The height of the diaphragm in the chest radiograph of normal adults.
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Adult↗
Biomedical subjects
G Simon
Publications and source records attributed to G Simon.
The cause and significance of some long line shadows in the chest radiograph.
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Humans↗
[Ultrastructure of the capillaries].
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Capillaries↗
Studies of dental and oral changes of pregnant diabetic women.
The longitudinal examination of 132 pregnant diabetic women under care showed a 96.2% prevalence of gingivitis. The intensity of gingivitis was most marked in weeks 11 to 15, and 24 to 26 of pregnancy, and the correlation with changes in oral hygiene was statistically significant (p less than 0.001). On the other hand, the severity of diabetes had no effect on the degree of gingival inflammation. As for caries, the mean DMF values increased during diabetic pregnancy, the number of carious (D) and filled (F) teeth to a higher, that of extracted (M) teeth to a lesser degree, than in diabetic non-pregnant women.
Adolescent↗
The fate of drotaverine-acephyllinate in rat and man. I. Absorption, distribution and excretion in the rat.
Two different labelled forms were used for the pharmacokinetic investigations: the carbon 1 in the isoquinoline ring (Drotaverine-14C-Acephyllinate) and the carboxyl group of theophylline-7-acetic acid (Drotaverine-Acephylline-14C-ate). Drotaverine-14C-Acephyllinate was rapidly absorbed from duodenal and ileal segments. Biliary excretion was substantial after oral administration and radioactivity was excreted mostly in the feces. Absorption of Drotavenine-Acephylline-14-C-ate from the gastrointestinal tract was very poor and radioactivity was therefore excreted for the most part in the feces. The results of the study were confirmed by whole body autoradiography.
Animals↗
Beyond principal component analysis: canonical component analysis for data reduction in classification of EPs.
The authors tested a new procedure for the discrimination of EPs obtained in different stimulus situations. In contrast with principal component analysis (PCA) used so far for the purpose of data compression, the method referred to as canonical component analysis (CCA) is optimal for the purpose of discrimination. To illustrate this, the authors performed both PCA and CCA for the same material, then after carrying out discriminant analysis ( SWDA ) for the data transformed in this way, compared the performance of the two procedures in discrimination. In view of both the theoretical and practical considerations, the authors recommend that in the future researchers use CCA instead of PCA in EP studies for data reduction carried out for discrimination.
Computers↗
Glycogenic myopathy. A case of skeletal muscle-glycogenosis in twins.
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Adult↗
Neuroticism and extraversion as predictors of health outcomes in depressed primary care patients.
Depressed primary care patients (N = 217) were assessed to determine if certain personality characteristics predict health domains independent of chronic disease, demographics, depression, and psychiatric diagnoses. Eleven health variables were used to create three outcome factor scores: disability (e.g., days missed work); somatization (e.g., medically unexplained symptoms); and subjective pain (severity, interference). Neuroticism explained significant variance in all health outcomes independent of the other predictors. Depression and neuroticism interacted in the disability and pain models. Depression was related to health in neurotic patients, while in the absence of neuroticism, little relation between depression and health was observed. Neuroticism may explain why persons with similar health problems have differing levels of disability, pain, and somatization.
Depressive Disorder↗
Rethinking practitioner roles in chronic illness: the specialist, primary care physician, and the practice nurse.
In this article, we describe an evidence-based stepped care approach to improving the care of chronic illness in organized health care systems. We review the common principles that have been found to improve the management and outcomes of patients with major depression, asthma, diabetes, and congestive heart failure. These population-based methods to improve care of chronic illness require reorganizing the roles of specialists, primary care physicians, and nurses.
Asthma↗
The use of administrative data to assess quality of care for bipolar disorder in a large staff model HMO.
We examined patterns of care for 1246 adults treated for bipolar disorder in a large health maintenance organization. Computerized pharmacy and visit data were used to identify patients treated for bipolar disorder. Automated medical records for the following year were used to assess continuity and dosing of treatment with mood stabilizers, laboratory monitoring for adverse effects and therapeutic serum levels, and frequency of follow-up visits. Of our 1246 subjects 83% filled a mood stabilizer prescription during the 1-year study period, and doses were within recommended ranges 80% of the time. Over 75% of the patients on mood stabilizers had at least one apparent interruption in medication use. Approximately half of the long-term users of mood stabilizers had at least one 7-month period without a recorded blood level and approximately half had a similar period without monitoring for adverse medication effects. Of the 116 subjects discharged from a psychiatric hospitalization 58% had a visit with a psychiatrist or a psychiatric nurse practitioner within 30 days. Of those discontinuing mood stabilizer treatment 68% made a mental health visit within 90 days. Our findings demonstrate the feasibility of using administrative data systems for population-based quality of care assessment and suggest opportunities for improving the care of bipolar patients.
Adolescent↗
Comorbidity assessment in hemodialysis and peritoneal dialysis using the index of coexistent disease.
The purpose of this paper is to describe the ICED, summarize outcomes of prior studies in which it was used, and describe the adaptations that have lead to the present instrument. We will then demonstrate its use in quantifying the burden of comorbid conditions in a sample of hemodialysis and peritoneal dialysis patients from our center, and show the relationship between ICED levels and outcomes in peritoneal dialysis patients.
Comorbidity↗
Methodologic issues in randomized trials of liaison psychiatry in primary care.
Most anxiety, depressive, and substance abuse disorders are treated exclusively in the primary care health system. However, recognition and treatment of these disorders in primary care is deficient. Psychopharmacologic and psychotherapeutic interventions have been developed and proven effective in randomized trials in specialty care. However, the results of successful trials of mental health interventions in specialty settings may not generalize to primary care settings because of epidemiologic differences in patients, differences in skills of providers, as well as differences in the very structure of care. The importance of the development of innovative randomized trials to improve recognition and treatment of mental illness in primary care is emphasized, as well as the methodologic problems inherent in carrying out these trials.
Humans↗
Somatic symptoms of distress: an international primary care study.
The objective of this study was to examine cross-national differences in somatic symptoms associated with psychological distress. Data from the World Health Organization (WHO) collaborative study of psychological problems in general health care (5438 patients at 15 sites) were used to examine somatic symptoms associated with psychological distress. At each site, a stratified random sample of consecutive primary care patients completed the 28-item General Health Questionnaire (GHQ) and the Composite International Diagnostic Interview (CIDI). At all sites, the number of current CIDI somatic symptoms (whether medically explained or not) was strongly associated with current psychological distress (measured by selected GHQ-28 items). Pearson correlation of somatic symptom count with psychological distress score was .42 for all sites and ranged from .20 to .58 (p < .0001 at all sites). Across all sites, anxiety and depressive symptoms showed roughly the same association with somatic symptom counts, and specific somatic symptoms or symptom clusters did not show differential association with anxiety or depression. Although somatic symptoms did cluster into meaningful groups (gastrointestinal, neurological/conversion, autonomic, and musculoskeletal), these symptom groups did not show differential association with psychological distress. Examination of individual somatic symptoms and symptom clusters across sites did not reveal clear patterns of association according to geography or level of economic development. These data show a strong association between somatic symptoms and psychological distress, which did not vary across disparate cultures and levels of economic development. Cultural factors, however, may influence the meaning attached to symptoms or the likelihood of presentation for health care.
Adolescent↗
Acremonium kiliense in oesophagus stenosis.
The aetiological significance of Acremonium kiliense is demonstrated for the first time in a human gastrointestinal infection. The mycotic oesophagitis with gastro-oesophageal reflux is described. The situation was treated effectively with itraconazole and anti-reflux surgery.
Acremonium↗
Long-term post-treatment follow-up of onychomycosis treated with terbinafine: a multicentre trial.
Between 1991 and 1993, 32 cases of fingernail mycosis and 20 cases of toenail mycosis caused by dermatophytes were treated with terbinafine. For 8 weeks, 250 mg of terbinafine was given daily for fingernail infections, and for 12 weeks the same dose was given for toenail involvement; the short-term follow-up was 24 and 48 weeks respectively. A long-term follow-up was performed twice, initially at 24 and then at 48 months after the end of the treatment. For fingernail mycosis, the mycological cure rate was 100% at the end of month 24 and 91% at the end of month 48. Mycological cultures gave negative results in toenail infections in 90% after 24 months and in 86% after 48 months. After 24 months, 23 out of 26 patients (88%) with fingernail and 17 out of 20 patients (95%) with toenail mycosis were clinically cured. After 48 months, 20 out of 22 cases (91%) with fingernail and 10 out of 14 cases (71%) with toenail involvement showed a complete cure.
Adult↗
Angiopathic serum factor in perinephritic hypertensive dogs.
To investigate the role of circulating humoral substances in the pathogenesis of increased vascular wall water and sodium concentration in experimental hypertension, rabbit aortic media explants were cultured in tissue culture medium supplemented (10-20%) with serum obtained from the same dogs (n = 7): 1) before the induction of hypertension; 2) after wrapping one kidney in silk (two-kidney perinephritic hypertension, 2-KPHT); and 3) after contralateral nephrectomy (1-KPHT). Cultures also were run with serum of sham-wrapped and then unilaterally nephrectomized normotensive dogs (n = 4). After 3 weeks of culture, the explants were harvested, and their water, sodium and potassium concentration was measured. Compared to the composition of explants cultured in prehypertensive serum, the water concentration of explants cultured in 1-KPHT and the sodium concentration of explants cultured in 2-KPHT and 1-KPHT serum were increased (p < 0.05). The water and electrolyte content of explants cultured in sera of sham-operated normotensive control dogs was the same regardless of the type of serum used, pre- or post-sham surgery or post-nephrectomy. The effects of serum from hypertensive dogs were not explained by variations in serum creatinine, sodium and potassium levels or in plasma renin activities. The experiments provide evidence for the role of serum factor(s) in the pathogenesis of abnormal vascular wall water and sodium concentration in experimental hypertension.
Animals↗
Reversibility of arterial and venous changes in renal hypertensive rats.
The effect of reversal of hypertension on vascular function and composition was investigated in renal-hypertensive rats. The study comprised three groups of rats: 1) 21 male Sprague-Dawley rats with one-kidney, one clip Goldblatt hypertension of 9 weeks' duration; 2) 20 rats with one-kidney, one clip hypertension that underwent removal of renal artery clip (were "unclipped") at 6 weeks of hypertension, 3 weeks prior to the study; and 3) sham-operated normotensive control rats. Venous pressure-volume and arterial pressure-flow relationships were measured at maximal vasodilation (sodium nitroprusside and papaverine) in the denervated, pump-perfused vascular beds of the hindquarters of rats. Anatomically defined segments of the aorta and of the vena cava were removed from rats for water, sodium, and potassium analysis. Hypertension was completely reversed in the "unclipped" rats. Compared to values obtained in normotensive control rats, the water concentration of the aorta and of the vena cava, the potassium concentration of the aorta, and the sodium concentration of the vena cava were increased (p less than 0.05) in rats with one-kidney, one clip hypertension. These changes were reversed in the "unclipped" rats. In contrast, the shift of the venous pressure-volume and of the arterial pressure-flow curves toward the pressure axis at maximal vasodilation in hypertensive rats (p less than 0.02) persisted following reversal of hypertension in the "unclipped" rats (p less than 0.05). In chronic, one-kidney renovascular hypertension, the contribution of vascular wall "water-logging" to increased structural arterial resistance and decreased structural venous capacity appears to be minor.
Animals↗
Short-term systemic hemodynamic adaptation to beta-adrenergic inhibition with atenolol in hypertensive patients.
Early systemic hemodynamic adjustments to antihypertensive therapy with the cardioselective beta inhibitor, atenolol, were investigated in 12 hospitalized men, mean age 52 years, with uncomplicated mild-to-moderate essential hypertension. Twice daily measurements of cardiac output (CO) by CO2 rebreathing, blood pressure by cuff, and heart rate were performed in all subjects for 3 days before and 5 days after initiation of oral atenolol therapy (50 or 100 mg daily). Cardiac output by CO2 rebreathing was checked with dye dilution just before, and 4 hours and 4 days after the start of therapy. Plasma volume (radioiodinated albumin) was measured before therapy and on Day 5 of therapy. The CO results obtained with the two methods were not significantly different (r = 0.88, p less than 0.01, n = 12). A reduction in heart rate, 18 +/- 2 beats/min (mean +/- SE), occurred in all patients while taking atenolol. By 4 hours after the first dose of atenolol, CO fell from 5.49 +/- 0./30 to 4.24 +/- 0.21 liters/min (p less than 0.01), while the control mean arterial pressure (MAP) of 108 +/- 4 mm Hg was not significantly changed, 110 +/- 4 mm Hg. At 24 hours, CO returned near baseline (5.10 +/- 0.21 liters/min) but MAP was reduced (95 +/- 3 mm Hg, p less than 0.001) and remained so thereafter. CO remained at baseline at 48 hours (5.50 +/- 0.29 liters/min) but fell again (p less than 0.01) to 4.81 +/- 0.11 on Day 4 and to 4.68 +/- 0.25 liters/min on Day 5 of atenolol therapy. Plasma volume, 3110 +/- 100 ml before therapy, was reduced to 2850 +/- 100 by Day 5 of atenolol therapy (p less than 0.01). The findings indicate a delayed onset of the antihypertensive action of atenolol. The transient return to baseline of CO on Day 2 and 3 of atenolol therapy suggests a reverse autoregulatory adjustment to the initial fall in CO.
Adrenergic beta-Antagonists↗