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Biomedical subjects

J M Dolezal

Publications and source records attributed to J M Dolezal.

8 recordsLinked to original sources
PubMed1995

Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus.

OBJECTIVE: This report documents that the gastric bypass operation provides long-term control for obesity and diabetes. SUMMARY BACKGROUND DATA: Obesity and diabetes, both notoriously resistant to medical therapy, continue to be two of our most common and serious diseases. METHODS: Over the last 14 years, 608 morbidly obese patients underwent gastric bypass, an operation that restricts caloric intake by (1) reducing the functional stomach to approximately 30 mL, (2) delaying gastric emptying with a c. 0.8 to 1.0 cm gastric outlet, and (3) excluding foregut with a 40 to 60 cm Roux-en-Y gastrojejunostomy. Even though many of the patients were seriously ill, the operation was performed with a perioperative mortality and complication rate of 1.5% and 8.5%, respectively. Seventeen of the 608 patients (< 3%) were lost to follow-up. RESULTS: Gastric bypass provides durable weight control. Weights fell from a preoperative mean of 304.4 lb (range, 198 to 615 lb) to 192.2 lb (range, 104 to 466) by 1 year and were maintained at 205.4 lb (range, 107 to 512 lb) at 5 years, 206.5 lb (130 to 388 lb) at 10 years, and 204.7 lb (158 to 270 lb) at 14 years. The operation provides long-term control of non-insulin-dependent diabetes mellitus (NIDDM). In those patients with adequate follow-up, 121 of 146 patients (82.9%) with NIDDM and 150 of 152 patients (98.7%) with glucose impairment maintained normal levels of plasma glucose, glycosylated hemoglobin, and insulin. These antidiabetic effects appear to be due primarily to a reduction in caloric intake, suggesting that insulin resistance is a secondary protective effect rather than the initial lesion. In addition to the control of weight and NIDDM, gastric bypass also corrected or alleviated a number of other comorbidities of obesity, including hypertension, sleep apnea, cardiopulmonary failure, arthritis, and infertility. Gastric bypass is now established as an effective and safe therapy for morbid obesity and its associated morbidities. No other therapy has produced such durable and complete control of diabetes mellitus.

Adolescent↗
PubMed1992

Assessing personal occupational safety and health training for students at U.S. medical schools.

Medical students potentially are exposed to numerous occupational hazards. This study examined the training and preventive measures medical schools use to protect the health and safety of students. In late 1990, questionnaires were mailed to the 126 schools in the United States. One hundred (79%) responded, reporting numerous incidents of illness and injury. Of the 100 schools, 60 agreed with the statement that their students were adequately prepared to work safely; 11 disagreed, and 24 gave neutral responses (five did not respond to the statement). However, 36 indicated that they planned to revise health and safety training. The authors recommend that schools adopt policies, procedures, and a uniform curriculum regarding students' occupational safety and health.

Curriculum↗
PubMed1989

Sunlight, skin sensitivity, and senile cataract.

This study explores the association between sunlight exposure and senile cataract, taking into account such individual differences as skin sensitivity to sunlight and the use of sun-shielding devices, i.e., sunglasses and hats. A case-control study was conducted among 160 matched pairs of subjects between October 1, 1984 and June 1, 1985 at the University of Iowa Hospitals and Clinics in Iowa City, Iowa. Cases were selected from among all patients admitted for inpatient or outpatient cataract surgery who were at least 40 years old. Controls were selected from among those waiting for a friend or relative who was attending one of the ophthalmology clinics. Controls were matched to the cases on a 1:1 basis on sex and age (+/- one year). No association was observed between history of sunlight exposure and senile cataract. However, independent of sunlight exposure, the cases with nuclear cataracts reported a more severe acute skin response upon exposure to sunlight for the first time in the summer (a severe burn with blistering) than did their age- and sex-matched controls (McNemar odds ratio (OR) = 1.73, 95% confidence interval (CI): 1.03-2.91). In addition, independent of sunlight exposure, the male controls reported a greater average lifetime use of head coverings in summer which shaded their eyes from the sun than did their age- and sex-matched cases (McNemar OR = 0.48, 95% CI: 0.25-0.94).

Adult↗
PubMed1989

Mild nephrotoxicity associated with vancomycin use.

Nephrotoxicity related to vancomycin hydrochloride therapy has been reported at overall rates of 7% to 16% and as high as 35% when combined with an aminoglycoside antibiotic. We conducted a prospective study in older men. A group that received vancomycin was compared with a control group to determine the incidence of nephrotoxicity secondary to vancomycin therapy alone and in combination with aminoglycosides, to identify possible risk factors associated with nephrotoxicity, and to determine the incidence of other adverse effects associated with vancomycin use. Nephrotoxicity occurred in 11 (17%) of 66 patients receiving vancomycin and in 3 (5%) of 57 controls overall. Stepwise logistic-regression analysis failed to identify underlying illnesses or concurrent risks that may have contributed to the development of nephrotoxicity associated with vancomycin. Adverse effects, including phlebitis (14%), neutropenia (1%), rash (0%), and red neck syndrome (0%), occurred at rates similar to previous reports.

Aged↗