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Biomedical subjects

R Kanter

Publications and source records attributed to R Kanter.

15 recordsLinked to original sources
PubMed2000

Resolving disease management problems in European-American and Latino couples with type 2 diabetes: the effects of ethnicity and patient gender.

The management of type 2 diabetes requires major life style changes. How patients and family members resolve disagreements about disease management affects how well the disease is managed over time. Our goal was to identify differences in how couples resolved disagreements about diabetes management based on ethnicity and patient gender. We recruited 65 Latino and 110 European-American (EA) couples in which one spouse had type 2 diabetes. Couples participated in a 10-minute videotaped, revealed differences interaction task that was evaluated with 7 reliable observer ratings: warm-engagement, hostility, avoidance, amount of conflict resolution, off-task behavior, patient dominance, and dialogue. A series of 2 x 2, Ethnicity x Sex ANOVAs indicated significant effects for Ethnicity and for the Ethnicity x Sex interaction, but not for Sex. Latino couples were rated as significantly more emotionally close, less avoidant, less hostile toward each other, and had less dominant patients than EA couples; however, Latino couples achieved significantly less problem resolution and were more frequently off-task than EA couples. These findings were qualified by patient gender. The findings highlight important differences

Adult↗
PubMed1996

Supraventricular tachycardia in four young dogs.

Rapid, clinical supraventricular tachycardia (SVT), without apparent underlying heart disease, was identified in 3 young Labrador Retrievers and 1 Labrador Retriever-type dog. The electrocardiographic characteristics, identification of ventricular preexcitation in 2 dogs, age at onset, response to antiarrhythmic agents, and recent electrophysiologic documentation of a concealed accessory pathway in another young Labrador Retriever suggested orthodromic atrioventricular reciprocating tachycardia as the mechanism of SVT.

Animals↗
PubMed1990

An empirical literature review of definitions of severe and persistent mental illness.

Seventeen definitions of the severely and persistently mentally ill have appeared in the literature over the past decade. These definitions have been used by 13 authors to formulate service programs and to estimate the prevalence of serious mental illness in the population. To test the applicability of these definitions, the authors operationalized each definition and applied it to a representative sample of 222 patients receiving services in one of Philadelphia's inner-city neighborhoods. The analysis showed estimates of prevalence of serious mental illness ranging from 4% to 88% of the treated population, depending on the definition applied. The NIMH (1987) definition was representative of the middle-range estimates of 45% to 55% arrived at by eight authors.

Adult↗
PubMed1990

Crossing state lines of chronic mental illness.

A federal law passed in 1986 required states to develop service plans incorporating each state's own definition of chronic mental illness. This study considered whether the state definitions can be used to identify comparable populations of chronic mentally ill patients and to obtain a meaningful national estimate of the number of such patients. The study applied definitions of chronic mental illness used in ten states to a representative sample of patients receiving public mental health services in West Philadelphia over a two-year period. The prevalence estimates of patients defined as chronically mentally ill ranged from 38 percent using the Hawaii definition to 72 percent using the Ohio definition. The National Institute of Mental Health definition, used as a reference point, produced a prevalence estimate of 55 percent. The authors conclude that the considerable variance among the states in prevalence estimates renders the sum of state counts of chronic mentally ill patients of limited use.

Adult↗
PubMed1982

Defective thyroid hormone action in fibroblasts cultured from subjects with the syndrome of resistance to thyroid hormones.

Two preadolescent girls and their mother with the syndrome of central and peripheral resistance to thyroid hormones are reported. The sisters had goiters, high radioiodine uptakes, high plasma levels of thyroid hormones, normal TSH levels, and brisk increases in TSH after TRH administration, but had no clinical evidence of thyrotoxicosis. The mother, who had undergone partial thyroidectomy and radioiodine therapy, presented with mild hypothyroid symptoms, normal thyroid hormone levels, and a high TSH level. On T4 treatment, her TSH fell toward normal, and thyroid levels became elevated without thyrotoxic symptoms. Special studies were performed with cultured skin fibroblasts. T3 stimulated low density lipoprotein receptor activity in cells from normal subjects, but failed to do so in fibroblasts form the three patients, indicating that their fibroblasts had a defective response to T3. However, after incubation of fibroblasts with labeled T3, no abnormalities in the binding capacity or affinity of nuclei were observed. These findings suggest that in this family, the thyroid hormone resistance demonstrable in vivo and in vitro results from a cellular defect at a site other than at the nuclear binding site.

Adult↗
PubMed1981

Biliary excretion of glycolipid in induced or inherited glucosylceramide lipidosis.

Metabolically inert L-[1-14C]glucosylceramide is stored predominantly in the liver after intravenous administration to mice. The half-time of this glycolipid analogue in the liver is 3.5 days and its clearance occurs predominantly via the bile. Within the limited number of Gaucher specimens available for examination very high levels of glucosylceramide were found in the bile of one patient and in the liver of two patients with biliary obstruction. The question of a possible relationship between biliary excretion of glycolipid and the pathogenesis of Gaucher's disease will require further studies.

Animals↗
PubMedDate not supplied

Lymphocyte response to phytomitogens in iron deficiency.

The lymphocytes of iron-deficient anemic and nonanemic patients have a decreased response to phytomitogens. Treatment of these patients with iron is followed by restoration of the lymphocyte response to normal. These findings indicate an important nonhemoglobin function of iron. Iron deficiency may be a factor in the production or potentiation of immune deficiency.

Adult↗
PubMedDate not supplied

Effectiveness of multiple EEGs in supporting the diagnosis of epilepsy: an operational curve.

Interictal epileptiform activity (IIEA) on EEG may be useful in the diagnosis and characterization of epilepsy. A single scalp EEG may fail to detect this abnormality, which is then discovered on repeat recordings. Since many people with epilepsy have persistently normal EEGs, a practical question arises concerning the yield of multiple EEGs. To determine the probability of finding IIEA with serial EEGs (the operational curve), we reviewed data from 1,201 EEGs on 429 adult patients, most with definite epilepsy presenting in adulthood. The diagnosis was made either clinically or with the support of the EEG. In 50% of our patients with IIEA, the abnormality is present on the first record, in 84% by the third EEG, and in 92% by the fourth. There is relatively little yield to serial EEGs beyond this point.

Adult↗
PubMedDate not supplied

Orthodromic reciprocating tachycardia and heart failure in a dog with a concealed posteroseptal accessory pathway.

A 4-month-old male Labrador Retriever was presented for recurrent bouts of pulmonary edema associated with tachycardia. Initial physical examination and echocardiography were unremarkable, and the electrocardiogram revealed only an intraventricular conduction disturbance. Subsequent recordings showed paroxysmal supraventricular tachycardia (SVT) (340 beats/min), which consistently produced pulmonary edema. The supraventricular tachycardia was unresponsive to adenosine, esmolol, and propranolol; was variable and transiently responsive to various vagal maneuvers and precordial thumps; and was always responsive to IV diltiazem. Multiple life-threatening episodes of SVT occurred, however, despite the chronic administration of oral diltiazem, propranolol, and procainamide. Diastolic cardiac dysfunction was documented by Doppler echocardiography and was thought to contribute to the development of pulmonary edema. A subsequent electrophysiologic study confirmed the presence of an atrioventricular posteroseptal accessory pathway that participated in orthodromic reciprocating tachycardia. This pathway was determined to conduct only in the retrograde direction ("concealed accessory pathway"). Intraoperative IV procainamide titration terminated the arrhythmia, which could not be reinduced when procainamide blood concentration approximated 20 micrograms/dL. Increasing the oral procainamide dose to achieve such plasma concentrations was successful in eliminating orthodromic reciprocating tachycardia, preventing heart failure, and returning Doppler indices of diastolic function to normal.

Animals↗
PubMedDate not supplied

Tracheomalacia in an infant with multiplex congenita (Larsen's) syndrome.

An infant born with multiplex congenita (Larsen's) syndrome developed respiratory distress 30 days following tracheostomy for relief of upper airway obstruction. The infant had structural and functional abnormalities of the thoracic cage. Tracheobronchoscopy revealed excessive compliance of the trachea with a tendency for collapse of the tracheal rings and obliteration of the tracheal lumen. Continuous positive airway pressure in the range of 20-25 cm H2O was used to maintain patency of the tracheal lumen and assure adequate ventilation. Hemodynamic and pulmonary barometric complications often observed when high levels of positive airway pressure are utilized in infants were not observed.

Abnormalities, Multiple↗
PubMedDate not supplied

Malnutrition in critically ill infants and children.

The prevalences of acute and chronic protein-energy malnutrition (PEM) and deficiencies in stores of fat and somatic protein have not been previously examined in pediatric intensive care unit. One hundred eight nutritional assessments were performed using anthropometric techniques on infants and children in a multidisciplinary intensive care unit. Overall, the prevalence of acute PEM was 19% and chronic PEM was 18%. The prevalence of fat store depletion was 14% and somatic protein store depletion was 21%. In general, children less than 2 years had poorer nutritional status compared to children greater than 2 years. There was not a statistically significant difference between medical and surgical patients. It is concluded that PEM and deficiencies in the macronutrient stores of fat and somatic protein are common in critically ill infants and children.

Anthropometry↗