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Biomedical subjects

Louis Katz

Publications and source records attributed to Louis Katz.

6 recordsLinked to original sources

Risk factors for groin wound infection after femoral artery catheterization: a case-control study.

OBJECTIVE: Groin wound infection (GWI) after femoral artery catheterization is unusual. However, several reports of GWI associated with the use of a Perclose device appear in the surgical literature. DESIGN: A case-control study. SETTING: We pooled 23 cases and 83 controls from a university hospital and a community medical center. PATIENTS: A case was defined as a patient who developed a GWI after a femoral artery catheterization. At the university hospital, 3 controls were randomly selected from the at-risk population and matched to each case by time of procedure only (within 2 weeks). At the community medical center, 4 controls were selected and matched to each case by time of procedure (within 2 weeks), sex, and age (within 5 years). RESULTS: We considered several covariates, including age, sex, body mass index, medical conditions, Perclose use, hematoma formation, and antithrombotic therapy. In a multivariate model, only hematoma formation (odds ratio, 68.8; 95% confidence interval, 12.1-391.4) and glycoprotein IIb/IIIa platelet inhibitor therapy (odds ratio, 6.1; 95% confidence interval, 1.1-33.6) were statistically significant predictors of GWI; Perclose use (odds ratio, 0.9; 95% confidence interval, 0.2-3.7) was not a statistically significant predictor of GWI. However, most of the hematomas (15/17) formed after procedures during which a Perclose device was used. CONCLUSION: Perclose use did not have any additional effect on GWI risk beyond the effect that hematoma formation had.

Case-Control Studies↗

The 2003 West Nile virus United States epidemic: the America's Blood Centers experience.

BACKGROUND: A detailed assessment of West Nile virus (WNV) yield is needed to evaluate the effectiveness of the WNV nucleic acid amplification technology (NAT) screening implemented in 2003. STUDY DESIGN AND METHODS: WNV NAT screening and donation data were compiled from members of America's Blood Centers, which collect nearly 50 percent of the US blood supply. WNV RNA screening was performed with either the Gen-Probe/Chiron Procleix transcription-mediated amplification assay or the Roche TaqScreen polymerase chain reaction. Results of alternate NAT and WNV immunoglobulin M (IgM) antibody assays conducted on index and follow-up samples were obtained from test manufacturers. Presumed WNV positivity was based on NAT repeat reactivity of the individual index donation whereas confirmatory status was based on additional IgM testing of the index donation and NAT and serology testing of follow-up samples. RESULTS: From July through October 2003, 2.5 million donations were screened for WNV RNA. Of 877 NAT-reactive donations (screening positivity rate of 3.5 per 10,000 units), 430 (49%) were confirmed positive, whereas 68 (8%) lacking follow-up data remained presumed positive. The sensitivity and positive predictive value of a presumed viremic result relative to final confirmatory status were 92 and 99 percent, respectively. WNV activity was highest in the central plains with prevalence per 10,000 peaking August 1 to 15 in Colorado (67.7) and South Dakota (77.5) and August 16 to 31 in Wyoming (74.1) and North Dakota (102.0). CONCLUSIONS: WNV screening interdicted many viremic units, thereby reducing transfusion-transmitted infections. This study demonstrates that a national collaborative effort facilitates timely surveillance of blood donor infectious disease prevalence rates.

Blood Banks↗

Did a severe flood in the Midwest cause an increase in the incidence of gastrointestinal symptoms?

Severe flooding occurred in the midwestern United States in 2001. Since November 2000, coincidentally, data on gastrointestinal symptoms had been collected for a drinking water intervention study in a community along the Mississippi River that was affected by the flood. After the flood had subsided, the authors asked these subjects (n = 1,110) about their contact with floodwater. The objectives of this investigation were to determine whether rates of gastrointestinal illness were elevated during the flood and whether contact with floodwater was associated with increased risk of gastrointestinal illness. An increase in the incidence of gastrointestinal symptoms during the flood was observed (incidence rate ratio = 1.29, 95% confidence interval: 1.06, 1.58), and this effect was pronounced among persons with potential sensitivity to infectious gastrointestinal illness. Tap water consumption was not related to gastrointestinal symptoms before, during, or after the flood. An association between gastrointestinal symptoms and contact with floodwater was also observed, and this effect was pronounced in children. This appears to be the first report of an increase in endemic gastrointestinal symptoms in a longitudinal cohort prospectively observed during a flood. These findings suggest that severe climatic events can result in an increase in the endemic incidence of gastrointestinal symptoms in the United States.

Adult↗

Blood-bank testing for infectious diseases: how safe is blood transfusion?

Remarkable progress has been made in transfusion safety from infection over the past three decades. Donor deferrals for at-risk behaviors, the introduction of more-sensitive viral-screening assays and the recent introduction of nucleic-acid amplification technology have nearly eliminated transmission of HIV and hepatitis C virus (HCV) by blood transfusion in North America. Nevertheless, risks of other infectious agents for which such robust screening tools have not been developed, such as bacteria and parasites, still remain. As a result of these successes, the non-infectious risks such as misidentification of patients and inadequate and inappropriate transfusion have become the primary sources of transfusion risk.

Blood Banks↗