Search PubMed⌕ Search

Biomedical subjects

J Bauer

Publications and source records attributed to J Bauer.

At least 163 records · Page 9Linked to original sources
PubMed1999

[Medical training therapy in lumbar syndromes].

Chronic low back pain can be considered to be one of the most frequently treated and most costly diseases in modern industrial societies. Dysfunctions and imbalances of the spine-supporting muscles increase the risk of low back pain. Consequently preventive treatment and rehabilitation have to aim at preserving and restoring the full capacity of the spine-supporting muscles as well as training coordination and spine-friendly behaviour. In addition to various measures of pain therapy, physiotherapeutic treatment including neuro-physiotherapy, physical treatment (eg electrotherapy), balneotherapy and supportive behavioural training, medical rehabilitation therapy (MRT) ranks among the most effective ways of treating low back pain. MRT applies guidelines and methods of exercise methodology within medically indicated programmes of preventive treatment and rehabilitation. Various objectives of MRT are outlined with special regard to the stages of MRT treatment, emphasizing positive adaptation of the neuro-muscular system in the course of rehabilitation. Physicians are responsible for MRT diagnosis and control. Taking into account the base disorder and the progress of therapy physiotherapists and the physicians in charge determine MRT objectives and treatment strategies.

Adaptation, Physiological↗
PubMed1999

[Ulcerative stomatitis as clinical clue to inadvertent methotrexate overdose].

Gastrointestinal side effects and the development of toxic liver fibrosis are well-known side effects of low dose methotrexate therapy. A female patient receiving a long term low dose methotrexate therapy for a seronegative chronic polyarthritis developed an ulcerative stomatitis, as clinical clue to an inadvertently given methotrexate overdose. A summary of other side effects of methotrexate and of oral side effects of other cytostatic agents and immunosuppressive drugs is given.

Aged↗
PubMed1999

Phase I clinical and pharmacological study of oral methoxymorpholinyl doxorubicin (PNU 152243).

PURPOSE: The methoxymorpholinyl doxorubicin analogue PNU 152243 was brought into clinical studies because of preclinical observations of its non-cross-resistance in mdr tumor cells, dose-limiting neutropenia, lack of cardiotoxicity, and antitumor activity after oral administration. METHODS: PNU 152243 was given orally every 4 weeks to 21 adults with a variety of solid tumors at doses ranging from 59 to 940 microg/m(2). Antiemetic prophylaxis with 5-HT3 antagonists and steroids, given i.v. on day 1 and orally on days 2-8, was required beginning with the dose of 118 microg/m(2). The plasma pharmacokinetics of PNU 152243 were determined by an HPLC method with fluorescence detection. The in vitro myelotoxic effects on granulocyte macrophage-colony forming cells (GM-CFC) of the plasma from 11 patients, obtained 4 and 6 h after treatment at all dose levels, were also assessed. RESULTS: Neutropenia was the main hematologic toxic effect and the maximum tolerated dose (MTD) for myelotoxicity was 940 microg/m(2), with neutropenia grade 3-4 in two of three patients. Dose-dependent nausea and vomiting were dose-limiting and the MTD for gastrointestinal toxicity was fixed at 820 microg/m(2), with grade 4 vomiting in one of two patients. Other frequent toxic effects were diarrhea and fatigue. Peak levels of PNU 152243 were achieved 4 h after dosing. Dose-dependent Cmax and AUCExp, and significant interpatient variability of the main pharmacokinetic parameters were found. Very low levels of the 13-dihydrometabolite PNU 155051 were detected only at the highest doses. The hematotoxicity tests showed a <70% colony growth inhibition with no correlation between the growth inhibition effect and the degree of myelotoxicity in the same patient. Plasma concentrations of PNU 152243 were 1000 times lower than the concentration inhibiting the growth of 70% of colonies. No objective tumor responses were seen. CONCLUSIONS: Owing to the occurrence of severe and prolonged nausea and vomiting, the clinical development of oral PNU 152243 was discontinued. The higher-than-expected neutropenia and its lack of relationship with plasma levels of PNU 152243 and its 13-dihydroderivative PNU 155051 might be related to the formation of potent cytotoxic metabolites present in human plasma at undetectable concentrations and with prolonged half-life, as suggested by hematotoxicity tests performed with plasma from patients in GM-CFC assays.

Administration, Oral↗
PubMed1999

Apoptosis of T lymphocytes in acute disseminated encephalomyelitis.

Apoptosis has been shown to be an efficient mechanism involved in clearance of T lymphocytes from the brains of animals with acute experimental autoimmune encephalomyelitis (EAE), an animal model for human multiple sclerosis. In this report we describe a case of acute disseminated encephalomyelitis following general measles infection. In this disease, which closely mimics the pathology of acute EAE we found a high percentage (30%) of apoptotic T cells. This indicates that in both rodent and human brain clearance of T cell-mediated inflammation follows similar mechanisms.

Adolescent↗
PubMed1999

Transgenic Lewis rats overexpressing the proteolipid protein gene: myelin degeneration and its effect on T cell-mediated experimental autoimmune encephalomyelitis.

Transgenic Lewis rats overexpressing proteolipid protein (PLP) genes in peripheral and central nervous myelin were produced by microinjecting murine genomic PLP sequences into fertilized eggs. The mouse PLP gene shares 98.7% homology in the nucleotide sequence with its rat counterpart, but both are fully identical on protein level. Homozygous rats show tremors early in postnatal life, eventually develop seizures, and die before they reach weaning age, while hemizygous animals are phenotypically normal and have a normal life expectancy. Transgene expression in the central nervous system (CNS) has profound consequences for myelin formation and maintenance: approximately twofold overexpression of PLP/DM-20, as seen in homozygotes, results in apoptosis of mature, and a developmental arrest of the remaining immature oligodendrocytes. Severe dysmyelination ensues, associated with reactive astrogliosis and microglia activation/proliferation. Activation of microglia is also prominent in hemizygous rats with low levels of transgene overexpression. In these animals, myelin sheaths remain intact, but there is low-grade myelin degeneration throughout life witnessed by myelin uptake and activation of microglia and astrocytes, in the absence of the expression of major histocompatibility complex class II gene products. There were no spontaneous lymphocytic infiltrates in areas of myelin degeneration. However, hemizygous LEW.PLP rats were more sensitive to experimental autoimmune encephalomyelitis mediated by T cells specific for PLP, but not another encephalitogenic myelin protein, MBP.

Animals↗
PubMed1999

The non-steroidal anti-inflammatory drug tepoxalin inhibits interleukin-6 and alpha1-anti-chymotrypsin synthesis in astrocytes by preventing degradation of IkappaB-alpha.

Tepoxalin is a structurally and functionally novel non-steroidal anti-inflammatory drug (NSAID) with potent anti-inflammatory and analgesic properties. Apart from its inhibitory effect on cyclooxygenase activity, tepoxalin is able to inhibit production of cytokines in peripheral cells outside the CNS. No data, however, are available concerning the effects of this drug in the CNS. Since cytokines such as interleukin-1 (IL-1) or interleukin-6 (IL-6) as well as acute-phase proteins such as alpha1-anti-chymotrypsin (ACT) participate in the etiopathology of Alzheimer's disease (AD), we were interested whether tepoxalin is able to inhibit the synthesis of these immunomodulators in primary rat microglia and astrocytes as well as in the human astrocytoma cell line U373 MG. We found that tepoxalin markedly inhibits IL-1beta-induced IL-6 and ACT synthesis in astrocytes and the synthesis of IL-1beta and IL-6 in lipopolysaccharide (LPS)-stimulated microglial cells. Electrophoretic mobility shift and reporter gene assays revealed that tepoxalin exerts its inhibitory effect through the inhibition of nuclear factor kappaB (NF-kappaB), a transcription factor involved in the induction of IL-1, IL-6 and ACT gene expression. We show that inhibition of NF-kappaB activation by tepoxalin is mediated by preventing IkappaB-alpha degradation. Based on this inhibitory effect of tepoxalin on cytokine and ACT synthesis and the documented therapeutic efficacy of NSAIDs in AD, we conclude that tepoxalin may be of therapeutic benefit for the treatment of AD patients and should therefore be tested in clinical trials.

Alzheimer Disease↗
PubMed1999

Development of a valid and reliable malnutrition screening tool for adult acute hospital patients.

Nutrition screening identifies individuals who are malnourished or at risk of becoming malnourished and who may benefit from nutrition support. The aim of this study was to develop a simple, reliable and valid malnutrition screening tool that could be used at hospital admission to identify adult acute patients at risk of malnutrition. The sample population included 408 patients admitted to an Australian hospital, excluding pediatric, maternity, and psychiatric patients. The ability of various nutrition screening questions to predict subjective global assessment (SGA) were examined in contingency tables. The combination of nutrition screening questions with the highest sensitivity and specificity at predicting SGA was termed the malnutrition screening tool (MST), and consisted of two questions regarding appetite and recent unintentional weight loss. Subjects who were at risk of malnutrition according to the MST had significantly lower mean values for the objective nutrition parameters (except immunologic parameters) and longer length of stays than subjects who were not at risk of malnutrition. Therefore convergent and predictive validity of the MST was established. The interrater reliability of the malnutrition screening tool was high (93-97%). The MST is a simple, quick, valid, and reliable tool which can be used to identify patients at risk of malnutrition.

Adult↗
PubMed1999

Principles underlying the organization of movement initiation from quiet stance.

The purpose of this study was to determine common principles underlying the programming of movement initiation from quiet stance. Subjects were asked to initiate gait, step over a ruler, or to step over a 10 cm high obstacle at a self-paced speed and as fast as possible. The independent variables were initiation condition (gait initiation, stepping over a ruler or obstacle) and initiation speed (self-paced and as fast as possible). The dependent measures for the stance limb only were the latency between postural soleus (S(1)) EMG inhibition and tibialis anterior (TA) EMG onset, the duration of both TA and soleus (S(2)) activity following TA, duration and slope, impulse, and peak forces of the anterior-posterior (Fx) ground reaction force. Selected timing events were also monitored. Analysis of variance was used to determine main and interaction effects. The following results were obtained. (1) The interval from the inhibition of S(1) postural activity to the onset of TA remained invariant between all conditions. (2) The duration of TA increased and S(2) decreased with an increase in speed of initiation. There was no difference in TA and S(2) duration between the initiation conditions. (3) Time to heel-off remained invariant for all conditions. (4) Prior to heel-off all force variables increased with initiation speed but were similar between initiation conditions. After heel-off force variables were different between speeds and conditions being greater for fast speed and stepping over the obstacle. Two conclusions may be drawn from this study. First, the results indicate that gait initiation consists of two, highly coordinated motor programs. Heel-off of the stance limb is the division between these two programs. Second, our findings also suggest that gait initiation and stepping are governed by the same motor programs.

Adult↗
PubMed1999

No simple thing.

Explore the source record for details and available documents.

Happiness↗
PubMed1999

Inspiration.

Explore the source record for details and available documents.

Adaptation, Psychological↗
PubMed1999

Anti-inflammatory substances - a new therapeutic option in Alzheimer's disease.

Among several pathogenetic elements underlying Alzheimer's disease (AD), a brain-specific inflammatory response has recently attracted attention as a cause of neurodegeneration and progressive cognitive decline. Markers of inflammation in AD are activated microglial cells, synthesis of cytokines, acute-phase proteins and complement proteins in areas of brain destruction. Epidemiological studies point to a reduced risk of AD among users of anti-inflammatory drugs. Influencing inflammatory parameters has become the focus of several new treatment strategies and a clinical trial with indomethacin shows promising results. The results from current clinical trials with steroidal and non-steroidal anti-inflammatory drugs will be available in the near future.

Journal Article↗
PubMed1999

Dose-finding study of epidoxorubicin and docetaxel as first-line chemotherapy in patients with advanced breast cancer.

BACKGROUND: Anthracyclines and taxanes are the most active drugs against breast cancer and the search after their optimal combination is under intensive investigation in both the advanced and early disease settings. A dose-finding study of epidoxorubicin (E) and docetaxel (D) was conducted in advanced breast cancer (ABC) to define the maximum tolerated dose (MTD) of the combination with and without granulocyte colony-stimulating factor (G-CSF) support and to characterise its toxicity and activity profile. PATIENTS AND METHODS: Forty-two patients who received neither palliative chemotherapy nor adjuvant anthracyclines (55% with dominant visceral disease and 66% with > or = 2 sites involved) with measurable/evaluable lesions, were treated at four dose levels starting from E 75 mg/m2 and D 75 mg/m2 to E 120 mg/m2 and D 85 mg/m2. A maximum of four cycles of the combination was given every three weeks and four additional cycles of single agent D were allowed in responding patients. Cardiac function was monitored at baseline and at every second course by echocardiography. RESULTS: Febrile neutropenia (two patients) and prolonged, severe neutropenia (absolute neutrophil count (ANC) < 0.1 x 10(9)/l for more than three days; one patient) defined the MTD of the combination without G-CSF support at E 90 mg/m2 and D 75 mg/m2. G-CSF was then routinely administered from the subsequent dose level of E 120 mg/m2 and D 75 mg/m2. The MTD with G-CSF support was established at E 120 mg/m2 and D 85 mg/m2 (one patient with neutropenic fever together with failure of ANC recovery at day 21, three patients with ANC less than 0.1 x 10(9)/l for more than three days, one patient with both and one patient with grade 4 thrombocytopenia and toxic death from typhlitis while neutropenic). No severe neurotoxicity, mucositis, or fluid retention were observed and there were no clinical signs of cardiotoxicity. Antitumor activity was not a primary endpoint of the study: the overall response rate (ORR) in 40 evaluable patients was 60% (95% confidence interval: 43%-75%, 58% in liver disease, 84% in soft tissue) with no apparent dose-related effect. After a median follow-up of 19 months (range 2-30+), the overall time to progression (TTP) in nine patients without maintenance hormonal therapy was five months. CONCLUSIONS: The combination of E and D proved to be an effective and safe regimen in poor- prognosis patients with ABC. G-CSF support allowed higher doses to be delivered safely but dose escalation did not translate into improved response rates (RR). The MTD without growth factors support was used, in a phase II trial, which also included patients with previous anthracycline-containing adjuvant regimens.

Adult↗
PubMed1999

Antibodies against Helicobacter felis in sera of cats and dogs.

Serum samples from 61 dogs and 49 cats were screened for circulating antibodies against Helicobacter felis by an enzyme-linked immunosorbent assay (ELISA) using sonicated bacteria as an antigen. To improve the specificity of the ELISA, sera were absorbed with Campylobacter jejuni subsp. jejuni H. pylori as well as H. felis. Sera from 26 dogs (43%) and 19 cats (39%) revealed clear positive absorbance readings determined as an optical density (OD) that was statistically significant above the OD mean value [P < 0.025 (one-tailed); log10]. The absorbance pattern of ELISA-positive sera corresponded to results obtained with bovine and human reference sera. Furthermore, a correlation between the immune response and results from histopathological examination of gastric specimens from 22 dogs was demonstrated. It could be shown that antibodies against H. felis in sera of cats and dogs can easily be detected using an ELISA. The diagnostic value of this test must be evaluated in further investigations.

Animals↗
PubMed1999

Validation of a malnutrition screening tool for patients receiving radiotherapy.

Nutrition screening identifies individuals who are malnourished or at risk of becoming malnourished and who may benefit from nutrition support. The aim of this study was to validate a new malnutrition screening tool (MST) in cancer patients undergoing radiotherapy. The MST was compared with the subjective global assessment (SGA) of nutritional status. One hundred and six patients attending two cancer care centres in Australia were independently rated as well nourished or malnourished using SGA and at risk or not at risk of malnutrition using the MST. Convergent validity of the MST was established by determining the ability of the MST to predict SGA. According to SGA, 89% of the patients were well nourished and 11% were moderately malnourished. According to the MST, 28% of patients were at risk of malnutrition. The MST had a sensitivity of 100% and a specificity of 81%. The positive predictive value was 0.4 and the negative predictive value was 1.0. The MST is easy to use and is a strong predictor of nutritional status. The malnutrition screening tool is a simple, quick, valid tool that can be used to identify radiation oncology outpatients who are at risk of malnutrition.

Adolescent↗
PubMed1999

Epidemiology of tuberculosis in HIV-infected patients in Denmark.

Denmark is an area of low incidence of HIV and tuberculosis (TB). The number of newly reported cases of HIV has been stable during the 1990s, whereas the number of TB cases has doubled in Denmark in the past decade, mainly due to immigration. However, among native Danes the incidence of TB has increased in the younger age groups, indicating more newly infected persons. This study was performed in order to assess the impact of the HIV epidemic and immigration on TB incidence among native Danes. The study was also designed to reveal transmission patterns of TB among HIV-positive patients. Data from HIV-TB co-infected patients identified in the national registers of TB and AIDS from 1992-95 were collected retrospectively from medical records. Restriction fragment length polymorphism (RFLP) analyses of TB isolates from co-infected patients were compared with all patterns registered in the nationwide Danish RFLP database (approximately 1,700 patients). Sixty-seven co-infected patients were identified, 26 Danes and 41 immigrants, representing only 4% of all TB cases during the study period. Danish co-infected patients were part of a cluster, i.e. they had a RFLP-pattern identical to a pattern in the national RFLP database, more often than immigrants (83% vs. 45%, p < 0.005). In only 2 cases were co-infected Danes and immigrants part of the same cluster. Danish HIV-TB co-infected patients were more often intravenous drug users than were co-infected immigrants (p < 0.0005). In conclusion, we found no evidence to suggest that the increase in TB incidence among young Danes was caused by the HIV-epidemic or transmission from immigrants. TB among HIV-positive Danes is most often due to recent infection. The patients often belong to a subpopulation living in Copenhagen characterized by intravenous drug use.

AIDS-Related Opportunistic Infections↗
PubMed1999

Increased high-density lipoprotein cholesterol in patients with epilepsy treated with carbamazepine: a gender-related study.

PURPOSE: Long-term treatment with carbamazepine (CBZ) may alter serum lipoprotein concentrations. Gender-related examinations, however, are rare and inconsistent in their results. METHODS: To examine possible sex differences, serum lipoproteins were analyzed in 127 clinic outpatients (56 women and 71 men) with epilepsies with focal or secondarily generalized tonic-clonic seizures (or both) treated with a CBZ monotherapy. Results were compared with a control group of 177 blood donors (67 women and 110 men) matched for age and weight. RESULTS: Total cholesterol, low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol were higher in both male and female patients treated with CBZ compared with controls. The known sex difference in serum lipoprotein concentrations (i.e., higher LDL cholesterol and triglycerides but lower HDL cholesterol in men) was confirmed in controls and patients treated with CBZ, with the exception of LDL cholesterol. The HDL as well as the LDL differences were significantly more pronounced in women treated with CBZ than in men when compared with their controls. These results were independent of the dose of CBZ and plasma concentrations. Lathosterol, a cholesterol precursor, and its ratio to cholesterol, an indicator of cholesterol synthesis, were not different, when compared between gender and different HDL groups. CONCLUSIONS: The observed increase in HDL cholesterol in patients with CBZ, especially in women, might correlate with the previously reported diminished rate of death from coronary heart disease in patients with epilepsy as HDL exerts an antiatherogenic effect.

Adult↗
PubMed1999

Disseminated infection with Mycobacterium genavense: a challenge to physicians and mycobacteriologists.

In the present study we compared the clinical presentations of patients with a clinical diagnosis of AIDS and disseminated Mycobacterium genavense infection (n = 12) with those of patients with AIDS and disseminated M. avium complex (MAC) infection (n = 24). Abdominal pain was seen more frequently in the group of patients infected with M. genavense than in patients infected with MAC (P = 0. 003). Analysis of microbiological data revealed that stool specimens from patients infected with M. genavense were more often smear positive than stool specimens from patients infected with MAC (P = 0. 00002). However, M. genavense could be cultured on solid media from only 15.4% of the stool specimens, whereas MAC could be cultured from 71.4% of the specimens. Bone marrow and liver biopsy specimens yielded growth of M. genavense within a reasonably short time, allowing species identification by DNA technology. Microbiological data clearly demonstrated the importance of acidic liquid medium for primary culture, the avoidance of pretreatment and the use of additives in culture, and the necessity for prolonged incubation if M. genavense is suspected. Susceptibility testing showed that M. genavense is sensitive to rifamycins, fluoroquinolones, and macrolides, whereas it is resistant to isoniazid. Susceptibility to ethambutol and clofazimine could not be evaluated. The mean survival times of patients in the two groups were similar.

AIDS-Related Opportunistic Infections↗