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Biomedical subjects

M Knapp

Publications and source records attributed to M Knapp.

At least 235 records · Page 13Linked to original sources
PubMed1975

Naturally occurring low molecular weight IgM in patients with rheumatoid arthritis, systemic lupus erythematosus and macroglobulinemia. I. Purification and immunologic studies.

A method for purification of low molecular weight IgM (LMW IgM) which utilized salt precipitation, gel filtration, and insoluble immunoadsorbents is described. The yield from pathologic sera containing LMW IgM in the range of 15 to 36 mg% was approximately 20%. Antisera prepared against LMW IgM, IgM, and reduced-alkylated IgM recognized common determinants. Purified LMW IgM from seropositive rheumatoid subjects did not have rheumatoid factor activity in agglutination tests but demonstrated binding to 125I-labeled aggregated IgG. LMW IgM from a patient with SLE and vasculitis had anti-nuclear factor activity and anti-native DNA activity. When complexed with reduced-alkylated aggregated IgG, LMW IgM and IgM with anti-IgG activity were essentially equivalent on a weight basis in complement fixation. The source and function of LMW in biologic processes remain unknown.

Animals↗
PubMedDate not supplied

Economic outcomes and costs in the treatment of schizophrenia.

Schizophrenia is an expensive illness, with hospitalization representing a major cost of treatment. To evaluate new drugs and management strategies for schizophrenia, we must have reliable measures of outcomes and costs. Cost-outcome evaluations are particularly important because they allow comparisons of the potential costs and consequences of various strategies. The best estimates of outcome use batteries of instruments to score the well-being of patients and their caregivers. Dimensions of well-being include clinical status, functional status, access to resources and opportunities, subjective quality of life, family well-being, and patient satisfaction with services. The best overall outcome may involve trade-offs between different dimensions (eg, moving a patient from hospital-based care to community-based care may improve the patient's quality of life but increase family burden). Although measuring direct costs of schizophrenia is reasonably straightforward, indirect costs are more difficult to measure. The cost of pain and suffering (intangible costs) caused by schizophrenia for an individual patient or family is seldom assessed, although quality-of-life measures may provide some information. Increased costs of treatments in one area (eg, medication) may well be offset by reduced expenditures in another (eg, hospitalization), Trade-offs between different dimensions and different schizophrenia management agencies are only possible once the boundaries between these have been made clear by proper economic evaluations.

England↗
PubMedDate not supplied

Reliability of isometric wrist extension torque using the LIDO WorkSET for late follow-up of postoperative wrist patients.

The objectives of this study were to determine interobserver, intraobserver, and overall reliability of isometric wrist extension torque using the LIDO WorkSET and then to estimate the minimal level of detectable change using the standard error of measurement. A generalizability study was conducted on 18 postoperative patients. Primary outcome was mean torque of three trials. Variance components were used to calculate generalizability coefficients for intraobserver (G = 0.96), interobserver (G = 0.94), and overall reliability (G = 0.92). When the same therapist is evaluating a patient on different days, a change of more than 16 inch-lb is needed to be 90% confident that true change has occurred. A greater value for change (23 inch-lb) is required when different therapists evaluate a patient on different days. The LIDO WorkSET measures wrist torque in a reproducible manner in an applied setting. The testing protocol is sensitive to differences in wrist torque between individuals and tolerated in the late postoperative period.

Adult↗
PubMedDate not supplied

[Economic perspectives in the care and treatment of patients diagnosed with schizophrenia].

OBJECTIVE: To consider the main problems associated with care and treatment of patients with diagnosis of schizophrenia in the light of the more recent literature of the economic aspects of this pathology. METHOD: An analysis of the literature related to the social costs of schizophrenia, the economic analysis of different health-care models, and the evaluation of the costs of antipsychotic treatments has been carried out. RESULTS: Schizophrenia is a pathology creating huge social costs. The health costs associated with the care of schizophrenia take up a significant amount of the resources of healthcare systems in the principal industrialised countries. Indirect costs, due mainly to the patients' exclusion from work, exceed the direct costs of treatment. In those countries where community care has been supported by a real organisational effort to create community and residential services, it has proved to be a cost-effective solution compared with psychiatric hospital-based care and provides patients and family members with better results. The introduction of new antipsychotic drugs and the development of psychosocial support could represent the means of encouraging new healthcare strategies. CONCLUSIONS: From an economic perspective, the organisation, technological means, and strategies which would allow the available resources to be invested in a rational way must be considered. Consideration of these issues appears to be unavoidable today, not only for the administrators and the policy makers but also for mental health service professionals.

Forecasting↗
PubMedDate not supplied

[Reference values for the concentration of free triiodothyronine (FT3), triiodothyronine (TT3), free thyroxine (FT4), thyroxine (TT4), thyrotropin (TSH) and thyroxine-binding globulin (TBG) in umbilical cord blood. Method: luminescence-enhanced enzyme immunoassay].

Physiological concentrations of FT3, TT3, FT4, TT4, TSH and TBG were determined using the luminescence enhanced enzyme immunoassay method in cord blood serum (n = 100). The results are presented in Table 1.

Fetal Blood↗
PubMedDate not supplied

[Age-specific and sex-specific reference values for the excretion of free amino acids in the 24-hour urine of children].

Free amino acids were determined quantitatively by ion exchange column chromatography in 24 h urine of 354 (male = 187, female = 167) "healthy" infants, children and adolescents. Urine was deproteinised by 5% sulphosalicylic acid (1:1, v/v). The results - 95% confidence range - are presented age-dependent (groups: up to 1 month, 1-24 months, 2-6 years, 6-10 years, 10-14 years) and sex-dependent in table 3 and 4.

Adolescent↗
PubMedDate not supplied

Linkage analysis in nuclear families. 1: Optimality criteria for affected sib-pair tests.

The affected sib-pair method can be applied to investigate linkage between a marker locus and a disease. Several statistics have been proposed to test if the observed pattern of marker alleles shared identically by descent (ibd) is compatible with the null hypothesis of no linkage. Here, we consider different optimality criteria for sib-pair linkage tests. While for recessive inherited diseases the mean test is found to be uniformly (in theta) most powerful, it can also be shown that, irrespective of the mode of inheritance, the mean test is the locally optimal test.

Chromosome Mapping↗
PubMedDate not supplied

Linkage analysis in nuclear families. 2: Relationship between affected sib-pair tests and lod score analysis.

It is believed that the main advantage of affected sib-pair tests is that their application requires no information about the underlying genetic mechanism of the disease. However, here it is proved that the mean test, which can be considered the most prominent of the affected sib-pair tests, is equivalent to lod score analysis for an assumed recessive mode of inheritance, irrespective of the true mode of the disease. Further relationships of certain sib-pair tests and lod score analysis under specific assumed genetic modes are investigated.

Data Interpretation, Statistical↗
PubMedDate not supplied

Applying TQM to community health improvement: nine works in progress.

Traditionally, quality improvement principles have been used in business and healthcare settings. Nine North American cities, however, have demonstrated how these same QI principles can be applied to improving community health. Guided by a conceptual framework based on a three-question model and employing a Plan-Do-Check-Act cycle, the communities were able to develop interventions that are bringing about change in targeted populations, ranging from reducing the number of suspensions from school due to violence among youths to improving post-neonatal mortality rates.

Academies and Institutes↗
PubMedDate not supplied

Autopsy of a smear.

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Aged↗