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Biomedical subjects

E Haller

Publications and source records attributed to E Haller.

At least 37 records · Page 2Linked to original sources
PubMed1990

Right arm involvement and pain extension can help to differentiate coronary diseases from chest pain of other origin: a prospective emergency ward study of 278 consecutive patients admitted for chest pain.

In a prospective study of 278 consecutive patients admitted to an emergency ward for chest pain, the 115 clinical and paraclinical parameters available at the time of admission were evaluated by computer comparison with the final diagnoses. The most valuable items for making the diagnosis were classified according to their sensitivity, specificity and predictive value. Among the 278 patients, 100 individuals had myocardial infarctions (MI), 47 had unstable angina, 25 had stable angina and 106 patients had a non-coronary disease. The twelve most sensitive items for distinguishing MI from other conditions were the following: sudden onset of pain (70%); duration of more than 60 min (88%); constriction and squeezing (79%); oppression (75%); prior anginal attacks (61%); sex male (72%); age over 60 years (74%); abnormal heart auscultation (62%); abnormal electrocardiogram (ECG) (98%); segment (ST) disturbances (86%); increased glucose level (77%); CKMB fraction greater than 6% of total creatine kinase (CK) level (63%). Among the twelve most specific items, also with the best positive predictive value, irradiation in the right arm is of most importance; among the 51 patients with right arm involvement, 48 suffered from a coronary disease and 41 from a myocardial infarction. The largest extension of pain was reported in the latter group. It is concluded that chest pain with a wide irradiation involving the right arm strongly suggests that a myocardial infarction is ongoing.

Arm↗
PubMed1990

Clozapine and seizures.

Clozapine is a newly released antipsychotic that is associated with a higher prevalence of seizures than traditional neuroleptics. The authors describe four patients who developed seizure activity during clozapine treatment and provide recommendations for clinical management of this problem.

Adult↗
PubMed1990

Clozapine--a new and different neuroleptic.

These discussions are selected from the weekly staff conferences in the Department of Medicine, University of California, San Francisco. Taken from a transcription, it has been edited by Homer A. Boushey, MD, Professor of Medicine, and Nathan M. Bass, MD, PhD, Associate Professor of Medicine, under the direction of Lloyd H. Smith, Jr, MD, Professor of Medicine and Associate Dean in the School of Medicine.

Adult↗
PubMed1989

Violence in geriatric patients with dementia.

Although the elderly have been studied as victims of violent behavior, there has been little investigation of this population as perpetrators of violence. Using the method of retrospective chart review, this study examines the issue of violence by geriatric patients with dementia who need acute psychiatric hospitalization. Of 52 patients, 44 percent engaged in physical attacks and/or fear-inducing behavior during the two weeks prior to admission, and 29 percent engaged in similar behavior within the first 72 hours of hospitalization. Married patients and those who lived with family were overrepresented in the group of violent patients. The authors discuss possible explanations and implications of these findings.

Aged↗
PubMed1988

[Diagnosis, clinical presentation and triage criteria of emergency patients admitted for chest pain: prospective study of 278 cases].

A prospective study of the clinical findings and transfer decision in 278 patients admitted to the emergency ward for chest pain showed that a combination of 115 clinical and ECG data makes it possible to predict 86% of acute myocardial infarctions and unstable angina (specificity 76%). However, the diagnosis of the emergency medical team was adequate in 91% of cases, yielding a 5% rate of unjustified admissions to the intensive care unit. Therefore, the utility of a decision algorithm based upon clinical and ECG data, as proposed by American authors, is questionable. Finally, the indication for transfer to the intensive care unit was not followed in a quarter of patients due to old age and/or associated diseases.

Acute Disease↗
PubMed1988

[Current role of biopsy in the diagnosis of hepatic disease].

The criteria for the use of liver biopsy as a diagnostic tool were retrospectively analyzed over a ten-year period in 390 consecutive patients. The four principal conditions in which this procedure was employed were alcoholism (33%), hepatitis (18%), abnormal hepatic tests (16%) and tumors (10%). The development of new, "non-invasive", investigative methods such as echography and tomodensitometry has led to an decrease in the number of liver biopsies performed annually, but no change in the relative frequency of the various indications. In this paper, evidence is presented which demonstrates that hepatic biopsy confirmed the clinical diagnosis in 62.4% of the cases reviewed and fundamentally modified the diagnosis in 20.2%. Based upon these findings, it can be concluded that liver biopsy remains an indispensable diagnostic procedure in the field of hepatology, since it can result in modification of the clinician's diagnosis in one out of five cases.

Adolescent↗
PubMed1988

Adjusted subcutaneous heparin versus heparin plus dihydroergotamine in prevention of deep vein thrombosis after total hip arthroplasty.

In a prospective randomized study, two different antithrombotic regimens were compared with regard to their effects on the incidence of deep vein thrombosis (DVT) in 102 patients undergoing elective total hip arthroplasty. Fifty patients (group 1) received heparin subcutaneously three times daily in doses adjusted as a function of activated partial thromboplastin time (APTT), and 52 patients (group 2) received a fixed dose of 5,000 IU heparin plus 0.5 mg dihydroergotamine twice daily. Both treatments were started 2 days before operation and continued for 7-9 days after operation, when venography of the operated leg was performed in all patients. The overall incidence of DVT was 22% in group 1 and 19.6% in group 2. Eight patients (16%) in group 1 and four (7.6%) in group 2 developed proximal DVT. These differences were not statistically significant. Hemorrhagic complications occurred more frequently in group 1. Heparin plus dihydroergotamine is a simple and effective method of preventing DVT in patients undergoing total hip arthroplasty. Daily APTT-adjusted subcutaneous heparin remains the best method of prevention of DVT in patients with contraindications to the use of dihydroergotamine and those with two or more DVT risk factors.

Dihydroergotamine↗
PubMed1986

[Prognostic value of the renin-angiotensin system in response to salt restriction and prognosis of alcoholic ascitic cirrhosis].

Prognostic factors in alcoholic cirrhosis with ascites were analyzed in a prospective study of 37 patients (25 men, 12 women), 26 of whom presented with clinically diagnosed ascites. A good therapeutic response following salt restriction was obtained in 50%; this response correlated well with an initially small ascites volume, male sex, daily urinary sodium excretion of greater than 10 mmol, plasma renin activity of less than 5 ng/ml/hr and a normal plasma aldosterone level. On the other hand, age, number of episodes and duration of ascites, hepatic functional parameters, plasma creatinine concentration and portal venous pressure had no predictive value as to therapeutic response. Patients' survival was inversely related to plasma renin activity and positively to sodium excretion. The one-year mortality rate reached 88% in patients with renin of greater than 5 ng/ml/hr or daily urinary sodium excretion of less than 10 mmol, while 70% of patients with renin of less than 5 ng/ml/hr or daily sodium excretion of greater than 10 mmol survived more than two years. No prognostic index of survival could be derived from age, sex, number of episodes, duration and volume of ascites, portal venous pressure or hepatic biochemical parameters. Thus, in cirrhotic alcoholic patients with ascites the determination of daily urinary sodium excretion, which is inversely related to the activity of the renin-angiotensin system, provides a useful prognostic index for the response to salt restriction and longterm survival.

Adult↗
PubMed1985

Immunoglobulin responses in acute Q fever.

Knowledge of the development of different classes of antibody during the course of acute Q fever is important to the clinician for interpreting a patient's serological test results. In the present study, the appearance of antibodies to Coxiella burnetii phases I and II was determined for a period of 1 year. A total of 683 sera from 191 patients with symptomatic Q fever were evaluated by the complement fixation and indirect immunofluorescence (immunoglobulins M and G [IgM, IgG]) tests. These patients had contracted acute Q fever in the fall of 1983 during an epidemic that resulted in 415 serologically confirmed cases of Q fever. As demonstrated by the complement fixation test, antibodies to C. burnetii phase II remained elevated throughout the entire study period, whereas antibodies to phase I were barely detectable. Although the immunofluorescence test was more sensitive than the complement fixation test, the specific anti-IgG response to C. burnetii to phases I and II gave the same general antibody profiles as did the complement fixation test. IgM anti-phase I and II titers appeared earlier but disappeared after 10 to 12 weeks. During this period, anti-phase II antibody levels were generally much higher than anti-phase I antibody levels.

Antibodies, Bacterial↗
PubMed1985

[Ergometric validation of a questionnaire on the physical activity in 2 Swiss towns].

A questionnaire concerning physical activity used in the National Research Program No. 1A (PNR 1A) was evaluated by using a physical fitness test on an ergometric bicycle. The values of maximum oxygen consumption correspond to different classes of physical activity set up according to the questionnaire (comparison of groups statistically significant). In addition, it appears that maximal oxygen consumption is in direct relation to the intensity of physical activity during leisure hours, whilst the degree of activity connected with professional or household duties is of very little importance.

Adult↗
PubMed1982

[Age and toxicopathy--Vaud 1977-1978].

Recent work on principles of pleasure and on endogenous opioïd system enlightens some regulations of mental comfort and of homeostasis of the nervous system. From this point of view, the choice of specific drugs, during the first months of their use, would give an indirect picture of the troubles which caused initially the use of these substances. The present study discloses, behind the apparent anarchy of mono- and polytoxicopathies, some constant relations between age and sex of drug-users and specific choice of drugs.

Adolescent↗
PubMed1981

[The nature of drug consumption from 1977-1978 in the canton of Vaud].

In the canton of Vaud, Switzerland, 1589 regular drug consumers used in 1977 and 1978 one or more of the following substances: cannabis, opiates, hallucinogens, amphetamines, cocaine, medicaments (principally usual sleeping pills, analgesic pills, and tranquillizers). Half of the consumers used only cannabis, or opiates, or medicaments. Amphetamines, hallucinogens, cocaine were used very seldom alone. The situation in drug associations is very different. The most popular drug associations are presented. Abuse and abstinence of alcohol and cigarettes could be analyzed among 698 drug consumers.

Cannabis↗
PubMed1980

Necrotic extrafusal muscle fibers of the dystrophic mutant mouse: the ultrastructure of the myoneural junction.

At 28 days postpartum, the extensor digitorum longus muscle of the dy2J mutant mouse contains a population of myofibers which exhibit coagulation necrosis for approximately 90% of their length. Using the electron microscope, motor endplates were found on more than half of the necrotic fibers studied, occurring in mildly, moderately, and severely necrotic regions of these fibers. The ultrastructural features of the axonal terminals did not vary with the condition of the fiber segment at which the endplate occurred. No morphological criteria could be established for distinguishing between the axonal terminals of necrotic fibers and those of "healthy" fibers in the dystrophic animal. The principle morphological changes at motor endplates of necrotic fibers involved not the axonal terminal, but the muscle fiber itself. This study demonstrates that the necrotic myofibers, which are present at the onset of the first clinical symptoms of murine dystrophy, are innervated. Therefore, necrosis is not precipitated by structural denervation. Furthermore, observations of motor endplates on mildly, moderately, and severely necrotic regions of the myofibers indicate that regional changes along the necrotic fiber's length are not a function of distance from the motor endplate.

Animals↗