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Biomedical subjects

J Waldman

Publications and source records attributed to J Waldman.

At least 19 recordsLinked to original sources
PubMed1992

Comparison of nomogram- and ultrasound-determined renal depths for calculation of glomerular filtration rates in spinal cord injury patients.

In an informal survey, poor correlation was found between 24-hour creatinine levels and glomerular filtration rates calculated from nuclear medicine studies in spinal cord injury patients. It was speculated that the discrepancies were because the nomograms used in the calculations did not take into account differences in body fat distribution for this patient group. Twenty-five chronic spinal cord injury patients were prospectively studied to compare glomerular filtration rates (GFR) using the nomograms based on height and weight and those using renal depth determined by ultrasound. It was found that the renal depth determined by nuclear medicine was significantly less than that determined sonographically. The mean difference between the total nuclear medicine-based GFR and total ultrasound-based GFR was 17.576 ml +/- 15.449 ml (P < or = 0.001). It was found that there was a significant difference between calculated GFRs based on renal depths as determined by the different methods. In addition, calculated GFRs based on ultrasound-determined depths corresponded more closely to 24-hour creatine clearance levels and with a smaller degree of error than those using renal depths determined by the nuclear medicine nomograms.

Adipose Tissue↗
PubMed1990

Cortical function assessment in the elderly.

The Cortical Function Assessment (CFA) is a 10-point test developed to overcome the limitations of current bedside mental status exams which emphasize orientation and memory. Items measure higher cortical function, such as naming, writing, drawing, and stereognosis. The test was given to young and old normal subjects, young and old depressive patients, and patients with dementia. Interrater reliability was high (alpha = .95) as was the correlation between it and the Short Portable Mental Status Questionnaire (r = .87) and the Mini-Mental State (r = .92). The study demonstrates the utility of the CFA as a screening tool in dementia and depression in the elderly and suggests its use in routine geriatric evaluations.

Adolescent↗
PubMed1989

Hydrostatic reduction of ileocolic intussusception: a second attempt in the operating room with general anesthesia.

Over a 3-year-period, standard treatment with hydrostatic pressure from a contrast enema failed to reduce ileocolic intussusception in 31 of 62 children. With the child anesthetized in the operating room, a second contrast enema was given before laparotomy. Of the 31 intussusceptions, 21 (68%) were reduced without complication, thereby avoiding the discomfort, longer hospitalization, complications, and expense of surgery. Nine of the remaining 10 intussusceptions were difficult to reduce manually during surgery or required resection. The overall nonoperative reduction rate for the 3-year period was 84%; for the last 2 years it was 90%. Success with the second enema may be related to the effects of general anesthesia. In addition, partial reduction with the first enema may improve blood flow from the intussusceptum so that it becomes smaller and easier to reduce with the second enema. Because it can easily be added to standard management protocols without increased risk, routine use of this second enema with anesthesia is recommended.

Anesthesia, General↗
PubMed1989

Neurofibromatosis and other disorders among children with CNS tumors and their families.

We conducted a population-based case-control study with 338 patients, less than 15 years of age, diagnosed with a primary tumor of the central nervous system from January 1968 through December 1977 in 53 New York State counties. The study also included 676 controls selected from the birth certificate files of the New York State Department of Health. We collected information on neurofibromatosis and congenital anomalies in study subjects, their siblings and parents by telephone interview with the mother of each case and control. We obtained supplemental information on neurofibromatosis in the patients and their families from hospital medical records. This study confirmed the strong association of neurofibromatosis with risk of CNS tumors. Thirteen cases and no controls had neurofibromatosis. Two fathers and 3 mothers of cases had neurofibromatosis. Five cases had siblings with neurofibromatosis. None of the first-degree relatives of controls had neurofibromatosis. We observed a relative risk of 4.49 for history of seizures. Seizures are often among the presenting symptoms for CNS tumors. We observed no difference between cases and controls in the occurrence of congenital anomalies. There was a nonsignificant excess of congenital anomalies among siblings of cases compared with controls. This decreased to 1.13 when adjusted for number of siblings.

Brain Neoplasms↗
PubMed1989

Cytomegalovirus infection of gastrointestinal endothelium demonstrated by simultaneous nucleic acid hybridization and immunohistochemistry.

To demonstrate the degree of involvement of endothelial cells in cytomegalovirus (CMV) infection of the gastrointestinal tract we have stained sections from gastrointestinal specimens that showed inclusion bodies on hematoxylin-eosin staining. Factor VIII was first detected using a rabbit anti-factor VIII primary antibody and an alkaline phosphatase-labeled sheep anti-rabbit secondary antibody. The CMV was then visualized with a biotin-labeled CMV probe detected by a streptavidin peroxidase technique with aminoethyl carbazole as the chromogen. Factor VIII staining was a bright blue and CMV a brick red. The specimens included one small-bowel resection and four colonic resections, as well as an esophageal biopsy. The patients' diagnoses included bone marrow transplant recipient, acquired immunodeficiency syndrome, ulcerative colitis, and renal transplant recipient. Cells positive for both CMV and factor VIII ranged from 35% to 60% of positive cells in a representative section, and the relative percentages (mean +/- SE) for cell type for infected cells were: endothelial, 48.9 +/- 4.5; vascular luminal (factor VIII negative), 6.1 +/- 1.7; perivascular (factor VIII negative in vascular wall), 16.2 +/- 3.2; and other cell (non-vascular factor VIII negative), 28.9 +/- 5.1. These findings and clustering of infected cells around the vessels provide evidence that CMV infection of the gastrointestinal tract is primarily vasculitic and related to infection of endothelial cells.

Adult↗
PubMed1988

An epidemiologic case-control study of central nervous system tumors in children and parental occupational exposures.

A population-based case-control study was conducted with 338 patients less than 15 years of age who were diagnosed with a primary tumor of the central nervous system from January 1968 through December 1977 in 53 contiguous New York counties. The study also included 676 controls who were selected from the birth certificate files of the New York State Department of Health. Parental occupational exposures at the time of each child's birth and at the time of tumor diagnosis were derived from maternal interviews. The current data set failed to show any consistent association between childhood central nervous system tumor risk and paternal occupational exposures to hydrocarbons or to electromagnetic fields, or employment in the aerospace industry or pulp and paper manufacturing. Findings for occupational exposures to ionizing radiation were also inconsistent. A positive association was observed between central nervous system tumor risk and paternal exposures to ionizing radiation based on industrial codes. Odds ratios ranged from 1.71 to 2.15. This association was not observed when paternal occupational titles were used to define exposure (range of odds ratios, 1.01-1.10). Maternal exposures to ionizing radiation were not related to risk regardless of the classification scheme used.

Adolescent↗
PubMed1985

Early extubation after surgical repair of congenital heart disease.

Of 220 pediatric patients recovering from surgical repair of congenital heart disease, 147 (67%) met our criteria for early extubation and were extubated either in the operating room or within 6 h after admission to the surgical ICU. The duration of postoperative mechanical ventilation correlated with the duration of cardiopulmonary bypass during surgical repair. In patients undergoing repair of ventricular septal defect, preoperative measures of pulmonary vascular status (PPA/PAO and RP/RS) also correlated with the duration of mechanical ventilation.

Adolescent↗
PubMed1975

Intracranial pressure in Reye syndrome. Monitoring and control.

Two patients who became comatose with Reye syndrome had continuous monitoring of intracranial pressure and blood pressure. Respirations were controlled, and mannitol and urea were administered to control elevated intracranial pressure. Continuous intracranial pressure monitoring proved to be a valuable adjunct to therapy for Reye syndrome.

Blood Pressure↗