The disparity between functional outdoor vision and the acuity measured in the standard refracting lane is well known among clinicians. A simple device, the brightness acuity tester (B.A.T.), was developed to predict a patient's functional outdoor acuity. The B.A.T. has an illuminated hemispheric bowl, 60 mm in diameter, with a 12-mm aperture. Fourteen normals and 50 patients with cataracts were tested using the B.A.T. and then tested outside in bright sunlight. The B.A.T. correlated extremely well (r = +0.84, P less than .0001) with the acuities measured outside. There was no decrease in visual acuity in the 14 normal patients, but there was a one to ten line decrease in vision among the cataract patients. Upon retesting, the B.A.T. scores did not vary, while outside testing scores did change due to variable outdoor ambient light levels on sunny days. The B.A.T. is a simple, repeatable, useful test for predicting functional outdoor acuity.
It is common belief that carcinoma of the pancreas has an inherent and unique ability to induce a hypercoagulable diathesis that leads to clinically significant thrombosis. We evaluated 130 consecutive patients with adenocarcinoma of the pancreas to document the incidence and the predisposing factors related to the postulated increased association of thromboembolic disorder (TED) and pancreatic carcinoma. Only nine such patients (6.9%) demonstrated TED complications of the classical Trousseau syndrome. In these instances, the location of the tumor and its mucin-producing potential were significant predisposing factors. In our series, TED was usually associated with tumors of the body and tail, which had a greater likelihood to be mucinogenic as compared with those localized to the head of the pancreas. Routine tests for hemostasis were not helpful in predicting the development of TED except, perhaps, for decreased platelet counts. Therefore, we believe that the relationship between cancer of the pancreas and TED should be de-emphasized since it is neither unique nor especially common to pancreatic carcinoma and since it may be frequently encountered in other varieties of visceral malignancies of the cancer patient population.
This study presents an analysis of the factors associated with HTLV-I seroprevalence in the endemic area of Tumaco, Colombia. During June to August 1988, 1,077 individuals were selected at random from a population of 45,594. The overall prevalence rate of HTLV-I antibodies was 2.8%. Among females prevalence was significantly higher (p less than 0.02) than among males. Rates increased substantially with age. HTLV-I prevalence among individuals with history of use of intravenous medications was significantly higher (p less than 0.001) than in those without such history. Logistic regression analysis included age in years, indicators for male gender, and for i.v. injections, and their interactions. Age was very strongly associated to HTLV-I infection among females. At early ages prevalence was not different between sexes, but females presented a significantly higher rate than males after age 42. History of i.v. administered medications was very strongly associated in the univariate analysis and, although significance was borderline in the multivariate analysis, it had the effect of doubling the odds of HTLV-I infection.
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