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Biomedical subjects

R D Wasnich

Publications and source records attributed to R D Wasnich.

115 records · Page 7Linked to original sources
PubMed1980

Significance of antibody to hepatitis B core antigen in a hemodialysis unit.

Serum hepatitis B surface antigen (HB(s)Ag), antibody to HB(s)Ag (anti-HB(s)) and antibody to hepatitis B core antigen (anti-HB(c)) were determined serially in patients and staff in a hemodialysis unit. A low prevalence of HB(s)Ag (2.8 percent) was found. However, in patients without HB(s)Ag, anti-HB(c) alone was present in 9.2 percent, and coexistent anti-HB(s) and anti-HB(c) in 19.2 percent. In persons with anti-HB(c) only, the levels of anti-HB(c) correlate positively with abnormal results on liver function studies (LFS). In all subjects with abnormal LFS findings, anti-HB(c) levels were greater than 6.04 radioimmunoassay (RIA) units. In subjects with both anti-HB(s) and anti-HB(c), all five subjects with higher anti-HB(c) relative levels had abnormal LFS results and all subjects with normal LFS results had higher anti-HB(s) relative levels. Along with other recent reports in the literature, these findings suggest a hepatitis B prevalence in this hemodialysis unit far in excess of that anticipated on the basis of HB(s)Ag prevalence.

Antibodies, Viral↗
PubMed1976

A high-frequency ultrasonic nebulizer system for radioaerosol delivery.

A prototype high-frequency ultrasonic nebulizer, coupled with a nebulization chamber, has been designed specifically to overcome the problem of inefficient and unpredictable radioaerosol delivery. The objective was to reduce mean particle size, increase aerosol concentration, and minimize dead space. Thirty-nine patients were studied, including 15 patients in significant respiratory distress. Delivery of the radioaerosol proved to be rapid, efficient, and reproducible, and excellent alveolar distribution patterns were obtained in all 39 patients. Minimal nonpathologic tracheal deposition occurred in five patients, but this did not interfere with the interpretability or diagnostic validity of the study. All other instances of airway aerosol deposition correlated with documented airway disease. The images obtained with this system are a reliable measure of ventilatory distribution and airway tubulence.

Aerosols↗
PubMed1975

Occult atrial septal defect in adults.

Two patients are described who presented with congestive heart failure and were found to have an atrial septal defect with a pulmonary blood flow approximately twice the systemic blood flow. Most of the usual clinical signs of atrial septal defect were absent, and the diagnosis was established by right heart catheterization and radioisotopic angiography. Both patients had hypertension and coronary artery disease. Atrial septal defect in the adult patient may not be recognized because of associated cardiac disease, including coronary artery disease and hypertension, or pulmonary disease which may obscure the usual clinical signs of a septal defect. Radioisotopic angiography and right heart catheterization should be considered in any patients with heart disease or congestive failure of obscure cause even if the usual diagnostic signs of atrial septal defect are absent.

Cardiac Catheterization↗
PubMedDate not supplied

Evidence that increased calcium intake does not prevent early postmenopausal bone loss.

Calcium's ability to prevent bone loss in early postmenopausal women is controversial. We used data on 394 women from the placebo group of the Early Postmenopausal Interventional Cohort study, a clinical trial of alendronate, to investigate the relation of calcium intake to bone loss. Calcium intake was recorded, and bone mineral density (BMD) (in the lumbar spine, total body, forearm, and hip) and biochemical markers of bone turnover (serum total alkaline phosphatase, serum osteocalcin, and urinary N-telopeptide crosslink levels) were measured at baseline and annually thereafter. Women whose baseline calcium intake was <500 mg/d were advised to increase their calcium intake. Mean (+/- SE) BMD decreased by 1.9% +/- 0.16% at the lumbar spine and 1.6% +/- 0.14% at the hip over the 24-month period. Despite wide variations in baseline calcium intake and changes in calcium intake, these measures were not significantly associated with changes in BMD or bone turnover. Even women whose total calcium intake was >1333 mg/d (the highest tertile of total calcium intake) showed a decline in BMD of almost 2%, similar to declines in the lower two tertiles of total calcium intake (<869 and 869-1333 mg/d, respectively). Increased calcium intake resulted in modest mean increases of approximately 200 mg/d. We were unable to demonstrate that increases of this magnitude or much greater (1 g/d) were protective against declines in BMD at any site, even in women who had the lowest calcium intake at baseline. In addition to adequate calcium intake, more effective therapy appears to be required when the therapeutic goal is to increase or maintain BMD.

Bone Density↗
PubMedDate not supplied

Appropriate clinical application of bone density measurements.

When bone mass is properly evaluated as a risk factor, as opposed to a diagnostic test, its relationship to fracture risk is apparent. There is now substantial agreement among several prospective studies relating bone mass of the radius and calcaneus to fractures of the wrist, spine, hip, and other sites. Thus, selection of menopause-age women for preventive measures, including estrogen replacement, can be guided by measurements of bone mass. Although levels of bone mass can indicate the presence of fracture risk, they are insufficient measures of disease severity, and additional information is required for clinical decision making. It is possible to estimate Remaining Lifetime Fracture Probability (RLFP) based upon current bone mineral content (BMC), current age, life expectancy, and anticipated rate of bone loss. Objective estimates such as RLFP can be used to determine which patients may benefit from drug treatment of osteoporosis. The ultimate objective is to match the level and intensity of treatment to the actual level of fracture risk.

Aged↗