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Biomedical subjects

H Steiner

Publications and source records attributed to H Steiner.

426 records · Page 24Linked to original sources
PubMedDate not supplied

Defense style and the perception of asthma.

Approximately 15% of patients with bronchial asthma are unable to sense marked changes in airway obstruction. We have investigated the hypothesis that inability to sense changes in the severity of bronchial asthma varies with insensitivity to emotional arousal, which in turn is associated with repressive defense styles. Nine asthmatic patients were studied comparing actual changes in peak flow rate using a coded peak flow meter and in arousal during a stress-inducing psycholinguistic protocol with perceived changes. Our hypotheses were confirmed. Ability to perceive changes in asthma could be predicted from performance on the psycholinguistic stress test (Spearman's rho = +0.733, p less than 0.01). Repressors performed significantly worse on the asthma perception task (Spearman's rho = -0.650, p less than 0.05). The results suggest a role for defense pathology in the psychomaintenance of asthma.

Adult↗
PubMedDate not supplied

Trauma spectrum adaptation: somatic symptoms in long-term pediatric cancer survivors.

The authors assessed somatic symptoms and the degree of association among somatic symptoms, global adjustment, trauma symptoms, and personality characteristics in long-term pediatric cancer survivors. Forty cancer survivors completed self-report questionnaires and clinical interviews. Participants' level of somatic symptoms fell between nonclinic and psychiatric populations. Somatic symptom scores correlated with general adjustment in the negative direction and with posttraumatic stress disorder (PTSD) scores in the positive direction. The majority of participants met at least partial current PTSD criteria. Because these survivors demonstrate a repressive adaptive style but endorse somatic symptoms, the latter may represent a method for detecting trauma-related distress in this population.

Adaptation, Psychological↗
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Linguistic analysis to assess medically related posttraumatic stress symptoms.

The authors examined the presence of posttraumatic stress symptoms (PTSS) in 20 patients requiring ventilation after acute respiratory distress. The subjects completed a semistructured interview about their ventilation experience that was subject to content and linguistic analysis. Subjects also completed two self-report measures to assess PTSS and socioemotional adjustment. Subjects who endorsed PTSS were more likely to use a narrative style suggesting emotional involvement in their recall of the stressful event. The authors indicate that the presence of PTSS is a common consequence of traumatic medical experiences and that denial of distress may be an adaptive short-term coping strategy.

Adaptation, Psychological↗
PubMedDate not supplied

Laser in situ keratomileusis to correct myopia of -6.00 to -29.00 diopters.

BACKGROUND: Photorefractive keratectomy can cause corneal scarring and visual loss in highly myopic eyes. We evaluated laser in situ keratomileusis (LASIK) because it has the theoretical advantage of preserving both the corneal epithelium and Bowman's layer. METHODS: In a prospective study, LASIK was performed in 62 myopic eyes (42 patients) using the Automatic Corneal Shaper (Chiron Vision) and the Keracor 116 excimer laser (Chiron Technolas). We measured refraction and visual acuity, and evaluated corneal topography (TMS 1) and corneal clarity after 4 to 8 weeks and 4 to 6 months. RESULTS: Four- to 6-month follow up was completed in 51 eyes. The mean preoperative spherical equivalent refraction was -14.80 diopters (D) (range, -6.00 to -29.00 D). Postoperatively, the mean deviation from the target refraction was -1.70 D (range, -9.00 to +2.50 D) at 4 to 8 weeks and -1.90 D (range, -9.50 to +2.25 D) at 4 to 6 months. At 4 to 6 months, 19 eyes (37%) were within +/- 0.50 D of the target refraction, 24 (47%) within +/- 1.00 D, 33 (65%) within +/- 2.00 D, and 40 (78%) within +/- 3.00 D. From 4 to 8 weeks to 4 to 6 months, the mean regression of myopia was -0.20 D (0.50 D or less in 24 eyes [47%], 1.00 D or less in 32 [63%], and 2.00 D or less in 42 [82%]). In six eyes (12%), the stromal interface was not visible, in 38 (74%) it was barely visible, and in seven (14%) it was clearly visible. Corneal topography revealed only small variations in clear-zone size and dioptric value, demonstrating a very stable correction 4 to 6 months postoperatively. CONCLUSIONS: LASIK may be a safe and effective procedure to correct high myopia. Further research is required to develop satisfactory microkeratome technology, effective laser algorithms, and to determine long-term stability of refraction.

Adolescent↗
PubMedDate not supplied

Contrast-enhanced transrectal color doppler ultrasonography (TRCDUS) for assessment of angiogenesis in prostate cancer.

BACKGROUND: The clinical relevance of tumor angiogenesis has been investigated in several human tumors, including prostate carcinoma (PC). Previously, we found angiogenesis, measured as microvessel density (MVD), to be an independent prognostic factor in PC. Therefore, we evaluated contrast-enhanced Transrectal Color Doppler Ultrasonography (TRCDUS) for assessment of angiogenesis in PC. MATERIALS AND METHODS: We investigated 15 patients with PC before radical prostatectomy (RP) and 3 control patients before radical cystoprostatectomy. TRCDUS was performed using a micro-bubble-based ultrasound enhancer Levovist for identifying hypervascularized areas within the prostate. Computer-assisted quantification of color pixel intensity (PI) was used to evaluate objectively the hypervascularized areas; resistive index (RI) measurements were also obtained in these areas. After histopathological examination of the entire prostate gland for tumor confirmation, immunohistochemical evaluation of MVD using a polyclonal antibody against factor VIII was performed as described by Weidner et al. (N Engl J Med 324: 1-8, 1991). TRCDUS findings were correlated with the immunohistochemical data. RESULTS: All patients showed hypervascularized areas (range: 1-9) on contrast-enhanced TRCDUS. Hypervascularized areas showed a sensitivity of 50.8% and a specificity of 95.2% for detecting PC. Analysis of TRCDUS data and immunohistochemistry revealed a significant correlation between PI and MVD in PC specimens, demonstrating a correlation coefficient of r2 = 0.977 (p<0.001). RI did not correlate with MVD. CONCLUSION: Contrast-enhanced TRCDUS showed a high specificity in identifying PC. PI correlated significantly with MVD. Therefore, quantification of color Doppler signals seems to be helpful for assessment of angiogenesis in PC.

Adenocarcinoma↗
PubMedDate not supplied

[Effectiveness of local prostaglandin instillations in tubal pregnancy in relation to preoperative beta-HCG level].

33 patients with tubal pregnancy and beta-HCG level less than 2500 mIU/ml were treated with local, laparoscopic Prostaglandin-injection. Re-operation was not necessary and beta-HCG fell to undetectable levels in 73% (p = 0.05). Serial beta-HCG correlated poorly with outcome. In patients with an increasing beta-HCG success was limited to 55% (p = 0.59). In contrast patients with falling or stable beta-HCG values had success rates of 85.7% (p = 0.22) and 83.5% (p = 0.30) respectively. Our data suggests there may be a clinical advantage to the use of prostaglandin-injection for the conservative management of early ectopic pregnancy. However the utility of preoperative serial beta-HCG values in predicting success showed a trend, without reaching statistical significance.

Abortifacient Agents, Nonsteroidal↗
PubMedDate not supplied

Treatment of erosive reflux oesophagitis: a double-blind multicentre trial with nizatidine 300 mg b.i.d. versus placebo.

Histamine H2-receptor antagonists at conventional doses have proved only partly efficacious in the treatment of reflux oesophagitis. The aim of this study, therefore, was to compare the efficacy of high doses of nizatidine (300 mg b.i.d.) versus placebo in 117 patients with grade I and II oesophagitis. After 6 weeks' treatment, 70.6% of nizatidine-treated patients showed complete endoscopic healing against 25.4% of placebo-treated subjects (p less than 0.001). After 12 weeks, the respective healing rates were 77.5% and 47.4% (p less than 0.01). Nizatidine also proved significantly more effective than placebo in improving overall symptoms (p less than 0.05). Antacid intake was significantly greater in the placebo group (p less than 0.001). Both treatments were well tolerated. In conclusion, this study demonstrates that nizatidine at the dose of 300 mg b.i.d. for 6-12 weeks constitutes an effective treatment for patients with reflux oesophagitis.

Adult↗
PubMedDate not supplied

Primary malignant histiocytosis of the brain: a clinical, radiological and morphological study with cytological and immunohistochemical demonstration of atypical histiocytes.

Clinical, radiological and morphological findings in the case of a 79-year-old patient with a primary malignant histiocytosis of the brain are reported. The tumor was exclusively situated in the brain as proven by autopsy and was spreading on the inside of the lateral ventricles. The demonstration of atypical histiocytic cells in the CSF and the immunohistochemical demonstration of lysozyme, alpha 1-antitrypsin and alpha 1-antichymotrypsin which are typical for histiocytes, underline the histiocytic origin of the tumor.

Aged↗
PubMedDate not supplied

Predominantly cerebral manifestation in Urbach-Wiethe's syndrome (lipoid proteinosis cutis et mucosae): a clinical and pathomorphological study.

The neurological and psychiatric manifestations in a case of Urbach-Wiethe's disease are reported. The present case is characterized by the predominance of cerebral symptoms: ataxia, psychomotoric seizures, paranoic hallucinatory psychosis and attacks of rage. At autopsy, deposits of amyloid-like material in the walls of the brain vessels could be observed. This finding, together with the mucocutaneous alterations, confirmed the diagnosis of the rare disease know as "lipoid proteinosis cutis et mucosae".

Adult↗
PubMedDate not supplied

[Risk of recurrence in HELLP syndrome].

The recurrence risk of HELLP-syndrome is reported to be between 2.6% and 24%. But yet, there are no accurate case reports about this topic available. In a retrospective study, 25 patients, which had suffered from a pre partum HELLP-syndrome, were interviewed about possible subsequent pregnancies. In 7 patients 8 pregnancies were found, which began between 5 and 55 months after the HELLP-syndrome. No recurrence of a HELLP-syndrome was observed in these 7 patients. Although in 71% a hypertension had been present during the HELLP-syndrome, only 1 patient had an elevated blood pressure in the subsequent pregnancy. Whilst all of the patients with HELLP-syndrome had been delivered by cesarean section, 50% of the patients were delivered vaginally in the subsequent pregnancy. There was no evidence of maternal or neonatal complications related to HELLP-syndrome. Nevertheless, even if the recurrence risk seems to be low, pregnancies after HELLP syndrome should be observed carefully.

Adult↗
PubMedDate not supplied

[Is there an intermittent HELLP syndrome?].

A case of an HELLP-syndrome in the 32nd week of gestation with complete remission of pathological biochemical data and clinical symptomatic within five days is reported. Twenty days later a Caesarean section because of severe fetal growth retardation was performed. Because of this case it has to be discussed, if an "intermittent" HELLP-syndrome does really exist?

Adult↗