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Biomedical subjects

L Schmid

Publications and source records attributed to L Schmid.

At least 73 records · Page 4Linked to original sources

Patterns of self-initiated smoking cessation among young adults.

Prochaska and DiClemente's (1984) cyclic-stage model of self-initiated smoking cessation divides the cessation process into five stages. This model was applied to a young adult population to determine the cross-sectional distribution of stages and the frequency and pattern of changes among stages over time. Compared to older adults, the distribution of the stages differed substantially: There were twice as many relapsers and only half as many maintainers among young adults. One-year changes in stages were examined using a static model, which did not take into account the cyclic nature of the change process, and a more realistic dynamic model, which did. Both models, especially the dynamic model, suggested substantially more movement among stages in younger than in older adults.

Adolescent↗

Use of a fully implantable drug delivery system in the treatment of acute leukemias and disseminated lymphomas.

In an open study, 42 venous Port-A-Cath systems (PAC) were implanted in 40 patients with AML (12), ALL/AUL (11), NHL with bone marrow infiltration (8), Hodgkin's lymphoma (3), solid tumors (5) and severe aplastic anemia (1). Mean duration of system use was 212 days. The cumulated duration of use of all systems was 8.883 days. 1,627 blood samples were taken from the PAC. Blood sampling was possible on 8,696 of 8,883 days of cumulated access (98%). A total of 522 blood transfusions were administrated. Fifty-two episodes of neutropenia (granulocyte counts less than 0.5 x 10(9)/l) with a mean duration of 17 days were observed in the group of the 23 patients with acute leukemias. A total of 25 complications were registered. The incidence was 2.8/1,000 days of access. Twelve complications were regarded as severe. Venous thrombosis was observed in 3 cases. In addition, there were 2 disruptions of the catheter, 1 disconnection, 1 looping and 4 local infections. The rate of systemic infection could not be accurately estimated because the catheter was always left in place and antibiotic treatment was started immediately in case of fever with or without bacteriemia. The overall rate of catheter-related complications in patients with acute leukemia was not higher than in patients with solid tumors.

Acute Disease↗

Major depression and agoraphobia in patients with angiographically normal coronary arteries and panic disorder.

Patients with panic disorder and/or agoraphobia appearing in psychiatric settings report rates for lifetime major depression between 24% and 91%. Between 40% and 90% of patients with panic disorder in psychiatric populations report concomitant agoraphobia. A recent study of panic disorder subjects appearing in an outpatient cardiology clinic confirmed the strong link between panic and depression but found only a weak association between panic disorder and agoraphobia. In order to test the reliability of these outpatient cardiology findings, the authors studied major depression and agoraphobia in patients with angiographically normal coronary arteries and panic disorder. Twelve of the 32 (37.5%) panic disorder subjects reported a lifetime history of major depression (nine current, three past only). Only two of the 32 (six percent) reported any phobic avoidance. This study confirms the previous findings which suggest that major depression is common in cardiology populations with panic disorder and that phobic avoidance is uncommon in this group.

Adult↗

[Icterus due to carotene associated with iron deficiency anemia].

We present 2 patients with carotenemia who also suffered from iron deficiency anemia. A causal relationship between the ingestion of excessive quantities of carrots and iron deficiency is postulated, since iron deficiency is known to be responsible for change of appetite (pica). A knowledge of this condition, which follows an indolent, reversible course, is necessary for the clinician mainly in view of the differential diagnostic aspects.

Adult↗

Panic disorder in patients with chest pain and angiographically normal coronary arteries.

Although patients with angiographically normal or near normal coronary arteries are at low risk for cardiac disease, several follow-up studies have shown that many continue to report recurrent chest pain associated with social and work dysfunction. Three diagnostic entities have been proposed to explain the morbidity of this group: microvascular angina, esophageal motility disorders and panic disorder. The purpose of this study was to test the hypothesis that panic disorder is found frequently in patients with chest pain who have normal epicardial vessels. Ninety-four subjects with angiographically normal coronary arteries were interviewed according to a structured psychiatric protocol within 24 hours of their catheterizations. Thirty-two (34%) fit Diagnostic and Statistical Manual of Mental Disorders (third edition, revised) criteria for current panic disorder. Because panic disorder can be effectively treated, physicians should consider this diagnosis in this group of patients. Current research findings suggest that panic disorder, microvascular angina and esophageal disorders may each form the basis for chest pain in approximately 25% of these patients. Miscellaneous problems account for the other 25%.

Adult↗

[Primary non-Hodgkin's lymphoma of the muscles].

On the basis of two personal observations and of 18 published cases, a review of primary non-Hodgkin lymphoma originating in the skeletal muscle is presented. The disease mainly affects persons in the seventh decade. Ninety-five percent of the tumors occur in the extremities, with 75% in the lower extremities. Most lymphomas were of low grade malignancy, with intermediate and high grade tumors accounting for 45% of cases. Reliable differentiation of NHL from other small round cell tumors of the soft tissues, such as rhabdomyosarcoma or Ewing sarcoma, and from metastatic carcinoma, is mandatory for therapeutic purposes. Diagnosis can be established by light microscopy alone in most patients. In doubtful cases immunohistochemistry may be required.

Combined Modality Therapy↗

Relapse cell population differs from acute onset clone as shown by absence of the initially activated N-ras oncogene in a patient with acute myelomonocytic leukemia.

We have conducted a follow-up study of a patient with myelomonocytic leukemia exhibiting an N-ras mutation (Gln61----Lys61) using the polymerase chain reaction method and synthetic oligonucleotide hybridization probes. This method allowed us to detect as little as 3% of N-ras-mutated cells within a population. When the patient went into clinical remission, the mutation became undetectable. When a relapse occurred, the blasts did not carry the N-ras mutation. Analysis of M13 cloned amplified N-ras sequences from relapse DNA revealed exclusively the wild type allele of the N-ras gene. These findings suggest that the relapse cell population is derived from a different clone than the acute phase population. Furthermore, the data argue that N-ras mutation is not an initiating lesion in this case of acute myelomonocytic leukemia (AMML).

Cell Transformation, Neoplastic↗

[Myeloproliferative syndrome and acute febrile neutrophilic dermatosis (Sweet's syndrome)--a rare association].

The case is reported of a 73-year-old man presenting with a history arthralgia, conjunctivitis, fever and typical lesions of acute febrile neutrophilic dermatosis (Sweet's syndrome). Due to massive leukocytosis, an unclassifiable myeloproliferative disorder was later diagnosed. The disease responded well to hydroxyurea but only partly to steroids. The case demonstrates the necessity of close hematologic follow-up in Sweet's syndrome, since some 10% of patients develop hematologic malignancies weeks or months later.

Acute Disease↗

[Simultaneous occurrence of hemophilia A and acute lymphatic leukemia].

In this paper the case of a man with haemophilia A is presented. At the age of 18 years an acute lymphatic leukaemia was observed. The case report demonstrates that even in the presence of a severe plasmatic coagulopathy an acute lymphatic leukaemia can be successfully treated with intensive chemotherapy, if the monitoring of the coagulation values and the substitution of antihaemophilic globulin and thrombocytes are guaranteed. Only 4 cases of haemophilia and acute leukaemia in the same patient are described in the literature. So we believe that the association of these two rare disorders is merely accidental.

Adolescent↗

[Which studies are suitable for the diagnosis of recurrences in resectable breast carcinoma? A retrospective analysis of the OSAKO 06/74 adjuvant study].

113 patients with first relapse in the OSAKO 06/74 adjuvant chemotherapy trial for resectable breast cancer were investigated retrospectively. Based on history alone, 85% of the relapses could have been presumed. Physical examination alone was positive in 82% of relapses. Depending on the localization of relapse, the relative importance of different methods of examination differed. If history and physical examination were analyzed together, 96% of all relapses could be presumed. 45% of the patients did not see the doctor before the fixed time, although they suffered from symptoms associated with relapse. 26% of the women complained of symptoms during at least 4 months before diagnosis of relapse. We conclude that regular clinical controls, including careful history and scrupulous physical examination, represent the most efficient method for diagnosis of relapse in patients with resectable breast cancer.

Breast Neoplasms↗