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Biomedical subjects

A Frei

Publications and source records attributed to A Frei.

47 records · Page 3Linked to original sources

[Quality control of liver diagnosis in newly admitted patients].

The evaluation of pathological clinical findings or abnormal laboratory tests in the liver was prospectively investigated. Pathological findings were used for diagnosis or differential diagnosis in only 40% of 102 patients investigated. Further investigations, mainly laboratory tests, resulted in definitive diagnosis only in 20%. The yield of pathological results when routinely ordering liver-specific tests is not more than 20%. Fewer, but perhaps more invasive, investigations would lower costs and improve the diagnostic yield.

Diagnosis, Differential↗

[Intensive surveillance in poisoning caused by tricyclic antidepressive agents].

Monitoring in an intensive care unit after intoxication with tricyclic antidepressants for 48-72 hours was reevaluated in a retrospective study of 57 patients. As described in the recent literature, severe neurologic (coma grade III and IV, seizure or respiratory insufficiency) or cardiovascular complications (bradycardia, ventricular tachycardia, hypotension, were not found after 24 hours of intensive monitoring. More prolonged monitoring control no longer appears necessary.

Antidepressive Agents, Tricyclic↗

[Use of physical therapy and ergotherapy in the day hospital].

The therapeutic possibilities of a day hospital orientated towards active rehabilitation are described. A survey revealed that 11 of the 34 patients were treated with active individual physiotherapy, 8 were attending remedial therapy and 5 regular individual speech therapy. The remaining patients followed physical or occupational therapy in groups. The patients receiving intensive individual procedures were mostly stroke patients with a history of less than two years or patients with chronic joint diseases. The accurate indication for the use of a staff- and time-consuming individual therapy is of great importance both in physiotherapy and occupational therapy. Treatment should be programmed for a carefully defined purpose and has to be adjusted continuously to the changing functional status of the patient.

Aged↗

Influence of antisera, purification procedures, and tracers on validity of a testosterone radioimmunoassay.

The levels of testosterone in pooled plasma from men and from women were measured by radioimmunoassay. Testosterone was isolated from plasma either by ether extraction (direct procedure) or by chromatography of the ether extract (chromatographic procedure). Three different antisera (all raised against testosterone-3-oxime albumin) were employed. An additional variable was the use of two tracers, [3H] testosterone and [125I] histamine testosterone. The latter tracer was employed in both a freshly prepared form and two months after labelling. The old tracer was used both in a nonpurified and repurified form. The results were compared with those given by one of the antisera using the assay with chromatography. The validity of this assay was verified earlier using a test of radiochemical purity. In the statistical evaluation of the data, it was found that the assays of both plasma pools gave the same results as the validated assay, even with two other antisera, but only when the chromatographic purification was used. The direct assays gave significantly increased values for testosterone in the male plasma pool with one antiserum, and in the female plasma pool with all three antisera. It is concluded that those assays maybe considered valid which give results statistically indistinguishable from those obtained by the valid assay. These were all chromatographic assays and, in the man, also two direct assays. The comparison of [3H] testosterone and [125I] histamine testosterone as tracers did not indicate any major differences in the validity of the assays. When the 125I-tracer was employed, a moderate (1.5-2 fold) increase of sensitivity was seen with all three antisera, and the antisera could be used in a 10-40 times higher dilution. Furthermore, it was possible to use [125I] histamine testosterone and obtain practically the same results after two months, whether repurified or not.

Adult↗

The N-terminal propeptide of collagen type III in serum reflects activity and degree of fibrosis in patients with chronic liver disease.

To evaluate the diagnostic significance of the collagen Type III (Col 1-3) N-terminal propeptide of procollagen Type III, with respect to activity and degree of liver fibrosis, Col 1-3 serum concentrations were measured in 111 patients with chronic liver diseases and in 60 patients were correlated with liver histology and morphometry. Col 1-3 was measured by a specific radioimmunoassay. Biopsies were read without knowledge of diagnosis. Periportal and intralobular lesions were assessed semiquantitatively by allocating 1 of 4 severity grades to each parameter. All portal areas were measured morphometrically. Compared to 27 normal controls, Col 1-3 concentrations were significantly elevated in patients with untreated chronic active hepatitis, cirrhosis and primary biliary cirrhosis, but not in chronic persistent hepatitis or fatty liver. Morphometrically measured portal tract area significantly correlated with Col 1-3 plasma levels. Among the semiquantitatively measured periportal lesions, the number of fibroblasts exhibited the closest relationship with Col 1-3 levels; there was no relationship between Col 1-3 levels and intralobular lesions. These data suggest that Col 1-3 serum levels reliably reflect the activity and degree of liver fibrosis and are useful along with liver biopsy in follow-up of patients with chronic liver disease.

Adult↗

Long-term follow-up of serum N-terminal propeptide of collagen type III levels in patients with chronic liver disease.

To evaluate the diagnostic and prognostic significance of the N-terminal propeptide of collagen Type III (Col 1-3) in chronic liver disease, the peptide level was measured in the serum of 4 patients with primary biliary cirrhosis, 5 with chronic persistent hepatitis, 12 with chronic active hepatitis, and 1 with autoimmune hepatitis, for a period of 2 to 10 years and compared with liver function and histology. In primary biliary cirrhosis, Col 1-3 peptide levels were always elevated, regardless of medical therapy; however, after liver transplantation in one patient, the Col 1-3 peptide level decreased. In chronic persistent hepatitis, the peptide level fluctuated around the upper limit of normal. Among patients with chronic active hepatitis, the Col 1-3 peptide level normalized in 2 patients during remission, but was elevated in 7 patients who developed cirrhosis. Only in a patient with autoimmune hepatitis was the Col 1-3 peptide level normal, although the patient developed cirrhosis during prednisone therapy. When prednisone was withdrawn, the Col 1-3 peptide level increased. The data suggest that the serum Col 1-3 peptide may estimate the course of liver fibrosis in chronic liver disease and has prognostic value, particularly in chronic active hepatitis. Persistent elevation suggests ongoing fibrosis and development of cirrhosis; normalization suggests remission.

Adult↗

Glycerol and dextran combined in the therapy of acute stroke. A placebo-controlled, double-blind trial with a planned interim analysis.

The results of clinical trials investigating various therapies in acute ischemic stroke have been inconsistent. The effect of glycerol therapy and a combination therapy of glycerol and dextran was evaluated in a double-blind, placebo-controlled study. Repeated neurologic examinations (Day 0, Weeks 1, 6, 12, and 24) according to a modified Mathew score were performed on 62 patients. Statistical analysis showed no superiority of either treatment compared with placebo in acute ischemic stroke. A retrospective estimation of the Type II error of the study yielded approximately p = 0.25. A major side effect was hemolysis in 98% of patients treated with glycerol.

Acute Disease↗