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Biomedical subjects

E Reiter

Publications and source records attributed to E Reiter.

At least 73 records · Page 4Linked to original sources

[Contact eczema and "standard test"--do "International Standard Test Series" coincide with Austrian local characteristics?].

Testing with a "standard" group of substances has proved of great value when allergic contact dermatitis is suspected and the offending agent cannot be pinpointed by careful history-taking. But internationally standardized series do not take into account locally important and individual factors, changing consumer habits or economic aspects. We have, thus, compared the suitability of two standard series, the ICDRG-European and the DKG-German standard, for Austrian purposes. 1,478 patients with a clinical diagnosis of contact dermatitis were patch tested between 11/88 and 4/90 with the ICDRG allergens; the second collective of 505 patients was tested between 5/90 and 1/91 with the DKG series. Only 12 out of the 27 substances of the ICDRG series exceeded the critical incidence of 1%; 6 were below this limit but positive in more than 0.5% and 9 hardly ever aroused positive reactions. In the DKG series, 17 out of 23 substances surpassed the limit, 2 were positive in more than 0.5%, and 4 caused virtually no reactions. However, 4 allergens with frequent sensitization rates were included neither in the ICDRG nor in the DKG series and 2 others were missing in the over-dimensioned ICDRG standard. Our results demonstrate that internationally established standard series have to adapted for the local situation in Austria, and that a constant review is essential with replacement of allergens as necessary according to changing production techniques and consumer habits. Suggestions for an "Austrian standard patch test series" are proposed on the basis of our results but in spite of being helpful in general terms interpretation of such a test in the individual patient with eczema remains problematic.

Allergens↗

[Contact eczema and epicutaneous tests--distribution of allergens and changes in the spectrum in Vienna].

Thousands of contact antigens have been defined. It is, however, remarkable that only a small group of substances (15 to 20) have proved to be frequent or otherwise important causes of allergic contact dermatitis. In agreement with reports from comparable centres, metals are high up on the "hitlist" of frequent allergens (nickel 24%, cobalt 9%, chromates 6%), followed by ingredients of cosmetics and toiletries (fragrances 16%, balsam of Peru 10%, Kathon 5%), whilst already way back are topical medicines (neomycin 4%, parabens 3%, lanolin 2%, benzocaine 1%) and rubber additives (thiuram-mix 2% and carba-mix 1%). Almost all other substances lie below the 1% limit. There was only one remarkable exception in comparison with the results of most other European studies, namely thiomersal, which is widely distributed as a preservative in vaccines in Austria and climbed to second place, with a sensitization rate of 18%. Although the phenylborate mercurials (historic sensitizations due to topical antiseptics) still reached a surprisingly high incidence of 6%, there were hardly any cases of cross-sensitization with thiomersal. A comparison with the international literature illustrates Austria-specific trends and a change in the spectrum over the past years. Interpretation of patch testing requires great specialist knowledge and experience.

Adolescent↗

Serum concentrations of 25-hydroxyvitamin D in Florida children: effect of anticonvulsant drugs.

The mean serum concentration of 25-hydroxyvitamin D (25OHD), determined by nonchromatographic radioassay, was significantly lower (P less than .02) in Florida children with epilepsy treated with anticonvulsant drugs (34.4 +/- 11.3 [SD] ng/ml) than in normal subjects (40.9 +/- 14.3), despite exposure of both groups to sunlight throughout the year. In 12% of children treated with anticonvulsant drugs, the 25OHD level was below the lowest value recorded in the control group. The mean serum concentration of 25OHD in normal Philadelphia children (27.5 +/- 9.1 ng/ml) was significantly less than in either group of Florida subjects. Annual monitoring of calcium homeostasis and vitamin D status is indicated in Southern children receiving anticonvulsant drugs, but routine vitamin D supplementation of such patients is unnecessary.

Anticonvulsants↗

Concentrations of 24,25-dihydroxyvitamin D and 25-hydroxyvitamin D in paired maternal-cord sera.

Mean serum concentrations of 24,25-dihydroxyvitamin D (24,25(OH)2D) and 25-hydroxyvitamin D (25OHD), measured by competitive radioassays, were significantly higher in maternal serum than in cord serum of term infants in both black and white subjects. There were positive correlations between maternal and cord levels of both metabolites of vitamin D. Serum concentrations of 24,25(OH)2D and 25OHD were significantly lower in white pregnant subjects than in nonpregnant women. In utero levels of 24,25(OH)2D and 25OHD probably reflect maternal stores of these metabolites.

Dihydroxycholecalciferols↗

Synthesis of 1,25-dihydroxyvitamin D in the nephrectomized pregnant rat.

Pregnant rats were maintained on diets either adequate or deficient in vitamin D. On the 20th day of gestation, animals were either nephrectomized bilaterally or sham operated. Immediately therafter, four groups of nephrectomized or sham-operated pregnant rats received iv [26,27-3H]25-hydroxyvitamin D3 ([26,27-3H]25OHD3), while two groups received [1,2-3H,4-14C]D3. The animals were sacrificed 10-24 h later. The distribution of the radiolabeled metabolites of vitamin D3 was determined in extracts of maternal plasma, maternal intestinal tract, placentae, and fetuses after Sephadex LH-20 column chromatography. Both vitamin D3 and 25OHD3 crossed the placenta and entered the fetus. In anephric animals receiving [26,27-3H]-25OHD3, 24,25-dihydroxyvitamin D and a polar peak eluting in the position of 1,25-dihydroxyvitamin D [1,25(OH)2D] and 25,26-dihydroxyvitamin D were identified in extracts of maternal plasma and intestinal tracts and of placentae and fetuses. The identities of 24,25-dihydroxyvitamin D and 1,25 (OH)2D were confirmed by high pressure liquid chromatography. In rats receiving [1,2-3H,4-14C]D3, approximately 50% of the polar metabolite consisted of 1,25(OH)2D. We conclude that the anephric pregnant rat is able to synthesize 1,25(OH)2D, that the fetal portion of the feto-placental unit is the most likely site of production of this hormone, and that this metabolite of vitamin D is able to cross the placenta from the fetus to the mother.

Animals↗

Measurement of 24,25 dihydroxyvitamin D in sera of neonates and children.

Serum concentration of 25OHD and 24,25(OH)2D were measured in lipid extracts of serum by competitive radioassay following separation of the metabolits by Sephadex LH-20 column chromatography. The concentration of 24,25(OH)2D in children and adolescents (3.3 +/- 1.3 SD ng/ml) was significantly greater (P less than 0.01) than the levels recorded in neonates (1.8 +/- 0.6 ng/ml), and was approximately one-tenth the concentration of 25OHD in the two populations (children 35.2 +/- 9.2 ng/ml; neonates 14.4 +/- 3.4 ng/ml, P less than 0.01). Although 24,25(OH)2D is present in significant quantities in the sera of children and adolescents, its metabolic function remains unknown at present.

Adolescent↗

Symmetrical necrosis of globus pallidus with severe gait disturbance in a patient with myelodysplastic syndrome given allogeneic marrow transplantation.

A 21-year-old Caucasian man received an allogeneic marrow transplant (BMT) from his HLA-identical brother because of myelodysplastic syndrome. He remained red blood cell (RBC) transfusion dependent with persistent antibodies against the donor's RBC. Six months following BMT the patient suddenly developed a severe akinetic syndrome with gait disturbance and frequent falls and bilateral symmetrical lesions in basal ganglia. Concomitantly, micrococcus species septicemia from an infected Hickman catheter developed. Despite antimicrobial therapy and withdrawal of cyclosporin A, neurologic abnormalities persisted and were unresponsive to various therapies. Ischemic damage due to a vascular event during severe infection could be the most probable reason for the lesions seen in our patient, although infectious or toxic complications cannot be ruled out.

Adult↗

Age-related changes in melatonin levels in humans and its potential consequences for sleep disorders.

Prior to three months of age there is little melatonin (MLT) secretion in humans. MLT production then commences, becomes circadian, and reaches its highest nocturnal blood levels between the ages of one to three years. During the remainder of childhood, nocturnal peak levels drop progressively by 80%. In adults, these levels show an additional drop of some 10%, mainly during senescence. The large drop in serum MLT during childhood is probably the result of the increase in size of the human body, despite a constant MLT production after infancy. The additional decline of MLT with higher age may be due to a yet unidentified physiological mechanism accompanying senescence. The biological significance of these MLT alterations remains unknown. Since the discovery of MLT, an immediate sedative action of this hormone has been known. A number of recent studies have demonstrated that MLT indeed exerts a sleep-promoting action by accelerating sleep initiation, improving sleep maintenance, and marginally altering sleep architecture. The potential of MLT in the treatment of insomnia is being explored, and the results are promising. Although in most of these studies pharmacological dosages of MLT have been used, preliminary data suggest that similar effects can also be achieved by physiological hormone concentrations. The latter observation raises the question of whether MLT might be involved in the physiological control of sleep.

Aging↗

[Hyperekplexia -- a treatable neuropediatric disease].

Hyperekplexia (OMIM 138491) is primarily an autosomal dominant disease characterized by exaggerated startle reflex and neonatal hypertonia. If untreated it can be associated with sudden infant death from apnea or aspiration pneumonia and serious injuries. Different mutations of the alpha1-subunit of inhbitory glyzine receptor (GLRA1) could be found. Clonazepame, a gammaaminobutyric acid (GABA) receptor agonist is the therapy of choice. An early diagnose will lead to appropriate treatment and genetic counseling.

Amino Acid Sequence↗

[Psychosocial adjustment, relationship and self-concept in siblings of children with idiopathic epilepsy syndromes].

BACKGROUND: Psychosocial adjustment, relationship and self-concept in siblings of children with idiopathic epilepsy was compared with healthy controls. PATIENTS: 173 persons--68 siblings, 62 mothers and 43 fathers--from the study group (children with idiopathic epilepsy) and matched controls were investigated. METHODS: Child Behaviour Checklist (CBCL), Self-Description-Questionnaire I and II (SDQ) and Sibling Relationship Questionnaire (SRQ) were used. RESULTS: There were more somatic complaints of the siblings reported by the mothers of the study group. They also noted more nurturance of the sibling than mothers of healthy children did. The data of the fathers showed more dominance of the sibling. Siblings of children with epilepsy showed more prosocial action towards their classmates. In families with a new diagnosed epilepsy the fathers noticed more problems in school und somatic complaints of the siblings. The number of seizures, which were seen by the sibling, not the absolute number of seizures, had an influence on the behavior of the siblings; these siblings had more social problems than siblings, who had never seen a seizure. CONCLUSIONS: We suggest a close cooperation with the families and constant inclusion in the treatment as claimed by recent systemic family medicine. Resource-orientated and salutogenetic aspects should be given a greater focus in modern work with families and especially siblings.

Adaptation, Psychological↗

Protective techniques.

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Dental Hygienists↗