Biomedical subjects

S Schmid

Publications and source records attributed to S Schmid.

151 records · Page 9Linked to original sources

PubMedDate not supplied

Candida endophthalmitis: clinical presentation, treatment and outcome in 23 patients.

The presumptive diagnosis of Candida endophthalmitis was made in 11 intravenous (i.v.) drug addicts, seven surgical patients and five individuals with no established risk factors. It was based on the clinical symptoms with partial to total visual loss and the findings of a retinohyalitic lesion eventually affecting the entire eye. Empiric antimycotic treatment consisted of i.v. amphotericin B (average cumulative dose 1,580 mg) and i.v. or oral flucytosine (mean cumulative dose 231 g). This treatment resulted in a significant mean improvement of visual acuity from 0.15 to 0.275 during treatment and 0.55 after completion of therapy. Long-term results showed stable scar healing of the inflammatory lesions and stable to improved visual acuity. Transient side effects of treatment included anemia, thrombocytopenia and a rise of serum creatinine. Empiric antimycotic treatment of presumptive Candida endophthalmitis favourably influences the course of this infection. Regular ophthalmological examination of these patients is mandatory.

Adolescent↗

PubMedDate not supplied

Anesthesia in a patient with acute respiratory insufficiency due to relapsing polychondritis.

We report on a male patient with advanced relapsing polychondritis (RP), who was hospitalized for an ophthalmologic intervention. He had to undergo a tracheostomy with general anesthesia due to respiratory decompensation. RP is a rare systemic, inflammatory, and destructive disease of the cartilaginous structures leading to multiple functional disorders in the affected organs. Involvement of the tracheobronchial tract may cause severe respiratory problems and even life-threatening respiratory insufficiency. Treatment consists of corticoids, chemotherapy, antirheumatics, and surgical intervention. Anesthesiologic management requires careful preoperative evaluation of vital organ functions, in particular respiration, so that the anesthetic approach can be tailored to the individual needs of each patient.

Acute Disease↗

PubMedDate not supplied

[Morphometric dual-energy roentgen absorptiometry in follow-up of scoliosis].

PURPOSE: Taking pictures of the spine with Morphometric X-ray Absorptiometry (DXA) leads to a radiation dose of just 1% of conventional X-ray. Purpose of this study was to evaluate if DXA is a suitable method for sufficient measuring of the scoliosis angle. METHOD: We examined 20 patients with scolioses I. Control-pictures were made with conventional X-rays and compared to those made by DXA, measuring of scoliosis angle was performed by the method of Lippmann/Cobb. RESULTS: The difference between both methods was -10.5% DXA to conventional X-ray-each angle examined on DXA was smaller. CONCLUSION: It is possible to measure scolioses I on DXA.

Absorptiometry, Photon↗

PubMedDate not supplied

Potential health benefits of child day care attendance.

Despite fears that child day care attendance enhances the transmission of infection among attending children, there are positive aspects of the day care experience that, from the standpoint of infectious diseases, directly and indirectly contribute to the child's well-being. Quality child day care first requires a preadmission physical examination and then requires that the child begin the series of prescribed immunizations, which might not have been received if care were provided at home by a care giver who was not knowledgeable of available mechanisms for the prevention of disease. Once enrolled, the child and parents can be exposed to health education, which benefits them in terms of overall good health for the entire family. The child day care environment, like every other place where children congregate, is subject to the transmission of infectious agents among child and staff. But the risk of infection can be minimized and the health benefits maximized, and child day care can make positive contributions toward the social and physical development of the child.

Adult↗

PubMedDate not supplied

Comparison of fatty acid composition of plasma lipid fractions in well-nourished Nigerian and German infants and toddlers.

The dietary intake of essential fatty acids is reflected by the plasma lipid composition. Only scanty data is available on the pattern of plasma fatty acids in young children and the influence of different environments. We analyzed the fatty acid composition of plasma sterolesters, triglycerides, and phospholipids in well-nourished-appearing children from Benin City, Nigeria (n = 8; aged 14.1 +/- 7.2 months) and Düsseldorf, FRG (n = 17; aged 15.2 +/- 5.1 months). The Nigerian group tended to have bigger proportions of the essential omega-6-fatty acids, linoleic acid, and its metabolites, and by far higher values for long-chain omega-3-fatty acids, which are considered to be protective against atherogenesis. The saturated and nonessential monoenoic fatty acids tended to be lower in the Nigerian children, and the ratio of polyunsaturated to saturated fatty acids was higher. We conclude that the quality of dietary fat in the German children was worse and may imply an increased risk for development of atherosclerosis.

Arachidonic Acid↗

PubMedDate not supplied

Conversion to cardiopulmonary bypass in off-pump coronary artery bypass grafting: its effect on outcome.

The surgical outcome of patients requiring conversion to cardiopulmonary bypass (CPB) during myocardial revascularization using the less invasive surgical approach (LISA) was assessed. The LISA was recently introduced as a technique for complete myocardial revascularization without CPB. It combines avoidance of CPB with the versatility of a median sternotomy for access to all coronary vessels. We have previously demonstrated reduced risk-adjusted mortality and complications in off-CPB coronary artery bypass grafting (CABG) using LISA compared to standard myocardial revascularization. From January to December 1997, 1210 patients underwent isolated CABG at our institution. Of these patients, 832 (63%) were scheduled as on-CPB cases and 378 (37%) as off-CPB. Of the off-CPB patients, 48 were converted to CPB. Team A surgeons used LISA as their primary strategy for CABG whereas team B surgeons used off-CPB CABG in selected patients. Conversions were divided in three classes: Class I patients were converted when the surgeon considered complete revascularization impossible off-CPB; Class II patients were converted due to hemodynamic instability during the procedure; and Class III patients were converted due to graft malfunction, determined by flow measurements or clinical evidence. There were four deaths. All had perioperative infarctions and required intra-aortic balloon pump (IABP). Conversion to CPB occurred in up to 25% of patients scheduled for off-CPB CABG. When off-CPB cases are done using the comprehensive LISA technique and modern technology, conversion rates may be reduced to 11%. Conversion is in general well tolerated except when it is instituted for graft malfunction combined with hemodynamic instability or collapse.

Adult↗

PubMedDate not supplied

Prevalence of human papilloma virus DNA in head and neck cancers carrying wild-type or mutant p53 tumor suppressor genes.

The normal function of the p53 tumor suppressor protein can be perturbed by non-mutational mechanisms. The E6 protein encoded by high risk strains of human papilloma virus (HPV) targets the p53 protein resulting in enhanced degradation via the ubiquitin pathway. We have used nested PCR for detecting the presence of HPV DNA in 58 primary head and neck tumors and 15 metastatic lymph nodes, which had been prescreened for p53 mutations in exons 5 to 8. HPV DNA sequences were detected in 12 tumors (20.6%) and 4 metastatic lymph nodes (21%). HPV type 16 DNA was predominantly found in tumors (n = 11) and lymph nodes (n = 4), one tumor was positive for HPV type 18 sequences. Five of 12 HPV-positive tumors (41%) carried a p53 mutation. Of 46 HPV-negative tumors, 16 (34.8%) carried a p53 mutation. Thus, HPV positivity and p53 mutations were not mutually exclusive in head-and-neck cancer. Three of 6 normal tissues adjacent to the tumor were positive for HPV type 16, while no viral DNA was found in the corresponding tumors. Thus, the presence of HPV type 16 DNA did not directly confer a growth advantage on the population of emerging tumor cells. Instead, these tumors lack normal p53 function due to mutation.

DNA, Viral↗