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Biomedical subjects

B Braun

Publications and source records attributed to B Braun.

At least 109 records · Page 6Linked to original sources
PubMed1992

Muscle function after exercise-induced muscle damage and rapid adaptation.

This brief review focuses on the time course of changes in muscle function and other correlates of muscle damage following maximal effort eccentric actions of the forearm flexor muscles. Data on 109 subjects are presented to describe an accurate time course of these changes and attempt to establish relationships among the measures. Peak soreness is experienced 2-3 d postexercise while peak swelling occurs 5 d postexercise. Maximal strength and the ability to fully flex the arm show the greatest decrements immediately after exercise with a linear restoration of these functions over the next 10 d. Blood creatine kinase (CK) levels increase precipitously at 2 d after exercise which is also the time when spontaneous muscle shortening is most pronounced. Whether the similarity in the time courses of some of these responses implies that they are caused by similar factors remains to be determined. Performance of one bout of eccentric exercise produces an adaptation such that the muscle is more resistant to damage from a subsequent bout of exercise. The length of the adaptation differs among the measures such that when the exercise regimens are separated by 6 wk, all measures show a reduction in response on the second, compared with the first, bout. After 10 wk, only CK and muscle shortening show a reduction in response. After 6 months only the CK response is reduced. A combination of cellular factors and neurological factors may be involved in the adaptation process.

Adaptation, Physiological↗
PubMed1992

A randomized trial of the cost effectiveness of VA hospital-based home care for the terminally ill.

All admissions to a 1,100-bed Department of Veterans Affairs (VA) hospital were screened to identify 171 terminally ill patients with informal caregivers who were then randomly assigned to VA hospital-based team home care (HBHC, N = 85) or customary care (N = 86). Patient functioning, and patient and caregiver morale and satisfaction with care were measured at baseline, one month, and six months. Health services utilization was monitored over the six-month study period and converted to cost. Findings included no differences in patient survival, activities of daily living (ADL), cognitive functioning, or morale, but a significant increase in patient (p = .02) and caregiver (p = .005) satisfaction with care at one month. A substitution effect of HBHC was seen. Those in the experimental group used 5.9 fewer VA hospital days (p = .03), resulting in a $1,639 or 47 percent per capita saving in VA hospital costs (p = .02). As a result, total per capita health care costs, including HBHC, were $769 or 18 percent (n.s.) lower in the HBHC sample, indicating that expansion of VA HBHC to serve terminally ill veterans would increase satisfaction with care at no additional cost.

Activities of Daily Living↗
PubMed1991

Phytochromes and bacterial sensor proteins are related by structural and functional homologies. Hypothesis on phytochrome-mediated signal-transduction.

Phytochrome and bacterial sensor proteins are related by functional and structural homologies. They are both sensors of environmental stimuli and share structural homologies which comprise a domain of about 250 amino acids (about 28 kg.mol-1). This domain is C-terminal in phytochromes and in several bacterial sensor proteins. In both groups of sensors this domain undergoes conformational changes which are caused by the N-terminal part sensing the stimulus. In the case of bacterial sensors, the conformational alteration is, regulated by additional proteins, conferred to a corresponding regulator protein which then acts on transcription. The coincidences between the two groups of sensors are striking enough to assume phytochrome to transduce signals in a way comparable to the bacterial two-component systems.

Amino Acid Sequence↗
PubMed1991

Failure to obtain long-term patency after implantation of fibrous polyurethane prostheses in the carotid arteries of rabbits.

Fibrous polyurethane prostheses were implanted in the carotid arteries and aortae of New Zealand white (NZW) and Chinchilla (CHIN) rabbits. No immediate post-implantation patency was obtained after implantation in the carotid arteries in NZW rabbits. In CHIN rabbits patency up to 1 week was obtained after carotid implantation. Attempts to increase patency rates by administration of 20 mg/kg body weight/day of both dipyridamol (DIP) and acetyl-salicylic acid (ASA) p.o., starting the week before implantation, had an adverse effect; prostheses became occluded within a few hours after implantation. Coagulation tests (Lee and White, Am J Med Sci 145:495-503, 1913) carried out with blood drawn from CHIN rabbits revealed hypercoaguability after administration of either 10 or 20 mg/kg body weight/day of both DIP and ASA compared to pre-medication values. Prostheses implanted in the aortae of both strains remained patent without anti-platelet-aggregation therapy for a 3-month observation period. It is concluded that in the NZW rabbit carotid implantation was not successful due to severe spasmic reactions and that in CHIN rabbits only very short-term patency could be obtained both with and without administration of 10 or 20 mg/kg body weight/day medication DIP and ASA.

Animals↗
PubMed1991

Effects of coenzyme Q10 supplementation on exercise performance, VO2max, and lipid peroxidation in trained cyclists.

The effects of dietary supplementation with Coenzyme Q10 (CoQ10), a reputed performance enhancer and antioxidant, on physiological and biochemical parameters were examined. Ten male bicycle racers performed graded cycle ergometry both before and after being given 100 mg per day CoQ10 or placebo for 8 weeks. Analysis of variance showed a significant difference between groups for postsupplementation serum CoQ10. Although both groups demonstrated training related improvements in all physiological parameters over the course of the study, there were no significant differences between the two groups (p > .05). Both groups showed a 21% increase in serum MDA (an index of lipid peroxidation) after the presupplementation exercise test. After 8 weeks this increase was only 5%, and again was identical for both groups. Supplementation with CoQ10 has no measurable effect on cycling performance, VO2max, submaximal physiological parameters, or lipid peroxidation. However, chronic intense training seems to result in marked attenuation of exercise-induced lipid peroxidation.

Adult↗
PubMed1991

Hirudin--a potential stabilizing factor for platelet preservation in transfusion.

The influence of additional hirudin in low doses on platelet and coagulation parameters was studied in platelet concentrates (PC) prepared by cytapheresis using citrate-dextrose solution formula A. The in vitro release of platelet factor 4 and beta-thromboglobulin was markedly lowered and morphological platelet alterations, as assessed by platelet size studies were considerably less accentuated in the presence of hirudin over a 5-day storage period; this suggests a possibly protecting effect on platelet function. No clear activation of the coagulation and fibrinolysis system was evident during PC storage with and without hirudin since thrombin-antithrombin III complexes and D-dimers did not markedly change.

Blood Coagulation↗
PubMed1991

Historical reliability: a key to differentiating populations among patients presenting signs of multiple personality disorder.

The clinical value of inconsistencies in the historical data of patients presenting with signs of multiple personality disorder was assessed. Three major inconsistencies in historical data were identified in 23 patients who were admitted to a Dissociative Disorders Program with a diagnosis of Multiple Personality Disorder. This group showed psychological disturbance that was quite different from 23 patients with a similar discharge diagnosis but who did not exhibit inconsistencies in history. The former group reported less psychological disturbance and fewer dissociative experiences. Patients who are less credible by virtue of inconsistencies in their historical reports may belong to a different diagnostic group. The findings point to the need to chart history carefully in authenticating genuine cases.

Adult↗
PubMed1991

The validity and predictive value of four assessment instruments for evaluation of the cervical and stomatognathic systems.

Four assessment instruments--a 10-item cervical pain questionnaire, a 10-item TMJ pain questionnaire, the Cervical Range of Motion (CROM) instrument, and the Craniomandibular Index--were used to evaluate 25 consecutive patients presenting to a physical therapy clinic for evaluation and treatment of cervical hyperextension-hyperflexion injuries. The assessment tools were tested for internal consistency between the cervical and stomatognathic measures as well as between the two sets of measures. The cervical questionnaire was strongly correlated to the CROM measurements. Tenderness to palpation of the superficial neck muscles was not correlated to the cervical questionnaire nor to measures of cervical flexion-extension or lateral flexion. It was, however, correlated to cervical rotation. The TMJ questionnaire was a useful predictor of muscular tenderness and self-reported symptoms in the stomatognathic system, but it was not related to the intra-articular signs of TMD. The flexion-extension and rotation measures of cervical mobility were useful predictors of masticatory muscle tenderness. These assessment tools are valid indicators of cervical or stomatognathic status and, when used together, provide a comprehensive description of jaw and neck status.

Humans↗
PubMed1990

Comparison of different prothrombin complex concentrates--in vitro and in vivo studies.

The potency and tests for thrombogenicity were studied prospectively in 7 different (two lots of each brand, A-G) prothrombin complex concentrates (PCC). Human albumine (H) and a factor IX concentrate (I), served as controls. The potency of coagulation factors and inhibitors varied considerably. Two brands (E, F) contained no protein S, additionally one brand contained no protein C. Two preparations exhibited high amidolytic activities, especially towards the thrombin-sensitive chromogenic substrate S-2238, in vitro. These activities could be quenched in part by the addition of hirudin or antithrombin III. The heparin and antithrombin III content of the PCCs was significantly different, and, after addition of antithrombin III an increase of thrombin-antithrombin III complexes in 2 preparations (B, D) was observed in vitro. Additionally, three brands (B, D, F) caused more severe cardio-pulmonary reactions in rabbits, associated with an increase of fibrin split products for brands B and D. We conclude that the use of these preparations in patients, in whom an acquired protein C or S defect, or a hypercoagulable state, can be suspected, cannot be recommended.

Animals↗
PubMed1990

[Myelolipoma of the adrenals--a chance sonographic finding].

A markedly echogenic and sharply marginated suprarenal mass was found incidentally during an abdominal sonography in the case of three patients. One female patient died due to a mesenterial infarct, in the other cases the tumors were removed surgically. In two cases the histological diagnosis indicated a myelolipoma of the adrenal gland, in one case an angiolipoma attached directly to the adrenal. Myelolipoma is a benign and hormone-inactive tumorous lesion, which most commonly occurs in the adrenal gland. Knowledge of the clinical and sonomorphologic characteristics along with computed tomography helps to distinguish other tumors of the retroperitoneum. Thus, unnecessary surgical intervention can be avoided.

Adrenal Gland Neoplasms↗
PubMed1990

Experimental dermatophytosis in nude guinea pigs compared with infections in Pirbright White animals.

With this investigation we wanted to compare the suitability of two different strains of guinea pigs to evaluate topical antifungals after experimental Trichophyton mentagrophytes infection. The "hairless"-strain was compared with the hairy Pirbright White strain. The infection areas were treated with a skin retention test (application before infection) and two sets of therapy tests (application after infection). In the retention test the different antimycotic compounds led to better gradations. Also, in the two sets of therapy tests the gradations among the compounds were more clearly and more comparable to published results of clinical trials. In the histological investigations the infections in the "hairless" animals developed in a way which is known from dermatophytoses in human skin. In the Pirbright White strain, however, due to the adjacent hair roots, a marked inflammatory reaction of the tissue persisted for 3 weeks which is not observed on human skin of the trunk and extremities. We, therefore, consider the "hairless" strain of guinea pigs to be more suitable than hairy animals for the comparison of topical antimycotics.

Animals↗
PubMed1990

[Subcutaneous injection of desmopressin (DDAVP) for increasing factor VIII and von Willebrand factor in plasmapheresis].

Desmopressin (DDAVP) is an effective tool for increasing factor VIII (FVIII)/von Willebrand factor (vWF) in normal subjects and in patients with haemophilia A and von Willebrand's disease. There are a few studies utilizing DDAVP to increase the FVIII/vWF yield in plasmapheresis donors. In these studies, DDAVP was given either by intranasal administration or intravenous infusion. The aim of our pilot study was to investigate the subcutaneous (s.c.) injection of DDAVP in combination with double bag plasmapheresis. 8 donors with blood group A and 5 with O were given 0.4 micrograms/kg body weight DDAVP as a s.c. injection 30 min prior to the first donation. FVIII increased 3.7 and ristocetin cofactor 2.5 the initial value in the donors. In the plasma bags, a 3 (1st bag) and 3.5 (2nd bag) fold higher FVIII level was found, when compared with baseline levels. There was only a mild decrease of blood pressure, and serious adverse effects were not observed. Our data suggest that s.c. DDAVP may be more effective and especially suited for increasing FVIII/vWF yield in plasmapheresis donors.

Blood Donors↗
PubMed1990

[Quality control of prothrombin complex preparations: in vivo and in vitro findings].

Prothrombin complex concentrates (PCC) are frequently used for the treatment of acquired coagulation factor deficiencies. However, a major problem when using these preparations is their thrombogenic potential. Thus, the potency and tests for thrombogenicity were studied prospectively in 7 different PCC's. Human albumine and a factor IX concentrate served as controls. The potency of coagulation factors and inhibitors varied considerably, especially for proteins S and C. Two preparations exhibited high amidolytic activities in vitro. These activities could be quenched in part by the addition of hirudin or antithrombin III. Additionally, these two preparations caused more severe cardiopulmonary reactions in rabbits and an increase of fibrin split products. We conclude that the use of these preparations in patients, in whom an acquired protein C or S defect, or a hypercoagulable state, can be suspected, cannot be recommended.

Blood Coagulation Factors↗
PubMed1990

[Recombinant human erythropoietin (rh-EPO) in chronic, dialysis-dependent renal failure: effects on macro- and microcirculation and hematologic parameters].

Recombinant human erythropoietin (rh-EPO) has been shown to be effective in the treatment of renal anemia. Additionally, rh-EPO improves the hemostatic defect of uremia. On the other hand, a hypertensinogen effect and an increased risk for thrombosis have been reported in hemodialysis (HD) patients with rh-EPO. 20 HD patients in Homburg were recruited for a multicenter, placebo-controlled study (MF 3981), aiming to assess the risk of rh-EPO. Initially, 10 patients received rh-EPO at a dose of 3 x 80 U/kg body weight and week which was subsequently adjusted according to the hematocrit. After 6 months, the patients receiving placebo were changed to rh-EPO therapy. Clinical and laboratory data were obtained before, as well as 1, 3, 6 and 12 months after beginning of the study. Erythrocyte counts increased significantly in the rh-EPO group. Also, an increase of platelet count, fibrinogen and plasma viscosity was observed during rh-EPO. Tissue type plasminogen activator and plasminogen activator inhibitor as well as von-Willebrand-factor remained unchanged, although a shortening of the bleeding time was observed. Blood pressure and arterial blood flow were not influenced by rh-EPO.

Blood Viscosity↗
PubMed1990

Cost-effectiveness of Veterans Administration hospital-based home care. A randomized clinical trial.

A randomized design was used to examine the cost-effectiveness of a Veterans Administration hospital-based home care program that case managed inpatient and outpatient care. Patients (N = 419) with two or more functional impairments or a terminal illness were randomized to hospital-based home care (n = 211) or customary care (n = 208). Functional status, satisfaction with care, and morale were measured at baseline and at 1 and 6 months after discharge from the hospital; health care utilization was tracked for 6 months. Findings included significantly higher (0.1 on a three-point scale) patient and caregiver satisfaction with care at 1 month and lower Veterans Administration and private sector hospital costs ($3000 vs $4245) for the experimental group. Net per person health care costs were also 13% lower in the experimental group. We conclude that this model of hospital-based home care is cost-effective and that its expansion to cover these two patient groups throughout the Veterans Administration system can improve patient care at no additional cost.

Aged↗
PubMed1989

[Ultrasonic diagnosis of acute appendicitis].

The ranking of sonography in the diagnosis of acute appendicitis and its complications was examined in 208 patients in a prospective study. With a prevalence of the disease of 31.25% the sensitivity of sonography was 91.5, and the specificity more than 96% with a low negative laparotomy rate of 12.9%. Since due to increasing experience in the techniques of examination and also due to technological improvements the normal appendix or concomitant appendicitis in enteritic disease patterns become visualisable, the sonographically determined appendix pattern is an important parameter. Sonography contributes to a reduction of the negative laparotomy rate due to the identification of differential diagnostically important diseases including lymphadenitis mesenterialis and Crohn's disease of the terminal ileum. At the same time, this method safely identifies perityphlitic abscesses and perforations of the appendix.

Abscess↗