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Biomedical subjects

R W Enzenauer

Publications and source records attributed to R W Enzenauer.

At least 19 recordsLinked to original sources
PubMed1992

Retinal findings after head trauma in infants and young children.

BACKGROUND: Many authorities believe that the finding of retinal hemorrhages in a child younger than 3 years of age with a history of head trauma, in the absence of an obvious cause for the injury, is pathognomonic of child abuse. To date, no studies have examined the prospective retinal examination of children who have had head trauma. The authors undertook such a study because the presence of retinal hemorrhage from any head trauma in children may have medicolegal diagnostic significance in differentiating accidental from nonaccidental trauma. METHODS: Seventy-nine children younger than 3 years of age, each of whom experienced head injury, underwent an ophthalmologic assessment, which included a dilated funduscopic examination. RESULTS: Seventy-five children sustained accidental head injuries and had normal funduscopic examinations. Three children had nonaccidental head injuries and all were found to have varying degrees of retinal hemorrhages. One child, with a normal fundus examination, had injuries that were of indeterminate cause. CONCLUSION: The finding of retinal hemorrhages in a child with a head injury suggests a nonaccidental cause.

Battered Child Syndrome↗
PubMed1992

Corneal diameter, axial length, and intraocular pressure in premature infants.

PURPOSE: Seventy premature infants 25 to 37 weeks' postconceptional age were examined during their first week of life to determine the correlation of corneal diameter, axial length, and intraocular pressure with gestational age and birth weight. METHODS: Corneal diameter measurement was determined with corneal templates, total axial length with standardized A-scan ultrasound, and intraocular pressure with a Tonopen II tonometer. RESULTS: Corneal diameter and total axial length showed parallel linear increases from 6.2 mm to 9.0 mm and 12.6 mm to 16.2 mm, respectively; however, no significant correlation was found between intraocular pressure and gestational age or birth weight. The mean intraocular pressure was 10.3 mmHg (standard deviation, 3.5). CONCLUSION: Normative values are established for corneal diameter and total axial length as they relate to birth weight and gestational age, and a mean and standard deviation for intraocular pressure in the premature newborn. These values will aid the ophthalmologist in assessing ocular dimensions in premature infants.

Birth Weight↗
PubMed1992

Sixth nerve palsy as the initial presenting sign of metastatic prostate cancer. A case report and review of the literature.

Cranial nerve palsies secondary to metastatic prostate cancer are uncommon occurrences. Usually appearing late in the course of the disease, they are associated with a poor prognosis. We report a case of a 71-year-old man who initially complained of diplopia and was found to have a right sixth nerve palsy and hyperdeviation caused by a mass in the clivus. Biopsy of the mass and extensive systemic workup revealed metastatic adenocarcinoma of the prostate gland.

Abducens Nerve↗
PubMed1992

Screening for fungal endophthalmitis in children at risk.

To evaluate the efficacy of screening ophthalmologic examinations in high-risk children, we reviewed the medical records for all patients hospitalized from 1985 through 1989 at The Hospital for Sick Children, Toronto, Ontario, who underwent ophthalmological consultation to rule out endogenous fungal endophthalmitis (n = 176). The patients were divided into groups: Group 1 (n = 47), those with deep-tissue fungal infection, and Group 2 (n = 129), those at risk for invasive fungal disease. Group 2 was subdivided further into two subgroups: Group 2a (n = 48), those with evidence of superficial fungal colonization (positive fungal culture) but no deep-tissue involvement, and Group 2b (n = 81), those with no evidence of fungal colonization (negative fungal culture). Of these 176 patients, 7 were diagnosed with endogenous fungal endophthalmitis: 6 from Group 1, 1 from Group 2a, and 0 from Group 2b. We found a significant association between the development of endogenous fungal endophthalmitis and the status of the fungal culture result (P less than .005). The odds ratio indicated the risk of endogenous fungal endophthalmitis in Group 1 patients with deep-tissue infection was at least 19 times that of Group 2 at-risk patients. The risk of endogenous fungal endophthalmitis in Group 1 patients was at least 7 times that of Group 2a colonized patients and 12 times that of Group 2b patients with no positive fungal culture. Our study confirms the necessity of careful dilated ophthalmoscopic examination in patients with invasive fungal disease and suggests screening for those at-risk patients with superficial fungal colonization.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Retinal vasculopathy associated with systemic light chain deposition disease.

A 35-year-old black male with the abrupt onset of blurred vision and decreased visual acuity was found to have severe retinal vasculopathy associated with systemic light chain deposition disease. While ocular manifestations are frequently reported in other plasma cell dyscrasias; ophthalmologic symptoms have not been previously reported in systemic light chain deposition disease alone. A possible mechanism of light chain deposition and damage to the retinal vasculature is proposed.

Adult↗
PubMed1990

Retinal pigment epithelial tear associated with subretinal hemorrhage: a case report.

Tears of the retinal pigment epithelium (RPE) are a recognized complication of pigment epithelium detachments associated with age-related macular degeneration (ARMD). The RPE tears are often associated with a poor visual prognosis and typically do not occur with subretinal hemorrhage. We report the case of a 76-year-old man with ARMD who developed an RPE tear associated with subretinal hemorrhage, without a demonstrable subretinal neovascular membrane. Temporally, there was a marked decrease in his vision that returned to his earlier baseline visual acuity over the course of six months of observation.

Aged↗
PubMed1989

Boxing-related injuries in the US Army, 1980 through 1985.

Boxing-related injuries, serious enough to involve hospitalization in US Army hospitals, were studied from 1980 through 1985. On average, there were 67 hospitalizations annually, with the injured spending an average of 5.1 days in bed and 8.9 days disabled, unfit for duty. There was one death from serious head injury and one instance of unilateral blindness from ocular trauma requiring enucleation. Head injuries accounted for 68% of all the injuries and were more common in the younger and presumably less experienced boxers. The advisability of continued promotion of boxing in the military needs to be addressed.

Adolescent↗
PubMed1989

Contamination of K-Sol corneal storage medium with Propionibacterium acnes.

K-Sol is a widely used corneal preservation medium. It has an excellent record for corneal storage and no previous report of contamination. During September 1988, on five of our K-Sol-stored donor rims Propionibacterium acnes grew. Cultures of unopened K-Sol also yielded P acnes. This report reviews previous contaminations of corneal storage media and the special characteristics of P acnes that enabled it to survive precautions taken against infection. The detection of P acnes was not obvious, and we emphasize the need for appropriate culturing of all donors, both aerobically and anaerobically, and close scrutiny of delayed inflammation in postoperative patients.

Chondroitin↗
PubMed1989

Boxing-related ocular injuries in the United States Army, 1980 to 1985.

Boxing is a controversial sport in which neurologic and ocular injuries can be particularly devastating. Currently, competitive boxing is promoted throughout the military. Ocular injuries attributable to military boxing were studied as a subset of a larger study of boxing-related injuries. Ocular injuries occurred in 5% (22/401) of soldiers hospitalized for boxing-related trauma. The 22 patients with eye injuries spent an average of 8.1 days in the hospital and 17.8 days unfit for duty. Ocular injuries, on average, resulted in a longer hospitalization and disability than all other boxing injuries. One soldier was blind in one eye after complications from a ruptured globe.

Athletic Injuries↗
PubMed1987

Declining frequency of circumcision: implications for changes in the absolute incidence and male to female sex ratio of urinary tract infections in early infancy.

The results of an investigation examining the circumcision frequency rate and its effect on the incidence of urinary tract infections in a large, widely dispersed population base during the 10-year period since the 1975 report of the American Academy of Pediatrics Ad Hoc Task Force on Circumcision are reported. Our study population included the 427,698 infants born in all United States Army hospitals, worldwide, from Jan 1, 1975, through Dec 31, 1984. There was an initial plateau in the circumcision frequency rate at approximately 85% during the first 4 years of the study period. In the subsequent 6 years there was a steady, significant decrease (P less than .001) of 1.4% to 4.0% per year through 1984, when the circumcision frequency rate reached its nadir of 70.5%. There was a concomitant increase in the total number of urinary tract infections among male infants (P less than .02) as the circumcision rate declined. This increase was due to the increase in the overall number of uncircumcised boys (who had a greater than 11-fold increased infection rate compared with circumcised boys). During the first half of the study period, there was a female predominance for urinary tract infections from birth onward. As the number of circumcised boys decreased (with a resultant increase in the total number of boys with infection), the male to female ratio of urinary tract infections during the first 3 months of life reversed, reflecting a movement toward a male predominance for infection in early infancy. This is the first, well-documented report of a decreasing rate of circumcisions performed on the American male population.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude of Health Personnel↗
PubMed1986

Decreased circumcision rate with videotaped counseling.

Despite the lack of medical indication for routine circumcision in the newborn, neonatal circumcision continues to be done on the vast majority of male infants in the United States. A trial of videotaped "informed consent" counseling was undertaken to determine whether such counseling could affect the parental choice about circumcision. We studied the circumcision frequency rate (CFR) after videotape counseling. We compared it to the rates following standard oral counseling. Videotaped counseling, in contrast to the standard physician-parent oral counseling, significantly reduced the incidence of parents' requests for routine neonatal circumcision.

Circumcision, Male↗