Search PubMed⌕ Search

Biomedical subjects

H Stalder

Publications and source records attributed to H Stalder.

At least 55 records · Page 3Linked to original sources
PubMed1994

[Development and adaptation of tensile strength by bones in the extremities in response to physical training exemplified by the tibia].

Results from an in vivo assessment of the bending stiffness of human tibiae with a new method demonstrate that bone mineral measurements are not a suitable predictor to evaluate changes of mechanical properties of long bones. In a study on 559 male military recruits, the bone mineral at tibial shaft resulted in a mean increase of +1.8% during 15 weeks of exercise. The bending stiffness however increased about 25%. An additional test 24 months later on a sample indicated that the increase of bone mineral content was only due to the natural maturation of bone. The bending stiffness however, decreased by about 6% demonstrating the earlier training effect. No correlation between bone mineral and bending stiffness could be found neither in absolute values nor in difference between the three measurements. At the same time first results of a normative study on children (9 to 18 years old, male and female) and on women (up to 80 years old) are presented.

Adolescent↗
PubMed1993

Adult bacterial nasopharyngitis: a clinical entity?

OBJECTIVE: To investigate bacterial nasopharyngitis as a cause of adult upper respiratory infection. DESIGN: Prospective case series. SETTING: Walk-in medical clinic of a university hospital. PATIENTS: 507 patients with cold or flu symptoms, sore throat, or recent cough; 21 control subjects without symptoms of upper respiratory infection. MEASUREMENTS AND MAIN RESULTS: After thorough history and physical examination, the patients underwent nasopharyngeal aspiration and throat culture. Nasopharyngeal specimens were cultured for both bacteria and viruses; antigens for influenza, parainfluenza, and respiratory syncytial virus were sought by enzyme-linked immunosorbent assay (ELISA); serum antibodies to viral respiratory pathogens were determined. Group A beta-hemolytic streptococci grew from the throat specimens of 39 of the 507 patients (8%) or 38 of 334 patients (11%) who had clinical diagnoses of pharyngitis. Thirty-three cases of influenza A, 20 cases of influenza B, and seven cases of parainfluenza infections were diagnosed. Bacteria were cultured from the nasopharyngeal secretions of 284 patients (56%). In contrast to pharyngeal culture, commensal mixed flora were rarely found in nasopharyngeal culture. Nasopharyngeal culture of bacteria usually considered to be respiratory pathogens was significantly associated with the presence of leukocytes. Streptococcus pneumoniae (odds ratio 6.0, 95% confidence interval 2.6-14.2), Moraxella catarrhalis (odds ratio 12.9, 95% confidence interval 3.1-79.5), and Hemophilus influenzae (odds ratio 3.0, 95% confidence interval 1.2-7.4) were all associated with the presence of leukocytes. In contrast, nasopharyngeal culture of coagulase-negative staphylococci, mixed flora, and the documentation of a viral infection were not associated with the presence of leukocytes. For none of 21 control subjects were "pathogenic" bacteria found. CONCLUSIONS: These data suggest that potentially pathogenic bacteria may have a causal role in adult nasopharyngitis, although further data are needed to confirm this hypothesis.

Adolescent↗
PubMed1993

Symptomatic primary infection due to human immunodeficiency virus type 1: review of 31 cases.

In this series of 31 patients with acute infection due to human immunodeficiency virus (HIV) type 1, the male-to-female ratio was 3.4:1 and the mean age was 31.3 years. Sexual transmission accounted for 83.9% of cases; 45.2% of the patients were homosexual and 38.7% were heterosexual. The mean duration of symptoms and signs was 21 days (range, 5-60 days). Fever (87.1%) and skin rash (67.7%) were most commonly reported. Physical examination findings were abnormal for 96% of the patients; the oral cavity (76.7%) and the skin (73.3%) were the most frequently involved sites. Thirteen of 25 patients with sexually acquired infection had genital or oral ulcers, whereas five intravenous drug users had none (P = .052). Thrombocytopenia was the most common hematologic abnormality and was detected in 17 of 23 patients tested. P24 antigenemia, an initially negative screening test for HIV antibody, and a low CD4+ lymphocyte count were noted in 23 of 29, 23 of 30, and 14 of 21 tested patients, respectively.

Adult↗
PubMed1991

Safety and immunogenicity of a genetically engineered human immunodeficiency virus vaccine.

A phase 1 trial of a candidate human immunodeficiency virus type 1 (HIV-1) vaccine was done in 25 healthy seronegative subjects. The antigen, env2-3 (SF2), was a nonglycosylated polypeptide representing the gp120 region of the env gene of the HIV-1(SF2) isolate. It was produced in genetically engineered yeast as a denatured molecule incapable of binding CD4. A synthetic lipophilic muramyl tripeptide (MTP-PE) was used as an adjuvant. Ten subjects received adjuvant alone and 15 received 50- or 250-micrograms doses of env2-3 (SF2) administered intramuscularly in two immunization regimens. In general, adjuvant and vaccine were well tolerated. Antibody responses to both the homologous antigen, env2-3 (SF2), and antigens from other highly divergent HIV isolates were elicited in the majority of vaccine recipients. However, antibody titers were low, without neutralizing activity. In 9 of 11 subjects who received the complete vaccine immunization series, a significant specific T lymphocyte response was observed.

Acetylmuramyl-Alanyl-Isoglutamine↗
PubMed1990

Early appearance of 2,3-butanediol in acute myocardial infarction. A new marker for ischaemia?

In 28 patients with acute myocardial infarction, the release pattern of 2,3-butanediol (BD), a product of intermediary metabolism, and creatine kinase activity (CK) in blood were compared. Whereas CK at entry was low in all patients, the BD level was elevated in 18 (64%). However, BD returned to normal levels during the next 24 h whereas CK increased. The BD level at entry did not allow differentiation between patients with transmural or non-transmural infarction; it was independent of clinical findings and biochemical parameters. We suggest that, in patients with acute myocardial infarction, elevated levels of BD originates from myocardial metabolism. Whether it reflects ongoing ischaemia or reperfusion of the infarcted area remains unresolved.

Aged↗
PubMed1989

[What the internist expects from the psychiatrist].

If internists could establish a list of wishes to the psychiatrists, it would, among others, contain the following ones: 1. The psychiatrist should take an active part in the diagnosis of problem patients: the arguments of the psychiatrists for or against a psychiatric illness can be incorporated in the differential diagnosis using methods of decision analysis. 2. The psychiatrists should express themselves in a comprehensible way: they should keep up with their reputation of communication specialists. 3. The psychiatrists should be ready to supervise the internists if they so wish: internists have to treat a great number of patients with psychiatric problems, since these often refuse a psychiatric consultation. The internists should therefore also have the possibility to discuss problematic cases with the psychiatrists, on an individual basis and outside the Balint groups. 4. The internist also expects a certain humility from the psychiatrist: like all diagnosis, the psychiatrists' ones are not infallible. They can stick to the patients' record and harm him. They often depend external circumstances and may change. The author would be happy if our colleagues psychiatrists could also send a list of wishes to the internists...

Diagnosis↗
PubMed1988

[The treatment of heart infarct in comparison: attempt at quality control].

Treatment of patients with acute coronary artery disease in a medium-sized hospital (with multidisciplinary intensive care unit) is compared with treatment in a university hospital. Two groups of 68 patients (under 70 years of age, without preexisting infarction) are comparable in history, physical findings, infarct size and localization, and complications. Quality or care is assessed on the basis of the findings at discharge and the length of hospital stay. We conclude that the quality of care in a medium-sized community hospital (in collaboration with the university hospital) is satisfactory.

Adult↗
PubMed1988

[Campylobacter pylori, gastritis and ulcer disease. Microbiological, histological and serological studies].

In a prospective study of 70 patients with epigastric pain, gastroduodenoscopy revealed gastric and/or duodenal ulcers in a total of 41 and no ulceration in the remainder. Biopsies were taken to assess the severity of gastritis and the presence of Campylobacter pylori (CP) by histology and culture. Gastritis was found in 54 patients. CP was detected in 78% of the ulcer patients and 52% of the patients without ulcer (p less than 0.05). CP was demonstrated in 83% of the histologically diagnosed cases of gastritis (all grades) but no CP was detectable in patients with normal gastric mucosa. Among the ulcer patients, CP was more frequent in those with no history of medication with nonsteroidal antiinflammatory drugs (p less than 0.01). Sera from CP-positive ulcer and gastritis patients have significantly higher levels of IgG antibodies to CP than sera from those found to be free of ulcer or gastritis. In 200 blood donors an increasing percentage of elevated CP-antibody titres were found with advancing age (50% over 60 years of age). Quantification of circulating CP antibodies, would thus seem a valuable adjunct in the diagnosis of gastritis and probably also of peptic ulcer. The data presented furnish further evidence of the high rate of association of CP and the gastritis-peptic ulcer complex.

Adult↗
PubMed1987

Escape of the response to a long-acting somatostatin analogue (SMS 201-995) in patients with VIPoma.

Two patients with severe secretory diarrhea due to metastatic vasoactive intestinal peptidoma were treated with a synthetic somatostatin analogue in an attempt to control the patients' vasoactive intestinal peptide-related symptoms. In both patients, a good initial response to this treatment could be demonstrated; not only did diarrhea subside but there was also a dramatic fall in vasoactive intestinal peptide plasma levels. However, after 11 and 4 days respectively, diarrhea recurred accompanied by a rise in vasoactive intestinal peptide plasma levels. In fact, under treatment with the somatostatin analogue and with natural somatostatin, a significant rebound state was observed regarding diarrhea as well as vasoactive intestinal peptide levels, which caused considerable difficulty in the clinical management in 1 patient. This patient had to undergo surgery. In the second patient, the responsiveness to somatostatin analogue returned a few days after discontinuation of the treatment, lasting, however, for a short period only. The possible mechanism of this escape and rebound with somatostatin treatment is discussed.

Adenoma, Islet Cell↗