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Biomedical subjects

R Jacobs

Publications and source records attributed to R Jacobs.

At least 289 records · Page 16Linked to original sources
PubMedDate not supplied

The systemic inflammatory response syndrome (SIRS): immunology and potential immunotherapy.

Despite widespread advances in intensive care practices, and more potent and effective antimicrobials, septic shock continues to have a mortality rate of greater than 40%. Although antimicrobials can treat the etiologic organism, they do not alter the host response. It is becoming clear that invading organisms and other insults induce the release of cytokines and secondary mediators by the host. These mediators produce alterations in cellular, metabolic and physiologic functions producing the clinical picture of septic shock. Recent advances in cellular and molecular biology have permitted the identification of some of the mediators involved in this inflammatory cascade. Potential therapies are being developed which block or interrupt their activity. Treatment populations must be meticulously defined if we are to extract useful information concerning the efficacy of these new treatment modalities. In the following, proposed definitions for clinical patterns seen in patients with sepsis, and their inherent problems when applied to pediatrics are discussed. The pathophysiology of sepsis is discussed, and specific therapies designed to interrupt the inflammatory cascade are examined.

Bacterial Infections↗
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Topical pharyngeal anesthesia for easing endoscopy: a double-blind, randomized, placebo-controlled study.

The aim of this work was to compare the efficacy of the Cetacaine topical anesthetic spray preparation to placebo. Cetacaine and placebo, from coded but otherwise identically packaged and scented sprays, were administered to 150 consecutive patients. After endoscopy, patients and physicians completed questionnaires evaluating the difficulty of the endoscopy. No statistically significant differences were found between the full formula and placebo-treated patient responses to the amount of cough or gag, or the degree of difficulty of intubation of the endoscope. Analysis of physician responses showed that in the subgroup of patients being endoscoped for the first time, the gastroscope was introduced more easily (p less than 0.05) when the premedication had been full formula rather than placebo.

4-Aminobenzoic Acid↗
PubMedDate not supplied

Comparative evaluation of the oral tactile function by means of teeth or implant-supported prostheses.

To clarify more of the tactile function of oral implants, both an interocclusal thickness detection and discrimination task were carried out in 4 different test conditions on 37 patients: t (tooth)/t, i (implant)/t, i/i and d (denture)/o (overdenture supported by implants). For the interocclusal detection of steel foils, the 50% detection threshold level (RL) in the 4 conditions was 20, 48, 64 and 108 microns, respectively, which indicates significant differences. The ability to discriminate interdental thickness differences was tested with a 0.2 and 1.0 mm standard. It was evaluated as the 75% discrimination level (DL). In the 0.2 mm discrimination task, corresponding DL-values for the t/t, i/t, i/i and d/o condition were 25, 55, 66 and 134 microns, whereas the 1.0 mm standard gave values of 193, 293, 336 and 348 microns, respectively. All results differed significantly from each other (p less than 0.05) except for the i/i-d/o comparison of the 1.0 mm discrimination task where the difference was negligible. The present findings indicate that the tactile sensibility of implants is reduced with regard to natural teeth. Remaining receptors of the peri-implant tissues might play a compensatory role in the decreased exteroceptive function.

Adolescent↗
PubMedDate not supplied

The reliability of pocket probing around screw-type implants.

This study involved 108 patients (age 38-82 years) rehabilitated with overdentures in the lower jaw supported by 2 endosseous screw-shaped implants. At each follow-up visit, the clinical attachment level (PAL) around the implants was assessed with a Merrit-B probe or a constant force electronic probe, Peri-probe, and biannually parallel long-cone radiographs were taken to locate the marginal bone level. These data were used to examine the relationship between bone and attachment level estimations around implants. As a mean, bone level and PAL, for mesial and distal sites, was 0.67 and 0.61 for the Merrit-B probe, and 0.76 and 0.65, respectively for the Peri-probe. The highest correlations were obtained for sites with a healthy gingiva or in absence of intra-bony craters. Duplicate PAL registrations showed a standard deviation for the intra-examiner variability of 2.37 (Peri-probe) or 0.40 mm (Merrit-B probe) with more than 90% of the variation within 0.5 mm. The mean difference in PAL between Merrit-B probe or Peri-probe was 0.05 mm. It was concluded that the clinical attachment level determination is a reliable indicator for bone level around implants with a moderate healthy gingiva.

Adult↗
PubMedDate not supplied

Non-O:1 Vibrio cholerae bacteremia: case report and review.

A case of non-O:1 Vibrio cholerae bacteremia and prostatic abscess in a patient with idiopathic aplastic anemia was studied, and the data were compared with those from 23 previously reported cases of non-O:1 V. cholerae bacteremia. The case-fatality rate for the 13 cases for which the outcome is known is 61.5%. The majority of known cases have occurred in immunocompromised patients, particularly those with hematologic malignancy or cirrhosis. Host susceptibility is potentially important in this condition. Bacterial products such as a cholera-like toxin and El Tor hemolysin also may play a role in the disease process. The incidence of enteritis due to non-O:1 V. cholerae is unclear because of the methods used for routine stool culture; however, the small number of reported isolates from blood is likely to reflect the infrequency of bacteremia, since Vibrio species are readily identifiable on sheep blood agar. While non-O:1 V. cholerae is sensitive to most antibiotics in vitro, no data are available on antibiotic efficacy.

Abscess↗
PubMedDate not supplied

Double-blind evaluation of collagenase injections for herniated lumbar discs.

A randomized clinical trial of 30 patients with refractory lumbar disc disease with evidence of a herniation at a single intervertebral space on the myelogram is presented. Collagenase or a saline placebo was injected into the affected disc. Lack of pain reduction or lack of functional improvement was considered a therapeutic failure. Patients who failed to respond to the placebo could subsequently receive a collagenase injection. Thirty-three percent (33%) of the 15 patients who received a placebo and 80% of the 15 patients who received collagenase were rated successful 8 weeks after injection. The study demonstrates a statistically significant effectiveness of collagenase in the treatment of herniated lumbar disc disease.

Adult↗
PubMedDate not supplied

Bicycle accidents and injuries among adult cyclists.

Bicycling accidents comprised the greatest recreational source of Emergency Room visits last year, numbering over 500,000. To evaluate cycling morbidity, 492 active adult bicyclists from a metropolitan area responded to a survey to determine cycle use and accident patterns. Nearly half (46%) have been involved in an accident with the cyclists being at fault 58.7% of the time. Soft tissue injuries to the extremities predominated with 9.3% of all injuries requiring hospitalization (average, 7 days) and 22.5% missing days from work or school. Significant factors contributing to bicycle accidents included rider carelessness (58.7%), cycle malfunction (14.9%), environmental factors (36.9%), turns (22.9%) and hills (13.4%), and companion riders (15%). The use of riding helmets decreased the severity of injury and hospitalization time. The education of cyclists and drivers with the integration of bicycles into normal traffic patterns should help decrease the morbidity and mortality.

Accident Prevention↗
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Occult foreign bodies of the foot.

This article illustrates several case reports of occult foreign bodies of the foot. The patients came for treatment from weeks to years after the inciting incident with chronic, sterile, draining wounds. The diagnosis of these foreign bodies can be quite difficult. Several radiographic and clinical clues are included, yet the single most valuable tool for the physician remains a high index of suspicion.

Adult↗
PubMedDate not supplied

ENU-induced in vitro neoplastic transformation of rat mammary epithelial cells.

Normal mammary epithelial cells, originating from female Sprague-Dawley rats, were grown in Dulbecco's Modified Eagles Medium containing 25% horse serum and hormone supplements. Once established as an epithelial cell culture, the cells were treated with N-ethyl-N-nitrosourea (ENU) in various doses (25-500 ug/ml) to study the process of in vitro mammary epithelial cell neoplastic transformation. The ENU-treatment of primary mammary epithelial cell culture resulted in a sequence of phenotypic changes, termed stages I-V. The rat mammary epithelial cells, after a period of approximately 30 days post-ENU exposure, showed a marked proliferation of morphologically altered cells which formed multi-layered colonies. Subsequently, these cells acquired the capacity to form colonies in soft agar and eventually produced a high yield of palpable tumors when inoculated into newborn female isologous hosts or female athymic nude mice. The immediate effect of ENU on these cells was monitored by measurement of cellular DNA content, unscheduled DNA synthesis, cell proliferation and chromosomal aberrations. The ENU effect on cell proliferation and DNA synthesis was dose dependent; doses greater than 100 ug/ml reduced the cell number and DNA synthesis. Cytofluorometric histograms of non-ENU-treated rat mammary epithelial cells showed a near diploid population of cells. The ENU exposed cells subsequently became hyperdiploid (24-72 hours after ENU) and then regained their near diploid pattern at 120 hours after ENU exposure. The ENU-treated cells also showed a second peak of cells with DNA content in the tetraploid and octaploid range at 24-72 hours after ENU exposure. Single chromatid breaks, isochromatid breaks, chromosomal exchanges, multiple chromosomal breaks and double minutes were among the chromosomal aberrations seen in ENU-treated cells. Most of the chromosomal aberrations peaked at 6 hours post-ENU exposure. The ENU-induced model of in vitro meplastic transformation of rat mammary epithelium as described in this communication appears to provide a good model for the systematic study of the early critical cellular events prerequisite to this carcinogenic process.

Animals↗
PubMedDate not supplied

The acute effects of hematoporphyrin derivative photoradiation on tumor and liver capillary blood flow.

The acute effects of photoradiation after administering hematoporphyrin derivative (Hpd) on capillary blood flow were studied in intrahepatic tumors and normal liver. The tumors were solitary Walker carcinosarcomas implanted within the livers of Sprague-Dawley rats. Capillary flow was measured by a laser doppler monitor with its probe positioned over the tumor or over normal liver. Within a minute after intraportal Hpd injection (1.7 mg), capillary flow in the tumors began to decrease. Minimal levels of flow were maintained for as long as 15 minutes after Hpd injection with no observed recovery of flow back to control levels. Ratio of minimal flow/control flow averaged 0.36. Similar results were seen in studies on normal liver tissue. These studies demonstrate the extremely rapid vasoactive effects caused by photoradiation of Hpd. Vasoconstriction, vascular stasis and ischemia have proven to be important mechanisms in producing tumor cell destruction by photodynamic therapy.

Animals↗
PubMedDate not supplied

[An exceptional human relationship (Michael P. Kierkegaard, Søren Kierkegaard)].

There were a father and a son, Michael and Sören Kierkegaard, both highly talented, imaginitive, witty, humorous, especially interested in shrewd dialectrical dialogues respectively debates, both profound melancholy ponderers. But according to very own individuality their congeniality wasn't absolute. The father, being under a questionable rigorous opinion of sin, suffered from undeserved divine grace since early childhood. And Michael Kierkegaard made Sören anxious with the religious experience of original sin. This anxiety moved (touched or affected) the sensitive son mighty. Nevertheless he should not despair hopelessly like his unlucky father. On the contrary: Sørens incomparable melancholy, mental agony and anxiety (fear or anguish) forced the faith, existing independently of them, in a radical refining. That is why Sören Kierkegaard succeeded in sublimation of all psychological and philosophic (al) attitudes (or opinions) in the sphere of religiousness. And the result? A novel philosophy of life: Christian existentialism.

Denmark↗