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Biomedical subjects

C Ernst

Publications and source records attributed to C Ernst.

At least 19 recordsLinked to original sources
PubMed1999

Smoking-attributable medical care costs in the USA.

Medical care costs attributable to cigarette smoking are estimated using an econometric model of annual individual expenditures for four types of medical services: ambulatory, hospital, prescription drug, and other (which includes home health and durable medical equipment and excludes dental and mental health). The model follows the two-part specification of Duan et al. (1983). Estimation is carried out using the 1987 National Medical Expenditure Survey. Fitted values are used to calculate smoking-attributable fractions (SAFs) of expense by type of service and by age and gender category. The overall weighted average SAF is 6.54%. SAFs are generally largest for ambulatory and smallest for hospital expenses. They are larger for males and for the older age categories. The model is analyzed for heteroscedasticity and goodness of fit. Additional analysis using the National Health Interview Survey is conducted to test for the possible effect of not being able to include alcohol consumption in the primary model. A balanced repeated replication analysis is conducted to evaluate the variance of the SAFs. Variances are found to be acceptably small. An extension of the model to support evaluation of smoking-attributable costs for special populations such as individual states, and special insurance pools such as Medicaid recipients, is described. Results for the fifty states are presented. Conclusions and subjects for further research are discussed.

Adult↗
PubMed1998

Oral health status of hospitalized children with cancer: a comparative study.

In this study, oral findings from children suffering from leukemia or other cancers, and hospitalized for treatments, are compared with findings from hospitalized patients from the Children s Surgery Department, without systemic or general illnesses. The aim of the study is to determine possible differences in the status of oral health between the hospitalized cancer-ward children and children hospitalized, but with good general health, in order to develop special prophylactic measures as required. The visual oral findings included the prevalence of caries (DMF/T, Decayed, Missed, Filled/Tooth), oral hygiene, severe periodontal diseases, records of defects of the oral mucosa, and information was collected on fluoridation. For both groups of children, the degree of treatment-need of the remaining dentition was 63%. Caries-free dentition was found in 53.7% of the surgery patients and 40.7% of the cancer-ward children. Good oral hygiene was found in only 49% of the cases among the cancer-ward children, while among the children without systemic illness the figure climbed to 87% of the cases. Gingivitis among the children without general illness was only diagnosed in 7.4% of the cases, but in contrast, among the cancer-ward children the percentage of gingivitis (62.8% ) was significantly higher (p < 0.0001). The present study strongly suggests that for children with cancer and subject to aggressive therapy and/or long hospitalizations, beyond the general medical examination on hospital admission, a dental examination should also be instituted.

Adolescent↗
PubMed1998

[Prevention of alcoholism].

Individual secondary prevention of alcoholism in medical practice is based on the diagnostic evaluation of the patient's motivation for a treatment. When the physician himself conducts the treatment, problems may occur concerning treatment goals and handling of relapses. Even an efficient secondary prevention may remain unsatisfying regarding a background of increasing public deregulation of alcohol consumption and consumption in general by young people. Restriction of alcohol access has been proven as the only possible way to effective primary prevention.

Alcohol Drinking↗
PubMed1998

Mapping quantitative trait loci for milk production and health of dairy cattle in a large outbred pedigree.

Quantitative trait loci (QTL) affecting milk production and health of dairy cattle were mapped in a very large Holstein granddaughter design. The analysis included 1794 sons of 14 sires and 206 genetic markers distributed across all 29 autosomes and flanking an estimated 2497 autosomal cM using Kosambi's mapping function. All families were analyzed jointly with least-squares (LS) and variance components (VC) methods. A total of 6 QTL exceeding approximate experiment-wise significance thresholds, 24 QTL exceeding suggestive thresholds, and 34 QTL exceeding chromosome-wise thresholds were identified. Significance thresholds were determined via data permutation (for LS analysis) and chi-square distribution (for VC analysis). The average bootstrap confidence interval for the experiment-wise significant QTL was 48 cM. Some chromosomes harbored QTL affecting several traits, and these were always in coupling phase, defined by consistency with genetic correlations among traits. Chromosome 17 likely harbors 2 QTL affecting milk yield, and some other chromosomes showed some evidence for 2 linked QTL affecting the same trait. In each of these cases, the 2 QTL were in repulsion phase in those families appearing to be heterozygous for both QTL, a finding which supports the build-up of linkage disequilibrium due to selection.

Analysis of Variance↗
PubMed1997

In vivo properties of monocyte chemoattractant protein-1.

Monocyte chemoattractant protein-1 (MCP-1) attracts monocytes, memory T lymphocytes, and natural killer (NK) cells in vitro. Its expression has been documented in disorders characterized by mononuclear cell infiltrates, suggesting that it may contribute to the inflammatory component of such diseases as atherosclerosis, multiple sclerosis, or rheumatoid arthritis. To prove a causal association, the in vivo properties of MCP-1 must be understood. Several lines of transgenic mice have been constructed to address this question. A transgenic line in which MCP-1 expression is controlled by the MMTV-LTR expressed high levels of MCP-1 in multiple organs but showed no evidence for monocyte infiltration. Instead, these mice were more susceptible to infection by the intracellular pathogens, Listeria monocytogenes and Mycobacterium tuberculosis. These mice had high serum levels of MCP-1, suggesting that their circulating monocytes may have been desensitized or that MCP-1 stimulated a Th2-dominant response. In contrast, another model in which MCP-1 expression was controlled by the insulin promoter demonstrated a monocytic infiltrate in pancreatic islets. These results indicate that MCP-1 expression at low levels in an anatomically confined area results in monocyte infiltration, suggesting that when properly expressed, MCP-1's in vitro properties are reproduced in vivo. This justifies the examination of MCP-1-deficient mice in disease models in order to explore MCP-1's role in pathogenesis.

Animals↗
PubMed1997

The Zurich Study. XXIV. Structural and emotional aspects of childhood and later psychopathology.

A Swiss cohort interviewed four times between ages 20 and 30 years reported on a structural aspect of childhood (separation from parents) and emotional aspects (family strain, childhood behavioral and emotional problems). These data were connected with DSM-III-R diagnoses of anxiety and depression, SCL-90R scores (all repeatedly ascertained) and with Freiburg Personality Inventory results at age 30 years. Adult psychopathology, personality deviations, and negative affectivity were not connected with early or later separation, but with a report of family strain and childhood disturbances. As variables associated with later psychiatric symptoms and disorder, interpersonal and subjective aspects of childhood out-weigh the fact of separation from parents.

Adolescent↗
PubMed1997

Recommended standards for reports dealing with lower extremity ischemia: revised version.

Recommended standards for analyzing and reporting on lower extremity ischemia were first published by the Journal of Vascular Surgery in 1986 after approval by the Joint Council of The Society for Vascular Surgery and the North American Chapter of the International Society for Cardiovascular Surgery. Many of these standards have been accepted and are used in the current literature on peripheral arterial occlusive disease. With the passage of time, some oversights, aspects that require clarification, and better modifications have been recognized. This report attempts to correct these shortcomings while reinforcing those recommendations that have proven satisfactory. Explanatory comments are added to facilitate understanding and application. This version is intended to replace the original version.

Acute Disease↗
PubMed1996

[Tibial pseudoarthrosis. Treatment using the Ilizarov technique].

In the period from the 1.1.1991 to the 31.5.1993 17 patients with a tibial pseudoarthrosis were treated by the Ilizarov method. The mean age was 35 years (13-88 years). Mean time from fracture to operation for pseudoarthrosis was 14.6 months (3-39 months). There were two hypertrophic, 14 atrophic and one defect pseudoarthrosis. Six of the pseudoarthroses were infected. After stable external fixation the treatment was compression over the pseudoarthrosis in four cases and alternating distraction and compression in eight cases. In five cases the treatment was supplemented by bone transport for the defects between 15 and 50 mm. Mean time of treatment with the external fixator was 5.2 months (2-11.5 months). The overall treatment time was 9.8 months (3-19 months). At the follow-up 14 pseudoarthroses were fully consolidated, one patient was still using an orthosis, and three patients were in need of reoperation with bone transplantation. During the period of fixation thirteen patients were hospitalized for short periods, and some of them several times. The treatments were for correction of the distraction, replacement of fixation of pintrack infection or treatment of pain. The Ilizarov method of treatment of pseudoarthrosis show a good stimulation of healing, but experience with the fixator system and aggressive treatment of various minor complications are essential for a successful outcome.

Adolescent↗
PubMed1995

[Bone lengthening of the extremities using the Ilizarov method].

We describe the indications and the results in 18 bone lengthenings carried out on 14 patients in our department during the period January 1991 to September 1993. Seven patients had limb length inequality, five patients had dysplasia or aplasia, one patient had Turner's syndrome and one patient had suffered traumatic amputation of all the fingers of one hand. The mean lengthenings achieved were: femur 4.9 cm; tibia 5.6 cm; fibula 1.5 cm; humerus 7.5 cm; ulna 3.5 cm; radius 1.9 cm; and metacarpals 1.6 cm. There were 14 cases of pin-problems which needed surgery. Nine cases of infection around the pin holes were treated with antibiotics only. We had five cases with severe pain due to distraction. We had two cases of fracture after removal of the external fixation. Both fractures healed without further problems, but in one case there was three cm loss of the achieved lengthening. Our conclusion is that the Ilizarov method for bone lengthening is a demanding procedure. Because of the many--often minor--complications the patients must be seen frequently, as one must be prepared for "aggressive" treatment of the problems.

Arm↗
PubMed1995

Development of a continuous system for the degradation of a cyanuric acid by absorbed Pseudomonas sp. NRRL B-12228.

Cyanuric acid in high concentrations (15.5 mM) was degraded completely by Pseudomonas sp. NRRL B-12228 independently of glucose concentration. In the batch fermentations there was a relation between the glucose concentration, on the one hand, and the liberation of ammonia or production of protein, on the other. The greater the supply of carbon, the more biomass was produced, and fewer NH4+ ions were released. Continuous fermentations using adsorbed cells could be performed to degrade cyanuric acid. In spite of different glucose feeding there was only a negligible difference in residues of s-triazine. In a one-step continuous system with dilution rates between 0.021 h-1 and 0.035 h-1, even a ratio of 0.65 between glucose and cyanuric acid was not sufficient to degrade the cyanuric acid supplied (320-540 mumol l-1 h-1) completely. When a continuous two-step system was applied with dilution rates between 0.035 h-1 and 0.056 h-1, the consumption of carbon source could be minimized while s-triazine degradation up to 860 mumol l-1 h-1 was complete. In this way the ratio between glucose and cyanuric acid could be increased to 0.25 (molar C:N ratio = 0.33:1). Thereby the process was made considerably more economic.

Adsorption↗
PubMed1995

Utilization of chlorinated s-triazines by a new strain of Klebsiella pneumoniae.

A bacterium utilizing 2-chloro-4,6-diamino-s-triazine (CAAT) as sole nitrogen source was isolated under a N2-free atmosphere and identified as Klebsiella pneumoniae. Concomitant to CAAT degradation the protein content increased and chloride was released into the medium. Under air and a N2-atmosphere no reduction of CAAT degradation resulted, though this strain is able to fix molecular nitrogen, but the decomposition accelerated under anaerobic conditions. The degradation rate increased continuously with increasing CAAT concentration. A continuous CAAT degradation without CAAT accumulation was possible up to a influx rate of 4.8 mumol.l-1h-1 (dilution rate = 0.007 h-1). K. pneumoniae A2 was also able to utilize deethylsimazine (CEAT) and deethylatrazine (CIAT) as nitrogen source. Both under aerobic and anaerobic conditions CEAT could be degraded faster than CIAT. The degradation sequence of mixed s-triazines was cyanuric acid < CAAT < CEAT < CIAT, which was reflected by the degradation times of single compounds. Complete degradation was assumed for all investigated s-triazine derivatives.

Atrazine↗
PubMed1995

Depression in old age. Is there a real decrease in prevalence? A review.

The discrepancy between the constancy or increase of the prevalence of depressive symptoms and dysphoria in old age on one hand, and the decrease in the prevalence of the DSM-III diagnoses of major depression and dysthymia on the other, is discussed in light of the most frequent explanatory hypotheses such as memory defects, interpretation of depressive as somatic symptoms, higher risk of institutionalization as well as higher mortality of depressives and a mitigated course of depression in old age. We conclude that higher mortality, mitigation and the rarity of true late-onset depression are arguments for a real decline in prevalence, which occurs in accordance with the decline in all psychiatric disorders that are connected with emotional upheavals and substance ingestion. On the other hand, the connection of depressive states with somatic illness is strengthened, and according to preliminary validation studies, clinically relevant depressive states not reaching the threshold of DSM-III diagnoses may be typical for the depressive psychopathology of old age.

Adolescent↗