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Biomedical subjects

K Kaye

Publications and source records attributed to K Kaye.

At least 37 records · Page 2Linked to original sources
PubMed1992

Reliabilities, norms and factor structure of the Behavioral Dyscontrol Scale.

This is a report on the statistical properties of a research and clinical measure of cognitive and behavioral functioning, which has so far demonstrated utility among elderly persons. This instrument, the Behavioral Dyscontrol Scale, is adapted from Luria's approach to the assessment of frontal lobe dysfunction. The scale shows high internal consistency and very good interrater reliability. In a clinically stable, elderly population, test-retest reliability is high. Normative data are presented for three different samples: 47 young adults, 141 cognitively normal elderly persons, and our total elderly sample of 229. A principal components analysis yielded 3 factors consistent with Luria's theory.

Aged↗
PubMed1992

High prevalence of cobalamin deficiency in elderly outpatients.

OBJECTIVE: To measure the prevalence of cobalamin (vitamin B12) deficiency in geriatric outpatients as documented by both low serum cobalamin levels and elevations of serum methylmalonic acid and homocysteine and to determine the response to cobalamin treatment. DESIGN: Prospective study screening elderly subjects for cobalamin deficiency using radiodilution cobalamin assays as well as stable isotope dilution gas chromatography-mass spectrometry methylmalonic acid and homocysteine assays. In patients with serum cobalamin levels < or = 300 pg/mL, the response to cobalamin treatment in the group with levels of methylmalonic acid and/or homocysteine > 3 standard deviations (SD) above the mean for normals was compared with that of those without such elevations. SETTING: Outpatient geriatric clinics at the VA Medical Center and University Health Sciences Center, Denver, CO. PATIENTS: One-hundred and fifty-two consecutive outpatients, ages 65 to 99, were screened. Twenty-nine subjects with serum cobalamin levels < or = 300 pg/mL were prospectively evaluated and treated with cobalamin. MAIN OUTCOME MEASURES: Cobalamin, methylmalonic acid, homocysteine, complete blood counts, neurologic examination, and neuropsychological testing. RESULTS: The prevalence of cobalamin deficiency as defined by a serum cobalamin level < or = 300 pg/mL and levels of serum methylmalonic acid and/or homocysteine elevated to > 3 SD was 14.5% of the screened outpatients. A similar proportion of patients with low normal serum cobalamin levels (between 201 and 300 pg/mL) demonstrated elevated metabolites > 3 SD (56%) compared with patients with low serum cobalamin levels (< or = 200 pg/mL) (62%). Cobalamin therapy caused a marked fall or complete correction of the elevated methylmalonic acid and homocysteine levels in each patient who was treated prospectively. Results for complete blood count, lactate dehydrogenase, bilirubin, baseline neurologic score, and baseline neuropsychologic scores did not differ in the group of patients with elevated metabolites compared with those with normal metabolites. The mean red cell volume fell significantly in the patients with elevated metabolites after 6 months of cobalamin treatment. One patient with elevated metabolites had marked improvement in his neurologic abnormalities after 6 months of cobalamin treatment. CONCLUSION: There was a high (14.5%) prevalence of cobalamin deficiency as demonstrated by elevations in serum methylmalonic acid and homocysteine in addition to low or low normal serum cobalamin levels in elderly outpatients. The serum cobalamin level was insensitive for screening since similar numbers of patients with low normal serum cobalamin levels of 201-300 pg/mL compared with patients with low cobalamin levels (< or = 200 pg/mL) had markedly elevated metabolites which fell with cobalamin treatment. Additional studies will be required to define the full clinical benefit from treatment with Cbl in elderly subjects.

Aged↗
PubMed1991

Granulomatous prostatitis: a spectrum including nonspecific, infectious, and spindle cell lesions.

Most granulomas of the prostate are nonspecific; infectious, post-operative, and allergic lesions are much less common. Fine-needle aspiration findings in the typical case are distinctive and easily recognized. Several series have been reported, but few have included histologic follow-up. We describe three cases of granulomatous prostatitis (GP) which showed a spectrum of findings confirmed by histologic sections. In all cases, carcinoma was suspected clinically. Case 1 represents typical nonspecific GP with epithelioid and multinucleated histiocytes. In case 2, aggregates of epithelioid histiocytes alternated with areas of necrosis and neutrophils. Histologically, the granulomas showed purulent centers. Silver stains revealed budding yeast in smears and sections. Cultures of FNA material subsequently revealed Cryptococcus. In case 3, the histiocytes were predominantly spindled and occurred singly and in groups. The differential diagnosis included reactive and neoplastic spindle cell lesions. Histologic sections showed GP with spindled histiocytes. Appreciation of the broad cytologic spectrum of GP will facilitate accurate cytologic diagnosis.

Aged↗
PubMed1991

Spermatic vein occlusion with hot contrast material: angiographic results.

Spermatic vein occlusion by means of selective injection of boiling contrast material into the spermatic vein was attempted in 175 men with symptomatic varicoceles or infertility. Seventy-six patients (43%) returned for follow-up venography. Of 115 veins injected, 96 (83%) were totally occluded on the follow-up venogram obtained at 6 weeks to 2 years after injection. In the latter portion of the study, the technique was changed slightly, with injection of larger volumes of hot contrast material, resulting in a 91% occlusion rate. Each vein that was found patent on the follow-up venogram (19 of 115 [16%]) was assessed radiographically, and results were categorized as grade 1, a complete failure in which there was no change from the presclerotherapy appearance (nine of 19 [47%]); grade 2, a failure in which the treated vein was smaller but patent (five of 19 [26%]); or grade 3, a failure in which the treated vein was occluded with newly developed collateral vessels (five of 19 [26%]). The pretreatment size of the spermatic vein and the quantity of hot contrast material injected were both statistically significant factors in the treatment outcome.

Adolescent↗
PubMed1990

Prediction of independent functioning and behavior problems in geriatric patients.

Folstein's Mini Mental State Exam, a test assessing the capacity to perform novel and/or repetitive motor tasks (Behavioral Dyscontrol Scale) and a brief measure of working memory were used in a sample of 50 male Veterans Affairs geriatric clinic patients who ranged in age from 63 to 105 (mean, 80.1). The purpose of this study was to attempt to predict the patients' capacity to regulate their behavior independently. We hypothesized that frontal lobe disorders often impair a patient's ability to function autonomously and that the Behavioral Dyscontrol Scale, a measure of frontal lobe impairment, would best predict the capacity for independent regulation of purposeful behavior. Therefore, we examined the relationship of the Behavioral Dyscontrol Scale with spouses' and caregivers' ratings of patients' independent living skills, and with behaviors that interfere with independent functioning. The results of hierarchial regression analyses indicated that the Behavioral Dyscontrol Scale was the only predictor of functional autonomy and was the best predictor of both impulsivity and apathy among geriatric patients. The Behavioral Dyscontrol Scale appears to assess a different functional domain than do the MMSE and similar measures, which rely heavily on the evaluation of orientation and gross cognitive status.

Activities of Daily Living↗
PubMed1990

Trends in reporting of maternal drug abuse and infant mortality among drug-exposed infants in New York City.

New York City trends in maternal drug abuse during pregnancy and in mortality rates for infants with in utero drug exposure are reported; causes of death among drug-exposed infants are studied, as is the association between maternal drug abuse and other factors that contribute to infant mortality (e.g., low birthweight, lack of prenatal care). Data for this study are derived from the linked files of New York City birth and infant death certificates. Reports of infants born to drug abusing mothers increased from 6.7 per 1000 live births in 1981 to 20.3 per 1000 live births in 1987, with abuse of cocaine accounting for most of the rise. When standardized for race and ethnicity, the mortality rate for drug-exposed infants born from 1978 through 1986 was 35.9, or 2.4 times that for infants in New York City in general. Drug-exposed infants were over three times as likely as infants in the general population to be of low birthweight. The association of both opiates and cocaine with increased mortality and low birthweight was similar. Death rates from SIDS and AIDS were especially higher for drug-exposed infants than for those in the general population, and were similar for opiate- and cocaine-exposed infants. The impact of drug abuse on infant mortality rates in selected low socioeconomic health districts is discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Birth outcomes for infants of drug abusing mothers.

Birthweight, gestational age, and Apgar scores of drug-exposed infants were compared to those of drug-free infants using data collected from birth certificates. Infants born to abusers of opiates and cocaine as well as opiates and cocaine together were also compared to one another. The presence of adverse neurologic signs, need for intensive care, and length of hospitalization after delivery were compared among different types of drug-exposed infants using data collected in a program for infants at risk for developmental delay. Infants of all drug abusers weighed an average of 423 g less than controls; mean gestational age for infants in the different drug groups ranged from four to ten days less than for controls. Opiate-exposed infants were significantly more likely to show adverse neurologic signs than were those with exposure only to cocaine, and were more likely to need intensive care. Infants of polydrug (cocaine + opiate) abusers fared worse than infants born to abusers of single drugs with respect to birthweight, gestational age, and length of hospital stay. Outcomes for infants of "crack" abusers were worse than those for infants exposed to other forms of cocaine with respect to birthweight and adverse neurologic signs. Our findings suggest that special outreach and follow-up efforts may be needed to facilitate the optimal development of these infants.

Apgar Score↗
PubMed1983

Topological analysis of the reovirus type 3 hemagglutinin.

We previously showed that the reovirus type 3 hemagglutinin (HA) has distinct functional domains. For example, we identified one group of anti-HA monoclonal antibodies which only inhibited virus-mediated hemagglutination and another group which exclusively neutralized reovirus infectivity. Using competition radioimmunoassays, we now report that these functionally discrete domains on the reovirus type 3 HA correspond to discrete antigenic regions of the protein.

Antibodies, Monoclonal↗
PubMed1983

Sleep patterns in patients with cancer and patients with cardiac disease.

Thirty cancer out-patients, 28 out-patients with cardiac disease, and 24 controls matched for age, sex, race, religion, and marital status were administered a 38-item questionnaire on sleep habits. Patients with cardiac disease perceived that they had more difficulty falling asleep, awakened earlier than planned, and felt sleepy during the day more often than the other two groups. Patients with cancer differed from controls only in feeling that they had more difficulty staying asleep. The findings demonstrate that while patients with two different chronic diseases have altered sleep patterns, the patterns are disturbed in different ways. This has important implications for therapy as a different approach is needed for the patient who has difficulty falling asleep as compared with the patient who has difficulty staying asleep.

Adult↗
PubMed1981

Urinary continence in children with neurogenic bladders.

Seventy-three children with neurogenic bladder dysfunction were assessed for urinary continence over periods ranging from 6 months to 4 years. Acceptable continence was achieved in 35 (48%), the majority by means of intermittent clean catheterisation, usually with drug manipulation. Two children had tobe diverted purely for intractable incontinence. A plan of management for children with neurogenic bladder dysfunction is described.

Adolescent↗
PubMed1980

Susceptibilities of anaerobic bacteria to cefoperazone and other antibiotics.

Two hundred fifty clinical isolates of anaerobic bacteria were tested for suceptibility to cefoperazone, cefamandole, cefoxitin, carbenicillin, clindamycin, and chloramphenicol. Anaerobic gram-positive cocci were susceptible to all of the antibiotics tested. Clindamycin was the most active agent against Bacteroides species, followed by chloramphenicol and then cefoxitin. Cefoperazone was less active than cefoxitin and equal in activity to carbenicillin. Cefamandole was the least active antibiotic against Bacteroides. B. distasonis, B. vulgatus, B. thetaiotaomicron, and B. ovatus were more resistant to the antibiotics than B. melaninogenicus, B. oralis, or B. bivius. Clindamycin was the most active agent against Clostridium species, followed by chloramphenicol; the three cephalosporins and carbenicillin were about equal in activity. Clindamycin was the most active antibiotic against Fusobacterium species, followed by chloramphenicol, carbenicillin, and cefoperazone (which were about equally active) and then cefamandole.

Anti-Bacterial Agents↗