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Biomedical subjects

A Hirsch

Publications and source records attributed to A Hirsch.

At least 109 records · Page 6Linked to original sources

Upper gastrointestinal endoscopy in the pediatric patient.

During a 4 year period (January 1988 to December 1991), 237 pediatric patients (mean age +/- SD, 9.75 +/- 5.17 years) underwent 289 upper gastrointestinal endoscopies. Premedication was used in only 102 of the endoscopic examinations, mostly in children between 2 and 10 years of age. Patients who were examined without sedation tolerated the procedure well. Abdominal pain was the most frequent indication, accounting for 57.4% of all procedures. Gastritis, esophagitis, duodenitis and duodenal ulcer were the most common endoscopic findings. Seventy-five endoscopies were performed to obtain small bowel biopsies. We found this procedure to be easy and safe and preferable to capsule biopsies. In our experience, upper gastrointestinal endoscopy with or without sedation is a safe and effective diagnostic procedure in the pediatric age group.

Adolescent↗

Analysis of p53 antibodies in patients with various cancers define B-cell epitopes of human p53: distribution on primary structure and exposure on protein surface.

p53 antibodies have been found in sera of patients with breast and lung carcinomas and in children with B-lymphomas. We report here the presence of p53 antibodies in sera of patients with 11 different types of cancer. The frequency of seropositives for p53 varied among the different types of cancer, but a correlation with the frequency of p53 gene alteration was established. Using a powerful peptide enzyme-linked immunosorbent assay, we demonstrated that the immune response of patients with p53 antibodies was restricted to a small subset of peptides localized in the amino and carboxy termini of p53, whatever the type of cancer. Given the similarities of the patterns of immune responses in patients with p53 antibodies and animals hyperimmunized with human p53, we propose that the p53 humoral response is the result of a self-immunization process which is itself the consequence of p53 protein accumulation in tumor cells.

Amino Acid Sequence↗

[Passive smoking. Effects on health].

Passive smoking--also called involuntary or environmental smoking--is the exposure of non-smokers to the tobacco smoke released by smokers. The physico-chemical composition of tobacco smoke, and notably its contents in toxic and carcinogenic substances, is the same in the secondary stream between puffs as in the primary stream released by the smoker. The pathogenic effects of passive smoking are increasingly well known and accepted. A high incidence of respiratory tract infections and of chronic respiratory and asthmatic symptoms is observed in children. In adults, passive smoking seems to be one of the main risk factors for cardiovascular diseases. Its repercussions on the respiratory tracts is difficult to evaluate, but there are marked by an increase of respiratory symptoms and perhaps of chronic obstructive lung diseases. Finally, it is now recognized that passive smoking is a major risk factor for primary lung cancer in non-smokers exposed to tobacco smoke.

Adult↗

[Non-drug aid to tobacco withdrawal].

The smokers who receive the interventions that have often been the source of information in the literature about smoking cessation represent about 4% of the population of smokers: volunteers and help-seekers. This population is not representative of the smokers seen by their doctors; smoking patients can be at any of the stages in their smoking career. But doctors can play an important role in facilitating a smokers's progression towards smoking cessation by a clear, consistent and unequivocable message not to smoke. Depending on the time available and patient desire, doctors can call upon strategies from techniques developed in cessation clinics. The number of contacts with the smoking patient to provide these strategies is the most important factor in the aid the doctor can provide.

Humans↗

Gamma knife surgery in acoustic tumours.

Presentation of the experiences with 254 acoustic neurinomas, treated at the Karolinska Gamma Knife Center from 1969 to 1991, with a minimum follow-up of 12 months. Early loss of contrast enhancement on CT or MRI was seen in 70%. Unilateral tumours showed size decrease in 55%, no change in 33%, and increase in 12%. NF 2 tumours had decrease in 33%, no change in 43%, and increase in 24%. Some degree of facial weakness was seen after 17% of treatments, but always with later improvement of function. The incidence of trigeminal neuropathy was 19%. Preservation of hearing was 77%. Gamma knife treatment is as efficient as microsurgery, but without risk of infection, bleeding or CSF leak. It requires no hospitalisation. The patient can go back to work after a few days. It therefore should be offered as an alternative to every acoustic neurinoma patient.

Female↗

Environmental tobacco smoke and the risk of cancer in adults.

The apparent effect of environmental tobacco smoke (ETS) exposure on cancer risk has become an important social and political issue. The risk of cancer in non-smokers is often the main reason for prohibiting or restricting smoking in public places. A number of epidemiological studies have shown an association between ETS exposure and lung cancer. However, the strength of this association has still to be estimated. Only a few studies have reported on ETS and cancer from sites other than the lung in adults. No definite conclusions can be drawn at present from a critical review of the epidemiological evidence, but the suggestion of an association is present for sinonasal cancer, while bladder cancer does not seem to be associated to ETS exposure. Positive studies are available for cancers from other sites, including the breast, the uterine cervix and the brain, but these are difficult to interpret.

Adult↗

[High dose endobronchial curietherapy and its role in the relief of bronchial obstruction due to tumors].

The prognosis of tumours invading the lumen of the tracheobronchial tree is very poor. The majority of patients can only be offered symptomatic treatment. Different techniques to relieve bronchial obstruction have recently been developed. Amongst these is endobronchial radiation treatment at high dosage, with the advantage of enabling ambulatory treatment to be given with a satisfactory tolerance level. The treatment combines treatment both of the luminal invasion, but also of the component of the tumour which is extrinsic to the bronchi. Following a review of the literature, we have reviewed the technique, the indications and the results of this new method of treatment.

Airway Obstruction↗

[Smoking habits of French general practitioners. Results of a representative sample of 1,012 physicians].

General practitioners are in a position to influence the behaviour of the general population, notably as regards their smoking habits. This study aims to estimate the smoking habits of general practitioners in France, taken from a representative sample of 1012 general practitioners. The overall percentage of medical smokers rose in 1987 to 37%. The smoking habits varied according to age; thus if one considers current medical non-smokers, the oldest group are often ex-smokers, while the youngest are usually those who have never smoked. Compared to information obtained in 1980 from the medical population, one notes that there has been a fall in the level of doctors who smoke, whilst the proportion of doctors who have never smoked has risen considerably during the same period, particularly amongst young doctors.

Adult↗

Heterofullerenes: structure and property predictions, possible uses and synthesis proposals.

Substituting carbon atoms of fullerenes by heteroatoms and vacancies will lead to new and yet unknown spherical-shaped molecules termed hereafter as heterofullerenes. The enormous structural diversity of these molecules is investigated and their structural, electronic and thermochemical properties are predicted using semiempirical computations. Computational results for complexes with ions lead to the hypothesis that these molecules behave like microscopic Faraday cages in which the electrons concentrate on the outer side of the sphere. It is predicted that some of these heterofullerenes are structurally and electronically similar to phthalocyanines and related molecules but offer many additional advantages. Potential uses such as adding heterofullerenes to fullerene materials, as superior starting materials for the fabrication of diamonds, as catalysts in hydrogenation reactions, as components of materials dominated until now by phthalocyanines, etc., are discussed. Simple synthetic routes to these compounds that are based on minor alternations of existing methods for fullerene production are proposed. On the basis of the thermochemical calculations, we believe that the most promising possibility consists of using metal cyanide/graphite composite target rods instead of pure graphite rods as in a conventional fullerene synthesis.

Carbon↗

Molecular mechanism of contractile dysfunction in cardiac allograft rejection.

Alterations in the beta-adrenergic receptor adenylyl cyclase pathway are well known in heart failure. To determine if an alteration in this pathway occurs during the reversible phase of cardiac allograft rejection, we used a rat heterotopic heart transplant model. Lewis rats received either isografts or Lewis Brown Norway allografts. Cardiac grafts and native hearts were explanted 4, 5, or 6 days later. Receptor-mediated modulation of adenylyl cyclase activity was investigated using isoproterenol, forskolin, and the muscarinic and adenosine receptor agonists carbachol and R-N6-(C2-phenyl-isopropyl)-adenosine (R-PIA), respectively. Allografts demonstrated evidence of histological rejection and a significantly impaired response to forskolin and isoproterenol on all days: [table: see text] (% increase in cAMP in response to forskolin or isoproterenol +/- standard error. All results P less than 0.03 except Day 4 forskolin and Day 5 isoproterenol.) No significant difference was noted between isografts and allografts stimulated with carbachol and R-PIA. These data suggest that a primary alteration in adenylyl cyclase activity may be a component of the molecular basis of reversible contractile dysfunction in cardiac allograft rejection.

Adenylyl Cyclases↗

Anti-tobacco measures in the world: the French case.

The devastating long-term effects of tobacco smoking registered in the developed world and now imminent in the developing world must be responded to on national and international levels. In France, governmental tobacco control action began in 1976. Despite the high rates of premature mortality among men and women, legislative controls that were introduced were not enforced. Over the past decade, overall smoking prevalence has remained stable, reflecting growth in women's rates which compensates declines in men's rates. Comprehensive tobacco control measures should include prohibiting tobacco advertising, real tobacco retail price increases and regulations protecting non-smokers in public places. New legislation was voted in 1991 both in France and in the European Community. These measures, reinforced by a framework of continuing public education, may be an important step towards effective health promotion.

Advertising↗

[Value of magnetic resonance imaging in the detection of intramedullary metastases of bronchial epidermoid carcinoma].

A 68 year old female presented with an intramedullary metastasis which was found to be caused by an epidermoid bronchial carcinoma. This type of metastasis is a rare complication and a diagnosis is difficult. The authors stress the importance of nuclear magnetic resonance as a non-aggressive diagnostic method which is very sensitive in detecting this type of pathology.

Aged↗

[Stages of grief in coping with diabetes?].

Forms of coping with diabetes were determined on the basis of self-ratings of emotions (depressive, sad, angry, anxious) and responses on a 30-item "stages of grief" questionnaire by 52 inpatients aged between 25 and 50 (diabetes duration 1 to 35 years) at the beginning of a 12 day diabetes education program. Psychometric qualities of the instruments were evaluated. To test empirically the notion of grief stages in coping with diabetes, the frequency of emphasis on one or more emotional areas or stages of grief was determined and tested to ascertain whether various conditions occurred more frequently than was expected by chance. Results indicated that shortly after diabetes manifestation scores on protest and depression with respect to diabetes were elevated. The majority of cases could not be assigned to a single emotion or stage of grief but displayed negative emotional reactions in different content areas simultaneously. Consequently the concept of grief stages for coping with diabetes as well as recommendations based on this concept are questioned.

Adaptation, Psychological↗