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M Eberhardt

Publications and source records attributed to M Eberhardt.

16 recordsLinked to original sources
PubMed2004

Comparison of a single global item and an index of a multi-item health status measure among persons with and without diabetes in the US.

This study examined the hypothesis that a single global item can be substituted for an index of a multi-item assessment and lead to equivalent interpretative outcomes. Substitutability would be demonstrated if: (1) the two measures were strongly correlated, and regression analysis showed that the same variables accounted for variation in each measure, and (2) difference scores between multi-item and global scores were close to zero and remained so as socio-demographic and co-morbid conditions varied. A multi-item assessment was constructed by mapping items from the NHANES I Epidemiologic Follow-up Study (NHEFS), using available data for persons with and without diabetes, onto the health-status classification system of the Health Utilities Index Mark 1 (HUI), creating the NHEFS-HUI. NHEFS-HUI data, when correlated to the self-assessed health status (SAHS) item, revealed a coefficient of 0.55. Regression analyses identified 9 of 14 variables contributed to the variability of each health status index, but differences existed in which variables were significant for which measure. Five of the possible 14 difference scores for persons with diabetes and non-diabetics approached zero. Persons with diabetes had lower NHEFS-HUI scores than non-diabetics. These data were considered insufficient for demonstrating substitutability. Suggestions were made on how optimal substitutability could be achieved.

Adult↗
PubMed2002

[Transient neurologic symptoms after spinal anesthesia with 4% hyperbaric mepivacaine].

This is a case report of transient neurologic symptoms (TNS) after spinal anesthesia with 4% hyperbaric mepivacaine,which have not been reported before. The patient was a 44-year-old man with a meniscus lesion who received spinal anesthesia with 80 mg 4% mepivacaine while undergoing knee arthroscopy. A L3-L4 mid-line approach was used with a 26-gauge Quincke needle and a 21-gauge introducer. The local anaesthetic was injected over approximately 30 s with the aperture of the Quincke needle in a cephalad direction. A transient pain syndrome was observed 4 h after spinal anesthesia, which included symmetric pain and/or dysesthesia in the buttocks and posterior thighs appearing 4 h after recovery from the spinal anesthesia and had a duration of 2 days. The patient stated that the pain radiated through the hips, buttocks, and posterior thighs and extended past the buttocks and lower legs. The pain was described as strong and aching,occasionally decreasing when walking around. It responded well to NSAID and resolved spontaneously within 3 days. No other neurologic symptoms or signs were noted.

Adult↗
PubMed1999

Differences in morbidity measures and risk factor identification using multiple data sources: the case of stroke.

BACKGROUND: Epidemiologic studies utilise medical information from a variety of sources. These include subject or proxy interviews, medical records, death certificates and administrative records. Since the choice of data source may affect the validity of study results, it is important to understand the effect of different case-ascertainment methodologies on estimates of risk. METHODS: The NHANES I Epidemiologic Follow-up Study (NHEFS) contains several sources of information that can be used to define case status. In this report we investigate whether the use of seven different algorithms for case ascertainment, each based on different combinations of data sources, results in substantive differences in the estimates of incidence rates and relative risks associated with selected, documented, risk factors for stroke. RESULTS: The seven different models of case identification gave very different estimates of stroke incidence. However, the characteristics of the cases defined by the models, except for cases identified by death certificate only, were remarkably similar. There was also remarkable similarity in relative risks obtained from six of the seven models. The model using only death certificate information generally produced higher relative risk estimates. CONCLUSIONS: Despite wide variations in the estimates of incidence, characteristics of the cases using different case definition were remarkably similar, as were the risks associated with stroke incidence. The main difference occurred when cases were identified from the death certificate only. These results furnish some evidence that analyses based on self report can provide valid, useful information.

Adult↗
PubMed1994

Knowledge of risk factors and risk behaviors related to coronary heart disease among blue and white collar males.

In this report the data regarding coronary heart disease (CHD) from the 1990 Health Promotion and Disease Prevention Supplement of the National Health Interview Survey are used to examine the relationship between risk factor knowledge and health related behaviors among currently employed white collar (N = 5,349) and blue collar (N = 4,158) men workers. Blue collar employees have less knowledge about CHD risk factors, less favorable risk factors status, and poorer health practices than their white collar workers. Despite these findings within each occupational group, the relationship of knowledge to either risk factor status or health practices is similar. Knowledge is generally related to the attempts to change behaviors. However, for the different risk factors, the associations vary. For example, knowledge of cigarette smoking as a risk factor of CHD is negatively associated with reported ever smoking or current smoking, but not with heavy smoking. In contrast, knowledge of overweight, high serum cholesterol, and high blood pressure as CHD risk factors is not associated with risk factor status. These results suggest that while difference in level of knowledge and risk profiles remain between blue collar and white collar employees, the associations between knowledge and risk profiles are similar. Programs located at worksites must continue to provide education opportunities about the risk factors, especially among blue collar workers.

Adolescent↗
PubMed1993

Medullary carcinoma of the thyroid--therapeutic strategy derived from fifteen years of experience.

BACKGROUND: The purpose of this investigation was to analyze our experience with patients treated for medullary carcinoma of the thyroid to identify prognostic factors and to develop a stage-related treatment strategy that might improve cure rates. METHODS: Between 1970 and 1985 a total of 40 patients with medullary thyroid carcinoma were treated (21 women, 19 men; mean age +/- SEM; 40 +/- 3 years; mean follow-up, 82 +/- 12 months). Initial operation involved total thyroidectomy (28 patients), subtotal resection (11 patients), and a lobectomy (1 patient). The initial lymph node dissection generally consisted of a selective removal of enlarged nodes. Unilateral neck dissection was performed in six cases. Secondary operation for recurrent disease was necessary in 26 patients. RESULTS: At the end of the follow-up period 10 patients were tumor free, 12 patients were scheduled for further treatment, six patients suffered from persistent but clinically occult disease, and 12 patients had died (mean survival time, 68 +/- 7 months). The paramount prognostic factor was the absence or presence of lymph node involvement at the time of primary operation (p = 0.011). Patients with distant metastases died within 2 years of diagnosis. Women, patients younger than 40 years of age, and those elicited by familial screening programs exhibited increased survival times. CONCLUSIONS: Because of the prognostic and therapeutic importance we recommend the total thyroidectomy with a complete dissection of the central lymph node compartment as primary treatment. Patients with lymph node involvement or elevated serum calcitonin levels should subsequently be treated by a modified radical neck dissection of the lateral compartments.

Adolescent↗
PubMed1985

Correlates of insulin antibodies in newly diagnosed children with insulin-dependent diabetes before insulin therapy.

Insulin antibodies, as measured by plasma radiolabeled insulin-binding capacity, were determined in 124 newly diagnosed insulin-dependent diabetic (IDDM) children before and after 1, 3, and 5 days of insulin therapy. Controls were 35 nondiabetic children with plasma insulin binding capacity of 1.0 +/- 0.7%. The patients were divided into three groups according to their plasma insulin-binding capacity. Group 1 (N = 79) had binding within two standard deviations (SD) of the control mean, group 2 (N = 20) had insulin binding 2-6 SD above controls, and group 3 (N = 25) showed insulin-binding capacity of more than 6 SD above the control mean. After exogenous insulin therapy, plasma 125I-insulin-binding capacity dropped significantly in both groups 2 and 3, concurrent with significant increases in plasma insulin levels. The three groups differed from each other in that patients in group 3 were significantly younger than in the other groups and clinically seemed to be more severely dehydrated, as reflected in their higher levels of serum urea nitrogen, plasma glucose, potassium, and elevated pulse rate. The three groups did not differ in respect to sex, HLA-DR antigens, Coxsackie-B antibody titers, islet cell cytoplasmic antibodies, immunoglobulin level, and C-peptide levels. Only two of 446 siblings of IDDM children showed elevated insulin binding, one of whom developed IDDM 6 wk later. The presence of an insulin-binding substance probably representing insulin antibodies in some cases of newly diagnosed IDDM suggests that autoimmunity in this disorder is not limited to the B-cell membrane and cytoplasm and lends further support to the heterogeneity of IDDM.

Adolescent↗
PubMed1976

[Effect of synovial fluid from rheumatoid arthritis patients on leukocyte migration].

By means of the migration inhibition test, the influence of the synovial fluid of rheumatoid arthritis patients on normal blood lymphocytes was investigated. There was the hypothesis that the migration inhibitory factor is already formed in the synovial membrane of rheumatoid arthritis patients. In 35 cases a migration inhibition could be demonstrated, in 3 cases the migration of normal lymphocytes remained uninfluenced, in 6 cases a migration enhancement occurred. The demonstration of the rheumatic factor in the synovial fluids used was partly positive, partly negative. Especially the demonstration of a migration enhancement--this phenomenon could be reproduced repeatedly--cannot yet be interpreted unequivocally and requires further investigations.

Arthritis, Rheumatoid↗