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Biomedical subjects

A Ritz

Publications and source records attributed to A Ritz.

At least 19 recordsLinked to original sources
PubMed2006

[Life experience of adults with unilateral agenesia of the forearm: effect of prosthesis on self image and social relations].

PURPOSE OF THE STUDY: This study was devoted to better understanding how adults with agenesia of the forearm live their condition. The malformation studied was identical to that of a previous study in children. The present study was designed to provide professionals and parents with a reference system for making therapeutic decisions. MATERIAL AND METHODS: An intensive survey using semi-directive interviews was conducted among adults aged 19 to 37 years, 12 women and 8 men, with unilateral agenesia of the forearm. The majority of the participants had an occupation and an active social and familial life. RESULTS: The survey revealed factors of limitation or progress, expectations and renouncements, marking the life experience of these persons. The prosthesis had a significant impact on their lives. DISCUSSION: Four types of life experience could be identified from the survey data. All four could be understood as a search for equilibrium between internal reality (desired self image) and external reality (image produced by the physical and human environment via the regards of others and obstacles encountered). Several modalities for using a prosthesis, several ways of coping with the absence of a hand, with or without a prosthesis, and several ways of constructing a self-representation were distinguished. Rather than a functional disability, agenesia was found to be perceived as a persistent problem in daily life, generating handicap- or discrimination-producing situations. CONCLUSION: Forearm agenesia creates a situation different from normal and as such makes the question of self-identity and social relations more complex than for others. The comments provided by these young adults who cope with the paradoxical condition of an amputated but functional body demonstrated the central role of the body.

Activities of Daily Living↗
PubMed2006

Initiation of hypertension treatment with a fixed-dose combination or its monocomponents -- does it really matter?

Despite efforts to diagnose and treat hypertension effectively, the goal of lowering blood pressure (BP) levels is rarely achieved, as treatment is often initiated with a single antihypertensive agent. The aim of this study was to assess the safety and efficacy of a first-line fixed-dose combination treatment compared with treatment with its monocomponents over a period of 4 weeks. Patients (n = 149) with essential hypertension were randomised to receive 2.5 mg of either ramipril or felodipine ER or the fixed-dose combination of ramipril 2.5 mg/felodipine ER 2.5 mg over a 4-week treatment period. BP and heart rate were measured by conventional methodology and 24-hour ambulatory blood pressure measurements. Treatment with the fixed-dose combination was significantly more effective in reducing systolic and diastolic BP (-15.8/-9.2 mmHg) compared with its monocomponents, ramipril (-7.6/-3.8 mmHg) and felodipine ER (-8.0/-5.0 mmHg). No significant difference could be observed in the occurrence of a greater fall in systolic and diastolic BP 6 h after the first dose of the three study medications. The adverse effects reported were mild, and less number of patients in the fixed-dose combination complained of adverse events. It can be concluded that initiating antihypertensive treatment with a low fixed-dose combination of ramipril/felodipine ER is more effective and safe when compared with treatment with its monocomponents.

Antihypertensive Agents↗
PubMed2006

Percutaneous transcatheter closure of patent foramen ovale.

In presence of a patent foramen ovale (PFO) with cryptogenic cerebral embolism, traditional therapy consists of oral anticoagulation or antiplatelet therapy. Surgery was considered only in case of recurrence. Transcatheter closure of PFO is currently performed. The availability of new user friendly devices and the increasing knowledge of pathophysiology, epidemiology, and follow-up of these patients has broadened the indications and marked reduced morbidity related to interventional PFO closure. This review presents the current knowledge and our own data concerning transcatheter closure of PFO.

Cardiac Catheterization↗
PubMed2003

[Wishes of nursing home residents concerning their life situation--results of a qualitative study].

OBJECTIVE: This study examined the wishes of nursing home residents concerning their life situation in the nursing home. METHODS: Using a qualitative study design, a representative sample of nursing home residents (n = 1656) of 24 nursing homes in a city situated in the eastern part of Germany were interviewed. RESULTS: The analyses of residents' wishes lead to major domains such as the quality of care, interpersonal contact, architecture and organization of the house, diversification, financial support, as well as themes like health and death and the wish to leave the nursing home. Residents focus on an individualized approach to care. CONCLUSIONS: Nursing home residents' views support the need to improve the psychological and social aspects of the quality of care. Implications of and consequences for the organization of care and concepts of nursing are discussed.

Aged↗
PubMed2002

[Unilateral forearm agenesis and prosthesis].

PURPOSE OF THE STUDY: Antebrachial agenesis is a congenital deformity which is not invalidating for the children who have a level of independence comparable to that of other children of the same age. Although the appropriateness of a prosthesis is rarely questioned by healthcarers, it is clear that it is the healthcarers' own representation of this condition (their knowledge of the deformity and of the prosthesis proposed) that leads to the indication. The purpose of this study was to better understand the respective representations of unilateral antebrachial agenesis to help determine appropriate health care proposals. MATERIAL AND METHODS: An intensive survey using semi-directive interviews was conducted in 16 families. Group interviews with three healthcare teams were then conducted. RESULTS: Three leading topics appeared: worry about the social integration of the child, a paradoxical representation of the child perceived as independent but handicapped, and a largely negative image of the prosthesis. There was a rather important difference in the representations formulated by the parents and by the healthcarers. DISCUSSION: The discussion focused on awareness of the narcissistic content of the expectations and the plastic and functional implications of prosthesis fitting, perceived differently by parents and healthcarers. CONCLUSION: The nature of the expected result involves a change in the representation of the child more than a change in the child's body, a concept which in itself is not a true objective of healthcare. Taken the understandably difficult position of healthcarers, it might be useful to propose a different scheme for the first consultation.

Adolescent↗
PubMed2001

Children's spatial behavior is differentially affected after traumatic brain injury.

Spatial behavior in 20 children with severe traumatic brain injury (TBI) and 20 healthy controls was investigated using the Kiel Locomotor Maze. Children had to remember defined locations in an experimental chamber with completely controlled intra- and extra-maze cues until learning criterion was reached. In a second experiment, spatial orientation strategies were assessed. Children with TBI were shown to be impaired in spatial learning and spatial memory. Spatial orientation was found to be deficient even in cases where spatial learning and memory proved to be unimpaired, especially in tasks that demanded the use of relational place strategies. Children who suffered a TBI at an early age proved to be more severely impaired in spatial learning and orientation than older children.

Brain Injuries↗
PubMed2000

[Stage-oriented nursing care rates in neurologic rehabilitation].

The aim of this pilot study done in a neurological rehabilitation center for children and adolescents was to increase the transparency of costs in relation to work and to gain differentiated daily rates according to the kind and amount of nursing and multidisciplinary treatment of patients in different phases (B, C, D) of neurorehabilitation. Presented and discussed are methods and instruments for performance registration and connecting them to costs. As the study shows quite different daily rates are necessary to assure adequate treatment for young patients in different phases--early to late--of neurological rehabilitation.

Adolescent↗
PubMed1999

High prevalence of CACNA1A truncations and broader clinical spectrum in episodic ataxia type 2.

OBJECTIVE: To characterize the nature of CACNA1A mutations in episodic ataxia type 2 (EA2), to search for mutations in sporadic cases, and to delineate better the clinical spectrum. BACKGROUND: EA2 is an autosomal dominant disorder characterized by recurrent acetazolamide-responsive attacks of cerebellar ataxia. The mutated gene, CACNA1A, located on chromosome 19, encodes the alpha1A subunit of a voltage-dependent calcium channel. So far, only three CACNA1A mutations have been identified-in two EA2 families and in one sporadic case. These three mutations disrupted the reading frame and led to truncated proteins. Interestingly, distinct types of CACNA1A mutations have been identified in familial hemiplegic migraine (missense mutations) and spinocerebellar ataxia type 6 (SCA-6) progressive cerebellar ataxia (expanded CAG repeats). However, except for SCA-6, these genotype-phenotype correlations relied on the analysis of very few families. METHODS: To characterize CACNA1A mutations, eight familial and seven sporadic EA2 patients were selected. All 47 exons of CACNA1A were screened by a combination of single-strand conformer polymorphism and sequencing analysis. In addition, the length of the CAG repeat has been determined in all patients. RESULTS: Seven new mutations were detected in four multiple case families and three sporadic cases. Six of them lead most likely to truncated or aberrant proteins. CAG repeat sizes were in the normal range. CONCLUSION: These data clearly establish the specificity of EA2 mutations compared with SCA-6 and familial hemiplegic migraine. Detailed clinical analysis of the mutation carriers showed the highly variable penetrance and expression of this disorder: Several of the carriers did not show any clinical symptom; others displayed atypical or permanent neurologic symptoms (such as recurrent, transient diplopia or severe, permanent, and isolated cerebellar ataxia).

Adolescent↗
PubMed1988

[The locked-in syndrome].

The locked-in syndrome is poorly understood, and may be misdiagnosed as coma. The syndrome consists of complete paralysis of all four limbs and the lower cranial nerve pairs, associated with an unaltered consciousness. Vertical eye movements and blinking remain intact, so allowing some form of communication by way of eye codes. Obstruction of the vertebral and basilar vascular system is the major cause, but the six cases reported show the aetiological diversity of this syndrome. If the vascular obstruction is diagnosed within the first few hours, fibrinolytic therapy may be considered. Although the patients usually die within a few days or after several months, some rare cases of recovery after several weeks have been reported. Intensive care is required by these patients (tracheostomy, artificial ventilation, intensive nursing care); the physicians and nursing staff looking after them should always keep in mind that these patients are conscious and able to communicate.

Adult↗
PubMed1986

Cranial nerve damage after paediatric head trauma: a long-term follow-up study of 741 cases.

A report is given on transient and permanent (6 months) impairment of cranial nerves after paediatric head injuries (N: 741). There is a link between severity of the injury, fractures on the base of the skull, its foramina and channels, and the frequency of cranial nerve involvement. One should try to establish whether a posttraumatic dysfunction of the cranial nerves is primary or secondary in nature, i.e. due to raised intracranial pressure or haemorrhage. In children after head injuries often the cranial nerves of the oculomotor system are affected (20.2%/7.0%)--transient (permanent), followed by optic atrophy (4.88%), lesion of the trigeminal nerve (4.2%/2.2%), and the facial nerve lower motor type (4.1%/1.7%). Loss of hearing (3.3%/1.2%) and of smell (3.2%/1.2%) are less frequent in children than in adults.

Child↗
PubMed1983

Abnormal metabolism of valproic acid in fatal hepatic failure.

A 7-year-old boy developed a severe unilateral grand mal seizure at the age of 5 years (phenobarbitone therapy); 1.5 years later valproate (2-propylpentanoic acid, VPA) was added to the therapy. After a seizure-free period of 3 months the patient died from hepatic failure resembling Reye syndrome. Several plasma and urine samples from the final stage before and during peritoneal dialysis were analyzed by GC/MS. The predominant feature was the abnormally increased formation of both 3 mono- and 4 double unsaturated metabolites of VPA amounting in plasma to 58%-71% of the sum of VPA plus all analyzed metabolites (controls maximal 15%) and in urine to 34%-61% (controls maximal 10%). The beta-oxidation pathway of VPA was shown to be suppressed (lack of 3-keto-VPA), whereas metabolites from the omega-oxidation pathway could still be measured (urinary 5-OH-VPA plus 2-propylglutaric acid ca. 1.6%, controls more than 10%). 4-en-VPA (2-propyl-4-pentenoic acid) (5%-21% in plasma) and 4,4'-dien-VPA (2(2-propenyl)-4-pentenoic acid) (4%-7%) have been found as abnormal unsaturated metabolites not detectable in controls. Additional typical findings were the high excretion of adipic acid, suberic acid, and 4-octen-1,8-dicarboxylic acid demonstrating the enhanced capacity of omega-oxidation in fatty acid oxidation.

Chemical and Drug Induced Liver Injury↗
PubMed1981

Cocaine and seizure protection in mice of varying brain weights.

The effects of cocaine administration on seizure duration and proportion of animals that seized were examined in mice genetically selected for differential brain weight. In the two experiments reported, mice of the Fuller brain weight lines and of the Binghamton Heterogeneous stock were used. In Experiment 1, 21 day old male and female mice were administered either 0, 5, 10 or 20 mg/kg of cocaine hydrochloride. Fifteen minutes after each mouse was injected, a transcorneal shock was administered to that animal. Type and duration of seizure were measured. Low brain weight mice were more susceptible to seizures and showed more severe seizures than the medium and high brain weight mice or the Heterogeneous stock. Cocaine hydrochloride provided a degree of protection against seizures in a dose dependent fashion, particularly in the medium brain weight and Heterogeneous stock mice. Experiment 2 examined whether repeated daily doses of cocaine (15-21 days of age) would alter the pattern of susceptibility described above. In this experiment mice were given either 0 mg/kg or 10 mg/kg of cocaine hydrochloride. At 21 days of age, 15 minutes after injection, mice were subjected to transcorneal shock and the subsequent nature and duration of seizures observed. Mice of the low brain weight line were again seen to have more seizures than those from the high brain weight line. Cocaine decreased the severity of transcorneal induced seizures.

Animals↗
PubMed1981

[Complicated migraine in children (author's transl)].

444 children and adolescents (266 boys, 178 girls) were examined because of migraine at the Department of Pediatric Neurology of the University Children's Hospital, Frankfurt/Main between 1967 and 1980. 378 of these had common and/or classical migraine, 66 complicated migraine. Family history, sex and age at onset in these two groups are compared. Based on this material (4 cases of ophthalmoplegic, 49 of hemiplegic and 13 of basilar artery migraine) clinical features, EEG findings angiographic and CAT-findings of these different forms of complicated migraine are discussed and demonstrated by typical case reports. The importance of basilar artery migraine even in childhood and the mainly poor prognosis of its special type of early onset- "alternating hemiplegia" - are stressed.

Adolescent↗
PubMed1978

Snack food consumption of 12 year old inner-city children and its relationship to oral health.

The relations between reported frequency of consumption of 18 common snack foods, SES variables, and oral health scores were studied in 92 12-year-old children from three inner-city schools in Rochester, New York. The group was composed of 44 males and 48 females who were either black or had a Spanish surname. The study documented only a few significant relations between consumption of snack foods and DMF scores or overall oral health. Reported cake consumption correlated positively with total debris and gingivitis, and consumption of chewy candy and ice cream was positively related to DMF scores. Black females exhibited the greatest number of decayed and DMF teeth, and both male and female black children had significantly greater amounts of total debris, gingivitis and decayed teeth.

Black People↗