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Biomedical subjects

M Berger

Publications and source records attributed to M Berger.

At least 793 records · Page 44Linked to original sources
PubMed1983

[Diabetes-specific hand changes in type I diabetes mellitus].

Diabetes-specific hand alterations (cheirarthropathy) were observed in 44 out of a total of 215 children and adolescents with insulin-dependent diabetes. In 28 of them limitations of movement in the proximal or (and) distal interphalangeal joints of one finger, and in the remaining 16 patients changes of at least two fingers were seen. Hand and shoulder joints or the vertebral column were not affected. In a control group of 110 probands without metabolic disorder only five showed cheirarthropathy. The frequency of diabetes-specific alterations of the hand increased with the age of the patients, the duration of diabetes and insulin requirements. In particular, the quality of metabolic control is of paramount importance for the as yet unclear pathogenesis of cheirarthropathy.

Adolescent↗
PubMed1983

[Anesthesia adjacent to the spine in vascular surgery in high-risk patients].

From 1978 to 1982, 515 patients underwent vascular surgery with 230 operations performed under epidural analgesia and 330 operations under spinal anaesthesia. In the case of vascular surgery on the lower limbs epidural analgesia was effective in 168 patients (97.1%) and ineffective in five (2.9%), spinal anaesthesia was effective in 312 patients (98.7%) and ineffective in four (1.3%). Epidural analgesia was effective for vascular surgery on the lower abdomen in 40 patients (70.2%), and inadequate in 17 patients (29.8%), whilst spinal anaesthesia was adequate in 9 patients (64%) and inadequate in 5 patients (36%). Nevertheless, lumbar spinal and epidural analgesia may be the method of choice in high-risk patients undergoing vascular surgery, especially on the lower limbs.

Abducens Nerve↗
PubMed1983

[Evaluation of education of the diabetic. Quality control in diabetes therapy].

Any successful treatment of type-I diabetic patients has to be based upon a detailed education of the diabetic patient in order to enable him to selfmanage his disease as much as possible. The goals of diabetes-therapy (i.e. near-normalization of glycaemia in order to prevent diabetic microangiopathy at as high a quality of life as possible) can only be achieved by actively involving the patient in his/her therapy. Thus patient education becomes the cornerstone of modern diabetes-care. The evaluation of diabetes-education has--eventually--be based upon an assessment of the quality of metabolic control. A number of studies have proven that effective diabetes-education programmes can substantially improve long-term metabolic control and the incidence of acute complications in type I diabetic patients. At present, it appears that the most efficient way to improve the overall quality of diabetes-care is to improve diabetes-education delivered to the patients.

Blood Glucose↗
PubMed1983

Degradation of pre-messenger RNA in bovine thyroid slices; effect of thyrotropin.

Bovine thyroid RNA labeled by incubation of slices in the presence of 32P-orthophosphate were fractionated by a two-step procedure. Total RNA were extracted by gel filtration on AcA 22 in the presence of pronase and separated by Sepharose 2B chromatography. A small fraction of heavily-labeled RNA (giant RNA) was obtained in the void volume (peak I); the major fraction of RNA (smaller than 45 S) was retarded on the column (peak II) and had a low specific radioactivity. Labeled and total RNA of peak I and labeled RNA species of peak II had a DNA-like nucleotide composition and were polyadenylated. In contrast, the nucleotide composition of total RNA of peak II was similar to that of ribosomal RNA and had a very low poly (adenylic acid) content. Pulse-chase experiments showed a precursor-product relationship between the two RNA fractions. These data indicate that labeled RNA of peak I and peak II likely correspond to newly-synthetized pre-mRNA and mRNA, respectively. Thyrotropin induced a decrease in the amount of 32P-labeled pre-mRNA and a proportional increase of 32P-labeled mRNA suggesting a stimulatory effect of the hormone on the degradation of pre-mRNA.

Animals↗
PubMed1983

Bicentric evaluation of a teaching and treatment programme for type 1 (insulin-dependent) diabetic patients: improvement of metabolic control and other measures of diabetes care for up to 22 months.

In two hospitals an identical diabetes teaching and treatment programme (in-patient, Monday to Friday, group teaching) was set up. Seventy-eight consecutive, conventionally treated Type 1 diabetic patients (duration of diabetes 10 +/- 6 years), referred during a certain period, were reinvestigated after 1 year, and again (for assessment of metabolic control only) 22 months after the teaching and treatment programme. Initially, mean glycosylated haemoglobin was 2.6%, after one year 1.0%, and after 22 months 1.5% above the upper limit of the normal range (p less than 0.001). Hospital admissions were reduced from a mean of 10 to a median of 1 day per patient per year (p less than 0.001). The long-term quality of diabetes care achieved by the diabetes teaching and treatment programme was unrelated to intelligence quotient, diabetes duration, or diabetes-related knowledge. Patients with normal levels of glycosylated haemoglobin on follow-up (33% of all patients) had particularly good compliance rates, and significantly lower initial values of glycosylated haemoglobin than patients with glycosylated haemoglobin levels greater than or equal to 10%. The data indicate that the diabetes teaching and treatment programme resulted in a substantial long-term improvement of metabolic control and a striking reduction of hospital admissions. The study substantiates the feasibility of applying this teaching and treatment programme on a large scale to other hospitals, so as to improve the quality of diabetes care and decrease health care costs.

Adolescent↗
PubMed1983

The use of continuous flow of oxygen and PEEP during apnea in the diagnosis of brain death.

The establishment of apnea for the diagnosis of brain death by disconnecting the patient from the ventilator may lead to dangerous hypoxemia at the end of the test period. We established apnea for 4 min in 8 patients with suspected brain death, both by disconnecting them from the ventilator after 10 min ventilation with FIO2 = 1.0 (method "A"), and by leaving them attached to an IMV ventilator circuit with a continuous flow of 100% O2 and PEEP of 4-8 cm H2O without mechanical ventilation (method "B"). PaO2 decreased during the apneic period by 143 +/- 65 (SD) mmHg using method "A", and by 48 +/- 28 mmHg using method "B" (p less than 0.002). The changes in PaCO2 and pH were similar following both apneic methods. We conclude that it is safer to test for apnea by leaving the patients on a continuous flow of 100% oxygen and low PEEP than to disconnect them from the ventilator.

Adolescent↗
PubMed1983

REM latency in neurotic and endogenous depression and the cholinergic REM induction test.

Latency of rapid eye movement (REM) sleep was measured in eight healthy volunteers under baseline conditions and after administration of physostigmine. An infusion of 0.5 mg of physostigmine 5 minutes after sleep onset caused a significant shortening of REM latency in comparison with baseline conditions. In 45 patients with major depression, REM latency during baseline nights was significantly shorter than in control subjects. This shortening of the REM latency was found to be similar in endogenous, neurotic, and unclassified depressed patients. In contrast to findings in the controls, the physostigmine infusion provoked no further significant reduction of REM latency in depressed patients, but awakened the majority of patients. The data concerning spontaneous REM latency and REM latency after physostigmine do not allow a differentiation among the endogenous, neurotic, and unclassified depressed subgroups. The results of the cholinergic REM induction test do not conclusively support the hypothesis of a cholinergic hypersensitivity in depression.

Adult↗
PubMed1983

Left ventricular outflow obstruction after aortic valve replacement: detection with continuous wave Doppler ultrasound recording.

A 33 year old woman developed left ventricular outflow obstruction due to a fibrous subvalvular membrane 2 years after insertion of a Hancock modified orifice, porcine aortic valve prosthesis. M-mode and two-dimensional echocardiographic studies failed to detect the membrane. Continuous wave Doppler study revealed a maximal velocity of 4.8 m/s and a calculated peak pressure gradient of 92 mm Hg between the left ventricle and aorta. This finding was in close agreement with the peak gradient of 100 mm Hg obtained at cardiac catheterization. Because of its ability to accurately measure valvular gradients, continuous wave Doppler ultrasound study appears to be a useful noninvasive technique in the evaluation of patients with suspected prosthetic valve dysfunction.

Adult↗