Search PubMed⌕ Search

Biomedical subjects

M Heim

Publications and source records attributed to M Heim.

At least 73 records · Page 4Linked to original sources
PubMed1997

Accidents among high school pupils in Israel: a recurrent disease?

Accidents are unexpected events usually producing injury. Many victims of trauma have a history of recurrent accidents. This study is a preliminary effort to verify the hypothesis that accidents may be considered as a recurrent disease in certain families; these children and families belong to a 'high risk group'. Two-hundred seventy-nine high school pupils participated in the study. Every pupil had experienced 1.7(+/- 1.7) mild to serious injuries that necessitated medical treatment during the years of elementary and high school. The geographical location of accidents was as follows: 26.4% were on the road; 23.1% occurred at school; 28.6% were associated with sport activities; and 22% occurred at home. The prevalence of injuries among boys was higher than among girls. A correlation was found between the number of accidents of the pupils and those of close family members, suggesting that these children and families are prone to accidents and form a 'high risk group'. The knowledge of accident and injury prevention did not change significantly during high school studies. The principal source of knowledge of accident and injury prevention of the pupils were the media: TV (98.8%), newspapers: (65.6%), and radio (58.1%). The contribution of physicians and nurses to this knowledge was very slight (16.5%). These families should be a target population; an educational program should be organized and transmitted by the media; family meetings with educational advisors, physicians and nurses should take place at school, especially for these target families. As a preventive measure for all, and especially to the high risk group, we would suggest that high school pupils work for 1-3 months in rehabilitation centers in which they can see the consequences of accidents and thereby gain an understanding of the effects of injury on the patient and his family.

Accident Proneness↗
PubMed1997

Predominance and characteristics of Burkitt lymphoma among children with non-Hodgkin lymphoma in northeastern Brazil.

The purpose of this paper was to define the histologic distribution, clinical features, and treatment response of childhood non-Hodgkin lymphoma (NHL) in northeastern Brazil. We reviewed medical records and histopathologic studies of 98 children treated for NHL from 1980 to 1987 at a major pediatric cancer center in Recife, Brazil. Treatment outcome was evaluated in relation to tumor burden (stage and serum LDH) and type of therapy (LSA2L2 vs other multiagent chemotherapy). There was a striking predominance of the small noncleaved cell (Burkitt) subtype, which occurred in 92 of the 98 children and adolescents diagnosed with NHL. Subsequent analyses focused on these patients. The majority (n = 84) had advanced (stage III/IV) disease at diagnosis. The abdomen was the most common site of disease (84 cases); jaw involvement was rare (three cases). Five-year event-free survival (excluding treatment refusals) was significantly better for patients with limited vs advanced stage disease (75 +/- 14% vs 42 +/- 6%; P < 0.04). Elevated serum LDH (>500 U/l) was associated with a poorer outcome (P = 0.008). The type of chemotherapy did not affect EFS (P = 0.95). Only 39% of patients are long-term survivors, reflecting the high rate of septic deaths (25% of patients) and parental refusal/abandonment of therapy (10%). Epstein-Barr virus (EBV) was detected in tumor cells from eight of the 11 cases studied. In clinical presentation, these cases resemble sporadic Burkitt lymphoma, yet in their apparent responsiveness to LSA2L2 therapy and association with EBV, they do not. Childhood NHL in northeastern Brazil is predominantly of the Burkitt subtype, and is associated with clinical features that appear to distinguish it from the endemic and sporadic forms of this tumor. These cases may represent a third or intermediate subtype of Burkitt lymphoma.

Adolescent↗
PubMed1997

Comparison of the transactivation domains of Stat5 and Stat6 in lymphoid cells and mammary epithelial cells.

Stat (signal transducers and activators of transcription) and Jak (Janus kinases) proteins are central components in the signal transduction events in hematopoietic and epithelial cells. They are rapidly activated by various cytokines, hormones, and growth factors. Upon ligand binding and cytokine receptor dimerization, Stat proteins are phosphorylated on tyrosine residues by Jak kinases. Activated Stat proteins form homo- or heterodimers, translocate to the nucleus, and induce transcription from responsive genes. Stat5 and Stat6 are transcription factors active in mammary epithelial cells and immune cells. Prolactin activates Stat5, and interleukin-4 (IL-4) activates Stat6. Both cytokines are able to stimulate cell proliferation, differentiation, and survival. We investigated the transactivation potential of Stat6 and found that it is not restricted to lymphocytes. IL-4-dependent activation of Stat6 was also observed in HC11 mammary epithelial cells. In these cells, Stat6 activation led to the induction of the beta-casein gene promoter. The induction of this promoter was confirmed in COS7 cells. The glucocorticoid receptor was able to further enhance IL-4-induced gene transcription through the action of Stat6. Deletion analysis of the carboxyl-terminal region of Stat6 and recombination of this region with a heterologous DNA binding domain allowed the delimitation and characterization of the transactivation domain of Stat6. The potencies of the transactivation domains of Stat5, Stat6, and viral protein VP16 were compared. Stat6 had a transactivation domain which was about 10-fold stronger than that of Stat5. In pre-B cells (Ba/F3), the transactivation domain of Stat6 was IL-4 regulated, independently from its DNA binding function.

Amino Acid Sequence↗
PubMed1997

A pilot study to determine the efficiency of lightweight carbon fibre orthoses in the management of patients suffering from post-poliomyelitis syndrome.

OBJECTIVES: To assess the usage of carbon fibre orthoses in assisting post-polio syndrome patients who reported advancing weakness and difficulty in maintaining their independent ambulatory status. DESIGN AND INTERVENTIONS: Carbon fibre orthoses that are 30% lighter than metal braces were constructed. SUBJECTS: Thirty patients who complained of difficulty in maintaining their ambulation using long-leg braces were provided with lightweight orthoses. RESULTS: Seventy per cent of the patients reported satisfaction with their braces. There were, however, problems in construction and use. CONCLUSIONS: Ambulation can be preserved in some patients who report advancing weakness because of post-polio syndrome.

Adult↗
PubMed1997

Silicone suspension of external prostheses. A new era in artificial limb usage.

The use of silicone inner sockets, with or without the incorporation of shuttle locks, has greatly improved the function of artificial limbs. They cushion and protect the stump and provide a means for prosthetic suspension, allowing more comfortable use, especially in patients with ischaemic stumps. They also allow greater movement at the proximal joint.

Adult↗
PubMed1997

[Color vision defects in endogenous depression].

8% of the men and approximately 0.5% of the women in a normal population suffer from congenital colour anomaly. We examined 75 women suffering from endogenous depressions. We found disturbed colour vision in 63% of them. We discuss the aetiopathogenic relationship between endogenous depression and disturbed colour vision.

Adolescent↗
PubMed1997

[Phototherapy and lithium prophylaxis].

A random sample of patients (n = 43) had been investigated to detect any difference in response of bright light therapy in lithium-treated inpatients (n = 18) suffering from depression. Only 27% of the lithium-based inpatients respond to bright light therapy, but 73% of patients respond who were not treated with lithium. We conclude that lithium therapy reduces the chance of achieving t remission of depression by bright light therapy.

Adult↗
PubMed1997

Pseudohypertriglyceridaemia.

A mistake can be made in interpreting plasma triglyceride levels since in some cases pseudohypertriglyceridaemia may result from increased plasma glycerol due to a glycerol kinase deficit. Most automated triglyceride assays used in laboratories do not contain a negative control, i.e. a glycerol assay. We report two cases with pseudohypertriglyceridaemia due to hyperglycerolaemia and describe the clinical and biological features which suggested the diagnosis.

Adult↗
PubMed1997

Orthotic management of the knee in patients with hemophilia.

The knee joint is the most frequently affected articulation in patients suffering from hemophilia. Before the availability of active coagulation factors, orthotic use was aimed at corrective functions. Orthotics in the modern era play a protective and preventative role, and they are used in the treatment of hemarthroses and in joints affected by chronic synovitis. Because levels of availability of clotting factors and orthotic material vary extensively world-wide, an overview is provided whereby each group of therapists can adapt themselves to the principles.

Acute Disease↗
PubMed1997

Orthotics and rehabilitation for chronic hemophilic synovitis of the ankle. An overview.

The ankle is the second most affected joint in hemophilia. Recurrent bleeding leads to chronic synovitis. Prevention of chronic synovitis should start with prophylactic replacement therapy or on demand treatment of recurrent hemarthrosis. Attention must be given to the function of the ankle joint. When instability is present, an extensive range of exercises is important. An orthotic or shoe adaption may be useful during the rehabilitation process. Viscoheels worn in shoes seem to reduce the bleeding frequency and pain.

Ankle Joint↗
PubMed1996

Attitude, knowledge and habits of high school pupils in Israel regarding oral health.

The purpose of this project was to study the habits, knowledge and attitudes of 132 high school students in regards to their teeth and oral health. An inflated amount of consumption of snack food and sweet beverages between meals was reported. Seventy-two point seven percent claimed to brush their teeth at least twice daily. Forty-nine point three percent claimed to visit their dentist annually. The results also demonstrated a poor general knowledge and misconceptions concerning teeth, food and oral health throughout the years of high school studies. Knowledge levels correlated with with age. More than half of the pupils attributed esthetical importance to the teeth appearance. The students' knowledge concerning prevention stemmed mainly from their dentist, parents, and the media and only 2.6% learned anything from formal school teaching. In the light of the students' poor knowledge, it would appear that resources should be invested in schools at the elementary and high school level for oral hygiene and caries prevention education in the hope of improving bad habits and perpetuating improved oral health and hygiene.

Adolescent↗
PubMed1996

Multiple joint procedures in a single operative session on hemophilic patients.

Hemophilia is a coagulation disorder wherein frequent hemarthroses result in premature joint degradation. This hemophilic osteoarthropathy is polyarticular, and despite modern coagulation possibilities, acute hemarthroses and chronic synovitis are common. Because repair of a single joint in polyarthritic conditions may not improve the patient's functional ability a policy has been adopted to create a functional limb. This therapeutic protocol succeeded in gaining the objectives of a functional limb, and it was noted that the complication rate was less than expected and that the rehabilitation period was relatively short.

Adult↗
PubMed1996

Role of fibrin sealants in surgical procedures on patients with hemostatic disorders.

Fibrin sealants have until now been used to a very limited extent in patients with a bleeding diathesis. The authors have accumulated experience from 8 minor and 40 major surgical procedures, plus 10 circumcisions and 118 tooth extractions in 106 patients suffering from hemophilia A, B, or von Willebrand's disease. Most of the patients had the severe form of the disease. The authors were able to show a reduction of blood loss and of requirements for replacement therapy with factor concentrates. The literature on the application of fibrin sealants in this group of patients, which mainly deals with dental procedures, is reviewed and compared with data from the current study. The composition of the glue is of major significance and is discussed in detail.

Blood Coagulation Disorders↗
PubMed1996

Feasibility of using recombinant factor VIIa in continuous infusion.

Recombinant factor VIIa (rFVIIa; NovoSeven) is a recent addition to the hemostatic alternatives for the treatment of hemophiliacs with inhibitors. A drawback in the use of rFVIIa has been its half-life of only about 2 h, which necessitates very frequent and punctual injections. We evaluated the stability of reconstituted, but not further diluted, rFVIIa in 3 infusion systems (WalkMed 350 and CADD-Plus minipumps and Meddex 2001 syringe pump). The factor VII (F VII) activity was maintained for at least 3 days at room temperature with only a minor and clinically insignificant increase in oxidized forms of rFVIIa and minimal leaching of the plastic softeners dibutylphthalate and di-octylphthalate after 24-48 h. Addition of heparin, 5-10 U/ml, to reconstituted rFVIIa caused a loss of about 50% of the activity within 4 h of storage in the infusion system, whereas low molecular weight heparin had no such effect. Repeated samples showed that the infusion systems maintained sterility. Reconstituted rFVIIa did not support bacterial growth when inoculated with Staphylococcus aureus or Escherichia coli to any greater extent than did reconstituted factor VIII, lidocaine in saline or heparin in saline. Two patients were treated with continuous infusion of rFVIIa on 4 occasions (total knee arthroplasty, wound revision, and twice straightening of a 90 degrees contracture of the knee under general anaesthesia). A preoperative pharmacokinetic evaluation was performed, and the clearance was used to calculate the maintenance dose, aiming at a FVII level of 10 U/ml, which proved to be a hemostatic level. The first patient had no change in the clearance during the two treatment episodes. He suffered from repeated thrombophlebitis at the infusion site. The second patient had a progressive decrease of the clearance from 86.4 to 24.7 ml/h/kg. He received during the first treatment a parallel infusion with heparin (approximately 250 U/24 h) to the same venous access and did not develop thrombophlebitis during 3.5 days of therapy. For the second episode low molecular weight heparin was added directly to the infusion bag, and no adverse effects were observed. Continuous infusion with rFVIIa is thus feasible with the minipumps used by us, eliminates the need for 2 h injections and reduces the total dose of rFVIIa by 50-75%, depending on the behaviour of the clearance.

Drug Stability↗
PubMed1996

Hydration-scanning tunneling microscopy as a reliable method for imaging biological specimens and hydrophilic insulators.

The recently discovered high lateral conductivity of molecularly thin adsorbed water films enables investigation of biological specimens, and even of surfaces of hydrophilic insulators by scanning tunneling microscopy (STM). Here we demonstrate the capabilities of this method, which we call hydration-STM (HSTM), with images of various specimens taken in humid atmosphere: We obtained images of a glass coverslip, collagen molecules, tobacco mosaic virus, lipid bilayers and cryosectioned bovine achilles tendon on mica. To elucidate the physical mechanism of this conduction phenomenon we recorded current-voltage curves on hydrated mica. This revealed a basically ohmic behavior of the I-V curves without a threshold voltage to activate the current transport and indicates that electrochemistry probably does not dominate the surface conductivity. We assume that the conduction mechanism is due to structuring of water at the surface.

Aluminum Silicates↗
PubMed1995

Multicenter double blind study of paroxetine and amitriptyline in elderly depressed inpatients.

Paroxetine is a phenylpiperidine compound which is a selective serotonin reuptake inhibitor (SSRI). Ninety-one hospitalised patients with a major depression (DSM-III) aged 65 and over from six Austrian and one German center were entered into the study, which compared the efficacy and tolerability of paroxetine versus amitriptyline. After 6 weeks both groups showed similarly good therapeutic results. In the paroxetine group, 64.3% of the patients had a 50% or more reduction of the HAMD total score compared to 58.1% in the amitriptyline group. Side effects were distributed similarly in both groups. Patients in the paroxetine group showed a higher incidence of anxiety and agitation; anticholinergic side effects were registered more often in the amitriptyline group.

Aged↗
PubMed1995

Lateral electrical conductivity of mica-supported lipid bilayer membranes measured by scanning tunneling microscopy.

Lateral electric conductivity of mica-supported lipid monolayers and of the corresponding lipid bilayers has been studied by means of scanning tunneling microscopy (STM). The surface of freshly cleaved mica itself was found to be conductive when exposed to humid air. Lipid monolayers were transferred onto such a surface by means of the Langmuir-Blodgett technique, which makes the mica surface hydrophobic and suppresses the electric current along the surface in the experimentally accessible humidity (5-80%) and applied voltage (0-10 V) range. This is true for dipalmitoylphosphatidylethanolamine (DPPE) as well as dipalmitoylphosphatidylcholine (DPPC) monolayers. Repeated deposition of DPPC layers by means of the Langmuir-Blodgett LB technique does not lead to the formation of a stable surface-supported bilayer because of the high hydrophilicity of the phosphatidylcholine headgroups that causes DPPC/DPPC bilayers to peel off the supporting surface during the sample preparation. In contrast to this, a DPPE or a DPPC monolayer on top of a DPPE monolayer gives rise to a rather stable mica-supported bilayer that can be studied by STM. Electric currents between 10 and 100 fA, depending on the ambient humidity, flow along the DPPE bilayer surface, in the humidity range between 35 and 60%. The DPPC surface, which is more hydrophilic, is up to 100 times more conductive under comparable conditions. Anomalous high lateral conductivity thus depends on, and probably proceeds via, the surface-adsorbed water layers. The prominence of ambient humidity and surface hydrophilicity on the measured lateral currents suggests this. The combination of our STM data and previously published water adsorption isotherms as a function of the relative humidity indicate that one layer or less of adsorbed water suffices for mediating the measurable lateral currents. The fact that similar observations are also made for other hydrophilic substrates supports the conclusion that lateral conductivity via surface-adsorbed water is a rather general phenomenon.

1,2-Dipalmitoylphosphatidylcholine↗