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Biomedical subjects

M S Schechter

Publications and source records attributed to M S Schechter.

At least 19 recordsLinked to original sources
PubMed2001

The association of socioeconomic status with outcomes in cystic fibrosis patients in the United States.

There is considerable variability in the clinical course of disease in cystic fibrosis (CF). Although currently unidentified modifier genes might explain some of this heterogeneity, other factors are probably contributory. Socioeconomic status (SES) is an important predictor of health status in many chronic polygenic diseases, but its role in CF has not been systematically evaluated. We performed a historical cohort analysis of pediatric CF patients in the United States using National Cystic Fibrosis Foundation Patient Registry (NCFPR) data for 1986 to 1994, and used Medicaid status as a proxy for low SES. The adjusted risk of death was 3.65 times higher (95% confidence interval [CI]: 3.03 to 4.40) for Medicaid patients than for those not receiving Medicaid. The percent predicted FEV(1) of surviving Medicaid patients was less by 9.1% (95% CI: 6.9 to 11.2). Medicaid patients were 2.19 times more likely to be below the 5th percentile for weight (95% CI: 1.91 to 2.51) and 2.22 times more likely to be below the 5th percentile for height (95% CI: 1.95 to 2.52) than were non-Medicaid patients. Medicaid patients were 1.60 times more likely to require treatment for a pulmonary exacerbation (95% CI: 1.29 to 1.98). There was no difference in the number of outpatient clinic visits for Medicaid and non-Medicaid patients. We conclude that low SES is associated with significantly poorer outcomes in children with CF. Barriers in access to specialty health care do not seem to explain this difference. Further study is indicated to determine what adverse environmental factors might cluster in CF patients of low SES to cause worse outcomes.

Cause of Death↗
PubMed1999

High-resolution inspiratory and expiratory CT in older children and adults with bronchopulmonary dysplasia.

OBJECTIVE: The objective of this study is to correlate high-resolution inspiratory and expiratory CT findings with pulmonary function results in older children and adults who have bronchopulmonary dysplasia. SUBJECTS AND METHODS: High-resolution inspiratory and expiratory CT of the thorax was performed prospectively on 26 patients (16 male, 10 female) with a clinical history of bronchopulmonary dysplasia. The median age was 10 years old (range, 5-18 years). High-resolution CT during inspiration was scored for areas of decreased density and evidence of interstitial lung disease; expiratory CT was scored for air trapping. Findings were correlated with pulmonary function measurements and clinical history. RESULTS: Twenty-four (92%) of the 26 patients had abnormal CT findings. Of these 24, 22 had reticular opacities and 18 had areas of architectural distortion. Twenty patients had areas of relatively decreased density. In 24 patients, air trapping was seen on expiratory CT. Abnormal pulmonary function correlated significantly (p < .05) with abnormal decreases in density, air trapping on expiratory CT, and architectural distortion. CONCLUSION: Abnormal findings on inspiratory and expiratory high-resolution CT of older children with bronchopulmonary dysplasia include scarring and air trapping with architectural distortion. The correlation between these findings and physiologic evidence of air trapping and obstructive lung disease was statistically significant.

Adolescent↗
PubMed1998

Relationship between socioeconomic status and disease severity in cystic fibrosis.

OBJECTIVE: This study was carried out to evaluate whether patients with cystic fibrosis (CF) who are socioeconomically disadvantaged, have a different outcome than higher-income patients. Medicaid insurance coverage was used as a proxy of low family income. STUDY DESIGN: A cross-sectional analysis was performed on a group of patients younger than 21 years of age seen at the University of North Carolina CF Center in 1994. RESULTS: The difference in median age at diagnosis for Medicaid (132 days) and non-Medicaid (177 days) patients was not statistically significant (p = 0.17). Medicaid patients' mean maximum percent predicted forced expiratory volume in 1 second for the year was 11.6% less than that of the non-Medicaid group (p = 0.01); this difference was constant across age. Medicaid patients averaged 0.8 more admissions for the year (p < 0.01) and 8.8 more days (p < 0.01) in the hospital but received the same amount of outpatient intravenous therapy. They also had 1.20 more outpatient visits to the center during the year (p = 0.02). CONCLUSIONS: Medicaid patients with CF have worse lung function and require more treatment for pulmonary exacerbations than their more advantaged counter-parts. This difference appears to begin early in life, does not increase with age, and is not explained by inadequate access to outpatient specialty care or delayed diagnosis. Other explanations such as inadequate access to primary care, poor adherence to prescribed regimens, or greater exposure to pollutants (e.g., environmental tobacco smoke) are speculative.

Adolescent↗
PubMed1978

A comparison of Freon- and water-based insecticidal aerosols for aircraft disinsection.

In Miami, USA, passenger compartments of wide-bodied jet aircraft were disinsected at "blocks away" or while parked. The application of 2% Freon- and water-based formulations of (+)-phenothrin at about 35 g/100 m(3) was highly effective against mosquitos and flies in all instances. More basic research is needed on water-based aerosols.

Aerosol Propellants↗
PubMed1976

Ammonium sulfate activation of phosphodiesterase in homogenates of larvae of the european corn borer.

European corn borer phosphodiesterase is highly activated by (NH4)2SO4 and moderately activated by NH4C1 (pH 7.6, 33 degrees). Vertebrate and crayfish diesterases, on the other hand, are inhibited by (NH4)2SO4. It is likely that (NH4)2SO4 causes some configurational change in the European corn borer phosphodiesterase molecule which results in the exposure of more active sites and hence greater enzyme activity. In in vitro tests caffeine (0.008 M) and theophylline (0.008 M) inhibit phosphodiesterase more effectively in European corn borer larvae than in crayfish, ovine, bovine, or rat tissue.

Ammonium Sulfate↗
PubMed1976

Aircraft disinfection: the physical and insecticidal characteristics of (+)-phenothrin applied by aerosol at "blocks away".

A 2% formulation of (+)-phenothrin dispensed from 340-g or break-off tip aerosol cans was highly effective against mosquitos in aircraft disinsection trials. Two minutes after application at "blocks away", the mass median diameter of the dispersed drops was 5.1-6.2 mum. The concentration of the insecticide in the cabin fell to 10% of the original concentration after 9.2 min. No odour or irritation was caused by the use of this insecticide.

Aerosols↗
PubMed1974

Desirability of three synthetic pyrethroid aerosols for aircraft disinsection.

Of several aerosol formulations of 3 synthetic pyrethroids, S-2539 Forte, resmethrin, and bioresmethrin, the 2% formulation was most effective for the disinsection of passenger spaces aboard jet aircraft; the 1.2% and 0.3% formulations were less effective. Break-off tip aerosol units gave good dispersal, but these limited production cans showed slight variability in the rate of release.

Aerosols↗