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Biomedical subjects

R Thoma

Publications and source records attributed to R Thoma.

At least 19 recordsLinked to original sources
PubMed2006

[What is the value of pain therapy in the German refined diagnosis-related-groups system?].

The German refined diagnosis-related-groups (G-DRG) system was introduced on 1st January 2003, initially on a voluntary basis and on 1st January 2004 the use of a G-DRG costing for stationary hospital treatment became obligatory. The possibility of a description of acute and chronic pain therapy in the G-DRG system was initially rudimentary and not logically planned and also a fair allotment of proceeds according to resources was not possible. By further development of the G-DRG system, pain therapeutic treatment could be improved in some areas, but in others it still remains unsatisfactory. This article offers a summary of the underlying systematics of the G-DRG system and consideration of chronic and current pain therapy in the G-DRG system 2006. In addition to information on currently available possibilities of a pain therapeutical coding in conformation with the G-DRG system, the tasks which are still outstanding will be outlined.

Acute Disease↗
PubMed2006

[Echinococcus multilocularis in Grisons: distribution in foxes and presence of potential intermediate hosts].

The southern border of the European endemic area of Echinococcus multilocularis runs along the alpine crest. This endemic transition area was analysed in the canton Grisons on a small spatial scale. A total of 543 foxes originating from 10 areas north and 4 areas south of the main alpine divide were investigated. Parasites were isolated using the sedimentation and counting technique on intestinal contents. The mean prevalence of E. multilocularis was 6.4% with significant differences between different areas. In the southern valleys, only foxes from the Val Müstair were infected (14.3%). On the northern side of the main alpine divide, prevalences varied between 0 and 40%. The predation habits of foxes on potential intermediate hosts was investigated by means of stomach content analyses (n=530). Rodents of the genera Microtus/Pitymys were found in 19.6% of fox stomachs, Clethrionomys glareolus in 8.0% and Arvicola terrestris in 0.4%. A small scale analysis based on a 10 x 10 km grid suggested that the predation rate on the genera Microtus/Pitymys significantly correlated with the prevalence of E. multilocularis in foxes (Spearman's r = 0.51). Hence, E. multilocularis appears to occur in the alpine study area on a very small spatial scale. These local sources of infection may persist for decades. This may partly explains why, during the last 34 years, some human cases of alveolar echinococcosis occurred in areas of the Canton Grisons where the parasite is presently endemic in foxes. No such human cases have been recorded in other areas free of E. multilocularis.

Animals↗
PubMed2006

Chlamydia-related abortions in cattle from Graubunden, Switzerland.

In 2001, the first case of bovine chlamydial abortion was reported in canton Graubunden, Switzerland. In this region, Chlamydophila (Cp.) abortus is endemic in small ruminants. Hence, we aimed to investigate the incidence of chlamydia-related abortions in cattle from Graubunden. During breeding seasons of 2003-2004, formalin-fixed and paraffin-embedded placenta specimens (n = 235) from late-term abortions in cattle were analyzed by histopathology, immunohistochemistry with a Chlamydiaceae-specific monoclonal antibody against chlamydial lipopolysaccharide (LPS), and 2 different polymerase chain reaction (PCR) methods (16 S ribosomal ribonucleic acid [rRNA] PCR, intergenic spacer [IGS-S] PCR), followed by PCR product sequencing. In 149 of 235 cases (63.4%), histopathologic lesions such as purulent and/or necrotizing placentitis were observed. Chlamydial antigen was clearly demonstrated in immunohistochemistry in only 1 of 235 cases (0.4%). Cp. abortus or Cp. psittaci was found in 12 of 235 (5.1%) and 10 of 235 cases (4.2%) by 16 S rRNA PCR and IGS-S PCR, respectively. However, we detected, by 16 S rRNA PCR, 43 of 235 cases (18.3%) to be positive for chlamydia-like organisms. In contrast to the situation in small ruminants in the canton Graubunden, bovine abortion from Cp. abortus seems not to play an important role. Nevertheless, zoonotic potential should be taken into account when handling abortion material from cattle. The significance of chlamydia-like isolates other than Waddlia chondrophila remains an open question in abortion and needs further investigation.

Abortion, Veterinary↗
PubMed2004

Seroprevalences for ovine enzootic abortion in Switzerland.

Our aim was to assess the seroprevalence of Chlamydophila (Cd) abortus (Chlamydia psittaci serotype 1), denoted ovine enzootic abortion (OEA), in the Swiss sheep population. A competitive enzyme-linked immunosorbent assay (cELISA) was adapted for the investigation of pooled serum samples (pool approach) and receiver-operator characteristic (ROC) analysis was applied to define the cut-off of the pool approach. At a cut-off value of 30% inhibition, the flock-level pooled sensitivity and specificity were 92.9% and 97.6% when compared to classifying the flock based on individual-animal samples. Subsequently, sera from 775 randomly selected flocks out of 11 cantons of Switzerland were investigated using the pool approach. The cantons included in the study represented 72% of the Swiss sheep flocks and 76% of Swiss sheep population. Antibodies against Cd. abortus were found in almost 19% (144) of the 775 examined sheep flocks. Test prevalences were adjusted for the imperfect test characteristics using the Rogan-Gladen estimator and Bayesian inference. Seroprevalence was highest (43%) in the canton Graubunden. In the remaining 10 cantons the seroprevalence ranged from 2 to 29%. The cELISA in combination with testing pooled sera and statistical methods for true prevalence estimation provided a good survey tool at lower costs and time when compared to other approaches.

Abortion, Veterinary↗
PubMed2004

[Treatment of pain in cancer patients].

Patients experiencing constant pain continue to receive less than optimal treatment. In the case of cancer pain in particular, adequate therapy is a must. On the basis of the WHO analgesic ladder, nonopioids and opioids of varying potency must be applied as required, together with antiemetics, laxatives, gastric-protective preparations and bisphosphonates to ameliorate side effects. A particular problem in the treatment of cancer pain is the suddenly occurring stress and perforation pain. This can be reduced with fast-acting opioids such as the fentanyl stick. If the patient does not respond adequately to any of the noninvasive methods, local anesthetics and opiates applied via an i.v. pump system that permits bolus application and spinal and epidural methods have proven useful.

Analgesics↗
PubMed2004

[Anaplasmosis in a Swiss dairy farm: an epidemiological outbreak investigation].

In summer of 2002, a case of severe clinical bovine anaplasmosis caused great losses in a dairy farm of an animal trader in Grisons. This article outlines the general approach of an outbreak investigation considering the case of anaplasmosis as an example. The goals of such investigations are to identify and eliminate the source of a disease outbreak in order to avoid additional cases. In addition, recommendations should be developed for preventing or limiting the magnitude of similar outbreaks in the future. In the outbreak presented, the causative agents were probably brought into the dairy farm by animal trade. Due to the large herd size, a missing quarantine for new animals and the coinfection with several pathogens, this case led to a high number of fatalities. The investigations of this outbreak demonstrated the importance of an universal and consistent identification of individual animals for the reconstruction of their movements. The veterinary practitioner should be reminded to act cautiously when facing strange clinical cases and to also consider "exotic diseases" as a possible cause.

Anaplasmosis↗
PubMed2002

Abortion in woman caused by caprine Chlamydophila abortus (Chlamydia psittaci serovar 1).

On a farm housing cattle and goats an abortion storm occurred affecting 50% of the goats during the lambing season 2000/2001. In one of three investigated caprine abortions Chlamydophila abortus could be identified as aetiology. During this time a pregnant woman (pregnancy week 19/20) had contact with aborting goats. She developed a severe generalized infection and aborted. The placenta contained Chlamydophila abortus shown by immunohistochemistry and PCR. The aim of the present case report is to alert medical doctors about the potential zoonotic risk of ovine/caprine abortions.

Abortion, Spontaneous↗
PubMed2002

[Abortion in humans caused by Chlamydophila abortus (Chlamydia psittaci serovar 1)].

On a farm housing cattle and goats an abortion storm occurred affecting 50% of the goats during the lambing season 2000/2001. In one of three investigated caprine abortions Chlamydophila abortus could be identified as etiology. During this time a pregnant woman (pregnancy week 19/20) had contact with aborting goats. She developed a severe generalized infection and aborted. The placenta contained Chlamydophila abortus shown by immunohistochemistry and PCR. Aim of the present case report is to alert veterinarians about the potential zoonotic risk of ovine/caprine abortions.

Abortion, Spontaneous↗
PubMed2002

[Abortion in cattle caused by Chlamydia psittaci].

A case of bovine abortion was for the first time in Switzerland diagnosed by immunohistochemistry PCR (16S rRNA, ompA) and gene sequence analysis to be caused by Chlamydia psittaci. A possible occurence of further cases has to be investigated. Based on the existence of several methods with very different sensitivity and specificity to diagnose chlamydia it is suggested that at least two verified diagnostic tools should be used to diagnose an involvement of chlamydia in bovine abortion.

Abortion, Veterinary↗
PubMed2002

[Ovine enzootic abortion: seroprevalence in Switzerland using a competitive enzyme-linked immunosorbent assay (cELISA)].

The present study gives an overview over the seroprevalence of ovine enzootic abortion in Switzerland. 639 sheep flocks out of eight cantons in Switzerland were examined by a competitive enzyme linked immunosorbent assay (cELISA) for antibodies against Chlamydophila abortus (Chlamydia psittaci serotype 1), the agent causing ovine enzootic abortion. The eight cantons included Aargau, Bern, Zürich, Appenzell-Ausserrhoden, Appenzell-Innerrhoden and Fribourg, the Vallais and the Graubünden. They were representative for 57% of the Swiss sheep flocks and for 60% of Swiss sheep population. In total, almost 19% (118) of the examined flocks were seropositive. Seroprevalence was the highest in Graubünden with 41%; this requires further examination and the evaluation of the need for a monitoring and controlling program. The examination of pooled sera made it possible to test a large number of samples with a reasonable amount of work. Higher sensitivity (92.9%) and specificity (97.6%) than the complement fixation test (CFT) in combination with testing of pooled sera makes the cELISA to be an usuable tool for serological screening on flock level.

Abortion, Veterinary↗
PubMed2002

[Abortion in small ruminants in Switzerland: investigations during two lambing seasons (1996-1998) with special regard to chlamydial abortions].

Abortion cases of 144 goats und 86 sheep were investigated etiologically during 2 lambing seasons (1996/1997, 1997/1998). Macroscopic inspection of fetus and placenta was completed by histopathology and bacteriological isolation of agents. In addition, immunohistologically the following antigens were labeled in formalin-fixed and paraffin-embedded tissue sections: Toxoplasma gondii, Neospora caninum, Chlamydophila abortus (formerly Chlamydia psittaci serovar 1) and Border Disease Virus. From farms with abortions caused by Chlamydophila abortus specific data were recorded. In 75% of abortion cases in sheep and in 59% of cases in goats an etiologic diagnosis could be substantiated. Chlamydophila abortus is the most commonly involved agent in the etiology of caprine and ovine abortion (sheep 39%, goats 23%), followed by Toxoplasma gondii (sheep 19%, goats 15%) and Coxiella burnetti (sheep 1%, goats 10%). All other agents are of minor importance. An infectious cause of abortion based on histopathologic findings without isolation of agents was observed in sheep (10%) and goats (21%). Malformation occurred in sheep (2%) and goats (3%) and lesions suggestive for Vitamin E/Selenium deficiency were seen in goats only (2%).

Aborted Fetus↗
PubMed2000

Structural evidence for evolution of the beta/alpha barrel scaffold by gene duplication and fusion.

The atomic structures of two proteins in the histidine biosynthesis pathway consist of beta/alpha barrels with a twofold repeat pattern. It is likely that these proteins evolved by twofold gene duplication and gene fusion from a common half-barrel ancestor. These ancestral domains are not visible as independent domains in the extant proteins but can be inferred from a combination of sequence and structural analysis. The detection of subdomain structures may be useful in efforts to search genome sequences for functionally and structurally related proteins.

Aldose-Ketose Isomerases↗
PubMed2000

Structure and function of mutationally generated monomers of dimeric phosphoribosylanthranilate isomerase from Thermotoga maritima.

BACKGROUND: Oligomeric proteins may have been selected for in hyperthermophiles because subunit association provides extra stabilization. Phosphoribosylanthranilate isomerase (PRAI) is monomeric and labile in most mesophilic microorganisms, but dimeric and stable in the hyperthermophile Thermotoga maritima (tPRAI). The two subunits of tPRAI are associated back-to-back and are locked together by a hydrophobic loop. The hypothesis that dimerization is important for thermostability has been tested by rationally designing monomeric variants of tPRAI. RESULTS: The comparison of tPRAI and PRAI from Escherichia coli (ePRAI) suggested that levelling the nonplanar dimer interface would weaken the association. The deletion of two residues in the loop loosened the dimer. Subsequent filling of the adjacent pocket and the exchange of polar for apolar residues yielded a weakly associating and a nonassociating monomeric variant. Both variants are as active as the parental dimer but far more thermolabile. The thermostability of the weakly associating monomer increased significantly with increasing protein concentration. The X-ray structure of the nonassociating monomer differed from that of the parental subunit only in the restructured interface. The orientation of the original subunits was maintained in a crystal contact between two monomers. CONCLUSIONS: tPRAI is dimeric for reasons of stability. The clearly separated responsibilities of the betaalpha loops, which are involved in activity, and the alphabeta loops, which are involved in protein stability, has permitted the evolution of dimers without compromising their activity. The preserved interaction in the crystal contacts suggests the most likely model for dimer evolution.

Aldose-Ketose Isomerases↗
PubMed2000

Occurrence of chlamydiae in the genital tracts of sows at slaughter and their possible significance for reproductive failure.

The aim of this study was to investigate further the role of chlamydiae as pathogens in the genital tracts of sows at slaughter. Genital tracts of 101 randomly selected sows were collected and specimens of genital tract localizations were systematically examined for chlamydiae using immunohistochemistry and PCR. In the genital tracts of 10 sows, Chlamydia psittaci DNA was detected by PCR, and was further typed as 'serotype 1' in nine cases and as avian strain 6 BC in one animal. However, all specimens examined by immunohistochemistry were negative for chlamydiae. Pooled samples of scalding tank water were additionally investigated for 95 animals. Of these samples, 63.2% contained chlamydial DNA, mostly C. trachomatis, and in one sample C. psittaci 'serotype 1'. Although in most cases contamination through influx of faecally contaminated scalding water is a possible reason for the positive PCR results in the genital tract, latent infection cannot be excluded. In conclusion, the results obtained suggest that chlamydiae are of no or only minor importance in the examined group of Swiss breeding sows. Nevertheless, the role and significance of chlamydiae as pathogens in porcine reproductive disorders remain unresolved and require further investigation.

Animals↗
PubMed1999

The evolutionary genetic underpinnings of schizophrenia: the developmental instability model.

The importance of genes in the etiology of schizophrenia is well known, but the manner in which the relevant genomic factors influence neural development and the nature of selection forces operating on these factors are poorly understood. In several prominent papers, Crow has provided a unique and comprehensive theory that attempts to deal with these issues. A central aspect of his theory is that a single gene leads to reduced cerebral lateralization, increased ventricular size, and risk for developing schizophrenia. He relies greatly on Annett's right shift theory of individual variation in handedness. An alternative approach, based on the construct of developmental instability, provides a different way to conceptualize genetic influences, selection forces, and atypical lateralization in schizophrenia. We suggest that the developmental instability model has stronger empirical support and is better grounded in contemporary evolutionary genetics.

Biological Evolution↗