Biomedical subjects

B Stein

Publications and source records attributed to B Stein.

208 records · Page 12Linked to original sources

PubMedDate not supplied

Protein phosphorylation in isolated trabeculae from nonfailing and failing human hearts.

Disturbances in the cAMP production during beta-adrenergic stimulation and alterations of Ca2+ transport controlling proteins and their regulation in the sarcoplasmic reticulum might be involved in the pathogenesis of the failing human heart. Thus, we investigated the cAMP-mediated phosphorylation of phospholamban, troponin I and C-protein in electrically driven, intact isolated trabeculae carneae from nonfailing and failing (NYHA IV) human hearts in parallel to contractile properties on the same tissue samples. The increase in force of contraction induced by isoproterenol (0.2 microM) or pimobendan (100 microM), a phosphodiesterase inhibitor, was diminished in the failing human hearts compared to nonfailing hearts by 49% and 36%, respectively. Concomitantly the isoproterenol-induced phosphorylation (pmol P/mg homogenate protein) of phospholamban, troponin I and C-protein was reduced from 13.0 +/- 2.4 (n = 4), 30.5 +/- 1.5 (n = 5) and 11.0 +/- 1.3 (n = 5) in the nonfailing heart to 5.2 +/- 0.6 (n = 13), 14.6 +/- 2.2 (n = 16) and 7.1 +/- 1.0 (n = 6) in the failing human heart, respectively. Pimobendan changed the phosphorylation state of these proteins similar to isoproterenol. The fact that combined addition of both agents or dibuturyl cAMP (1 mM) alone restored the phosphorylation capacity as observed in the control groups indicates that i) a reduced cAMP generation is related to the reduced phosphorylation of regulatory phosphoproteins located in the sarcoplasmic reticulum and contractile apparatus e.g. phospholamban, troponin I and C-protein, that ii) there is a relationship between protein phosphorylation state and contractile activity and that iii) no changes in the respective content of phosphoproteins are involved in the limitation of cAMP-mediated inotopic activity in the failing human heart.

Adolescent↗

PubMedDate not supplied

Interactive patterns of social support and individual coping strategies in melanoma patients and their correlations with adjustment to illness.

Combined patterns of social support and coping style and correlations with adjustment to cancer were investigated in early-stage melanoma patients. The authors studied 358 consecutive patients attending regular follow-up who answered standardized instruments that assess social support, coping behavior, and tumor-related distress. Regression analyses identified high active and low depressive coping behavior as stronger predictors for perceived support than sociodemographic and clinical variables. Cluster analyses yielded four coping-support patterns. High social support, combined either with active coping or with stoicism, was associated with good adjustment, whereas low perceived support in the subjects living alone or in the patients exhibiting depressive coping behavior was associated with poor adjustment.

Adaptation, Psychological↗

PubMedDate not supplied

Leuprolide acetate 22.5 mg 12-week depot formulation in the treatment of patients with advanced prostate cancer.

Two open-label, multicenter studies were conducted to evaluate the efficacy and safety of a long-acting depot formulation of leuprolide acetate (22.5 mg) administered intramuscularly every 12 weeks to patients with stage D2 prostate cancer. Clinical evaluations were performed every 12 weeks, and serum testosterone levels were monitored biweekly or weekly for 24 weeks. Onset of castrate levels (< or = 50 ng/dL) of testosterone was achieved within 30 days of the initial depot injection in 87 (95%) of the 92 assessable patients enrolled in the two studies. Mean testosterone levels remained well within the castrate range throughout each dosing interval. Two patients experienced a transient escape (testosterone levels > 50 ng/dL on two consecutive determinations). Delay of an injection of up to 2 weeks did not have an effect on testosterone suppression: in 16 patients in whom the depot injection was delayed by 3 to 14 days, testosterone values remained within the castrate range. A favorable objective tumor response (no progression) to treatment occurred in 85% of the patients. Prostate-specific antigen and prostatic acid phosphatase decreased by 50% or more in 96% and 84% of patients, respectively, with elevated pretreatment values and at least one treatment value. Assessment of local disease status and overall performance status showed improvement or stability in most patients. The most common adverse events were hot flashes (59%), pain (27%), and testicular atrophy (21%). The 22.5-mg depot formulation of leuprolide, which acts in a manner similar to the monthly 7.5-mg depot formulation, was shown to be effective and safe in treating patients with advanced prostate cancer.

Delayed-Action Preparations↗

PubMedDate not supplied

Consultation-Liaison psychiatric service delivery: results from a European study.

The reported findings of the European Consultation-Liaison Workgroup (ECLW) Collaborative Study describe consultation-liaison service delivery by 56 services from 11 European countries aggregated on a C-L service level. During the period of 1 year (1991), the participants applied a standardized, reliability tested method of patient data collection, and data were collected describing pertinent characteristics of the hospital, the C-L service, and the participating consultants. The consultation rate of 1% (median; 1.4% mean) underscores the discrepancy between epidemiology and the services delivered. The core function of C-L services in general hospitals is a quick, comprehensive emergency psychiatric function. Reasons to see patients were the following. deliberate self-harm (17%), substance abuse (7.2%), current psychiatric symptoms (38.6%), and unexplained physical complaints (18.6%) (all means). A significant number of patients are old and seriously ill. Mood disorders and organic mental disorders are most predominant (17.7%). Somatoform and dissociative disorders together constitute 7.5%. C-L services in European countries are mainly emergency psychiatric services and perform an important bridge function between primary, general health, and mental health care.

Adult↗

PubMedDate not supplied

[Ultrasonic Quantification of spinal configuration and postural capacity for evaluation of different muscle strengthening programs in the therapy of back pain].

AIM: The aim of this study was the evaluation of the effectiveness of different muscle strengthening programs in the therapy of back pain. METHODS: 102 male longshoremen aged from 29 to 63 years with chronic back pain since > two years, matched by pain intensity and functional limitations, were randomized to three test groups (TG) and one control group (CG). The test persons carried out a program for intensified muscle strengthening over a period of six months one to two times weekly in a therapeutic practice (TG1), in a health club (TG2) and in a gymnastic group (TG3). The CG did not complete any intervention. Ultrasound topometry for recording spinal configuration and postural capacity as well as the determination of pain intensity and functional limitations were used as instruments of assessment. RESULTS: The data obtained for the CG remained virtually unchanged over the period of investigation. In contrast a decrease of pain intensity and functional limitations could be proved for all TG. Furthermore, the training programs induced both an improved postural capacity while performing the arm-raising test and an increasingly erect sagittal spinal profile. The power of effectiveness was on a homogeneous level for the medical training therapy (0.41), the fitness training (0.4) and the spinal gymnastics (0.41). CONCLUSION: The three muscle strengthening programs investigated have equally favorable effects on the parameters evaluated and are qualified as effective strategies in the therapy for chronic spinal discomforts.

Adult↗

PubMedDate not supplied

European consultation-liaison services and their user populations: the European Consultation-Liaison Workgroup Collaborative Study.

The authors identified variations in the characteristics of patients referred to 56 consultation-liaison (C-L) services in 11 European countries. The authors found differences in the types of patients referred to the services, and there were significant differences between countries. The first difference lays in whether services saw patients for deliberate self-harm and for substance abuse. German psychosomatic C-L services saw virtually no such patients, although in other C-L services these patients constituted one-quarter to one-third of the patients referred. The second difference lays in the remaining group of referred patients. This group is best characterized by two dimensions. One describes the severity of psychopathology -- ranging from organic mental conditions to somatization. The other describes the clarity of the physical diagnosis -- ranging from patients referred by surgical wards to those referred by general medicine and neurology wards.

Adult↗

PubMedDate not supplied

Care complexity in the general hospital: results from a European study.

There is increasing pressure to effectively treat patients with complex care needs from the moment of admission to the general hospital. In this study, the authors developed a measurement strategy for hospital-based care complexity. The authors' four-factor model describes the interrelations between complexity indicators, highlighting differences between length of stay (LOS), objective complexity (such as medications or consultations), complexity ratings by the nurse, and complexity ratings by the doctor. Their findings illustrate limitations in the use of LOS as a sole indicator for care complexity. The authors show how objective and subjective complexity indicators can be used for early and valid detection of patients needing interdisciplinary care.

Diagnosis-Related Groups↗

PubMedDate not supplied

Risk factors for complex care needs in general medical inpatients: results from a European study.

The authors linked admission risk factors to a series of indicators for complex care delivery to enable detection of patients in need of care coordination at the moment of admission to the general hospital. The authors found 13 risk factors to be predictive of more than one indicator of care complexity. An admission risk screening procedure to detect patients in need of care coordination should focus on these risk factors and should include predictions made by doctors and nurses at admission and information collected from the patient and the medical chart.

Diagnosis-Related Groups↗

PubMedDate not supplied

COMPRI--an instrument to detect patients with complex care needs: results from a European study.

The authors developed a screening instrument to detect patients in need of complex care coordination at admission to a general hospital. On the basis of a series of risk factors for care complexity, the authors constructed a short, care complexity prediction instrument (COMPRI) and assessed its qualities. The COMPRI is an easily administered screening instrument that detects patients at risk for complex care needs for whom care coordination is indicated. COMPRI's predictive power exceeds all currently available case-mix instruments.

Diagnosis-Related Groups↗

PubMedDate not supplied

Amiodarone pulmonary toxicity. Clinical, cytologic and ultrastructural findings.

Amiodarone, a new antiarrhythmic drug, may produce severe and potentially lethal pulmonary toxicity. A case is presented of a patient on amiodarone therapy who presented with recurrent pleural effusions and subsequently developed pulmonary infiltrates. The diagnosis of lung toxicity was documented by the cytologic examination of the pleural effusions and the bronchial washings. It was further supported by the ultrastructural demonstration of the characteristic cytoplasmic osmiophilic lamellar inclusions in the foamy macrophages. We conclude that cytologic and ultrastructural examinations of bronchial lavage cells are extremely helpful in the diagnosis of amiodarone-induced pulmonary toxicity.

Aged↗