Factor VIII inhibitor associated with ciprofloxacin.
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Abscess↗
Biomedical subjects
M Peters
Publications and source records attributed to M Peters.
Is body fat topography a risk factor for breast cancer?
OBJECTIVE: To determine whether body fat distribution is associated with the onset of breast cancer. DESIGN: Case-control study. SETTING: Memorial Sloan-Kettering Cancer Center, New York, New York. PATIENTS: Three hundred thirteen healthy, white women, born in the United States. MEASUREMENTS: Waist and hip circumferences were measured on the day before diagnostic breast surgery, and an extensive risk assessment of clinical and family history data was done. After the results of diagnostic breast surgery were obtained, study participants were divided into three groups: women with breast cancer (n = 156); controls (n = 126) with benign tissue at biopsy and an average risk for breast cancer; and high-risk women (n = 31), defined as being at a risk for breast cancer development of 1% per year, based on rigorous histologic or clinical criteria. RESULTS: The waist-to-hip ratios (WHR) were identical (mean +/- SD) in case patients (0.80 +/- 0.06), controls (0.80 +/- 0.06), and high-risk women (0.80 +/- 0.08). Further, no trend could be detected between increasing WHR and breast cancer risk; the estimated relative risk for cancer incidence in women with WHR greater than or equal to 0.81 was 0.78 (95% Cl, 0.36 to 1.71), compared with women with WHR of less than 0.73. No difference in WHR was noted between the case patients and controls when analyzed separately according to menopausal status, age, absolute weight, or relative weight. CONCLUSION: In the women studied, body fat topography as defined by WHR was not associated with breast cancer development.
Adipose Tissue↗
Acute hepatic failure: limitations of medical treatment and indications for liver transplantation.
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Hepatic Encephalopathy↗
The effect of formula versus breast feeding and exogenous vitamin K1 supplementation on circulating levels of vitamin K1 and vitamin K-dependent clotting factors in newborns.
The influence of breast or formula feeding together with that of a single supplementation of vitamin K1 at birth, on the vitamin K1 level and vitamin K-dependent clotting factors were studied in 65 breast and 15 formula fed infants. All breast fed newborns without supplementation (n = 25) had very low serum vitamin K1 at weeks 1 and 6. Oral vitamin K supplementation (n = 22) or i.m. (n = 18) at birth resulted in high serum levels at week 1, while at week 6 the effect had disappeared. Formula fed infants had vitamin K1 values within the normal adult range at all study points. The low serum levels of vitamin K1 were not associated with haemorrhagic disorders or coagulation abnormalities. The mean values of vitamin K1 in maternal sera at weeks 1 and 6 were 2.3 nmol/l and 1.8 nmol/l and in breast milk 2.7 nmol/l and 2.0 nmol/l respectively. No correlation existed between the values in breast milk and maternal serum. To maintain serum levels of vitamin K1 within the adult physiological range, repeated administration of low doses is needed in breast fed newborns beyond 1 week of age.
Breast Feeding↗
Meningovascular neurosyphilis in human immunodeficiency virus infection as a differential diagnosis of focal CNS lesions: a clinicopathological study.
The acquired immunodeficiency syndrome (AIDS) appears to alter the course of syphilis and particularly neurosyphilis. We report the case of an HIV-positive patient with two CNS lesions due to vascular complications of neurosyphilis of the meningovascular type, 18 months after he had developed a penile chancre. On admission, CT scans were inconsistent with cerebral toxoplasmosis or CNS lymphoma. At necropsy, histopathological examination showed typical Heubner's endarteritis of the basilar and posterior cerebral arteries. In AIDS patients, superadded meningovascular syphilis must be suspected, especially when CT scanning reveals the presence of multi-focal, low density lesions with the particular characteristics of infarction.
Acquired Immunodeficiency Syndrome↗
Factor analyses of pooled hand questionnaire data are of questionable value.
A number of researches have used factor analyses and principal components analyses on handedness questionnaire data in order to learn something about handedness. However, these researchers have analyzed pooled data from righthanders and lefthanders. The practice of pooling groups that are known in advance to be heterogeneous is highly questionable because it is not possible to disentangle the sources of variance that are contributed by within group differences from those that arise from between group differences. The factor structure and item loadings that result from pooled data are misleading and cannot inform meaningfully about the relation of hand preference to handedness. Similar problems can be anticipated in other neuropsychological applications of factor analysis, where data from heterogeneous groups is pooled.
Adult↗
Evaluation of competency in midwifery.
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Clinical Competence↗
Performance of male and female children, adolescents and adults on spatial tasks that involve everyday objects and settings.
Nine different spatial tests were given to 52 male and 52 female children, 30 male and 33 female adolescents and 46 male and 48 female adults. Eight of the tests were designed to involve stimuli and settings with which subjects would have everyday experience. Significant sex differences were observed only on 2 of the nine tasks. In those cases where sex differences were observed, the effect sizes were well below .100, suggesting that the magnitudes of the sex differences were minimal. The fact that no sex effects were found on 7 of the 9 spatial tasks allows, at most, the statement that males perform better than females on some spatial tasks. There is no justification for the global statement that "males excel in spatial abilities".
Adolescent↗
Dynamic contrast bolus computed tomography for the assessment of renal function.
RATIONALE AND OBJECTIVES: We preliminarily investigated whether dynamic contrast bolus computed tomography (CT) could be used to measure glomerular filtration rate. METHOD: After bolus intravenous contrast injection, rapid sequence CT scans were performed at a fixed level through the kidneys and aorta in three patients with biochemically normal renal function who underwent routine CT examination. A mathematical technique developed initially for positron-emission tomography was adapted for analysis of the CT data for measurement of renal contrast clearance per unit renal volume and of the fraction of renal tissue occupied by blood volume. RESULTS: Renal blood volumes in the 3 patients were 0.28, 0.29, and 0.31 of total renal volume, respectively, and the corresponding contrast clearances were 0.44, 0.41, and 0.35 mL per min per mL of renal tissue. CONCLUSIONS: This preliminary study in normal patients demonstrates that dynamic contrast CT might be developed for clinical physiological renal studies. Further work to validate the accuracy and reliability of the method in comparison with established isotope methods is suggested.
Blood Volume↗
The role of expert systems in improving the test requesting patterns of clinicians.
The many strategies proposed for influencing the test requesting patterns of clinicians have had only limited success, largely because they are labour intensive and depend on motivation and commitment. Clinical protocols which have been locally agreed between laboratory staff and clinicians are potentially one of the more successful strategies, but detailed study of their application in different clinical settings has been limited by practical problems. Expert systems offer a way of implementing locally agreed protocols and, consequently, of assisting the identification, audit and refinement of laboratory testing strategies. Where these systems have been applied in specialist units they have resulted in savings in time by both clinical and laboratory staff, and an overall reduction in the number of clinical chemistry tests done within and out of hours. These systems offer promise as a method of improving laboratory utilization.
Clinical Laboratory Information Systems↗
Endothelin levels in human amniotic fluid at mid-trimester and at term before and during spontaneous labor.
Endothelin (ET)-1 is synthesized in human amnion and immunoreactive (ir) ET is present in amniotic fluid in concentrations 10- to 100-times those found in plasma. ET-1 is a potent uterotonin; therefore, the possibility must be considered that ET-1, derived from amnion/amniotic fluid, serves to promote the uterine contractions of human labor. In term pregnancies, after labor begins, the amniotic fluid normally becomes divided into the upper and forebag compartments as the fetal presenting part is engaged in the maternal pelvis. The forebag tissues are exposed in the vagina because of cervical dilatation. Vaginal fluid contains microorganisms, bacterial toxins, and cytokines, e.g., interleukin-1 beta, that oblige an inflammatory reaction. Increased ET-1 formation in these tissues of the forebag would be indicative that the greater rate of ET-1 formation and entry into amniotic fluid was an aftereffect of labor, not a cause of parturition. The levels of irET in amniotic fluid during the midtrimester of human pregnancy, 93.3 +/- 7.4 pmol/L (mean +/- SEM, n = 38), were significantly greater than those in amniotic fluid at term before the onset of labor, 39.8 +/- 4.1 (n = 33, p < 0.01). The levels of irET in the upper compartment during labor, 45.5 +/- 3.5 pmol/L (n = 40), were not significantly different from those in amniotic fluid before labor, but were significantly less (p < 0.01) than those in amniotic fluid of the forebag, 82.1 +/- 5.2 pmol/L (n = 125). These findings are suggestive that increases in the concentration of ET in amniotic fluid at parturition are confined to the forebag and are the result of ET formation after labor begins. Inflammation of the tissues lining the forebag compartment of the amniotic fluid is a normal consequence of labor. Therefore, the entry of inflammatory response mediators, some of which are uterotonins, viz., ET and prostaglandins, into forebag amniotic fluid is an aftereffect of labor and not indicative of a role for these agents (in amniotic fluid) in the initiation of parturition. In a subset of the amniotic fluids from normal pregnancies at term, prostaglandin (PG) levels also were determined. There was a highly significant correlation between the levels of irET and PGE2 in the forebag compartment (p < 0.0001); there was no correlation between irET and PGE2 levels in the upper compartment or in amniotic fluid collected at term prior to labor onset.(ABSTRACT TRUNCATED AT 400 WORDS)
Amniotic Fluid↗
Increased tachykinin receptor gene expression in asthmatic lung and its modulation by steroids.
Substance P has several inflammatory effects on the airways mediated via neurokinin 1 receptors (NK1Rs) and, if released from sensory nerves, may amplify the chronic inflammation seen in asthma. Northern blot analysis of NK1R mRNA in lung showed a 52 +/- 10% (S.E.M.; P < 0.01) increase in mRNA in the asthmatic lung compared with non-asthmatic control tissue. NK1R mRNA was reduced by 84.5 +/- 1.9% after incubation with dexamethasone (1 microM) for 3 h (P < 0.01). In contrast, NK2R mRNA was unaltered in asthmatic lungs and dexamethasone treatment had no effect on the level of NK2R mRNA. These results suggest that chronic inflammation in asthma may result in increased NK1R gene expression and that this effect is reversed by glucocorticosteroids.
Adolescent↗
[The restoration of endodontically treated teeth. A literature study of the mechanical behavior of post-core restorations].
Rapid developments in dental health and science have resulted in an increasing number of teeth receiving post and core restoration. The dentist can choose from a wide range of restoration-modalities. Success or failure of these restorations largely depends on their ability to meet functional demands. This article presents a review of the literature on the mechanical behaviour of post-core restorations, as it is determined by functional forces, shape of the tooth and restoration and properties of the materials the construction encorporates. Some attention is drawn to the importance of failure characteristics in view of re-restoration possibilities. As a conclusion some guide-lines for the use of post and core restorations in the general dental practice are formulated.
Dental Restoration, Permanent↗
Bar-code technology applied to drug-use evaluation.
Bar-code technology was used to determine: (1) patterns in histamine H2-receptor antagonist use and (2) the occurrence of adverse drug effects and drug interactions associated with the use of these agents in critically ill patients. Patients at Henry Ford Hospital (Detroit) receiving histamine H2-receptor antagonists over a two-month period were evaluated. Clinical information was collected in the intensive care units by using a bar-code system. The data-capture menu was based on drug-use-evaluation criteria for H2-receptor antagonists. Data collected in the scanning wands were uploaded into a computer database and were analyzed at the end of the study. Data were collected for 207 patients. Cimetidine was the predominant H2-receptor antagonist used, and the predominant indication was stress-ulcer prophylaxis. Dosing trends followed accepted guidelines for cimetidine dosage adjustment in renal and hepatic failure. Two drug interactions and six adverse drug reactions occurred. Pharmacists made 92 recommendations to the medical staff regarding modification in therapy, involving 32% of the patients. Data collection required an average of 10 minutes per day each for three pharmacists. H2-receptor antagonist use patterns were evaluated in intensive care units through the application of bar-code technology. The speed and efficiency of this automated tool facilitated collection of a large amount of data.
Clinical Pharmacy Information Systems↗
Freedom to choose--a global perspective.
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Child↗
[Expectations of treatment in a psychosomatic clinic].
Expectations of patients staying in a psychosomatic clinic differ in a wide range. At first the structure of the expectations was studied. We then were able to separate 4 groups differentiated by different aims. Further analysis concerned the different expectations of this groups and that of the staff and of the GP or psychiatrists referring to the clinic.
Adult↗
[Results of studies from the AIDS counseling center of the Frankfurt/M. city health office January 1990 to December 1991].
Between January 1990 and December 1991 5854 clients entered the AIDS-Counselling Service of the Municipal Health Department in Frankfurt/M; 1997 (34%) of them were female and 3857 (66%) male. In 5228 cases blood samples were examined for HIV-antibodies and the prevalence of positive tests was 84 (1.6%). Among the subjects who were seropositive for HIV, 51 (61%) were homosexual, 9 (11%) bisexual and 11 (13%) heterosexual men, furthermore 5 (6%) heterosexual women. 8 (9%) seropositive persons were intravenous drug abusers (5 male, 3 female). With the aid of an anonymous questionnaire that was filled in voluntarily by the clients, information about the sexual anamnesis, reasons for wanting the test, and whether they had been already tested for HIV in the past, could be gained. During the examined period, safer sex has been practiced by 414 (58%) of 712 homosexual men and by 1183 (24%) of 4867 heterosexuals (2923 male, 1944 female). By reason of a new partner 141 (19%) homosexuals and 1261 (26%) heterosexuals wanted to be tested for HIV; 529 (74%) homosexuals and 1806 (37%) heterosexuals had been already tested for HIV in the past. Summing up we can state, that the large attendance of the AIDS-Counselling Service, now as before, could be traced back to great acceptance and trust placed the population in the Municipal Health Department. HIV-testing is accepted by heterosexual and homosexual couples as well, and often performed at the beginning or at the end of a partnership. Safer-sex plays, now as before, a subordinate role among heterosexuals in comparison to homosexuals.
AIDS Serodiagnosis↗
[Prognosis and success of inpatient psychotherapeutic dermatologic treatment of neurodermatitis patients].
A large group of patients with atopic dermatitis underwent a combination of psychotherapy dermatological treatment, and 40 were selected for evaluation. Most of them had benefited from the cure, particularly those who themselves felt they were emotionally disturbed, those who were well educated and those with functional complaints.
Administration, Topical↗