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Biomedical subjects

M Steiner

Publications and source records attributed to M Steiner.

At least 163 records · Page 9Linked to original sources

Urinary fluoride excretion in children with low fluoride intake or consuming fluoridated salt.

The purpose of this study was to compare urinary fluoride excretion with fluoride ingestion in children who had either a low fluoride intake or received supplemental fluoride through salt or water. The urinary samples were collected in two ways. In procedure A, urine was collected in the morning, at noon and during the afternoon. This covered a continuous period of approximately 7 h from the beginning to the end of the school day. In procedure B, morning, afternoon and night samples were collected. The morning and afternoon samples were obtained under supervision at school. Procedure B was more useful than procedure A for monitoring salt fluoridation projects. Children with a history of low fluoride intake excreted a mean of 10 micrograms F/h during the night and the morning, but 13-16 micrograms F/h after the main meal. Children in a water-fluoridated town or in comprehensive salt fluoridation programs excreted between 19 and 33 micrograms F/h. However, after the intake of meals prepared with fluoridated salt (250 ppm F) the mean excretion of fluoride ranged between 31 and 49 micrograms F/h. The levels of excretion corresponded with the levels of fluoride intake and meal patterns in the various groups.

Adolescent↗

Patterns of integration and clinical value of voiding cystourethrography in the work-up of urinary tract infection in children.

OBJECTIVE: To evaluate the patterns of integration and the clinical value of voiding cystourethrography (VCUG) in the imaging work-up of children with urinary tract infection (UTI). METHODS: We reviewed the medical records of a consecutive sample of 80 children that underwent VCUG as part of routine investigation for UTI. We assessed the following: the appropriateness of integration of VCUG in the patient work-up as determined by the presence or absence of a valid indication for VCUG in the specific clinical situation encountered, the correct timing of the examination and interpretation of its result; the change in clinical management initiated by the result of the test, and the reassurance conferred to the clinician. RESULTS: Sixty-nine percent of the VCUG examinations were judged appropriately integrated, 14% of the examinations inappropriately integrated, while for the rest of the patients (17%) the appropriateness of integration of the test was rated as unclear. The change in patient management attributable to the VCUG result could be categorized as: no change (15%); decision to end the imaging investigation of the patient (39%); decision to end all investigations, and prophylactic or therapeutic interventions (17%); decision to discontinue chemoprophylaxis (1%); decision to end the imaging investigation and introduce chemoprophylaxis and follow-up for bacteriuria (5%); decision to continue the imaging investigation and introduce chemoprophylaxis and follow-up for bacteriuria (15%), and decision to operate or help in planning the surgical treatment required (8%). CONCLUSION: The findings show the need for an increased effort to minimize overuse of VCUG in pediatric UTI. Future interventions should focus on issues of clinical efficacy of the method that may have not been emphasized sufficiently.

Child↗

Silent brain infarcts and transient ischemic attacks. A three-year study of first-ever ischemic stroke patients: the Klosterneuburg Stroke Data Bank.

BACKGROUND AND PURPOSE: We undertook to study the clinical relevance of silent strokes and history of transient ischemic attacks (TIAs) and their individual and combined effects on outcome variables of neurological and epidemiological interest in first-ever stroke patients. METHODS: We performed univariate and multivariate analyses of data prospectively collected in the Klosterneuburg Stroke Data Bank, a hospital-based registry in Austria that includes a 3-year follow-up program. RESULTS: Of 728 patients (mean age, 68 +/- 10 years) with a first-ever ischemic stroke, 110 (15%) had had a previous TIA, and 66/618 (11%) patients did not have a history of TIA but showed evidence of silent brain infarct on CT. Outcome variables of neurological interest were not significantly different between groups, including time between stroke and study entry, activities of daily living status at first presentation, median time of hospitalization, 30-day mortality, or 3-year mortality. Univariate analyses of epidemiologically important risk factors showed either history of TIA or evidence of silent infarct to be more frequently associated with hypertension (P = .007). Cox models of survival showed that neither history of TIA nor evidence of silent infarct were significantly associated with an increase in 3-year mortality. CONCLUSIONS: Over a period of 3 years, neither history of TIA nor evidence of silent infarct diagnosed at the time of the presenting major stroke in first-ever ischemic stroke patients exert an important influence on neurological or epidemiological outcome variables.

Adult↗

Multicenter, placebo-controlled study of fluoxetine in seasonal affective disorder.

OBJECTIVE: The authors investigated the efficacy and safety of fluoxetine in the treatment of winter seasonal affective disorder. METHOD: Sixty-eight outpatients who met the DSM-III-R criteria for recurrent major depressive episodes, seasonal (winter) pattern, were randomly assigned to 5 weeks of treatment with fluoxetine, 20 mg/day (N = 36), or placebo (N = 32). The outcome measures included the 29-item modified Hamilton Depression Rating Scale, administered by experienced clinicians, and the self-rated Beck Depression Inventory; adverse events and safety data were also recorded. Clinical response was defined as a greater than 50% reduction in depression score between baseline and study termination. RESULTS: Both groups showed significant improvement. The fluoxetine group had lower depression scores at termination than the placebo group, but these differences did not achieve statistical significance. However, the rate of clinical response in the fluoxetine group (59%) was superior to that in the placebo group (34%). Post hoc analyses showed that the greatest fluoxetine responses were in the most markedly depressed patients and that overall response was greater for patients studied later in the season. Fluoxetine was well tolerated, and few subjects dropped out because of adverse events. CONCLUSIONS: On the basis of clinical response rate, fluoxetine appears to be an effective, well-tolerated treatment for seasonal affective disorder. Because the differences between fluoxetine and placebo in the continuous outcome measures did not reach statistical significance, further studies with larger study groups and longer treatment periods are required to conclusively demonstrate efficacy of fluoxetine for seasonal affective disorder.

Adult↗

[The dental health of permanently resident schoolchildren in 16 Zurich rural communities in 1992].

Between 1964 and 1992, caries prevalence (DMFT) of permanently resident school children in 16 communities in the Canton of Zurich decreased by 85 to 87%. In the ten- to fourteen-year-olds, the reduction amounted to 25-29% in the period of 1988 to 1992. In 1992, the fourteen-year-olds had only 1.90 DMFT and 2.49 DFS, the average DS being 0.28. The 21% children with the highest caries experience showed only 9 DFS on average. Such a low caries activity does not favour positive cost-benefit results for individual intensive prevention. From 1964 to 1984 caries prevalence in primary teeth of 7-year-old children decreased to the level of 1.81 dmft; the further reduction to 1.55 dmft in 1992 was not significant. Few primary molars were lost prematurely. According to a saliva-test, 59% of the children aged 10 to 12 with high concentrations of mutans streptococci were free of caries; by comparison, 80% of the children with the lowest mutans-test value, were free of caries. In spite of the easy availability and the multiple usages of fluorides (dentifrices with either 250 or 1000-1500 ppm F, domestic salt, gels with 12,500 ppm F and rinsing solutions with 230 ppm F since 1986-88), only 16% of the children showed signs of dental fluorosis.

Adolescent↗

Clinical characteristics of patients with a second primary tumor in the endometrium or ovary.

The clinical characteristics of patients with second primary tumors in the ovary and endometrium were compared to those with single primary tumors treated at our Center during the same period of time. Despite the fact that the patients were under medical surveillance for the first primary tumor, most second tumors were diagnosed following patient symptoms and complaints, and not at a routine follow-up appointment. Patients with a second primary endometrial cancer had a more advanced stage of disease at diagnosis as compared to those with single endometrial cancer. This was not found to be true for patients with second ovarian cancer. Patients with primary breast cancer and colon cancer, lymphoma or melanoma were found to be at higher risk for developing a second primary tumor in the endometrium or ovary as compared to those with a primary tumor at other sites. Although there are no proven means for the early detection of these gynecologic malignancies, it seems prudent to draw the attention of medical practitioners to the need for a better gynecologic evaluation for women with cancer at other sites during their follow-up visits. Studies on the efficacy of currently available diagnostic techniques should be carried out to evaluate their yield in this high risk group.

Breast Neoplasms↗

[Caries occurrence in schoolchildren of the canton of Glarus in 1974 to 1992: the effect of the use of fluoridated salt].

Between 1974 and 1976, fluoridated salt (250 ppm F) was introduced in the Swiss Canton of Glarus and has been used since by the bakeries and most households (domestic salt) in the Canton. Caries prevalence in schoolchildren of this Canton declined from 1974 to 1992 by 80 to 85%. As an example, 12-year-old children had 6.5 DMFT in 1974, but only 1.1 in 1992. In 1992, most DF sites were fissures and pits and most of them filled. Caries prevalence in primary teeth (dmft) decreased by 49 to 66% in the age groups 7, 8 and 9, and most of the reduction had occurred before 1983. In 1974, the average fluoride concentration in urine amounted to 0.36 ppm; between 1979 and 1992 it increased from 0.74 to 0.86 ppm. 46 to 60% of the bread samples contained between 3 to 9 ppm F; this bread had obviously been produced with fluoridated salt. Salt fluoridation contributed to caries decline until up to 1987, while subsequent caries reductions in permanent teeth must have been caused by other factors. In comparison to other Swiss data the caries prevalence of pupils in the Canton of Glarus was low in 1992.

Adolescent↗

[The dental status of schoolchildren from abroad in Canton Zurich 1992 to 1994].

Between 1992 and 1994 DMF-experience was determined in several hundred schoolchildren from the City of Zurich and 16 small communities distributed over the whole Canton. Immigrants were distinguished from permanently resident children with respect to their length of residence. Children who had arrived after the age of 5 or 6 (kindergarten-age) showed higher caries prevalence; e.g., at the age of 12, 2.00 (16 communities) and 3.14 (City of Zurich) as compared to 1.13 and 1.24 DMFT. Children in special classes for learning German, who had arrived from former Yugoslavia the year before, had 3.64 DMFT at the age of 12. All the children, whether Swiss nationals or non-citizens, who were integrated into the school dental service of the City, had satisfactory treatment levels. In contrast, recent immigrants from former Yugoslavia had about half of their diseased teeth unfilled and often badly destroyed. Therefore, fortnightly tooth-brushings were introduced as a first measure to lower caries activity.

Adolescent↗

Effects of chemotherapy in patients with dental implants.

Endosseous implant placement is generally considered to be contra-indicated in patients undergoing chemotherapy for the treatment of cancer. A case is presented where a patient was diagnosed with cancer and began chemotherapy four weeks after endosseous implants were placed. The impact of chemotherapeutic agents on endosseous implant acceptance as well as upon oral tissue is examined.

Abdominal Neoplasms↗

Screening of dysfibrinogenaemia using the fibrinogen function versus antigen concentration ratio.

The diagnosis of inherited and acquired dysfibrinogenaemia is usually suspected in patients with otherwise unexplained prolonged thrombin time or other tests with thrombin-like enzymes (1). Confirmation of the diagnosis requires discordant results from the investigation of functional fibrinogen and its antigen concentration. However, the issue of the difference between the two results required to confirm dysfibrinogenaemia has rarely been addressed. A difference of at least 0.5 g/l between functional fibrinogen using the method of Clauss and heat precipitation method according to Schulz has been suggested as a prerequisite (1). In the case of acquired dysfibrinogenaemia with an underlying liver disease the discordance should reach at least 1.0 g/l (2). Rodgers and Garr (3) suggested to establish a ratio between fibrinogen function and antigen concentration. In that study plasma from healthy blood donors was investigated using the Clauss method and radial immunodiffusion. We applied this approach to randomly selected patients at the time of admission to a University Hospital Department. Since fibrinogen is one of the major acute phase proteins, the determination of the C-reactive protein (CRP) was included for comparison.

Adult↗

Erythropoietin receptor mRNA expression in human endothelial cells.

A previous report demonstrated that endothelial cells have erythropoietin receptors and respond to this hormone with enhanced proliferation. The present study demonstrates the existence of mRNA for erythropoietin receptor in human umbilical vein endothelial cells. We have reverse transcribed mRNA of endothelial cells and then used different PCR primers to amplify erythropoietin receptor target cDNA between exons 5 and 6 as well as 3-5 in addition to an internal standard DNA fragment. Correspondence of size as well as location of restriction endonuclease scission (Ava II) was used in comparing the amplified fragments of human endothelial cell erythropoietin receptor to those of two human erythroleukemia cell lines, OCIM1 and K562. No alpha- or gamma-globin mRNA was detected in endothelial cells but was readily demonstrable in OCIM1 cells. In addition, to determine whether the expression of human erythropoietin receptor on endothelial cells occurs in vivo, sections of umbilical cord and placenta were immunostained with antibodies against the extracellular portion of the receptor; the results showed strong positive staining of the vascular endothelium.

Base Sequence↗

Thioallyl compounds: potent inhibitors of cell proliferation.

S-Allylmercaptocysteine was shown to inhibit vascular smooth-muscle and umbilical endothelial cell proliferation. Inhibition was dose-dependent and affected smooth-muscle cells more than endothelial cells. S-Allylmercaptocysteine was two orders of magnitude more potent than S-allylcysteine and cells grown in its presence showed distinct changes in their phosphorylation compared to untreated controls. Among the proteins whose phosphorylation was altered were GTP-activating protein, protein tyrosine phosphatase-1B and p34cdc2. We conclude that thioallyl compounds, natural constituents of garlic and known to inhibit malignant cells, can also reduce the proliferation of normal cells.

Animals↗

Atrial natriuretic factor: does it have a role in psychiatry?

Atrial natriuretic factor (ANF) is the first of a group of atrial natriuretic peptides (ANPs) discovered since 1981. This group of peptides is thought to have an important role in sodium homeostasis and regulation of fluid volume. Although the role of ANF in cardiovascular and renal disorders is under investigation, the specific signaling involvement that ANF may have in the central nervous system is still unexplored. To date, ANF has not as yet been associated with a given functional area in the brain, nor has it been shown to be linked to any particular psychopathology. Neuropharmacology research of these peptides and their drug manipulation is needed to advance our knowledge of the possible role of ANF in psychiatry beyond the current level of speculation.

Atrial Natriuretic Factor↗

Testicular seminoma: 20-year experience at the Northern Israel Oncology Center (1968-1988).

Eighty-four patients with testicular seminoma were treated at the Northern Israel Oncology Center during the years 1968-1988. Using the staging classification of Hussey, 69 patients (82%) had Stage I, eight (10%) had Stage IIA, four (5%) had Stage IIB, one (1%) had Stage IIIA, and two (2%) had Stage IIIB disease. Sixty-nine patients (82%) had classic pure seminoma, nine (11%) had anaplastic seminoma and six (7%) had spermatocytic seminoma. Seventy-four patients (88%) underwent high inguinal orchiectomy and ten (12%) had a scrotal approach. Seventy-five patients (85%) were treated with postoperative irradiation. Stage I patients received 26-30 Gy to the paraaortic and ipsilateral pelvic lymph nodes. Stage IIA patients were treated in the same manner with a boost to the involved lymph nodes. With a mean follow-up of 97 months, 65 patients (77%) are alive and well with no evidence of disease, 7 patients (8%) are dead due to disease progression. The 5-, 10-, 15-, and 20-year actuarial survival for all patients was 90%, and for early stage patients 94%. Eight patients (14%) relapsed; 3 of them were salvaged by chemotherapy. Serious side effects of irradiation included lethal respiratory failure due to bleomycin-induced pulmonary fibrosis in one patient, peptic ulcer in three patients, hydronephrosis due to paraureteral fibrosis in one patient and recurrent paralytic ileus in one patient. Eight patients (10%) developed nine second cancers, three of them within the previous radiation field.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗