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Biomedical subjects

M Klein

Publications and source records attributed to M Klein.

At least 883 records · Page 49Linked to original sources
PubMedDate not supplied

A comparison of verapamil and propranolol for the initial treatment of hypertension. Racial differences in response.

We compared verapamil and propranolol hydrochloride for monotherapy of hypertension. Verapamil lowered blood pressure (BP) more effectively than propranolol in black and white patients. Verapamil was equally effective in blacks and whites, whereas propranolol was more effective in whites. Heart rate was reduced by 6.0 beats per minute by verapamil, and by 13.6 beats per minute by propranolol. In blacks, verapamil lowered systolic BP 16.9 vs 8.1 mm Hg for propranolol; verapamil reduced diastolic BP 12.8 vs 8.6 mm Hg for propranolol. In whites, verapamil lowered systolic BP 19.0 vs 12.7 mm Hg for propranolol; verapamil reduced diastolic BP 16.7 vs 12.3 mm Hg for propranolol. Increases in systolic BP were observed in 22% and 3.4% of patients receiving propranolol and verapamil, respectively. The PR interval was increased from 163.5 to 174.9 ms for verapamil vs 160.3 to 164.4 ms for propranolol. Constipation (15%) and headaches (10%) were most frequent complaints for verapamil vs fatigue (18%) and dizziness (7%) for propranolol. Changes in blood biochemistry values were of small magnitude. We conclude that verapamil monotherapy is a safe and effective means of achieving BP control in patients with essential hypertension.

Adult↗
PubMedDate not supplied

[Studies on sleep quality in old age].

A survey of 480 randomly chosen men and women over 65 years of age observed complaints concerning the quality of sleep in 26%, the use of sleeping drugs in 33%; complaints and/or drugs were found in 45% of cases. On the average complaints were more often made by women. The percentage of men complaining increased from 65 to 90+ years. In the group over 90 years of age both sexes showed the same frequency. The quality of sleep was correlated with self-rated health-status, mobility and impairment especially of the cardiovascular system. No correlations were found with contentment, place of residence, noise, outdoor exercise and socioeconome status. Sleeping drugs were most effective in subjects with cerebral impairment and of least effect when subjects suffered from cardiovascular trouble.

Age Factors↗
PubMedDate not supplied

The Israel Cancer Association's national program for the early detection of breast cancer.

Since 1970 the Israel Cancer Association has operated 13 regional clinics in hospitals and 55 voluntary clinics through the country. The original aim of the clinics was the screening of women greater than 35 yr, who were invited for check-up by mail based on the registration of local inhabitants. About 25% of the women invited appeared for screening. Over the years, the regional; clinics have become, in part, consulting clinics, since the physicians employed are senior surgeons. During the 10 years surveyed in this report, 108,143 women--30% of whom were less than 35 yr-- visited the clinics on their own initiative. Out of 260,484 examinations performed, 1,841 cases of breast cancer were detected. Th important functions of the clinics are: early detection, public and professional education to increase awareness of the subject, accurate and complete reporting of all biopsies performed, and linkage with the Israel Cancer Registry. Plans for the future include the continued operation of the clinics and a national project for training women in breast self-examination.

Adult↗
PubMedDate not supplied

[Risk of recurrence in HELLP syndrome].

The recurrence risk of HELLP-syndrome is reported to be between 2.6% and 24%. But yet, there are no accurate case reports about this topic available. In a retrospective study, 25 patients, which had suffered from a pre partum HELLP-syndrome, were interviewed about possible subsequent pregnancies. In 7 patients 8 pregnancies were found, which began between 5 and 55 months after the HELLP-syndrome. No recurrence of a HELLP-syndrome was observed in these 7 patients. Although in 71% a hypertension had been present during the HELLP-syndrome, only 1 patient had an elevated blood pressure in the subsequent pregnancy. Whilst all of the patients with HELLP-syndrome had been delivered by cesarean section, 50% of the patients were delivered vaginally in the subsequent pregnancy. There was no evidence of maternal or neonatal complications related to HELLP-syndrome. Nevertheless, even if the recurrence risk seems to be low, pregnancies after HELLP syndrome should be observed carefully.

Adult↗
PubMedDate not supplied

[Obstetrical management in maternal tuberous sclerosis (Pringle-Bourneville syndrome)--a case report].

The rupture of visceral hamartomas in tuberous sclerosis (Pringle-Bourneville) is more likely in pregnancy because of the increased blood volume and can be followed by lifethreatening retroperitoneal hemorrhage. To avoid complications during delivery the vacuum extraction in epidural anesthesia is recommended. Preconceptional genetic counseling in this autosomal dominant disorder is obligatory.

Adult↗
PubMedDate not supplied

[Control of muscular bioenergetics by the thyroid hormones].

Thyroid hormones control the expression of genes coding for myosin isoforms, the Na-K ATPase pumps and the Ca-ATPase canals of the sarcoplasmic reticulum. This explains the increase of contractility and relaxation of skeletal muscles observed in hyperthyroidism, as opposed to hypothyroidism. Control of key-enzymes of the main energetic pathways accounts for inhibition of oxidative metabolisms in hypothyroidism and excessive glycolysis recruitment in hyperthyroidism. In both cases muscle performance is reduced, with accumulation of lactic acid at exercise. This is due to defective pyruvate oxidation and proton expulsion in hypothyroidism, and to acceleration of glycolysis in hyperthyroidism. These abnormalities partly explain why subjects with dysthyroidism are intolerant to exertion.

Energy Metabolism↗
PubMedDate not supplied

[High dose intravenous immunoglobulins in therapeutic arsenal in autoimmune and systemic diseases].

Immune globulin are extracted from plasma pooled from 1000 or more donors. Each lot should contain at least 90% of intact IgG. Intravenous immune globulin are recommended unequivocally for some diseases: acute autoimmune thrombocytopenic purpura of childhood, autoimmune erythroblastopenia, haemophilia with anti-VIII antibodies, Kawasaki's syndrome, and perhaps, Guillain-Barré syndrome. Nevertheless, this therapy has been reported to be beneficial for more than 35 diseases thought to be produced by immunopathology. Large amounts of immune globulin, such as 400 to 2000 mg/kg are proposed over a period of two to five days. The safety of this treatment, which may be introduced without any special structure, is a very interesting quality of the intravenous immune globulin therapy. However, comparative efficacy against reference therapy, surveillance for long-term positive and adverse effects and cost-effectiveness should be carried out.

Autoimmune Diseases↗
PubMedDate not supplied

Identification of axons in the peri-implant region by immunohistochemistry.

In the edentulous patient with a completely implant-supported prosthesis, periodontal ligament receptors are absent. However, the implant patient's mandibular function during mastication and clenching is significantly improved and can be similar to that of dentulous subjects. The underlying mechanisms that govern this proprioceptive control are not well understood. One possibility that has been explored only partially is that residual axonal elements in the peri-implant region may have a proprioceptive function. To survey the peri-implant region for axonal elements, this study utilized immunohistochemistry with neurofilament as the marker. Histologic sections of the peri-implant area from 12 implants placed in the mandibles of three dogs were examined for the presence of neurofilament. Two to three labeled sites per section in the peri-implant region were commonly found. However, the functional significance of these axons must be further evaluated before any conclusions regarding their role in proprioception can be made.

Alveolar Process↗