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Biomedical subjects

D Schaffer

Publications and source records attributed to D Schaffer.

12 recordsLinked to original sources
PubMed1995

Periconceptional vitamin use, dietary folate, and the occurrence of neural tube defects.

With a case-control study, we investigated whether periconceptional intake of supplemental or dietary folate reduced the risk of having a neural tube defect (NTD)-affected pregnancy. Mothers of 549 (88% of eligible) cases and 540 (88%) controls were interviewed in person about vitamin supplements used in either the 3 months before or the 3 months after conception and also about usual diet in the 3 months before conception. Women with any use of a folic acid-containing vitamin in the 3 months before conception had a lower risk of having an NTD-affected pregnancy [odds ratio (OR) = 0.65; 95% confidence interval (CI) = 0.45-0.94]. ORs were similar for 3 levels (< 0.4, 0.4-0.9, and > 0.9 mg per day) of average daily intake of folic acid. Any level of use in the first 3 months after conception resulted in a lowered risk as well (OR = 0.60; 95% CI = 0.46-0.79). Reduced risks were less marked for Hispanics and were not observed among women who graduated from college. Modest reduced risks were noted among non-vitamin users whose estimated daily dietary intake of folate was more than 0.227 mg. We observed decreasing risk with increasing folate intake from combined dietary sources and vitamin supplements. A reduction in NTD risk associated with folate intake is consistent with other studies; however, the reduced risk may be particular to subsets of the population, primarily non-Hispanic women and women whose education does not exceed high school.

Adult↗
PubMed1992

Multicenter study of change in dialysis therapy-maintenance hemodialysis to continuous ambulatory peritoneal dialysis.

Serial prospective observations were made on 40 patients with end-stage renal failure who transferred voluntarily from long-term maintenance hemodialysis (MHD) to continuous ambulatory peritoneal dialysis (CAPD). Adequate data were available through 6 months on CAPD in 26 participants, whereas 20 completed the study (1 year on CAPD). There were 12 (30%) treatment failures, including two deaths. Standard CAPD (four 2-L exchanges per day) proved to be inadequate therapy in large, young males with low total urea clearances (Ktu) on MHD. There was a large variation in Ktu within MHD and CAPD therapies that employed apparently similar or identical dialysis prescriptions; this underscores the need to quantify dialysis by a measure such as Ktu. Hematocrit, white blood cell (WBC) and platelet counts, and serum bicarbonate levels were significantly higher, whereas blood urea nitrogen (BUN) and serum potassium levels were significantly lower on CAPD than on MHD. While body weight, blood pressure, bone disease, parathyroid hormone (PTH) levels, and lipid profile did not change significantly, nutritional indices tended to decline with time on CAPD. Urea generation rate (Gu) decreased significantly after transfer to CAPD and correlated with Ktu regardless of treatment modality. Central nervous system (CNS) function reflecting uremic symptomatology and as indexed by average quantified electroencephalogram (EEG) discriminant scores did not change significantly. Hospitalization rates and stays were similar during equal time intervals on both therapies. Sufficiently diverse responses followed the MHD to CAPD therapy change to warrant more extended observations on larger numbers of patients.

Body Constitution↗
PubMed1990

Black hairy tongue.

Black hairy tongue is a benign disorder characterized by hypertrophy of the filiform papillae of the tongue. A brownish-black discoloration of the papillae occurs. The etiology is unclear, but the disorder has been associated with numerous predisposing conditions. Although black hairy tongue is usually cured by removal of these factors, a variety of measures, particularly brushing of the tongue, may aid in resolution.

Adult↗
PubMed1982

Disseminated intravascular coagulation in infancy and in the neonate. Ocular findings.

We report two cases of neonatal disseminated intravascular coagulation (DIC). One case is associated with placenta previa and respiratory distress, and the other shows hemorrhage with Gram-negative sepsis. In both cases, results of autopsy show microscopic confirmation of DIC in several body tissues. One pair of eyes demonstrates intraocular hemorrhages and intravascular fibrin in the choriocapillaris (a typical manifestation) and intravascular fibrin in the ciliary body vessels of one eye. In addition, the other pair of eyes shows involvement of iris vessels, a unique finding, as is intraretinal intravascular fibrin in one eye of the same patient.

Bacterial Infections↗
PubMed1982

Vitamin E supplementation and the retinopathy of prematurity.

The effect of high-dosage E treatment (Rx) initiated at the stage of 3-plus active disease (target serum E levels, 5-6 mg/dl) was evaluated by a standardized scoring system of visual morbidity at the one to two year eye exam among infants cared for in the University of Pennsylvania Neonatal Complex (1976-1978). The incidence of legal blindness in both eyes or worse was decreased from 71 to 40% in E Rx (n = 10) as compared to non-E Rx (n = 14) infants, and the number of infants with minimal visual morbidity was increased. Pilot studies (1972-76; target serum E level, 1.5 and 3.0 mg/dl) of the prophylactic effect of E Rx from birth on showed a decrease in mean severity of acute stage disease and a decrease in sequelae at one to two years. A strikingly difference in visual morbidity following resolved low-grade ROP was seen when prestudy infants (1968-72) who were fed early iron supplements and given formulas with low E:PUFA ratios were compared to non-E Rx as well as to E Rx 1972-76 infants. Vitamin E seems to exert a beneficial effect at all stages of ROP, perhaps because of its broadly based regulatory role.

Animals↗
PubMed1977

Indications and guidelines for mammographic examinations.

The value of mammography in evaluating the asymptomatic patient has been clearly demonstrated by the HIP program, as well as the National Cancer Institute's breast demonstration projects. A one-third reduction in mortality from breast cancer in mammographically screened women has been substantiated. Nonetheless, questions concerning the long-term effects of repeated radiation exposure associated with mammography have been raised, and for this reason judicious selection of women is urged. In general, women who are asymptomatic or at high risk for breast carcinoma should be evaluated with a planned regimen. Mammographic guidelines and recommendations for attaining the greatest benefit at the lowest possible risk are suggested.

Adult↗
PubMedDate not supplied

Mothers' motivations to participate in a pregnancy health survey.

An important question in interpreting epidemiologic data is why some persons agree to participate in a health survey while others do not. Information about why people agree to interview or answer a questionnaire could help researchers to devise procedures for a health survey and to chose information to be communicated in the interview or questionnaire so as to increase subjects' participation. The authors interviewed 180 mothers who gave birth to a child with a birth defect and 198 mothers whose children were born without a birth defect. The interviews were part of two case-control studies to determine risk factors for selected birth defects. In the course of the interviews, each mother was asked why she agreed to be interviewed, and whether anything about the survey procedures that were followed could be improved. Among both the case mothers and the control mothers the most common reason for agreeing to be interviewed was humanitarian, expressed as "to help others" or "to prevent what happened to my baby from happening to babies in the future." Case mothers, more frequently than control mothers, gave as their reason for participating either to help themselves, their child, their family, or to further scientific understanding. Emphasizing these as benefits of participation to those who are survey subjects at the time of the initial contact could increase the proportion who agree to respond.

Altruism↗