Search PubMed⌕ Search

Biomedical subjects

R Mader

Publications and source records attributed to R Mader.

At least 37 records · Page 2Linked to original sources
PubMed1997

Failure of manual massage to alter limb blood flow: measures by Doppler ultrasound.

The ability of manual massage to alter muscle blood flow through three types of massage treatments in a small (forearm) and a large (quadriceps) muscle mass was tested in 10 healthy individuals. A certified massage therapist administered effleurage, petrissage, and tapotement treatments to the forearm flexors (small muscle mass) and quadriceps (large muscle mass) muscle groups in a counterbalanced manner. Limb blood flow was determined from mean blood velocity (MBV) (pulsed Doppler) and vessel diameter (echo Doppler). MBV values were obtained from the continuous data sets prior to treatment, and at 5, 10, and 20 s and 5 min following the onset of massage. Arterial diameters were measured immediately prior to and following the massage treatments; these values were not different and were averaged for the blood flow calculations. The MBV (e.g., 5.77 +/- 0.4 and 9.73 +/- 0.7 cm.s-1) and blood flows (39.1 +/- 6.4 and 371 +/- 30 ml.min-1) for brachial and femoral arteries, respectively, were not altered by any of the massage treatments in either the forearm or quadriceps muscle groups (P > 0.05). Mild voluntary handgrip (approximately 35% maximal voluntary isometric contraction) and knee extension (15 cm) contractions resulted in peak blood velocities (15.2 +/- 1.2 and 28.1 +/- 3.1 cm.s-1) and blood flow (126 +/- 19 and 1087 +/- 144 ml.min-1) for brachial and femoral arteries, respectively, which were significantly elevated from rest (P < 0.05). The results indicate that manual massage does not elevate muscle blood flow irrespective of massage type or the muscle mass receiving the treatment. Further, the results indicate that if an elevated muscle blood flow is the desired therapeutic effect, then light exercise would be beneficial whereas massage would not.

Adult↗
PubMed1997

Strategies for assessing pain and pain exaggeration: controlled studies.

OBJECTIVE: To compare structured with intuitive methods of detecting exaggerated pain, in 2 randomized studies, with masked observers, and to compare properties of measures of relative tenderness, as surrogates for measures of pain. METHODS: Pairs of experienced rheumatologists assessed tenderness and behavior in subjects who were either giving honest responses (Not Acting) or exaggerating their tenderness while hiding the deception (Acting). In Study 1 (20 subjects) the assessments of behavior were descriptive only; for Study 2 (25 subjects) a prestructured format was developed. The challenge to the examiners was to detect Acting. The challenge to the analyst was to develop, from the recorded data, an algorithm that described or bettered the examiners' performance. RESULTS: By exaggerating, nontender patients could meet formal ACR criteria for fibromyalgia. The addition of a prestructured pain behavior assessment in Study 2 was associated with improvement in the observers' ability to detect Acting, with improvement of sensitivity from 60 to 90% (p = 0.0003, Study 2 compared with Study 1). False positive diagnoses of Acting by the observers were uniformly uncommon, with specificity of 85 and 86% in the 2 studies. CONCLUSION: Formal numerical techniques are required and feasible for separately assessing the structural and psychogenic components of chronic pain.

Adult↗
PubMed1996

First-pass uptake of methotrexate after intra-arterial bolus injection in human head and neck cancers.

The aim of this study was to quantify first-pass uptake of methotrexate into tumour and healthy tissue after intra-arterial (i.a.) injection in patients with head and neck cancers. Twenty-one patients were studied; during surgery, a bolus injection of 10 mg of 3H-labelled methotrexate was administered into the tumour-supplying artery. At 15-20 s after injection, and again 2-3 h later, a biopsy of the tumour and of surrounding healthy tissue was taken and radioactivity was measured. In 8 of 17 pretreated patients the biopsy specimens contained no tumour cells. In tumour-bearing patients, radioactivity in tumour was three times higher than in healthy tissue (P = 0.006). In tumour-negative patients there was no difference in activity between the two biopsy sites (P = 0.889). However, after 2-3 h the concentration of methotrexate in all surgical specimens returned to near background level and the initial difference between tumour-positive and tumour-negative samples was lost. Our results show that i.a. injection of methotrexate does not necessarily lead to high tumour cell exposure.

Antimetabolites, Antineoplastic↗
PubMed1996

Carbohydrate-deficient transferrin as a screening marker for drinking in a general hospital population.

We investigated the usefulness of the laboratory marker of alcohol consumption carbohydrate-deficient transferrin (CDT) in 101 consecutively admitted patients in a surgical and internal medical ward of a hospital in a rural wine-growing area. Four major aspects were considered: the influence of liver disease, the method of expression of CDT values (relative % vs absolute units/1), level and pattern of alcohol consumption and comparison with y-glutamyl transferase (GGT). The results show that %CDT is a more valuable discriminating marker of high alcohol consumption than absolute CDT values and its usefulness in this respect is independent of changes in serum total transferrin levels, as in liver disease. Sensitivity and specificity of % CDT were 70 and 98% respectively, compared with 65 and 83% respectively for GGT.

Adult↗
PubMed1996

Alcohol dependence: is carbohydrate-deficient transferrin a marker for alcohol intake?

We investigated %CDT (carbohydrate-deficient transferrin) in 92 ethanol-intoxicated alcohol-dependent patients after consecutive admission to hospital and followed the for 28 days under controlled conditions. At admission, 63% (58 patients) showed elevated CDT (> 2.5%) and 34 patients (37%) had normal CDT levels (< 2.5%). No correlation of the %CDT values to alcohol-related disabilities, severity of the withdrawal syndrome, alcohol-drinking pattern before admission, or several other factors was found. The sensitivity of GGT (gamma-glutamyl transferase) was 58% for the same group of patients. Levels of %CDT decreased during the 28 days following abstinence, whereby we could separate four statistically different groups of "CDT decrease'. In two of these groups, comprising most of the cases studied, normal %CDT levels were reached after 14 days of abstinence. Those patients with %CDT levels exceeding the upper normal level after 14 days of sobriety, showed a decrease during the following 14 days to levels of 2.55-2.61%.

Adult↗
PubMed1995

Does injectable gold retard radiologic evidence of joint damage in psoriatic arthritis?

The aim of this investigation has been to assess whether gold therapy prevents radiologic progression of psoriatic arthritis (PsA) over a period of 2 y. Eighteen patients (11 males, 7 females, mean age 42 y, DD 6.5 y) who were initiated on intramuscular gold during their attendance at the Psoriatic Arthritis Clinic were studied. For each gold-treated patient, 2 matched control patients, who had never had gold therapy, were identified from the PsA database. The control patients were similar to the patient population in gender, age, disease duration, number of actively inflamed joints, radiologic score and other medications used, and were followed in the clinic for at least 24 months. Actively-inflamed joint count decreased by > or = 40% in 9 of 18 gold-treated patients at 12 months. Seven patients continued gold for 24 months, while 11 discontinued gold for either lack of efficacy (4) or side effects (7). A comparison of the change in radiographic evidence of damage in the peripheral joints between the 18 gold-treated patients and the 36 controls revealed that there was no statistical difference in disease progression. These results suggest that gold therapy does not prevent the progression of damage in patients with psoriatic arthritis.

Adult↗
PubMed1994

Late endogenous potentials in three-tone experiment in short- and long-term abstinent alcoholics.

Information processing (and cognitive ERPs as their concomitants) has been observed to be disturbed in chronic alcoholics and to recover with sustained abstinence. However, some specific components of ERPs appear to remain significantly decreased in long-term abstinent alcoholics. Using a longitudinal design we investigated the effect of abstinence and relapse on P300 and Late Slow Wave. P300 was evoked by a three-tone paradigm, which results in a two-stage process for evaluating and classifying stimuli. The amplitude of P300 in short-term abstinent alcoholics was reduced significantly and recovered with time of abstinence at least partly. In alcoholics abstinent for eight months the mean amplitude was lower than of the control group, but this difference failed to be significant. The long latency of the positive peak at about 600 ms seems to reflect delayed information processing in alcoholics, revealed by two-stage processing. This component arises later in alcoholics whether they stay abstinent or not.

Adult↗
PubMed1994

Soluble CD23 reliably reflects disease activity in B-cell chronic lymphocytic leukemia.

PURPOSE: This study was initiated to evaluate whether soluble CD23 (sCD23) reflects disease activity and tumor load in B-cell chronic lymphocytic leukemia (B-CLL) and to determine its prognostic potential for this disease. PATIENTS AND METHODS: The concentration of sCD23 was measured in the serum of 45 B-CLL patients, 50 patients with other lymphoproliferative disorders, and 41 healthy donors (HD). sCD23 serum levels from B-CLL patients were correlated with parameters of disease activity and total tumor mass (TTM) score. In selected cases, sCD23 was measured repeatedly over a 24-month period. Expression, density, and calculated total amount of membrane CD23 on peripheral-blood B-CLL cells, as well as its correlation to sCD23 levels in serum and supernatants, were determined. RESULTS: sCD23 in B-CLL patients serum was highly elevated as compared with other lymphoproliferative disorders, with the exception of immunocytoma (IC). Both advanced Rai stages and active forms of B-CLL were associated with higher levels of sCD23. There was a highly significant reciprocal relationship between sCD23 and lymphocyte count doubling time (LCDT). Serum sCD23 correlated positively with serum deoxythymidine kinase activity and TTM score, but not with absolute lymphocyte counts. The repetitive measurement of serum sCD23 showed the usefulness of this marker in monitoring disease progression in B-CLL. The total amount of membrane CD23 on in vitro-cultured B-CLL cells correlated significantly with sCD23 levels in the supernatant, whereas correlation between serum sCD23 and membrane CD23 on freshly isolated B-CLL cells was absent. CONCLUSION: Our results indicate that sCD23 is a highly sensitive and specific parameter with prognostic potential for B-CLL, which may be used as a tumor marker and may help to assess disease activity.

Biomarkers, Tumor↗
PubMed1994

Inflammatory myopathy--early diagnosis and management by serum myosin light chains measurements.

The use of serum myosin light chain 1 (MLC1) in the diagnosis and treatment response of a patient with biopsy proven inflammatory myopathy is presented. A serum MLC1 level was elevated at presentation despite a normal creatine phosphokinase level. MLC1 levels more closely paralleled the clinical status than the aspartate aminotransferase and lactate dehydrogenase levels. The results suggest that MLC1 levels may facilitate the early diagnosis and management of patients with inflammatory myopathy. Moreover, the excellent response of our patient to low dose prednisone might suggest that the results of treatment could be improved by early detection and institution of therapy.

Aspartate Aminotransferases↗
PubMed1994

Post pulmonary embolism pericarditis. A rare entity diagnosed by combined lung scanning and chest radiograph study.

A patient is described in whom pericarditis appeared a few days after pulmonary embolism. Prompt improvement was noted following corticosteroid therapy. The possibility of pericarditis appearing following pulmonary embolism should be kept in mind, considering that both entities present with similar clinical manifestations but require different therapeutic approaches. The combination of ventilation and perfusion lung scanning and plain chest radiographs for the prompt and early diagnosis of post pulmonary embolism pericarditis, is illustrated.

Diagnosis, Differential↗
PubMed1993

Treatment of the alcoholic organic brain syndrome: double-blind, placebo-controlled clinical, psychometric and electroencephalographic mapping studies with modafinil.

In a double-blind study 40 abstinent hospitalized male patients with an alcoholic organic brain syndrome (OBS; ICD 9: 291.2) were treated for 6 weeks with either placebo or 200 mg modafinil b.i.d. Modafinil (CRL 40476) is a vigilance-promoting, putative central alpha 1-adrenergic agonist with a pharmacological profile quite different from that of amphetamine. Clinical investigations demonstrated that the spontaneous remission of the alcoholic OBS was augmented and accelerated by modafinil, which was found significant as compared with placebo by confirmatory statistics in the target variable, the Clinical Global Impression scale. The drug was well tolerated. Psychometric tests revealed significant improvement of the noopsyche after modafinil as compared with placebo, while the thymopsyche and psychophysiological measurements were not affected. Electroencephalographic mapping showed significant differences between the central effects of modafinil and placebo indicating an improvement of vigilance under modafinil. Typical vigilance-promoting properties were seen after acute drug administration, were less evident before the morning dose after chronic treatment but re-occurred after super-imposed daily drug administration. Thus, our clinical, psychometric and neurophysiological investigations in alcoholic OBS patients demonstrated a therapeutic effect of modafinil in the early phase of abstinence.

Adult↗
PubMed1993

Serum enzyme activities in full-term asphyxiated and healthy newborns: enzyme kinetics during the first 144 hours of life.

Little is known about the kinetics of most serum enzymes during the first hours of life, and even less about the effect on such enzyme activities of perinatal hypoxia-ischaemia. It was the aim of the present study to evaluate the serum kinetics of seven differently located cell enzymes in healthy and asphyxiated newborns during the 1st week of life. The serum activities of cytoplasmic and mitochondrial [aspartate aminotransferase (ASAT), creatine kinase (CK), glutamate dehydrogenase (GLDH), lactate dehydrogenase (LDH), and hydroxybutyrate dehydrogenase (HBDH)] and membrane-bound (gamma-glutamyl-transferase and leucine arylaminidase) enzymes were prospectively measured in full-term asphyxiated (n = 49) and healthy (n = 87) newborns during the first 144 h of life. The blood samples were taken serially at five fixed times: 0 (cord), 12, 24, 72, and 144 h postpartum. The asphyxiated newborns had significantly increased serum activities of ASAT, LDH, and HBDH up to 72 h postpartum, whereas healthy newborns showed higher CK and GLDH activities. Only the activities of ASAT, LDH, and HBDH seemed to depend on the oxygen supply of the fetus or newborn. If other causes of increased serum enzyme activities, e.g. liver diseases, haemolytic disorders, tumours, or inborn errors of metabolism, are excluded, elevated serum activities of ASAT, LDH, and HBDH should draw one's attention to a perinatal hypoxic-ischaemic insult of the newborn.

Aging↗