Search PubMed⌕ Search

Biomedical subjects

T Paul

Publications and source records attributed to T Paul.

At least 127 records · Page 7Linked to original sources
PubMed1988

Relationship marketing for health care providers.

A relatively new concept termed "relationship marketing" is examined in terms of its usefulness for providers targeting employers as direct purchasers of health care services. The discussion includes (1) a consideration of why employers' rhetoric about health care purchasing practices has so far exceeded the reality of change and (2) ways in which relationship marketing can be adopted by providers to influence the health care purchasing practices of organizational buyers.

Commerce↗
PubMed1988

Behavioural factors involved in the control of food intake in man.

This paper reviews several psychological models to explain disturbed food intake: the "psychosomatic theory", the "stimulus-binding theory", the "concept of restraint eating", closely related to the "concept of latent obesity", the "set-point-theory" and the "boundary model". All are based on the assumption that there are biological regulating processes of body weight (and with this also of feelings of hunger, appetite and satiation as the determinants of food intake), nevertheless the resulting body weight can be inconsistent with social standards and individual self-concepts. In this case a cognitive control of food intake (dieting behaviour) is activated for weight regulation, which in turn interacts with biological regulatory mechanisms, and as a result leads to specific behavioural dispositions which can be supported by experiments.

Feeding Behavior↗
PubMed1988

[Percutaneous intraluminal balloon dilatation of valvular pulmonary stenoses in infancy and childhood. Presentation of results with special reference to balloon size].

34 percutaneous balloon valvuloplasties (BVP), including four repeat procedures, were performed in 30 patients (aged 3 months to 19.4 years, mean 5.8 years) with congenital pulmonary valve stenosis. Out of six failures four were due to dysplastic thickened valves; in two children a significant part of obstruction was on the subvalvular level. After first BVP a significant reduction of the right ventricular outflow tract (RVOT) gradient (mean 58.8 +/- 13.2%) was achieved in 24 of 30 cases. The mean pre-BVP RVOT gradient of 67 +/- 24.4 mm Hg was reduced to 27.2 +/- 10.2 mm Hg. Of 24 patients, 14 had a residual RVOT gradient of 25 mm Hg or less. Of the 24 patients, nine were recatheterized 12 to 24 months later, and a further RVOT gradient reduction (33.4 +/- 9.9 mm Hg to 24.2 +/- 14.5 mm Hg) was observed. In four patients additional RVOT gradient reduction (37.3 +/- 11.6 mm Hg to 18.5 +/- 10.5 mm Hg) was achieved by repeat BVP. Balloon size exceeded valve annulus diameter by up to 58% (mean 22%). No definite correlation between balloon size related to pulmonary valve annulus diameter and magnitude of right ventricular systolic pressure reduction was observed. Even using a maximal balloon size of 158%, no significant complications were noted, not even pulmonary valve insufficiency.

Adolescent↗
PubMed1988

[Acute epiglottitis: therapeutic consequences of change in the resistance of Haemophilus influenzae serotype B].

From July 1977 to May 1987, 27 children with acute epiglottitis were treated in our intensive care unit. Haemophilus influenzae type b was identified by positive blood culture in 14 of 27 cases. Until 1983 the first 11 children were treated with ampicillin (100 mg/kg) for a mean duration of 10 days according to the standard therapeutic regimen and/or proven sensitivity from blood cultures (5 of 11 cases). The first finding of an ampicillin resistant Haemophilus influenza type b strain dates from January 1984. From this date on initial antibiotic therapy consisted of cefotaxime (100 mg/kg). Blood cultures proved good sensitivity to cefotaxime (100%) but an increasing rate of resistance to ampicillin (3 of 9 identified strains). Haemophilus influenzae septicemia in acute epiglottitis is verified by the isolation of Haemophilus influenzae type b from blood cultures (14/27) and the additional pneumonias (14/27). Additional meningitis as seen is a very rare complication. Facing these potentially life-threatening secondary foci of this invasive infection, an effective antibiotic therapy is mandatory. Our experiences confirm recommendations from US, UK, Australia, and Spain, where ampicillin was replaced by third generation cephalosporins as initial antibiotic therapy due to the increasing rate of resistance of Haemophilus influenzae type b.

Ampicillin Resistance↗
PubMed1987

Effect of iodine intake and methimazole on lymphocytic thyroiditis in the BB/W rat.

Spontaneous LT and elevated serum anti-Tg occur in the diabetes prone BB/W rat, but thyroid function is essentially normal in the rats with LT. Prolonged low dose MMI decreases the incidence of LT in BB/W rats. The administration of excess iodine beginning at 30 days of age markedly accelerates the occurrence of LT and anti-Tg at 90 days of age. Low iodine intake decreases the incidence of LT. Excess iodine intake did not induce LT in W-line, Wistar-Furth, and Sprague-Dawley rats. This suggests that iodine induced LT occurs only in genetically susceptible rats. Despite the increased incidence of LT during iodine administration, thyroid function remains essentially normal. This is in contrast to the frequent induction of hypothyroidism following iodine administration to euthyroid patients with Hashimoto's thyroiditis. In order to decrease thyroid reserve, rats were hemi-TX at 30 days of age. The administration of iodine markedly increased the incidence of LT and serum anti-Tg, increased the weight of the remaining lobe, and induced hypothyroidism as determined by significantly lower serum T4 and T3 concentrations and elevated serum TSH concentrations. Excess iodine administration to hemi-TX W-line rats (genetically equivalent, non-diabetes, non-LT prone BB/W rats) did not induce LT but did induce hypothyroidism, suggesting that BB/W and W-line rats are susceptible to iodine induced hypothyroidism, perhaps unrelated to the induction of LT. Excess iodine did not induce LT or affect thyroid function in hemi-TX Wistar-Furth and Sprague-Dawley rats.

Animals↗
PubMed1987

[Successful treatment of a brain abscess with antibiotics and drainage puncture in an 11-year-old boy with a complex cyanotic heart defect].

A Blalock-Taussig-anastomosis was performed at the age of 2 years in a boy with transposition of the great arteries, ventricular septal defect, and pulmonary atresia. Nine years later he developed a transient aphasia. Cranial computed tomography (CT-scan) revealed a structure compatible with brain abscess. The boy was conscious and no neurological deficit was found. Initial therapy consisted of Ampicillin, Tobramycin, and Metronidazole, 12 days later an acute hemiplegia developed. 30 ml of pus were aspirated from the brain abscess, and the boy's condition dramatically improved. Streptococcus milleri was found bacteriologically and antibiotic therapy was continued over six weeks. Serial CT-scans during and after therapy demonstrated disappearance of the brain abscess. The presented case shows that after a shunt procedure in cyanotic heart disease right-to-left-shunting and therefore chronic oxygen desaturation and polycythemia are still present as facilitating factors for focal encephalomalacia, cerebritis, and brain abscess. In case of short duration of neurological symptoms and a size of abscess less than 4 cm in diameter antibiotic therapy without total excision may eliminate the infection.

Anti-Bacterial Agents↗
PubMed1986

[Cavernous hemangioma and disseminated intravascular coagulation (Kasabach-Merritt syndrome) in a newborn infant with a large ventricular septal defect].

In a 3170 g newborn with a large cavernous hemangioma at the left thigh, heart failure was evident. Echo- and angiographically a large perimembranous ventricular septal defect was found. An important a-v shunt within the hemangioma could be excluded by hemodynamic investigation and selective arteriographic examination of the vascular tumor. Thrombocytopenia present from the first day of life was only temporarily overcome by corticosteroid therapy but nevertheless consumption coagulopathy (Kasabach-Merritt-Syndrome) developed and additional therapy with heparin was necessary in order to normalize the coagulation factors. However, no regression in size of the tumor occurred over the first 8 weeks of life and a total exstirpation of the hemangioma was performed. Postoperatively no further cortison or heparin therapy was necessary. Despite vigorous medical treatment the congestive heart failure persisted. After surgical closure of the ventricular septal defect at the age of three months the infant thrived and could be discharged without pathological symptoms.

Cardiac Catheterization↗
PubMed1985

The relationship between anaerobic performance and muscle metabolic capacity and fibre distribution.

Relationships between functional anaerobic indicators and the character of cellular muscle energy metabolism were studied. Twelve untrained male students were tested by a specific anaerobic test on the treadmill. The mean values of the anaerobic test were as follows: blood lactate 10.69 mmol . 1(-1), running speed 16.08 km . h-1 and duration 92.67 s. The average distribution of muscle fibres (m. vastus lateralis) was: type I 52.2%, type II A 29.0% and type II B 18.8%. The mean enzyme activity values were: triosephosphate dehydrogenase (TPDH) 4.67 mu kat . g-1 w.w., lactate dehydrogenase (LDH) 5.76 mu kat . g-1 w.w, citrate synthase (CS) 0.21 mu kat . g-1 w.w. and hydroxyacyl-CoA dehydrogenase (HAD) 0.12 mu kat . g-1 w.w. Significant negative correlations were found between delta LA and CS (r = 0.64) and % of fibre type II B and CS (r = 0.78) and positive correlations between % of fibre type I and CS and/or HAD (r = 0.60 and r = 0.62, respectively).

3-Hydroxyacyl CoA Dehydrogenases↗