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Biomedical subjects

M A Kapusta

Publications and source records attributed to M A Kapusta.

At least 19 recordsLinked to original sources
PubMed1998

Vitritis as the primary manifestation of ocular syphilis in patients with HIV infection.

PURPOSE: To describe dense vitritis as the primary manifestation of ocular syphilis in three human immunodeficiency virus (HIV)-positive patients and to determine the response of these patients to the established regimen for neurosyphilis. METHODS: Anti-Toxoplasma gondii IgM and IgG antibody titers, tuberculin skin test, chest radiograph, and serum angiotensin-converting enzyme level were obtained because tuberculosis, sarcoidosis, and toxoplasmosis were in the differential diagnosis. Two of the three patients were not known to have HIV infection at the time of initial examination and consented to HIV testing. Treponemal and nontreponemal tests were performed on serum and cerebrospinal fluid to establish a definitive diagnosis. Treatment for neurosyphilis was initiated, and daily ophthalmic examinations were performed, with careful attention to signs commonly associated with syphilitic eye disease. RESULTS: All three patients exhibited improvement in visual acuity and resolution of vitreous haze. There was no evidence of other signs of posterior uveitis. The one patient for whom there has been a 6-month follow-up showed no sequelae of his eye disease. CONCLUSIONS: Human immunodeficiency virus-positive patients with syphilis may present atypically dense vitritis. In these patients, vitritis may be the first manifestation of syphilis. The regimen for neurosyphilis provides effective therapy. Moreover, in some patients, syphilitic vitritis may be the initial manifestation of HIV disease.

Adult↗
PubMed1996

Use of the ganciclovir implant in the treatment of recurrent cytomegalovirus retinitis.

OBJECTIVE: To evaluate the efficacy of the ganciclovir implant in the treatment of recurrent cytomegalovirus (CMV) retinitis. METHODS: Patients with acquired immunodeficiency syndrome and recurrent CMV retinitis were evaluated for entry into the study. A ganciclovir implant was inserted in 91 eyes of 70 patients between October 1992 and October 1995. The efficacy of the implant and visual results were retrospectively reviewed. RESULTS: Fifty-three (76%) of 70 eyes had inactive CMV retinitis 1 month postoperatively (positive initial response). Twenty-one eyes of 19 patients had less than 1 month of follow-up. Nineteen (36%) of 53 eyes developed recurrent CMV retinitis. The median time to recurrence for those patients with a positive initial response was 7 months. Forty-eight (84%) of 57 patients with follow-up longer than 1 month after implant insertion in the first eye received systemic anti-CMV medication during the study. The cumulative risk for developing a retinal detachment was 23% at 6 months following implant insertion. Other complications included vitreous hemorrhage, hyphema, and suprachoroidal implantation of the device. CONCLUSION: The ganciclovir implant is effective as an adjunct to continued systemic therapy in those patients with recurrent CMV retinitis.

AIDS-Related Opportunistic Infections↗
PubMed1996

Outcomes of dropped nucleus during phacoemulsification.

PURPOSE: To evaluate the clinical outcome of vitrectomy in the management of dropped nucleus during phacoemulsification. METHOD: Twenty-five consecutive patients who underwent pars plana vitrectomy for the management of dropped nucleus from phacoemulsification, over a 36-month period, were studied. Twenty-two patients underwent vitrectomy within 15 days of cataract surgery. Most of the patients were followed for more than 6 months. RESULTS: Final visual acuity was 20/40 or better in 71% (17/24) of eyes and 20/50 in 8% (2/24). Visual acuity was 20/70 or worse in 21% (5/24) of patients. Complications included persistent cystoid macular edema in three eyes, epimacular proliferation in two eyes, and a choroidal detachment in one eye. CONCLUSION: Poor visual outcome after dropped nucleus at phacoemulsification cataract extraction can be avoided if managed by prompt pars plana vitrectomy.

Aged↗
PubMed1990

Illness worry and disability in fibromyalgia syndrome.

Fibromyalgia (FM) is a common syndrome of functional somatic symptoms. This article examines whether an amplifying somatic style (increased body awareness and illness worry) might explain the distress and disability expressed by FM patients. Twenty FM patients were compared to twenty-three rheumatoid arthritis (RA) patients on measures of depressive and somatic symptomatology, pain, disability, and amplifying somatic style. FM patients reported greater somatic symptomatology, equivalent levels of pain, and less physical disability than did RA patients. No differences were observed between groups on body awareness or illness worry. Illness worry correlated highly with symptomatology for both groups but with physical disability only among FM patients. Results suggest that disability in functional somatic syndromes may be determined by patients' worry about having a serious disease. Feelings of vulnerability and apprehension about having an illness of unknown origin may contribute to FM sufferers' activity limitations, inability to sustain a work effort, and varied somatic distress.

Activities of Daily Living↗
PubMed1988

Somatization and depression in fibromyalgia syndrome.

Psychiatric diagnoses, self-reports of symptoms, and illness behavior of 20 fibromyalgia patients and 23 rheumatoid arthritis patients were compared. The fibromyalgia patients were not significantly more likely than the arthritis patients to report depressive symptoms or to receive a lifetime psychiatric diagnosis of major depression. These results do not support the contention that fibromyalgia is a form of somatized depression. Fibromyalgia patients, however, reported significantly more somatic symptoms of obscure origin and exhibited a pattern of reporting more somatic symptoms, multiple surgical procedures, and help seeking that may reflect a process of somatization rather than a discrete psychiatric disorder.

Aged↗
PubMed1977

The book of job and the modern view of depression.

The Biblical Book of Job is a wisdom book. Wisdom, in this context, refers to the intellectual discipline taught by the sages of ancient Isreael to provide professionals with a realistic approach to the problems of life. Chapter 30 of the Book of Job is a key-index of ideas that, if followed through the book, discloses a modern scientifically accurate description of a depression that, at times, was life-threatening. There are practical clinical clues to distinguish between normal mourning and depression, as well as aids to the differential diagnosis of somatic symptoms that may arise from depression. A timeless model of the scope and limitations of the professional relation between patient and comforter is also presented. Part of the wisdom of the Book of Job is to use depression as an example of a life-threatening illness to provide an unexcelled standard of clinical observation and medical intervention.

Bible↗
PubMed1976

Restoration of diminished T-cell function in adjuvant induced disease by methotrexate: evidence for two populations of splenic T-cell suppressors.

Diminished splenic T-cell function, as measured by their response to phytohemagglutinin and Concanavalin-A, was noted only during the active phase of adjuvant induced disease. This diminished function is due to at least two types of suppressor cell: (a) cells which adhere to glass but not plastic, and which are sensitive to methotrexate in vitro; (b) cells which adhere to plastic and glass, and which are relatively insensitive to methotrexate in vitro. Methotrexate treatment in vivo inhibits adjuvant induced disease, and is associated with the absence of both types of suppressor cells in the spleen.

Animals↗