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Biomedical subjects

J S Marks

Publications and source records attributed to J S Marks.

At least 73 records · Page 4Linked to original sources
PubMed1985

Trends in clinical characteristics of infants with spina bifida--Atlanta, 1972-1979.

In Atlanta, the birth prevalence of spina bifida declined from 10.1 per 10,000 live births in 1972-1973 to 5.8 per 10,000 live births in 1978-1979. This trend cannot be explained by use of prenatal diagnosis, because it was unavailable in Atlanta until 1976, and even in the late 1970s was not used widely. To determine if this decrease was associated with changes in the distribution of clinical characteristics among infants with spina bifida, we reviewed the medical records of a population-based group of 154 infants with spina bifida, born in Atlanta during the eight-year period from 1972 through 1979. Distribution by the highest level of the defect on the spine did not change during these years. The proportions of infants with isolated spina bifida (ie, no other major malformations) and with open spina bifida (ie, not covered by skin) did, however, decrease. When we examined these two characteristics simultaneously, we found declines in both the proportion of infants with open-isolated spina bifida and the birth prevalence of infants with open-isolated spina bifida. If this trend persists, it will have important implications for workers involved with prenatal alpha-fetoprotein screening and researchers investigating the etiology of spina bifida.

Abnormalities, Multiple↗
PubMed1985

Effectiveness of mumps vaccine in a school outbreak.

An outbreak of mumps in a middle school (grades 6 through 8) in Ohio during 1981 was investigated to determine the effectiveness of mumps vaccine. Of the 481 middle school students on whom questionnaires were completed, 62 (12.4%) exhibited clinical mumps. The overall vaccine efficacy was 81.2% when children with a history of mumps disease are excluded from the analysis. Using a logistic regression model with the presence or absence of clinical mumps as the dependent variable, three factors were found to be significant: mumps vaccine, a history of mumps disease, and sex. Factors that did not significantly affect the rate of disease among vaccinated pupils included whether the mumps vaccine was administered singly or in combination with rubella and/or measles vaccine, age at vaccination, year of vaccination, and month of vaccination.

Adolescent↗
PubMed1985

Survival of infants with spina bifida--Atlanta, 1972-1979.

We studied the survival of a population-based cohort of 154 infants with spina bifida who were born during the eight-year period from 1972 through 1979 to residents of Atlanta. Our objectives were to describe the cohort's survival experience and to explore relationships between clinical characteristics and survival. Overall, 57% of the cohort survived one year or more. This figure is misleading, however, because it conceals important differences in survival among subgroups of affected infants. From univariate analyses, we observed significant differences in survival among infants categorized by year of birth, birth weight, the open-closed status of the defect, the highest level of the defect on the spine, the presence of multiple major birth defects, and the presence of hydrocephalus at birth. More infants born in the late 1970s survived their first year of life than infants born in the early 1970s; infants with open defects had lower survival than those with closed defects; and infants whose defects were low on the spine had better survival than those whose defects were higher. When comparing the survival experience of this cohort with that of other groups from other areas or from more recent years, health workers must consider referral biases and differences in the distribution of clinical characteristics.

Abnormalities, Multiple↗
PubMed1985

Rheumatoid neck.

Rheumatoid arthritis of the cervical spine may cause spinal cord compression. The diagnosis may be delayed if the neurological features are wrongly attributed to an entrapment neuropathy or rheumatoid peripheral neuropathy. Neurological progression should be treated by a cervical fusion in patients who are otherwise fit.

Anti-Inflammatory Agents↗
PubMed1985

Mumps disease and its health impact: an outbreak-based report.

An outbreak of mumps in a middle school (grades 6 to 8) in Ohio during 1981 was investigated to describe the clinical findings, health impact, and costs. Individuals with clinical mumps in the middle school and in family members were questioned concerning symptoms, complications, hospitalizations, school days absent, and parental work days missed. There were 62 cases of clinical mumps in the middle school and 13 cases among family members. Parotitis lasted an average of 7.4 days and fever (if present) lasted an average of 2.5 days with a mean temperature of 38.6 degrees C (101.4 degrees F). The duration of parotitis and fever increased with age. Complications included encephalitis, aseptic meningitis, orchitis, oophoritis, mastitis, and pancreatitis. Visits to physicians were made by 62.7% (47/75) of the individuals with mumps for a total of 63 visits, and two patients were hospitalized for a total of six days. Persons who attended middle school missed an average of 4.9 days of school. The estimated direct and indirect costs associated with this outbreak were $2,460 and $1,353, respectively, or $51 per case. States lacking mumps immunization requirements experienced a three-times greater incidence of mumps in 1982 than States that required all school pupils to be immunized. We recommend that all States institute compulsory mumps school immunization laws for all school children.

Absenteeism↗
PubMed1984

Effects of the specific cAMP antagonist, (Rp)-adenosine cyclic 3',5'-phosphorothioate, on the cAMP-dependent protein kinase-induced activity of hepatic glycogen phosphorylase and glycogen synthase.

The cAMP-dependent protein kinase-induced effects on phosphorylase and glycogen synthase activities and glucose production were studied in hepatocytes isolated from fed rats in the presence of the diastereomers of adenosine cyclic 3',5'-phosphorothioate, (Sp)-cAMPS and (Rp)-cAMPS. Incubation of hepatocytes with (Sp)-cAMPS or glucagon, both of which lead to cAMP-dependent protein kinase activation, resulted in a concentration-dependent increase in glycogen phosphorylase activity and a decrease in glycogen synthase activity. Incubation of hepatocytes with the cAMP-dependent protein kinase antagonist, (Rp)-cAMPS, in the absence of an agonist, had no significant effect on phosphorylase or glycogen synthase activities. Incubation of hepatocytes with a half-maximally inhibitory concentration of (Rp)-cAMPS shifted the agonist-induced activation curves for phosphorylase and the agonist-induced inhibition curves for glycogen synthase to 5-fold higher concentrations for both (Sp)-cAMPS and glucagon. Phosphorylase activity was very sensitive to the rapid, concentration-dependent inhibition by (Rp)-cAMPS of agonist-induced activation of cAMP-dependent protein kinase. The effects on phosphorylase activity were observable in 30 s and were concentration-dependent with half-maximal inhibition at 10 microM, similar to that observed for cAMP-dependent protein kinase. In contrast, glycogen synthase activity was less sensitive to (Rp)-cAMPS inhibition of agonist-induced activation of cAMP-dependent protein kinase. The effects on glycogen synthase activity lagged behind those on phosphorylase activity and the concentration dependence did not parallel the cAMP-dependent protein kinase effect, but was shifted to higher concentrations of (Rp)-cAMPS with half-maximal inhibition at 60 microM. Glucose (10 to 40 mM) increased the sensitivity of glycogen synthase to (Rp)-cAMPS inhibition of cAMP-dependent protein kinase over a narrow range of agonist concentration, but had no significant effect throughout most of the agonist-induced activation range. Thus, the diastereomers, (Sp)- and (Rp)-cAMPS, influence glycogen metabolism and the glycogenolytic enzymes through their modulation of cAMP-dependent protein kinase levels.

Animals↗
PubMed1984

Cost implications of routine antenatal administration of Rh immune globulin.

Using decision analysis, we estimated the benefits, risks, and costs of a program for routine antepartum administration of Rh immune globulin to Rh-negative primiparous women, who were studied through their second deliveries. The number of births of second-order infants with Rh hemolytic disease of the newborn averted by an antepartum program for 10,000 Rh-negative primiparous women was estimated by race to be white, 14; black, 18; and Asian, 35. For all races, the costs incurred by an antepartum program were more than double the costs averted. Sensitivity analyses showed that the most crucial factor influencing the benefits of routine antepartum administration of Rh immune globulin is the probability of severe chronic disability from hemolytic disease of the newborn. Current data are unavailable for the probability of this event. Another factor affecting the program's benefits is the rate of antepartum Rh sensitization among primiparous women. If the program were restricted to primiparous women at high risk for antepartum Rh sensitization, its benefits might exceed its costs.

Cost-Benefit Analysis↗
PubMed1984

Therapeutic abortions following rubella infection in pregnancy: the potential impact on the incidence of congenital rubella syndrome.

In 1977, a large rubella outbreak occurred in Hawaii. Because attack rates were high among women of childbearing age, we conducted extensive surveillance efforts to detect both pregnancies complicated by rubella and cases of congenital rubella syndrome (CRS). Initial surveillance included a survey of physicians and hospitals, review of fetal death and birth certificates, and cord blood screening for rubella-specific IgM of infants born following the epidemic. Two years after the outbreak, the medical community was again surveyed to identify affected children who were missed initially. No case of CRS was identified either shortly after the outbreak or in the ensuing two years. In addition, none of the 5,605 cord serum samples obtained was found to contain rubella-specific IgM antibody. Through active surveillance, we received 12 reports of rubella in pregnant women, of whom 11 elected to terminate their pregnancies. The extensive use of therapeutic abortion by exposed women may have prevented the birth of infants with CRS. Surveillance for rubella-related abortions is an important component in assessing the health impact of rubella in a community.

Abortion, Therapeutic↗
PubMed1984

Benefits of multiple joint replacement in rheumatoid arthritis.

The benefits of multiple joint replacements were assessed in 21 patients with rheumatoid arthritis who had bilateral hip and knee replacements. The main benefit was relief of pain with 40 hips and 25 knees becoming completely pain-free. There was an improved range of movement in 38 hips but in only 11 knees and 8 knees were stiffer after surgery. Hip replacement was the preferred initial surgery but there was a mean delay of 50 months between hip and knee surgery suggesting a "domino effect" with increasing mobility as a consequence of hip replacement eventually causing knees to deteriorate. All patients who completed a postal questionnaire found their ability to walk had improved but many noted an increase in ankle and foot pain which limited their walking. After their surgery patients were better able to perform certain activities of daily life, especially housework and dressing. It is concluded that multiple joint replacement contributes to improving the quality of life in disabled arthritic patients.

Adult↗
PubMed1983

Mechanisms underlying calcium homeostasis in isolated hepatocytes.

The steady state relationship between intra- and extramitochondrial free Ca2+ across the inner mitochondrial membrane has been investigated in isolated liver mitochondria. The extramitochondrial free Ca2+ concentration was essentially independent of the mitochondrial calcium content above 4 nmol/mg of protein. Below this value, a decrease in the mitochondrial calcium content was accompanied by a decrease in the extramitochondrial free Ca2+ concentration. The experimental data are compatible with a model in which the steady state distribution of calcium is described in terms of the kinetic parameters of the separate carriers catalyzing Ca2+ influx and efflux across the mitochondrial inner membrane. The corresponding relationship between cytosolic free Ca2+ concentration and the amounts of calcium in the mitochondria and endoplasmic reticulum was investigated in isolated river cells over a range of cellular Ca2+ contents by using a nondisruptive technique based on the selective release of calcium from mitochondrial and total cellular pools by addition of carbonyl cyanide p-trifluoromethoxyphenylhydrazone and A23187, respectively. A net increase in cell calcium from 1 to 5 nmol/mg dry weight, increased the cytosolic free Ca2+ concentration from 0.1 to about 0.3 microM and increased the calcium contents of both mitochondria and endoplasmic reticulum. Above 5 nmol of calcium/mg cell dry weight, the endoplasmic reticulum calcium pool became filled, and further increases in calcium content were accounted for by increases of the mitochondrial pool but no further increase of the cytosolic free Ca2+ concentration. These studies and experiments with mixtures of isolated microsomes and mitochondria suggest that, in cells as normally isolated (containing 5 to 6 nmol of calcium/mg dry weight), the endoplasmic reticulum is saturated with calcium and is unlikely to play a major role as an intracellular calcium buffer. The in situ mitochondrial calcium content is sufficiently high (approximately 16 nmol/mg of protein) for these organelles to buffer effectively the cytosolic free Ca2+ concentration at a value of about 0.3 microM. In addition, it may be concluded that intramitochondrial Ca2+-dependent enzymes will be exposed to saturating concentrations of free Ca2+.

Animals↗