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C Meyer

Publications and source records attributed to C Meyer.

At least 73 records · Page 4Linked to original sources
PubMed2004

A short form of the Fagerström Test for Nicotine Dependence and the Heaviness of Smoking Index in two adult population samples.

Few data exist about the Fagerström Test for Nicotine Dependence (FTND) and the Heaviness of Smoking Index (HSI) from population samples. The goal was to prove to what degree (1) a reduced item solution of the FTND and (2) the HSI represent the FTND. Two randomized adult population samples were used from northern Germany. Sample 1 included 1462 and sample 2 included 1042 current daily cigarette smokers aged 20-64 years with FTND data. The results show that four items of the FTND as well as the HSI represent the FTND. It is concluded that both are valid measures of the urge to smoke and the tobacco-smoke-seeking behavior.

Adult↗
PubMed2004

[Colorectal stapled anastomosis: results after anterior resection of the rectum for cancer].

OBJECTIVE: Stapled end to end anastomosis makes the restoration of digestive continuity at the level of lower pelvis easier, but carries a certain risk. The aim of this report was to evaluate this risk in terms of immediate results and tumor recurrence after surgery for rectal cancer. PATIENTS AND METHODS: The data of 301 patients operated on following this technique between 1980 and 2000 have been reviewed in order to analyse the tumor characteristics, the operation and associated complications, the immediate postoperative complications and recurrence rate. RESULTS: Among the 301 patients (192 males and 109 females) with median age of 66 years, 19 (6.3%) received an emergency operation due to bowel obstruction. The rectal adenocarcinoma was located in the upper rectum in 132 cases (43.8%), in the middle rectum in 141 cases (46.8%) and in the lower rectum in 19 cases (9.4%). Preoperative radiotherapy was carried out in 148 cases (49%): between 1987 and 1996 with a dose of 30 Grays (Gy), later increased to 39 Gy and 45 Gy in 12 cases. From 1990, 113 patients have received adjuvant chemotherapy for stage III and IV tumors and in some position cases for stage II tumor. The excision left a safety margin under the tumor of less than 2 cm in 59 cases (19.6%), and the anastomosis was located at 5 cm or less from the anal verge in 178 cases (59%). Primary defunctioning stoma was formed in 39 cases (13%). An anastomotic defect was observed during the operation in 18 cases (6%) and 26 fistulas occured postoperatively (7.6%), significantly related to the location of the anastomosis with regard to the anal verge (P = 0.0009). The hospital mortality was 8 cases (2.6%). Cases of stenosis were uncommon : 11 cases (3.6%), significantly associated with preoperative radiotherapy (P =0.02). The local recurrence rate was 12% (37 cases) in a median time delay of 16 months, essentially related to the tumor stage (P = 0.004) and the considered period (P = 0.001). CONCLUSION: Stapled end-to-end colorectal anastomosis after excision of rectum for cancer is a reliable technique with a low rate of complication and tumor recurrence, when the surgical procedure is included in the curative therapy management of cancer.

Adenocarcinoma↗
PubMed2004

Retrospective study of laparoscopic adjustable silicone gastric banding for the treatment of morbid obesity: results and complications in 127 patients.

OBJECTIVES: Laparoscopic gastric banding is currently the most popular surgical technique for morbId obesity. This wIdespread use of surgery has been evaluated by a number of clinical studies, particularly on weight change. METHODS: In a retrospective study of 127 obese patients operated between 1996 and 2000, data were collected for weight change, medical and surgical complications. RESULTS: Of 127 patients, failures of gastric banding were noted during 2 surgical operations. The average follow-up period was 33 +/- 20 Months. Average weight loss in all patients was 19.9 +/- 5.3 kg (15.3 +/- 4.2%). No difference in weight loss was observed between diabetic and non-diabetic patients. During the follow-up, data were collected on 53 complications (42.4% of all gastric banding operations). 3 main types of complication were found: access port related complications (22.6% of the total), band slippage (20.7% of the total) and tubing related complications (16.9% of the total). No prognostic factor for these complications could be Identified from multivariate analysis. CONCLUSIONS: Our results are very similar to those of other weight evolution studies. We found that there was a significant incIdence of surgical and medical complications during the follow-up because of the meticulous way all complications were recorded, even the most insignificant. This morbIdity must be borne in mind before surgery is performed.

Adult↗
PubMed2004

Association between vascular dysfunction and reduced myocardial flow reserve in patients with hypertension: a LIFE substudy.

Impaired myocardial flow reserve (MFR) has been demonstrated in hypertension, and has been associated with peripheral vascular changes. We investigated whether MFR was impaired and associated with structural and/or functional vascular changes in hypertensive patients without evidence of coronary artery disease (CAD). We measured left ventricular (LV) mass index by echocardiography and MFR by positron emission tomography in 33 unmedicated, hypertensive patients with electrocardiographic LV hypertrophy without CAD, and 15 age- and gender-matched normotensive subjects. We also measured 24-h ambulatory blood pressure, minimal forearm vascular resistance (MFVR) by plethysmography, media:lumen ratio in isolated, subcutaneous resistance arteries by myography, intima-media cross-sectional area of the common carotid artery, and flow-mediated (FMD) and nitroglycerin-induced dilatation (NID) of the brachial artery by ultrasound. Compared to the controls, the patients had impaired MFR (2.4 (95% CI 1.95-2.8) vs 3.4 (2.7-4.2), P<0.01) due to increased resting myocardial blood flow (MBF) (0.82 (0.73-0.91) vs 0.65 (0.56-0.75) ml/g min), and decreased dipyridamole-stimulated MBF (1.80 (1.55-2.1) vs 2.3 (1.80-2.8) ml/g min, both P<0.05). The difference in resting MBF disappeared (80 (74-87) vs 86 (74-97) microl/kg mmHg, NS) when normalized for blood pressure and heart rate. MFR correlated negatively to median 24-h systolic blood pressure (r=-0.50, P<0.01) as well as to LV mass index (r=-0.45, P<0.05) and MFVR in men (r=-0.47, P<0.05), and positively to FMD (r=0.44, P<0.05) and NID (r=0.40, P<0.05). Hypertensive patients with electrocardiographic LV hypertrophy without CAD had impaired MFR associated with cardiovascular hypertrophy and vasodilatory dysfunction. This suggests that MFR is impaired by LV hypertrophy and structural/functional vascular damage in the coronary and noncoronary circulation.

Aged↗
PubMed2004

Plant growth: the translational connection.

The TOR (target of rapamycin) pathway is a phylogenetically conserved transduction system in eukaryotes linking the energy status of the cell to the protein synthesis apparatus and to cell growth. The TOR protein is specifically inhibited by a rapamycin-FKBP12 complex (where FKBP stands for FK506-binding protein) in yeast and animal cells. Whereas plants appear insensitive to rapamycin, Arabidopsis thaliana harbours a single TOR gene, which is essential for embryonic development. It was found that the product of this gene was capable of binding to rapamycin and yeast FKBP12. In-frame fusion with a GUS reporter gene shows that the TOR protein is produced essentially in proliferating zones, whereas the TOR mRNA can be detected in all organs suggesting a translational regulation of TOR. Phenotypic analysis of Arabidopsis TOR mutants indicates that the plant TOR pathway fulfils the same role in controlling cell growth as its other eukaryotic counterparts.

Gene Expression Regulation, Plant↗
PubMed2004

[Recommendations for personal respiratory protection in tuberculosis].

These recommendations of the German Central Committee against Tuberculosis give an overview of the current scientific knowledge on the tuberculosis risk of health service employees and on the risk of infection in individual areas of work. The efficacy of face masks and their benefit in tuberculosis control is discussed. There are no reliable data on the efficacy of face masks in preventing infection with M. tuberculosis, nor can such data be expected in the near future, due to the complex interaction of infection-preventing measures. As rapid case finding, isolation, and immediate, effective treatment of infected patients already greatly diminish the risk of transmission, we consider face masks to be of limited use in reducing this risk. However, they may be beneficial in certain areas of work and in certain situations, particularly in the presence of elevated aerosol concentrations. The benefit of face masks depends largely on their correct application. The choice of a particular type of mask requires knowledge of the current epidemiological situation, and a competent assessment of the risk in the area of work for which it is chosen, taking into account the closeness of contact with potentially infectious tuberculosis patients.

Germany↗
PubMed2004

[Medical care requested by smokers and at-risk alcohol consumers: results of a representative population survey].

PURPOSE OF THE STUDY: Due to difficult availability of subjects with substance-related disorders (especially nicotine and alcohol) via the existing specialised treatment services, the impact of proactive early interventions in hospitals and general practitioners is increasingly acknowledged. Only little is known as to known many persons with substance-related disorders are not attainable via this pathway and where such persons could be contacted. In the present study, we analysed the prevalence of substance-related disorders and the motivation to change in subjects drawn from a representative population survey with and without use of medical services during the preceding year. METHOD: The present analysis is based on data from the TACOS ("Transitions in Alcohol Consumption and Smoking") Study (N = 4075) conducted in the town of Luebeck and its environs in Northern Germany. Utilisation of medical services was differentiated in non-utilization (NI), hospital admission during the previous year (KH), at least one visit to a general practitioner (HA), specialist only (FA) and dentist only (ZA). RESULTS: 75% of the population had been to a hospital or their general practitioner in the previous year, a further 18.3% visited a specialist or a dentist only and 4.8% did not contact medical services. Analysis revealed a higher prevalence of smoking and increasing alcohol consumption combined with a higher unemployment rate in NI, followed by KH, HA, FA and ZA. CONCLUSION: The majority of smokers and subjects with at-risk alcohol consumption can be attained via medical services. Additionally, early interventions in dentist practices and employment offices might include further substantial groups of smokers and at-risk drinkers.

Adolescent↗
PubMed2004

[The value of applying nitroglycerin in 3D coronary MR angiographie with real-time navigation technique].

PURPOSE: Nitroglycerin administration results in dilation of epicardial coronary vessels and in an increase in coronary blood flow, and has been suggested to improve MR coronary angiography. This study evaluates systematically whether administration of nitroglycerin improves the visualization of coronary arteries and, as a result, the detection of coronary artery stenosis during free breathing 3D coronary MR angiography. MATERIALS AND METHODS: Coronary MR angiography was performed in 44 patients with suspected coronary artery disease at a 1.5 Tesla System (Intera, Philips Medical Systems) (a) with and (b) without continuous administration of intravenous nitroglycerin at a dose rate of 2.5 mg/h, using an ECG gated gradient echo sequence with real-time navigator correction (turbo field echo, in-plane resolution 0.70 x 0.79 mm(2), acquisition window 80 ms). Equivalent segments of the coronary arteries in the sequences with and without nitroglycerin were evaluated for visualized vessel length and diameter, qualitative assessment of visualization using a four point grading scale and detection of stenoses > 50 %. Catheter coronary angiography was used as a gold-standard. RESULTS: No significant differences were found between scans with and without nitroglycerin as to average length of the contiguously visualized vessel length (p > 0.05) and diameter (p > 0.05). There was also no significant difference in the coronary MR angiography with and without nitroglycerin in the average qualitative assessment score of the visualization of LM, proximal LAD, proximal CX, and proximal and distal RCA (2.1 +/- 0.8 and 2.2 +/- 0.7; p > 0.05). Sensitivity (77 % [17/22] vs. 82 % [18/22] p > 0.05) and specificity (72 % [13/18] vs. 72 % [13/18] p > 0.05) for the detection of coronary artery stenosis also did not differ significantly between scans with and without intravenous administration of nitroglycerin. CONCLUSION: Administration of nitroglycerin does not improve visualization of the coronary arteries and detection of coronary artery stenosis in free breathing 3D coronary MR angiography.

Coronary Angiography↗
PubMed2004

Vascular dysfunction and autonomic neuropathy in Type 2 diabetes.

AIMS: To test the hypothesis that arterial dysfunction in Type 2 diabetes is related to autonomic neuropathy. METHODS: Arterial function and autonomic neuropathy were assessed over two consecutive days in 45 Type 2 diabetic and control subjects. Systemic arterial compliance (SAC), arterial stiffness (pulse-wave velocity, PWV) and carotid intima thickness (IMT) were assessed; these markers reflect early vascular disease and predict clinical vascular events. Autonomic neuropathy was assessed using heart rate variability with continuous ECG recording during various breathing and postural manoeuvres and an overall autonomic score was generated. Fasting metabolic parameters including glucose, insulin, HbA(1c) and lipid profile were measured. RESULTS: Autonomic neuropathy tests were all repeatable in diabetic subjects. Compared with controls, diabetic subjects had arterial dysfunction with increased PWV (P = 0.009), IMT (P < 0.001) and reduced SAC (P = 0.053). After adjustment for age, central PWV correlated with fasting insulin (r(2) = 0.45, P < 0.05) and autonomic score (r(2) = 0.44, P < 0.05), peripheral PWV correlated with autonomic score (r(2) = 0.51, P < 0.005) and IMT correlated with fasting insulin (r(2) = 0.5, P < 0.005). The presence of autonomic neuropathy correlated with fasting insulin (P = 0.015), but not age, duration diabetes, lipids or blood pressure. CONCLUSION: Using repeatable measures of autonomic neuropathy and vascular function in Type 2 diabetic subjects, we have demonstrated associations between autonomic neuropathy, vascular dysfunction and hyperinsulinaemia. This may help to explain the excess cardiovascular mortality seen in diabetic subjects with autonomic neuropathy.

Aged↗
PubMed2004

The use of the standard exercise test to establish the clinical significance of mild echocardiographic changes in a Thoroughbred poor performer.

A 4-year-old Thoroughbred gelding racehorse was referred to the Onderstepoort Veterinary Academic Hospital (OVAH) with a history of post-race distress and collapse. In the absence of any obvious abnormalities in the preceding diagnostic work-up, a standard exercise test was performed to determine an underlying cause for the post-race distress reported. In this particular case oxygen desaturation became evident at speeds as slow as 6 m/s, where PO2 was measured at 82.3 mm Hg. Similarly at a blood pH of 7.28, PCO2 had dropped to 30.0 mm Hg indicating a combined metabolic acidosis and respiratory alkalosis. The cause of the distress was attributed to a severe hypoxia, with an associated hypocapnoea, confirmed on blood gas analyses, where PO2 levels obtained were as low as 56.6 mm Hg with a mean PCO2 level of 25.4 mm Hg during strenuous exercise. Arterial oxygenation returned to normal immediately after cessation of exercise to 106.44 mm Hg, while the hypocapnoeic alkalosis, PCO2 25.67 mm Hg, persisted until the animal's breathing normalized. The results obtained were indicative of a dynamic cardiac insufficiency present during exercise. The combination of an aortic stenosis and a mitral valve insufficiency may have resulted in a condition similar to that described as high-altitude pulmonary oedema, with respiratory changes and compensation as for acute altitude disease. The results obtained were indicative of a dynamic cardiac insufficiency present during exercise and substantiate the fact that an extensive diagnostic regime may be required to establish a cause for poor performance and that the standard exercise test remains an integral part of this work-up.

Animals↗
PubMed2003

Alcohol high risk drinking, abuse and dependence among tobacco smoking medical care patients and the general population.

BACKGROUND: Little is known about the synergies of smoking and alcohol consumption in medical care patients. The objective, therefore, is to estimate the coincidence of hazardous and harmful alcohol consumption as well as alcohol abuse and dependence with tobacco smoking in a general hospital and general practices. METHODS: Three samples of 18-64 year olds include 510 consecutively admitted currently smoking in-patients of a general hospital, 271 patients of a randomized sample of general practices, and 1567 current smokers from a regional population in Germany. Data include the number of cigarettes and a diagnosis of alcohol dependence and abuse (DSM), harmful or hazardous alcohol use. RESULTS: The rates of current daily cigarette smokers with an alcohol dependence or abuse, harmful or hazardous alcohol consumption are 47.1% in the general hospital and 32.1% in the general practice sample compared with 18.4% in the general population. The rates increase from nonsmokers to smokers and with the number of cigarettes. CONCLUSIONS: The findings fit into the evidence about alcohol and tobacco interactions in morbidity and mortality. General medical care settings are appropriate for the detection of alcohol dependence or abuse via smoking.

Adolescent↗
PubMed2003

Somatoform dissociation in eating-disordered patients.

This study investigated the role of somatoform dissociation in eating disorders and pathological eating behaviour, relative to the established association of eating pathology with psychological dissociation. The participants were 131 women with DSM-IV diagnoses of anorexic or bulimic disorders and 75 women who had no such disorder. Each woman completed measures of psychological and somatoform dissociation, as well as a measure of bulimic attitudes. The current presence or absence of specific bulimic behaviours was identified during the clinical interview. Levels of both forms of dissociation were higher in the women who had diagnoses of disorders with a bulimic component (bulimia nervosa; anorexia nervosa of the binge/purge subtype) than in the non-clinical or restrictive anorexic women. Somatoform dissociation showed particularly strong links with the presence of bulimic behavioural features (excessive exercise, laxative abuse, diet pill abuse, diuretic abuse) and with bulimic attitudes. The formulation and treatment of cases where there are bulimic features is likely to be enhanced by the assessment of somatoform dissociation.

Adult↗
PubMed2003

Gender differences in unipolar depression: a general population survey of adults between age 18 to 64 of German nationality.

BACKGROUND: Several studies from different epidemiological backgrounds have shown that unipolar depression is more prevalent in females than in males. This study examines gender differences in depression in a sample of 4075 probands recruited representatively from the general population in the northern German epidemiological catchment area of Lübeck. METHODS: Probands were interviewed with M-CIDI by lay interviewers. RESULTS: Being married only seems to increase the female depression risk when having children, while higher education reduced female excess; both male and female risk for depression raised sharply in separated, divorced and widowed probands. Not being employed was associated with an increased risk in male depression whereas in females risk was nearly unchanged. The gender ratio increased with the minimum number of depressive symptoms. Female excess was not reduced by a higher degree of subjective impairment or melancholic features. Females also predominated in longer episode durations. Female excess in the total group emerged beginning from adolescence with a tendency for a male excess in the prepubescent ages. No birth cohort effect was observed. LIMITATIONS: The cross-sectional design of this study precluded causal analysis of reported associations and some retrospective assessments are error-prone because of recall bias. CONCLUSIONS: We support previous findings of variations in gender differences in depression, however observed social parameter influences underline the need for a more detailed analysis of subgroups and underlying psychological mechanisms.

Adolescent↗
PubMed2003

[Gastroplasty: complications and their prevention].

Bariatric surgery is now frequently proposed for the treatment of morbid or complicated obesity since the introduction of minimally invasive laparoscopic anti-obesity operations such as the adjustable silicone gastric binding gastroplasty. However this reversible procedure in not always as safe as presumed and the results in weight loss may be sometimes disappointing. Side effects are common and early or late complications occured in more than 20% out of the patients. They are favoured by post operative eating disorders. Nutritional consequences are probably underestimated and are not limited to uncomfortable digestive symptoms. Some deficiencies in micronutriments have been described. The worsening of previous eating disorders or psychosocial abnormalities are not seldom. Gastroplasty is not an harmless procedure. A good selection in patients, a regular follow up, nutritional advices and psychosocial management by a multidisciplinar team are required to reduce complications after gastroplasty.

Gastroplasty↗
PubMed2003

[Minimal invasive cannulated screw osteosynthesis of Bennett's fractures].

PURPOSE OF THE STUDY: The current study presents a new technique and results of minimal invasive screw osteosynthesis in the treatment of Bennett's fractures and discusses its advantages and disadvantages. OPERATIVE TECHNIQUE: The Bennett's fragment has to be of sufficient size (at least one quarter of the articular surface) and closed reduction must be possible to achieve. Temporary fixation by K-wire is followed by minimal invasive osteosynthesis using a cannulated 3.0 mm screw in the lag screw technique. RESULTS: 18 patients underwent minimal screw osteosynthesis, of whom two were lost for follow-up. Average time of follow-up of the remaining 16 patients was 17.2 weeks. Fracture healing was achieved in all of the 16 patients. There were good to excellent results in 13 patients, fair results in one patient and poor results in two patients. CONCLUSION: Good results can be achieved by minimal invasive screw osteosynthesis in the treatment of Bennett's fractures. Correct indications and minute operation technique are indispensable preconditions for this new kind of treatment.

Adult↗
PubMed2003

Types of natural recovery from alcohol dependence: a cluster analytic approach.

BACKGROUND: Social capital and a low severity of alcohol-related problems have been focused upon to explain the processes of natural recovery from alcohol dependence. However, studies using control groups have not found significant differences in these variables. Subtypes of natural remission which might account for this inconsistency have only been described on grounds of qualitative data. AIMS: To identify subtypes of natural remitters using cluster analysis. PARTICIPANTS: One hundred and seventy-eight media-recruited natural remitters were interviewed personally. Several triggering mechanisms and maintenance factors of remission were assessed using standardized questionnaires. Based on age of onset and severity of dependence, adverse consequences from drinking, social pressure and social support, cluster analyses were performed. RESULTS: Cluster analyses yielded three groups of natural remitters: one cluster with a high severity of dependence, low alcohol-related problems and low social support ('low problems-low support'; n = 65), one group characterized by high severity of dependence, high alcohol-related problems and medium social support ('high problems-medium support'; n = 37), and a third group which consisted of subjects with high social support, late age of onset, low severity of dependence, and low alcohol-related problems ('low problems-high support'; n = 76). Cluster solutions were confirmed using discriminant analyses. Analyses of variance (ANOVAs) revealed further group differences on other triggering and maintaining factors of remission. CONCLUSIONS: Failure to identify specific pointers to natural recovery in previous research might be due to heterogeneous subgroups of natural remitters. In order to build a conceptual framework for understanding the processes of natural recovery, interactions of different independent variables should be considered.

Adult↗