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Biomedical subjects

A Wagner

Publications and source records attributed to A Wagner.

608 records · Page 34Linked to original sources

Is the incidence of acute mountain sickness (AMS) at medium altitude in the Austrian Alps influenced by the height of home residence of the alpinist?

UNLABELLED: In previous studies the incidence of acute mountain sickness (AMS) at medium altitude was examined in the Austrian Alps, where many tourists come from low parts of Europe. This study assesses the influence of the height of home residence on the incidence of AMS at medium altitude. The severity of high-altitude adaptation disorder was quantified by using a scoring system after an interview and a clinical examination in 84 lowlanders, mainly those from Hungary. Forty-two alpinists with a home residence of 800 to 1000 m served as control. The incidence of AMS was 1.4% at 2000 m and 7.4% in 3000 m. The most frequent symptoms were slight headache and peripheral or periorbital oedema. The AMS-score of the Hungarian alpinists did not differ significantly from that of the alpinists with a home residence of height 800 to 1000 m. CONCLUSION: in contrast to the situation at high altitude, at medium height tourists from lowlands are not at higher risk of AMS than other alpinists.

Acclimatization↗

Detection of high risk patients in chronic myelogenous leukemia by DNA-image cytometry.

Peripheral blood smears from the time of diagnosis of 64 patients with chronic myelogenous leukemia (CML) in chronic phase were restained according to Feulgen. Nuclear DNA content of at least 100 myeloblasts and promyelocytes was measured by interactive DNA-cytometry using a TV-image analysis system, combined with an automated microscope. From the resulting DNA values the DNA parameters stemline ploidy, stemline shoulder fraction and "proliferative" fraction, which reflect cytogenetic and cell kinetic characteristics of CML, were derived. Each of these DNA parameters identified subgroups with a significantly different survival time and duration of chronic phase. Indicators for a good prognosis were a near-diploid stemline ploidy (median survival time 49 v. 26 months), a low percentage of nuclei in the stemline shoulder fraction (45 v. 28 months) and a high "proliferative" fraction (45 v. 23 months). Independently of clinical and hematological features, the DNA-cytometric parameters yielded additional prognostic information both in the univariate and multivariate analysis.

Adult↗

Self-medication for elderly patients.

This paper describes the introduction of a self-medication programme for elderly in-patients using action research. The programme was initiated by a steering group which met regularly to implement and monitor self-medication. Ward staff were interviewed to assess their learning needs before the start, meetings were held as the project advanced, and a final staff evaluation questionnaire was administered. Patients' opinions were also monitored. Self-medication was successfully introduced and minor problems were rapidly solved by participating staff. Patients were highly satisfied with the new independence and self-esteem they had gained through taking their own medications. Nurses shared these feelings, but also felt that self-medication was more time consuming than previous drug rounds. Suggestions for further research and development are given.

Aged↗

[Comparative studies of the response of normolipemic and dyslipemic aged subjects to 2 forms of delayed-action nicotinic acid polyesters. Pentaerythrotol tetranicotinate and inositol hexanicotinate. Results of a controlled cross-over trial].

A cross-over trial was run to compare the effects of two delayed-action nicotinic acid polyesters (pentaerythritol-tetranticotinate, PETN, and inositol-hexanicotinate, MIEN) in 59 aged normo- and dyslipaemic subjects. PETN tended to normalise the lipid picture in much the same way as nicotin acid, without a drastic effect on circulating lipids and lipoproteins. MIEN, on the other hand, had only a slight effect on total blood lipids, and appeared to be ineffective or negative with respect to the other lipid parameters. PETN proved capable of releasing active concentrations of nicotinic acid in vivo for a period of time that was sufficient to correct hyperlipaemia in age subjects. The side-effects were slight, infrequent and quickly reversible.

Age Factors↗

[Severe essential arterial hypertension; the physiopathogenic role of the adrenal medulla. I. Population studies and experimental research].

The authors have carried out a populational study by performing psychomorphological and blood determinations, and have detected the presence of a chronic hyperactivity syndrome of the adrenals in 12,5 percent of the healthy young subjects engaged in various activities that they have investigated. In an experimental study the oxydative processes in the enzymatic cycle of Krebs were cut off by injecting the adrenal medullary area with a 40% solution of sodium salicylate, while the secretion of the adrenal cortex was maintained, as was demonstrated by the unaffected activity of the hexose monophosphate shunt in this tissue. The experimental results demonstrated that the adrenal medullary tissue represents a major pathogenetic link in the complex etiopathogeny of essential arterial hypertension, and this invalidates the role attributed by Volhard (in 1931) to the renal tissue, explaining the failure of haemodialysis, bilateral nephrectomy and kidney transplantation in preventing the recurrence of essential arterial hypertension.

Adrenal Cortex Hormones↗

[Chemical medullosclerosis with 40-percent sodium salicylate, combined with splanchnicosympathectomy, with or without contralateral adrenalectomy, in severe essential arterial hypertension. II. Clinical, paraclinical and technical studies. Results for a period of 2 to 20 years (original concepts and therapy)].

Unilateral medullosclerosis associated with splanchnicosympathectomy was applied in 60 cases of severe essential arterial hypertension. In 21 patients this was associated with contralateral adrenalectomy. No deaths were recorded. The late results (2 to 20 years) varied in terms of the anatomoclinical stage of the disease when surgery was performed. Systolic pressures fell to 30-50 mm Hg, hypertensive oscillations disappeared, mean adrenalinaemia values decreased by 47.9% after unilateral medullosclerosis and slanchnicosympathectomy and by 72.2% after bilateral interventions in two stage. The constitutional hyperadrenergic psychosomatic background was modified and became normohypoadrenergic. There was no case of adrenocortical insufficiency, the secretion of corticoids being insured by activity of the hexose-6-mono-phosphate dehydrogenase shunt.

Adrenal Medulla↗

Physiologic and pathogenic role of the adrenal medulla in severe essential arterial hypertension. Populational and experimental investigations. Therapeutic implications.

The syndrome of constitutional chronic hyperadrenalism was detected biochemically by blood cathecholamine assays as well as psychically and morphologically in 12.5% of the young apparently healthy subjects from Bucharest, investigated. Experimentally, the enzymatic cellular oxidative process in the adrenal medulla was blocked by chemical sclerosis of the adrenal medulla with a 40% solution of sodium salicylate (2.5 M), without influencing cortical secretion ensured bythe hexose monophosphat shunt. Chemical medullosclerosis associated with splanchnicosympathectomy and with or without suprarenalectomy on the opposite side performed in 60 patients with severe essential arterial hypertension resistant to drug therapy gave good results depending on the anatomical and clinical evolutive stage of disease.

Adolescent↗

Effect of alcohol on body core temperature during cold-water immersion.

This study investigates the influence of alcohol on body core temperature during cold-water immersion in human volunteers. In this randomised, double-blind, placebo-controlled crossover trial, 8 healthy male volunteers were randomised to drink 1 litre of beverage containing 50 g alcohol or placebo before 20 degrees C cold-water immersion for 1 hour. Body core temperature was measured before cooling and after 1 hour of immersion with an infrared ear thermometer. After a 1-week interval subjects crossed to the other study branch. In the placebo test, mean temperature decreased after immersion by 0.66 degrees C; after the alcohol mean temperature decreased by 1.0 degrees C (mean difference 0.34, 95% CI 0.14-0.53, P = 0.002).

Adult↗

[Intravenous urapidil versus sublingual nifedipine in the treatment of hypertensive emergencies].

In a 6-month prospective study, the efficacy and safety of urapidil and nifedipine in an out-patient population with hypertensive urgencies (systolic blood pressure > 200 mmHg; diastolic blood pressure > 110 mmHg) was investigated. Response to treatment was defined as a stable reduction of systolic blood pressure below 180 mmHg and diastolic blood pressure below 100 mmHg 15 minutes after application of a single dose of either 25 mg urapidil intravenously (N = 26) or 10 mg nifedipine sublingually (N = 27). If the blood pressure was still elevated, a second dose of 10 mg nifedipine or 12.5 mg urapidil was given, and blood pressure response was evaluated 15 minutes after application of the second dose according to the aforementioned criterias. After the first application of nifedipine, 19 (70%) responders have been observed. Eight patients needed an additional 10 mg of nifedipine. In four of these patients, no reduction of blood pressure was observed after a second dose of nifedipine. In contrast, 24 (92%) patients responded well to the first application of 25 mg of urapidil. Two patients required a second dose of 12.5 mg of urapidil, but no nonresponder to urapidil was observed. No severe side-effects were noted in both groups. Intravenous urapidil is a highly effective drug in the treatment of hypertensive urgencies and is more effective than sublingual nifedipine, because the number of patients treated successfully was significantly higher.

Administration, Sublingual↗

Final height and craniofacial development after surgical resection of craniopharyngioma.

Seventeen patients (twelve males and five females) with craniopharyngioma were studied by retrospective review (stature, bone age, and hormone therapy) and by follow-up assessment in all seventeen survivors (stature and craniofacial development). Roentgencephalometric films in the lateral and frontal projections were analyzed. Individual and mean facial diagrams were produced based on 221 reference points in the individual patients and compared to normative data. The posterior cranial base was significantly reduced in length and the cranial base angle was significantly increased. In the facial regions great variations in size and prognathy of the jaws were recorded; on average the patients' maxilla and especially the mandible were short and retrognathic in relation to the anterior cranial base when compared to average adults. Average size and shape of the calvaria, cranial base, and facial regions in the adult male craniopharyngioma group corresponded closely to the average male at the stage of maximum growth in body height, i.e., around 14 years of age. It was concluded that size and morphology of the sphenoid and basioccipital bones were severely affected, possibly as a result of the interfering growth of a craniopharyngioma in childhood. The retrusion of the facial regions might be present as a result of the flattening of the posterior cranial base, but the relatively short and retruded mandible could also be caused by growth hormone deficiency before diagnosis/operation and in periods of sub-optimal therapy. The close resemblance of craniofacial morphology between adult males with craniopharyngioma and normal boys at the time of peak height velocity might reflect the fact that imitation of the natural, optimal balance between growth hormone and sex steroid in puberty is difficult to obtain in therapy.

Adolescent↗