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Biomedical subjects

R Spiegel

Publications and source records attributed to R Spiegel.

At least 73 records · Page 4Linked to original sources
PubMed1992

First record of breeding populations of Aedes albopictus in continental Africa: implications for arboviral transmission.

Eggs of Aedes albopictus were collected in oviposition cups from 3 forested areas of Delta State in south-central Nigeria during September 1991 as part of a post-yellow fever outbreak investigation. These eggs were shipped to the Centers for Disease Control in Colorado, where they were reared to the adult stage and identified. This is the first record of breeding populations of Ae. albopictus in continental Africa. Other taxa reared from the same oviposition cups included Ae. aegypti, Ae. apicoargenteus, Ae. africanus, Ae. lilii and Ae. simpsoni subgroup. The introduction and establishment of Ae. albopictus in Africa may have important implications for transmission of indigenous arboviruses.

Aedes↗
PubMed1991

[Neurofibromatosis Type 1: genetic studies with DNA markers in 38 families].

To establish preclinical DNA-diagnosis of neurofibromatosis type 1 (NF1) in familial cases we have investigated 38 families segregating for the disease. The families were tested with 6 polymorphic DNA markers from the chromosome region 17p11.1-q11.2. Two-thirds of the families were informative for flanking markers. An informative situation was achieved for 33 out of 40 individuals at risk (i.e. first degree relatives): 30 cases were diagnosed as noncarriers of the mutated gene, and three clinically normal individuals (including an adult and two children aged three and six respectively) were found to carry the risk haplotype. The remaining 7 persons at risk could not be typed unequivocally due to non-informative markers or recombination events. In 5 families with healthy grandparents the origin of the mutation could be traced back to the grandfather's germ cells. Despite the recent cloning and initial characterization of parts of NF1 gene, studies using linked and eventually intragenic DNA markers will continue to be of great value for genetic counselling. Such analyses allow highly accurate preclinical and prenatal diagnosis in close relatives of familial cases.

Adolescent↗
PubMed1991

Direct access to serum macromolecules by intraerythrocytic malaria parasites.

Trafficking pathways in malaria-infected erythrocytes are complex because the internal parasite is separated from the serum by the erythrocyte and parasitophorous vacuolar membranes. Intraerythrocytic Plasmodium falciparum parasites can endocytose dextrans, protein A and an IgG2a antibody. Here we show that these macromolecules do not cross the erythrocyte or parasitophorous vacuolar membranes, but rather gain direct access to the aqueous space surrounding the parasite through a parasitophorous duct. Evidence for this structure includes visualization of membranes that are continuous between the parasitophorous vacuolar and erythrocyte membranes, and surface labelling of the parasite with fluorescent macromolecules under conditions that block endocytosis. The parasite can internalize by fluid-phase endocytosis macromolecules from the aqueous compartment surrounding it. Thus, surface antigens on trophozoites and schizonts should be considered as targets for antibody-directed parasiticidal agents.

Animals↗
PubMed1991

A new behavioral assessment scale for geriatric out- and in-patients: the NOSGER (Nurses' Observation Scale for Geriatric Patients).

Although a great number of psychometric tests and rating scales for the assessment of psychogeriatric patients is available, there is still an urgent need, in research and practice, for a clinical rating instrument that meets the following main requirements: (1) applicable to institutionalized and community patients and covering a wide range of behavioral pathology; (2) acceptable and easy to use for professionals and lay persons alike; (3) covering a wide range of behavior relevant to daily functioning but independent of sex or social status of the individual assessed. The NOSGER contains 30 items of behavior, each rated on a 5-point scale according to frequency of occurrence. Item scores are summarized into 6 Dimension scores (memory, instrumental activities of daily life, self-care, mood, social behavior, and disturbing behavior) which are clinically relevant in dementia, depression, and other psychiatric disorders of old age. Validation studies with a preliminary version of the NOSGER indicated good acceptance of the scale, high inter-rater and test-retest reliability, and high correlations of all NOSGER Dimension scores with results of a variety of established assessment instruments. The NOSGER is currently being used in a number of European and North American centers and should turn out to be a useful instrument for longitudinal studies in psychogeriatrics.

Activities of Daily Living↗
PubMed1989

The cholinergic rapid eye movement sleep induction test with RS-86. State or trait marker of depression?

Rapid eye movement (REM) sleep disinhibition at the beginning of the night is one of the most frequently described biologic abnormalities in depression. As REM sleep in animals and humans seems to be facilitated by cholinergic neuronal activity, it has been postulated that REM sleep disinhibition in depression is a consequence of cholinergic neuronal overactivity. The current study with the newly available cholinergic agonist RS-86, which is orally active, has a half-life of six to eight hours, and exhibits only minor peripheral side effects, supports this assumption. The application of this compound before sleep led to a significantly faster induction of REM sleep at the beginning of the night in patients with major depressive disorders compared with healthy subjects and patients with other nondepressive psychiatric diseases, such as eating disorders. Whereas 14 of 16 depressed patients displayed sleep-onset REM periods after the administration of RS-86, this happened only in three of the 16 healthy controls and in one of the 20 patients with other diagnoses. The increased susceptibility of REM sleep to cholinergic stimulation was limited to the state of depression and was not observed in a group of remitted depressed patients.

Adolescent↗
PubMed1989

Muscarinic agonists for senile dementia: past experience and future trends.

Clinical experience with muscarinic agonists in the symptomatic treatment of Alzheimer's disease includes studies of the effects of pilocarpine, arecoline, bethanechol, oxotremorine and RS 86. Although the results are somewhat conflicting, there is evidence that a subgroup of patients may respond with an improvement of cognitive and/or behavioural function. The existing agents tend to induce adverse effects due to the stimulation of peripheral muscarinic receptors. Furthermore they reduce (at least in vitro) acetylcholine release by an action on presynaptic receptors. Strategies to overcome these problems include the development of potent agonists with high blood-brain barrier penetration, the search for agents selective for muscarinic receptor subtypes (using cloned receptors as tools) and the identification of agents acting as presynaptic receptor antagonists, to increase acetylcholine release.

Alzheimer Disease↗
PubMed1989

[The memory clinic].

The aim of the Memory Clinic, in operation at Basel since 1986, is the early detection of dementing disorders in ambulatory elderly patients. Special emphasis is put on the differential diagnosis and detection of reversible mental disorders such as depression. Treatment comprises medical, psychological and social measures. For suitable patients, drug treatment with investigational compounds is offered. Memory training programs and therapeutic groups for patients with coexisting affective disorders as well as groups for relatives are held. By these means the Memory Clinic attempts to improve the situation of elderly patients with cognitive disturbances and to maintain them longer in the community. Experience with the first 180 patients is reported.

Aged↗
PubMed1988

Role of recombinant interferon alpha 2 and cimetidine in patients with advanced malignant melanoma.

Following recent reports suggesting that the addition of cimetidine to interferon may enhance response rates in patients with metastatic malignant melanoma, we have completed a Phase II study of the use of recombinant alpha 2 interferon and cimetidine in patients with advanced malignant melanoma and who had progressive disease following interferon therapy alone. We observed two partial responses, no complete responses, and two patients had stable disease. Toxicity encountered was analogous to that of interferon alone. We conclude that the additional of cimetidine to alpha interferon is not beneficial in the treatment of advanced metastatic malignant melanoma.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Seventy-two hour polygraphic and behavioral recordings of wakefulness and sleep in a hospital geriatric unit: comparison between demented and nondemented patients.

Continuous 72-h polygraphic recordings were carried out in 30 hospitalized, mostly severely demented patients and 14 nondemented control patients. Mean age was greater than 80 years in both groups. In the dementia group, the diagnoses were senile dementia Alzheimer type (n = 16), multi-infarct dementia (n = 8), and mixed or undefined dementia (MIX) (n = 6). The nondemented controls suffered from various medical or psychiatric disorders or were recovering from previous accidents. Dementia patients had less stage 2 and REM sleep and thus less total sleep time than did control subjects. No statistically significant differences were noted between dementia subgroups. There were no differences between controls and demented patients in terms of NREM-REM cycle, and there was no association between the severity of the clinical condition and any of the sleep parameters in the demented patients. In contrast to healthy elderly and old persons, women and men patients with dementia showed no differences in their sleep patterns. In both patient groups, most sleep occurred at night, and wakefulness was predominant during the day. Only three of the dementia patients displayed somewhat more daytime than nighttime sleep. The main conclusions were that polygraphic sleep recordings did not contribute to a better differential diagnosis in patients with advanced dementia and that inversion of the sleep/wakefulness rhythm was uncommon in these separately roomed demented patients.

Aged↗
PubMed1987

[Acral rewarming. I: "Normal data" of a healthy adult population].

The acral rewarming test was investigated in 285 healthy subjects (mean age: 44.1; 20-71) to establish "normal" or reference values as a basis for interpreting patient data. The study was disposed in a manner to look also for possible diurnal and seasonal variations of the rewarming parameters. Healthy controls show a considerable interindividual variability in the speed and the pattern of acral rewarming, with a striking bimodal distribution of the individual values. This variability is mainly due to the factors "season" and "gender", while "age" and "daytime" are more related to basal finger temperature as to the rate of rewarming. According to these findings seasonal variations must necessarily be included in the definition of normal reference values of the rewarming test. In the healthy subjects neither personality characteristics (Freiburger personality inventory) nor the individual's psycho-social situation (Life Event questionnaire) and "depressivity" (Beck inventory) correlate with rewarming parameters. However, momentary "fatigue" (Visual Analogue Scale) correlates negatively and the sum of "somatic complaints" positively with acral rewarming time. The issue of variability in normative data is discussed with reference to clinical applications of the rewarming test in part II.

Adult↗
PubMed1987

[Acral rewarming. II: Comparison of healthy probands and depressed patients].

The effect of local cooling on acral rewarming function was measured in healthy subjects and depressed patients. Although group comparison showed that acral rewarming is significantly slower in depressed patients, this parameter cannot be considered as specific for thermoregulatory disturbances in depression since there is marked overlap between groups. Comparison of the annual course was more informative. Annual variations in acral rewarming rate with sex specific differences were found in both groups. However, the variation with time of year was of greater amplitude in depressed patients. Furthermore, in the patient group an annual rhythm was present even in basal finger temperature. Significant March and October troughs in rewarming efficiency after local cooling were found in women (both groups). The greater proportion of depressed women, and the higher spring and autumn incidence of affective illness, may thus have a physiological correlate. The results are discussed in view of the relevance of the acral rewarming test in psychiatric practice and research, the seasonal changes in thermoregulatory measures in the light of a chronobiological approach to depression.

Adult↗