Search PubMed⌕ Search

Biomedical subjects

S Goetz

Publications and source records attributed to S Goetz.

8 recordsLinked to original sources

Intermediate results of health related quality of life after vertical banded gastroplasty.

OBJECTIVES: The purpose of this study is to evaluate (a) health-related quality of life (HRQL) after vertical banded gastroplasty (VBG) (Mason) and (b) predictors of HRQL. SUBJECTS: Eighty-two consecutive patients were assessed preoperatively and then after 6, 12 and 24 months. Patients filled out questionnaires for subjective appraisal of HRQL (physical well-being, mood, physical performance, perceived health, social support and coping/adjustment). RESULTS: The greatest improvement in weight and HRQL was seen within 6 months of surgery. Twenty-four months after VBG weight reduction (P<0.05), perceived health (P<0.05), physical well-being (P<0.05), physical performance (P<0.05), mood (P<0.05), coping/adjustment (P<0.05) continued to be better than before surgery. Preoperative binge eating was the most important predictor of HRQL. CONCLUSION: Two years after VBG weight loss and a significant improvement of HRQL can be found. HRQL and weight loss are not associated in terms of outcome, indicating that weight loss alone may not be enough to improve HRQL.

Adaptation, Psychological↗

Discoidin domain receptor 1 (DDR1) signaling in PC12 cells: activation of juxtamembrane domains in PDGFR/DDR/TrkA chimeric receptors.

The discoidin domain receptor (DDR1) is characterized by a discoidin I motif in the extracellular domain, an unusually long cytoplasmic juxtamembrane (JM) region, and a kinase domain that is 45% identical to that of the NGF receptor, TrkA. DDR1 also has a major splice form, which has a 37 amino acid insert in the JM region with a consensus Shc PTB site that is lacking in the shorter receptor. One class of ligands for the DDR receptors has recently been identified as being derived from the collagen family, but neither native PC12 cells, which express modest amounts of DDR1, nor transfected PC12 cells, which express much larger amounts of DDR1, respond to this ligand. A chimeric receptor, containing the extracellular domain of hPDGFRbeta fused to the transmembrane and intracellular regions of DDR1, also fails to mediate neuronal-like differentiation in stably transfected PC12 cells and is only weakly autophosphorylated. However, chimeric receptors, which are composed of combinations of intracellular regions from DDR1 and TrkA (with the extracellular domain of hPDGFRbeta), in some cases provided ligand (PDGF) -inducible receptor responses. Those with the TrkA kinase domain and the DDR1 JM regions were able to produce differentiation to varying degrees, whereas the opposite combination did not. Analysis of the signaling responses of the two chimeras with DDR1 JM sequences (with and without the insert) indicated that the shorter sequence bound and activated FRS2 whereas the insert-containing form activated Shc instead. Both activated PLCgamma through the carboxyl-terminal tyrosine of the TrkA domain (Y785 in TrkA residue numbering). Mutation of this site (Y-->F) eliminated PLCgamma activation (indicating there are no other cryptic binding sites for PLCgamma in the DDR1 sequences) and markedly reduced the differentiative activity of the receptor. This is in contrast to TrkA (or PDGFRbeta/TrkA chimeras), where ablation of this pathway has no notable effect on PC12 cell morphogenic responses. Thus, the activation of FRS2 and Shc (leading to MAPK activation) is weaker in the DDR1/TrkA chimeras than in TrkA alone, and the PLCgamma contribution becomes essential for full response. Nonetheless, both DDR1 JM regions contain potentially usable signaling sites, albeit they apparently are not activated directly in DDR1 (or DDR1 chimeras) in a ligand-dependent fashion. These findings suggest that the DDR1 receptors do have signaling capacity but may require additional components or altered conditions to fully activate their kinase domains and/or sustain the activation of the JM sites.

Animals↗

Forensic issues in the psychiatric emergency department.

To function effectively in the ED, mental health clinicians must be able to: Competently evaluate and manage psychiatric patients in acute crisis. Obtain informed consent for treatment or procedures from patients or substitute health care decision makers. Develop clinical data about patients from collateral sources, such as family members and current treaters. Retrieve records of previous admissions to the ED or hospital psychiatric unit. Conduct competent suicide and violence risk assessments that direct clinical interventions. Conduct risk-benefit assessments before discharging suicidal or potentially violent patients. Observe basic safety precautions and procedures with potentially violent patients. Work with community mental health facilities for the follow-up care of chronically mentally ill patients. Possess a working knowledge of the legal regulation of mental health practice, especially as it applies to evaluating and treating patients in the ED. Obtain legal consultation when in doubt about matters of law affecting patient care.

Emergency Service, Hospital↗

High "need for control" as a psychological risk in women suffering from ischemic stroke: a controlled retrospective exploratory study.

The assumption is tested that women scoring high on dimensions of coping pattern termed "need for control," which underlies several of the components of Type A behavior, are at increased risk of ischemic cerebrovascular disease. Consecutively admitted patients to medical wards, nineteen with ischemic cerebrovascular disease, were compared with nineteen patients with non-arteriovascular disease and nineteen healthy females doing volunteer hospital work. "Need for control" was assessed by a psychometric test based on forty-five dichotomous items defining six unidimensional scales. The Bortner Type A behavior was filled out by the subjects and by their next of kin for an impression of the subject. In ANOVA the dimensions "work commitment, hard driving" (F = 6.87, p less than .002), "perfectionism, need for making plans" (F = 6.26, p less than .003), and "inability to withdraw from work obligations" (F = 3.89, p less than .02) differentiated the three groups in the expected direction. Duncan multiple range test resulted in very similar, significant findings, as did Bortner measures, filled out by a next of kin (F = 4.63, p less than .01). In all analyses, effects of age, current smoking, and coronary artery disease (CAD) were controlled. Our results suggest that high "need for control" defines a psychological risk in women suffering from ischemic stroke. Prospective studies should be undertaken. If they confirm our results, interventions aimed at modifying the "need for control" should be planned.

Adaptation, Psychological↗

[Struma, hyper- and hypothyroidism].

Careful history and physical examination form the basis of thyroid diagnostics. They are important for the choice of the appropriate laboratory and imaging tests such as sonography and scintigraphy. Estimation of FT4 and TSH (measured with a 'sensitive' assay) are nowadays considered to be the principal laboratory tests for thyroid disease. Euthyroidism and hypothyroidism are confirmed by measuring FT4 and TSH (not FT3 or TT3), hyperthyroidism by measuring FT3, FT4 and TSH. If a goitre is observed, the primary tests are TSH and sonography.

Diagnosis, Differential↗