontal gratings is higher than for obliquely oriented gratings, a phenomenon known as the oblique effect. We compared visual evoken potential and preferential looking estimates of the oblique effect in nonastigmatic 3-month-old infants and found that orientation effects occurred more frequently by visual evoked potential measure than by preferential looking.

Evoked Potentials, Visual↗
PubMed1989

Lumbar seatbelt injury in a child: case report.

Spinal injuries are uncommon in children and quite rare in the lumbar spine. A case report of an 8-year-old child sustaining a lumbar seatbelt injury with successful surgical treatment consisting of reduction and stabilization with two small Harrington compression rods, and fusion with an iliac crest autologous graft is presented.

Child↗
PubMed1988

Infant grating acuity is temporally tuned.

Studies of infant visual development have shown that acuity estimated with pattern visually evoked potential (VEP) techniques is higher than acuity estimated with preferential looking (PL) techniques. A major difference is that VEP stimuli are temporally modulated while PL stimuli are typically stationary. We measured PL acuity in 2-10-month-old infants for stationary gratings and for gratings phase alternating at 2.5, 7.5, 14 and 23 reversals/sec using a computer generated staircase method. The acuity functions were temporally tuned at 7.5 or 14 rev/sec for infants 3 months and older. Acuity for 7.5 and 14 rev/sec gratings was 0.5 to 1.0 octave higher than for stationary, 2.5 and 23 rev/sec gratings. When adults' grating acuity was measured foveally and 5 deg eccentrically, tuning occurred only for the eccentric targets, suggesting that the retinal area used by the infants to detect gratings acts like the adult perifovea. In a second experiment, VEP and PL acuity were both measured from the same infants using 14 reversals/sec gratings. The VEP/PL acuity difference was less for phase alternating gratings than for stationary gratings. The magnitude of the difference was age dependent, decreasing from 2 octaves at 2 months to 0.5 octave at 12 months. Even though the use of phase alternating gratings results in improved PL acuity, temporal modulation does not completely account for the difference between VEP and PL acuity.

Adult↗
PubMed1987

Hip flexion deformity secondary to acute pyogenic psoas abscess.

The data from ten patients who underwent incision and drainage of an acute pyogenic abscess were studied with respect to the presence of an associated hip flexion deformity prior to incision and drainage of the abscess, bacteria cultured intraoperatively, treatment of any persistent hip flexion deformity postoperatively, and any additional sequelae noted at an average follow-up of seven years (range, one to 17 years). Six of the ten patients presented with an associated hip flexion deformity. In three patients, the deformity had resolved spontaneously and completely--in one by the third postoperative day and in two by the 45th postoperative day. Follow-up of these patients at up to 17 years revealed no residual flexion deformity. The flexion deformity in two of the six patients improved following incision and drainage, but residual flexion deformities of 10 degrees and 15 degrees were noted at three- and six-year follow-up, respectively. The sixth patient was treated with skin traction both preoperatively and postoperatively, but it was ineffective in totally correcting the deformity. Follow-up of this patient at one year revealed a residual 15 degrees hip flexion deformity. All six patients had normal ambulation at follow-up examination. Bacteria cultured intraoperatively did not appear to affect either the initial development of the flexion deformity or the time to resolution following incision and drainage of the abscess. Of 183 patients with an acute pyogenic psoas abscess reviewed in 14 series from the literature, 96% (176/183) presented with an associated hip flexion deformity. A hip flexion deformity in a patient with fever and pain on attempted extension of the thigh is therefore a reliable sign for the diagnosis of an acute pyogenic psoas abscess. Treatment may be indicated for a persistent deformity following incision and drainage. Skin traction is the most commonly used and successful method of treatment. Persistence of the hip flexion deformity postoperatively may be secondary to fibrosis within the psoas sheath or actual substance of the muscle, or both. A mild residual flexion deformity may be present years after incision and drainage but apparently will cause no functional abnormality.

Abscess↗
PubMed1987

Electrophysiological evidence for the oblique effect in human infants.

Visually-evoked potentials (VEPs) were recorded from infants between the ages of 2 and 11 months in response to 2.5 c/deg main axis and oblique square wave gratings. The oblique effect first appears at 3 months of age; some infants showed smaller VEP amplitude and/or longer VEP latency for obliquely oriented gratings. Regarding the age of onset of the oblique effect, VEP data from this study agree with the results obtained with preferential looking (PL) studies which have directly paired vertical and oblique gratings, but the current study found that fewer infants show an oblique effect by VEP than by PL.

Aging↗
PubMed1985

Contrast sensitivity in diabetics with and without background retinopathy.

Contrast sensitivity measurements were obtained from 64 patients with insulin-dependent (IDDM) and non-insulin-dependent (NIDDM) diabetes mellitus who had normal Snellen acuity and minimal or no visible diabetic retinopathy. Contrast thresholds were determined for stationary gratings at six spatial frequencies, ranging from 0.5 to 22.8 cycles/degree (c/deg), and for 1.0-c/deg gratings phase-alternated at 15 Hz. Data from each group of diabetic patients were compared with data from age-matched normal subjects. We found that (1) patients with IDDM and no retinopathy had normal contrast sensitivity, (2) patients with NIDDM and no retinopathy had abnormal contrast sensitivity at only one spatial frequency (22.8 c/deg), and (3) patients with NIDDM and background retinopathy had abnormal contrast sensitivity at all spatial frequencies tested. We also found a dissociation of Snellen acuity and contrast sensitivity, indicating that contrast sensitivity can be used as an early index of changes in the retina not demonstrated by measurements of visual acuity.

Adolescent↗