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Biomedical subjects

M L Katcher

Publications and source records attributed to M L Katcher.

36 records · Page 2Linked to original sources
PubMed1988

Screening programs for congenital hypothyroidism. How can they be improved?

High-sensitivity neonatal hypothyroid screening tests are used throughout the country. Because of low specificity, primary care physicians are faced with an abundance of false-positive results that challenge the interpreting physician with clinical, economic, and medicolegal considerations. We surveyed 154 physicians caring for Wisconsin-born infants with the highest newborn-screen thyrotropin values in a two-year period. Our results indicated that (1) confirmation of thyroid normalcy is often delayed beyond 6 weeks of age; (2) there is wide variation among physicians regarding therapeutic goals if hypothyroidism is confirmed; and (3) physicians prefer autonomy in the management of congenital hypothyroidism. Modifications in hypothyroid screening programs may include confirmatory tests by a central laboratory (that distributes filter paper with all abnormal results), provision of a management decision tree for primary care physicians, and a one-time subsidy for a visit to a pediatric endocrinologist. We suggest that these modifications may improve the long-term outcome of hypothyroid infants identified by the screening program.

Attitude of Health Personnel↗
PubMed1987

Prevention of tap water scald burns: evaluation of a multi-media injury control program.

A prospective study was designed to evaluate a mass media injury prevention program reaching two million people to determine its impact on risk awareness of hot tap water burns and injury-prevention behavior. Liquid-crystal thermometers for testing hot water temperature were offered at no cost; 140,000 were requested. Pre- and post-program general population random surveys (N = 337 and 318, respectively) found increased awareness of the danger of hot tap water, from 72 per cent to 89 per cent, but no increase in testing or lowering of water heater temperatures. A third random sample survey (N = 325) among thermometer requesters found a higher rate of testing (difference 58.1 per cent, 95 per cent CL 55.3 per cent, 60.9 per cent) than in the general population. Of those who tested, 43 per cent reported temperatures in the dangerous range of 54.4 degrees C (130 degrees F) or greater; 52 per cent of this group lowered their water heater thermostat. These findings indicate that: more than 25 per cent of the public is unaware of the potential danger of hot tap water; a safety education program which increases awareness will not necessarily result in injury-control behavior; and most people motivated to request a free thermometer will test their hot water temperature and lower it if necessary. As a result of this effort, thermostats of an estimated 20,000 water heaters were lowered from dangerously high levels.

Adult↗
PubMed1987

Lower extremity burns related to sensory loss in diabetes mellitus.

A chart review of 37 hospitalized patients with diabetes mellitus who received burn therapy showed that ten (27 percent) had preventable lower-extremity burns related to sensory loss. Most of these ten burns occurred from heat applied for self-care of diabetes, namely, from hot tap water, a hot moist compress, or a heating pad. These ten patients, compared with the other 27 diabetic burn patients, were more likely to be men younger than 45 years old, to have insulin-dependent diabetes, and to have been burned during self-treatment. These findings underscore the importance of injury-prevention educational efforts by physicians in cautioning their diabetic patients, especially those with lower-extremity sensory losses, about potential burns from heat applied to the lower extremities for self-care.

Adult↗
PubMed1986

Severe injury and death associated with home infant cardiorespiratory monitors.

Five cases of electrical injury to young children caused by misuse of components of home cardiorespiratory monitors are reported. The injuries, which included one electrocution, occurred when partially or completely disconnected electrode wires were inserted, by an older monitored child or preschool-aged sibling, into a live power cord or an uncovered wall outlet. Anticipatory guidance of home monitor users should emphasize potential electrical injuries and appropriate injury-control behaviors.

Accidents, Home↗
PubMed1982

Prophylaxis of neonatal conjunctivitis. An analytic review.

The recommendation by the Centers for Disease Control (CDC) that erythromycin and tetracycline ointments, as well as silver nitrate solution, are acceptable regimens for prophylaxis of gonococcal ophthalmia neonatorum (GON) has resulted in widespread local review of policies for ocular prophylaxis. The data concerning the efficacy and side effects of these agents are somewhat confusing or nonexistent. We discuss the etiologies of neonatal conjunctivitis and the topical and systemic agents used for prophylaxis of GON. We also review all studies that have compared the efficacy of one prophylactic agent with that of another agent or with no prophylaxis. It is found that all three agents have similar efficacy in preventing GON, although silver nitrate has been used more extensively in populations at high risk for GON. However, since Chlamydia trachomatis is the most common infectious cause of neonatal conjunctivitis in the United States at this time, and erythromycin appears to be very effective in prevention of neonatal conjunctivitis due to C. trachomatis, it may have an advantage over the other two agents. In addition, erythromycin use is associated with fewer ocular reactions than is silver nitrate.

Administration, Topical↗
PubMed1981

Scald burns from hot tap water.

Hot tap water is a common source of household burn injury. The charts of all patients hospitalized for tap water scalds in Dane County, Wisconsin, during a ten-year period were reviewed. Of 33 patients, 29 (88%) had readily identifiable risk factors: 17 (52%) were children younger than 5 years; three (9%) were older than 65 years; ten (30%) were physically or mentally disabled. One additional person was burned in a nonhome environment. Of the five deaths, three occurred in children younger than 30 months, and two occurred in patients older than 70 years. Almost all of these injuries could have been prevented by lowering the temperature of the household water heater to below 54.4 degrees C (130 degrees F) and preferably between 48.9 and 51.7 degrees C (120 to 125 degrees F). Physicians can play an important role in the prevention of this type of injury.

Accidents, Home↗
PubMed1980

Prevention of antigen-induced bronchoconstriction by lodoxamide ethyl, a new orally active antiallergic drug.

Lodoxamide ethyl, an orally active drug with pharmacologic activity similar to that of cromolyn sodium, blocks passive cutaneous anaphylaxis (PCA) in rats and antigen-induced bronchoconstriction in guinea pigs and monkeys. Its effectiveness in preventing antigen-induced airway obstruction was studied in 12 asymptomatic asthmatic adults with immediate skin test sensitivity to ragweed, Alternaria, or animal dander. The dose required to reduce the forced expiratory volume in 1 sec (FEV1) by 20% (PD20) was determined by dosimeter bronchoprovocation challenge with the appropriate antigen. At 1-wk intervals each subject received either placebo of 1, 3, or 10 mg drug in a randomized, double-blind fashion 30 min prior to starting bronchoprovocation challenge. On average, 1 mg increased the PD20 fivefold, 3 mg about sixfold, and 10 mg about 27-fold. Dose-related side effects began 10 min after drug and lasted up to 40 min. Thus the oral administration of lodoxamide ethyl was effective in preventing antigen-induced bronchoconstriction, and both the beneficial effects and side effects are dose related.

Adult↗
PubMed1977

Absence of spermatogonia in the Prader-Willi syndrome.

Bilateral testicular biopsies in an 81/2 year old boy with the Prader-Willi syndrome showed total absence of spermatogonia. Similar findings in postpubertal cases (Wannarachue et al., 1975) suggest that testicular dysplasia is one of the reasons for hypogonadism in males with the Prader-Willi syndrome.

Biopsy↗
PubMedDate not supplied

Air bag safety: what physicians should know.

The presence of air bags in motor vehicles has been credited with saving thousands of lives in frontal, high-speed collisions. However, air bags have also contributed to the deaths of some children and adults in the driver and front-passenger positions in low-speed crashes. It is important for physicians to understand the relative benefits and risks of air bags and to inform the public repeatedly that all motor vehicle occupants should be buckled at all times and that all children ages 12 and under should ride properly restrained in the back seat. With very few exceptions, air bags should NOT be deactivated. Through in-office counseling and community speaking and writing, physicians have the opportunity to give advice that could save many lives in motor vehicle crashes.

Accidents, Traffic↗