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J Braunstein

Publications and source records attributed to J Braunstein.

5 recordsLinked to original sources
PubMed1992

Negative predictive value of a population-based preschool vision screening program.

BACKGROUND: The Enhanced Vision Screening Program is a population-based vision screening program that has, at present, examined 59,782 children. Its main goal is to detect amblyopia, strabismus, and high refractive errors. An average of 11,910 4 1/2- to 5 1/2-year-old children are screened yearly. The current study determines the negative predictive value of the screening program: For a subject having passed the vision screening test, what is the probability of not having amblyopia, strabismus, or high refractive errors? METHODS: Of the 11,734 subjects who passed the vision screening, 200 were randomly chosen to undergo a strictly defined gold standard examination by an orthoptist and an ophthalmologist. RESULTS: Of the 200 randomly chosen subjects, 157 underwent the gold standard evaluation. The negative predictive value of the Enhanced Vision Screening Program was 97.6% for any potentially vision-threatening ocular condition. It was 98.7% if we considered only the visually significant ocular problems that the test was designed to detect. CONCLUSION: Because the negative predictive value of the Enhanced Vision Screening Program is not 100%, some children with amblyopia, strabismus, or refractive errors are missed. Occasionally, a rare, potentially vision-threatening condition may go undetected. Parents should be made aware of this when they receive the results of the vision screening.

Child↗
PubMed1988

Condylomata acuminata of the urinary bladder. Natural history, viral typing, and DNA content.

Three patients with condylomata acuminata of the urinary bladder are reported. Two of the patients were immunosuppressed, and one had longstanding extensive condylomata acuminata of the external genitalia and adjacent areas. All lesions recurred at least once and were difficult to treat. The diagnosis was confirmed by in situ hybridization on archival material with human papillomavirus (HPV) DNA probes under stringent conditions. In two of the patients, probes for HPV types 6 and 11 were positive; HPV 11 only was identified in one patient. Probes for HPV types 16 and 18 and pBR322 vector controls were negative. In one patient with a strong hybridization signal, the lesion was also positive for common papillomavirus antigen. DNA content measured by cytophotometry of Feulgen-stained whole nuclei isolated from lesions in two patients revealed a markedly aneuploid DNA pattern. Whether this is a factor in the behavior of the lesions is not known at this time. Although rare, HPV infection of the urinary bladder may result in widespread condylomatosis and may mimic giant condylomas of Buschke-Löwenstein or even verrucous carcinomas, sometimes necessitating radical treatment. Nevertheless, until there is proof to the contrary, the lesions must be considered benign and should not be confused with squamous cancer of the bladder.

Adult↗
PubMed1987

Parental perception of urgency and utilization of pediatric emergency services.

Emergency Room utilization has increased dramatically in recent years. Parental perception of urgency may be one factor that influences utilization of pediatric emergency services, yet little is understood about factors influencing this perception. The goal of this study was to determine if the perception of urgency is a critical factor in the decision of a parent to seek care in an emergency room, if demographic and access factors influence parental perception of urgency, and whether there is agreement of urgency rating by parent and physician. One hundred and one parents were interviewed to determine background demographic and access factors and perception of urgency. Physician and parental urgency was evaluated on a 5 level scale. Chi-square analysis was used to determine association between demographic and access factors and parental urgency ratings. Pearson product moment correlation was used to determine agreement between parent and physician urgency ratings. The majority of visits were acknowledged by both parents and physicians to be non-emergent. Fourteen (13.9%) and 10 (9.9%) of parents and physicians rated the visits as emergent (levels 1 and 2) while 65 (64.4%) parents and 76 (75.3%) physicians rated the visits as nonemergent. No association between demographic or access variables and parental perception of urgency was demonstrated.

Adult↗