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Biomedical subjects

M Fischer

Publications and source records attributed to M Fischer.

At least 955 records · Page 53Linked to original sources
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Use of the restricted academic task in ADHD dose-response relationships.

Behavioral assessment techniques have been shown to make a significant contribution in the evaluation of stimulant medication response in children with attention-deficit/hyperactivity disorder. This article examines the role of a behavioral measure consisting of standardized observation of a child while he or she performs an academic-like task (Restricted Academic Task). This technique is reliable and valid for repeated administrations across medication dosages and placebo. It can assist in optimizing medication dosage for individual children, given its sensitivity to dosage effects. It also allows the capture of medication-related changes in an area of functioning that is not directly assessed by parent and teacher judgments and ratings. In this way the Restricted Academic Task may have greater ecological validity than the results of other, more traditional in-clinic measures. Finally, given the idiosyncratic nature of stimulant medication effects on individual children, it contributes to the explication of a specific child's behavioral dose-response relationship.

Adolescent↗
PubMedDate not supplied

Glutamine peptide-supplemented long-term total parenteral nutrition: effects on intracellular and extracellular amino acid patterns, nitrogen economy, and tissue morphology in growing rats.

Glutamine (GLN) is a nonessential amino acid that is not included in current regimens for parenteral nutrition because of its chemical instability. This study tested the hypothesis that GLN supplementation during long-term total parenteral nutrition (TPN) (3 weeks) would enhance GLN availability, thereby improving nitrogen economy and growth in a growing rat model: Standard TPN delivering 300 kcal/kg per day (lipid:carbohydrate = 1.1) including 2.1 g of nitrogen per kilogram per day in an all-in-one solution was compared with an isonitrogenous, isocaloric, and isovolemic TPN regimen with 0.29 g of nitrogen per kilogram per day substituted by GLN derived from the dipeptides glycyl-GLN and alanyl-GLN (TPN GLN). Enterally fed controls were included. Analysis was confined to nonbacteremic animals with negative blood culture, in which extracellular and intracellular amino acid concentrations including GLN, nitrogen balance, serum protein concentrations, growth, and histologic sections of liver and small-bowel mucosa (light and scanning electron microscopy) were evaluated. Hepatic intracellular GLN concentrations were significantly lower, in animals receiving GLN-free TPN (11.7 +/- 1.6 nmol/mg fat-free dry and solid tissue mass, n = 9) compared with both GLN-supplemented TPN (16.0 +/- 3.0, n = 7) and enteral feeding (18.2 +/- 1.8, n = 6) (p < .001). Corresponding results were found for intracellular GLN concentrations in skeletal muscle (TPN standard 12.5 +/- 3.1, TPN GLN 14.7 +/- 3.1, enteral control 17.3 +/- 2.3, p < .05), intestinal mucosa, and spleen as well as for plasma concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)

Amino Acids↗
PubMedDate not supplied

Use of intravenous lipids in critically ill patients with sepsis without and with hepatic failure.

BACKGROUND: Fat is the preferred energy fuel both in patients with sepsis and with hepatic failure. Thus lipid emulsions should serve as an ideal nutritional substrate in parenteral nutrition. However, previous studies have generated conflicting results on the utilization of artificial lipids in these disease states, and systematic studies in critically ill patients with combined organ dysfunctions and additional complications are lacking. We compared the elimination, hydrolysis, and oxidation of a 20% lipid emulsion in critically ill patients on respiratory support with sepsis and with sepsis plus hepatic failure and in healthy control subjects. SETTING: Medical critical care unit of a university hospital. SUBJECTS AND METHODS: Eight critically ill patients with sepsis, 8 patients with sepsis and decompensated chronic hepatic failure, and 10 healthy volunteers were investigated. Elimination and hydrolysis was evaluated during constant i.v. infusion of 4.5 mg.kg body wt-1.min-1 of triglycerides during 120 minutes. Concentrations of plasma triglycerides, free fatty acids, and glycerol were measured, and elimination parameters were analyzed from plasma curves of triglycerides by using a two-compartment model. Resting energy expenditure and substrate oxidation were measured by indirect calorimetry. RESULTS: In patients with sepsis without and with hepatic failure the rise in plasma triglycerides was blunted and the clearance of triglycerides was enhanced by 20% and 40% (p < .05), respectively, compared with healthy controls. Basal free fatty acid concentrations were elevated, and the rise of free fatty acids and glycerol was comparable to healthy subjects. Energy expenditure was increased and lipid oxidation (as fraction of total energy expenditure) was slightly elevated in both patient groups; the rise in lipid oxidation during lipid infusion was comparable to controls. No side effects or impairment of gas exchange was seen. CONCLUSIONS: In a clinically relevant dosage range, the utilization of an i.v. lipid emulsion, the elimination and hydrolysis of triglycerides, and the lipid oxidation is not impaired in ventilated critically ill patients with sepsis or sepsis and chronic hepatic failure. Lipid emulsions thus are efficiently metabolized in critically ill patients with combined organ dysfunctions and associated sepsis.

Adult↗
PubMedDate not supplied

Prevention of congenital malformations in infants of insulin-dependent diabetic mothers.

From April 1977 to April 1981, 420 deliveries of infants of insulin-dependent diabetic women were performed in our department. Of the infants delivered, 23 had congenital malformations (5.5%). The malformation rate was 1.4% for infants of 420 nondiabetic women. Strict metabolic control was begun after 8 wk gestation in 292 of the diabetic women who delivered 22 infants with congenital malformations (7.5%). Intensive treatment was begun before conception in 128 diabetic women planning pregnancy. There was only one malformation in infants of this group (0.8%), a significant reduction from the anomaly rate in the late registrants (X2 = 7.84; P less than 0.01). These observations indicate that reasonable metabolic control started before conception and continued during the first weeks of pregnancy can prevent malformations in infants of diabetic mothers.

Congenital Abnormalities↗
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Care not cure.

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Chronic Disease↗
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Crux medicorum ulcerated radiation-induced fibrosis - successful therapy with pentoxifylline and vitamin E.

Case report of a 60 year-old patient with an ulcerated radiation-induced fibrosis after therapy for breast cancer. Treatment with oral administration of pentoxifylline 3 x 400 mg/day and vitamin E 2 x 200 mg/day was started. The ulcers were almost completely healed after 18 months. Sonographic examination showed a reduction in dermal thickness and in the laser Doppler fluxmetry, a regulation in the amplitude and increase in flux was found compared to the measurements made before the start of treatment. The therapy was very well tolerated without any side effects. The treatment of radiation-induced fibrosis with PTX and vitamin E is a practicable and cost-effective regimen, especially for inoperable patients. The efficacy of this treatment is probably due to a combination of blood flow stimulation and immune modulation which lead to a reduction in the fibrosis.

Administration, Oral↗
PubMedDate not supplied

Pap Testing Stages of Adoption among Cambodian Immigrants.

PURPOSE: We examined levels of Pap testing and factors associated with screening participation among Cambodian refugees. METHODS: A community-based, in-person survey was conducted in Seattle during late 1997 and early 1998. Interviews were completed by 413 women; the estimated response rate was 73%. We classified respondents into four Pap testing stages of adoption: precontemplation/contemplation (never screened), relapse (ever screened but did not plan to be screened in the future), action (ever screened and planned to be screened in the future), and maintenance (recently screened and planned to be screened in the future). Bivariate and multivariate techniques were used to examine various factors. FINDINGS: About one-quarter (24%) of the respondents has never been screened, and a further 22% had been screened but did not plan to obtain Pap tests in the future. Fifteen percent were in the action stage and 39% were in the maintenance stage. The following factors were independently associated with cervical cancer screening stages: previous physician recommendation; younger age; beliefs about Pap testing for post-menopausal women, screening for sexually inactive women, and regular checkups; provider ethnicity; prenatal care in the US; and problems finding interpreters. CONCLUSIONS: Our findings confirm low Pap testing rates among Cambodian immigrants, and suggest that targeted interventions should be multifaceted.

Journal Article↗
PubMedDate not supplied

Changes in hepatic mRNA levels of acute phase proteins during rat adjuvant arthritis.

Using specific cDNA probes, we have investigated changes in hepatic mRNA concentrations of the major acute phase proteins fibrinogen, alpha 2-macroglobulin (alpha 2-MG), albumin and alpha 1-acid glycoprotein (alpha 1-AGP) during developing adjuvant arthritis in Lewis rats. Continuously increasing levels in the mRNA of the positive reactants beta-fibrinogen, alpha 2-MG and alpha 1-AGP were found during developing disease with peak levels from day 15 to 21, whereas mRNA concentrations of the negative reactant albumin decreased, reaching their lowest levels on day 11 to 15. As early as 4 days after arthritis induction, the hepatic mRNA levels of beta-fibrinogen, alpha 1-AGP and albumin were distinctly different from control values. The most dramatic changes in the hepatic mRNA levels and plasma concentrations of acute phase reactants were seen between days 11 and 21. These results indicate that overproduction of the major inflammatory cytokines IL-1, TNF-alpha and IL-6, which are now felt to be largely responsible for the acute phase response in the rat, is an early event during adjuvant arthritis and that the highest amounts are produced during the inflammatory phase of the disease. mRNA changes in the acute phase proteins alpha 1-AGP and albumin, which are mainly regulated by IL-1/TNF alpha, were more pronounced than those of alpha 2-MG and beta-fibrinogen, which are predominantly controlled by IL-6.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute-Phase Proteins↗
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Human herpesvirus-6 infection may predispose cells to superinfection by other viruses.

Double infection of cells by HHV-6, Epstein-Barr virus (EBV) and by human immunodeficiency virus (HIV-1) can enhance viral effects though genetic transactivation. It remained to be clarified, however, by which mechanism different viruses may enter the same cell. We have shown that HHV-6 infection of immature lymphoid cells rigidifies the cytoplasmic membrane and causes receptor proteins for viruses such as CD4 for HIV-1 and CR2 for EBV to be expressed. In our experiments, HHV-6 infected cells were superinfected by HIV1 and caused enhanced cell death. The mechanisms by which receptors were expressed after HHV-6 infection appears independent of cell membrane rigidification alone and is suppressed by cycloheximide only to a certain extent.

Cell Line↗
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The hand-foot syndrome--a frequent secondary manifestation in antineoplastic chemotherapy.

The hand-foot syndrome (HFS) (palmoplantar erythrodysesthesia) designates acute, painful erythemas of the palms and soles of the feet caused by antineoplastic chemotherapies. The most frequent trigger substances are 5-fluoruracil and its derivates. At maximum severity, the HFS is bullous to erosive or ulcerous in character. The pathogenesis has not yet been clarified. Histologically, the HFS is characterized by a toxic keratinocyte reaction. Furthermore, there is sub-basal edema with a tendency to bullae, dilated blood and lymph capillaries and usually only mild perivascular lymphocytic infiltration. Early recognition and delineation from other differential diagnoses is prerequisite to targeted management of the disease. Depending on the severity, HFS requires dose reduction, interruption or switch in the antineoplastic chemotherapy.

Antineoplastic Agents↗
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Therapy of pheochromocytoma with [131I]metaiodobenzylguanidine.

Fourteen patients with chromaffin tumors were treated with [131]metaiodobenzylguanidine (131I-MIBG); 13 of them suffered from malignant and one from benign pheochromocytoma. In all patients clinical symptoms were improved. In some of these patients tumor shrinkage was observed. In one patient surgery of all tumor tissue was made possible by 131I-MIBG treatment. As shown in one patient, close follow-up is necessary in any case because remnant tumor tissue may start growing again after a long period of rest.

3-Iodobenzylguanidine↗
PubMedDate not supplied

Music as therapy.

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Humans↗
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[Nuclear medicine diagnosis and treatment in pheochromocytoma and neuroblastoma].

Localization procedures are required in catecholamine producing tumors following clinical and biochemical confirmation of phaeochromocytoma or neuroblastoma. Whereas computed tomography and ultrasound reflect morphological abnormalities, adrenomedullary scintigraphy with radiolabeled meta-iodobenzylguanidine depends on function. MIBG scintigraphy has the advantage of being able to detect intra- and extra-adrenal, uni- and bilateral or multilocular, benign and malignant phaeochromocytomas and neuroblastomas. Especially small lesions and tumor tissue in bone marrow in children with neuroblastoma can be visualized more easily. The same radiopharmaceutical agent radiolabeled with high doses of 131I may be used for treatment of phaeochromocytomas and neuroblastomas stage III and IV. In patients with malignant phaeochromocytomas this therapy may improve clinical symptoms and reduce tumor volume for months or even years, but probably this therapy is not curative. In children with neuroblastoma complete remission may be achieved by combining surgery, chemotherapy, and 131I-MIBG treatment. Therefore, this therapeutic modality should be included in the therapeutic strategy of stage III and IV neuroblastoma.

3-Iodobenzylguanidine↗
PubMedDate not supplied

[Circadian rhythm of testosterone level in plasma. I. Physiologic 24-hour oscillations of the testosterone level in plasma].

The testosterone level in plasma is measured in 10 males by radioimmunoassay (RIA) at the following times: 07.00 h, 08.00 h, 09.00 h, 10.00 h, 13.00 h, 16.00 h, 19.00 h, 23.00 h and 03.00 h. A circadian rhythm can be noted. Peak levels are reached between 07.00 h and 10.00 h. At 19.00 h testosterone values reach their minimum and rise at night. In the morning between 07.00 h and 10.00 h testosterone levels seem to have a plateau. Between the morning and the evening the values show great differences.

Adult↗