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Biomedical subjects

T Schneider

Publications and source records attributed to T Schneider.

At least 55 records · Page 3Linked to original sources
PubMed2004

[Ethics, motivations of plasmapheresis donors].

For 50 years, the French Blood Transfusion Service has been developing ethical concepts of anonymous, voluntary and non-profit donation. The subject of this work is the study of ethical aspects and motivations of plasmapheresis donors. Three hundred donors were questioned on these subjects. The questionnaire was created after analysing the semi-orientated interviews of ten donors. The donors are male, aged over 35, with relatively high social and professional backgrounds. The main reason given for the first donation is the request by a relative or another person. With regards to further donations, solidarity with patients is mentioned as a reason. Even if the majority of the donors are aware of the ethical aspects of donation, over 50% of them accept to give plasmapheresis regardless of these principles. Plasmapheresis donors are primarily motivated by solidarity reasons. Thereby, they are fully active in the evolution of society.

Blood Donors↗
PubMed2004

[The norovirus-epidemic in Berlin - clinic, epidemiology, and prevention].

INTRODUCTION: During the winter 2002/2003, an increased number of outbreaks of acute gastroenteritis caused by norovirus was reported from Germany, some other European countries and the USA. In this study, the epidemiological and clinical features of the Berlin norovirus outbreak were investigated in order to identify the reasons for the spread of norovirus gastroenteritis and possible control measures. METHODS: Cases and spread of norovirus infection in eleven long-term care facilities and a university hospital in Berlin were monitored from October 2002 to February 2003. To investigate the symptomatology and routes of transmission, a retrospective and interview-based study of infected staff members was performed. RESULTS: Norovirus outbreaks in eleven long-term care facilities affected 314 patients (attack rate: 28.3 %, rate of hospitalisation: 20.7 %). 219 persons were affected in the hospital, during a period of four months. Sequence analysis revealed the circulation of Norovirus genogroup II (Grimsby-like viruses). The mean duration of symptoms was 69 hours. The duration of outbreaks on specific wards was negatively correlated with the time of returning to work (mean: 1.8 days) of the staff members after the disease. DISCUSSION: This report demonstrates the potential of norovirus to cause large outbreaks by person to person transmission. Spread by aerosols generated by vomiting and environmental contamination seem to be particular important in institutional settings. The duration of symptoms was longer than reported previously, reflecting a possible increased virulence. Besides this, the outbreak was facilitated by insufficient preventive measures.

Adult↗
PubMed2004

[Video capsule endoscopy in a group of networked users: effective and cost saving].

BACKGROUND: At present extensive application of video capsule endoscopy (VCE) as the most innovative diagnostic tool for small bowel diseases is limited by its high costs. The present study describes the first experience in the mobile use of VCE in a cooperation of associated gastroenterology departments in different hospitals. METHODS: The VCE device was bought by a centrally located hospital. In the case of a need for VCE elsewhere the mobile equipment was brought to the respective hospital. The examination was done on site by local physicians, who additionally were responsible for the procedure itself. The evaluation of the VCE pictures was carried out exclusively by the Ophysicians of the central hospital. RESULTS: Within 15 months VCE was performed in 40 patients (19 male, 21 female; age 61 +/- 14 years). Ten examinations were performed in the central hospital, 30 in the associated gastroenterology departments of other hospitals. Indications for VCE were obscure GI bleeding (65 %), chronic diarrhea and Crohn's disease (17.5 %) or suspected small bowel neoplasms (17.5 %). Clinically relevant pathological abnormalities were detected in 62.5 % of the patients, mainly ulcerations and erosions. Complications were non-spontaneous capsule passage in one patient. Compared to a single hospital, the multicenter use of VCE increased the frequency of investigations four times and reduced expenses to almost 30 %. CONCLUSIONS: The mobile use of VCE makes this innovative technique available for every patient while remaining in his local gastroenterology department. Additionally, this concept accelerates amortization and improves the quality of evaluation by focusing experience.

Cooperative Behavior↗
PubMed2004

Shoulder rotation characteristics in professional tennis players.

Aim of this study was to assess the glenohumeral joint internal and external rotational range of motion using an ultrasound based kinematic measurement device. Twenty-seven male professional tennis players were bilaterally measured for internal and external rotation at 90 degrees of shoulder abduction while avoiding scapulothoracic motion. The control group consisted of 20 asymptomatic volunteers not involved in overhead sports activities. The dominant arm (playing arm) had a significantly greater range of external rotation than the non-dominant arm, while their internal rotation showed a significant deficit as compared to the non-dominant arm. The dominant arm total rotational range of motion was also significantly reduced in comparison to the non-dominant arm and to the controls. No significant difference was found between the dominant and non-dominant extremity in the control group. For objective measurement of glenohumeral rotational range of motion ultrasound based real time motion analysis is a new application for the diagnostic testing of specific shoulder parameters in orthopedics and sports physical therapy. It is therefore concluded that the specific methodology aiming at isolated glenohumeral motion may have clinical application for the development of rehabilitation and preventative programs.

Adult↗
PubMed2003

A sensitive LC/MS/MS method using silica column and aqueous-organic mobile phase for the analysis of loratadine and descarboethoxy-loratadine in human plasma.

A sensitive method using liquid chromatography with tandem mass spectrometric detection (LC/MS/MS) was developed and validated for the simultaneous analysis of antihistamine drug loratadine (LOR) and its active metabolite descarboethoxy-loratadine (DCL) in human plasma. Deuterated analytes, i.e. LOR-d(3) and DCL-d(3) were used as the internal standards (I.S.). Analytes were extracted from alkalized human plasma by liquid/liquid extraction using hexane. The extract was evaporated to dryness under nitrogen, reconstituted with 0.1% (v/v) of trifluoroacetic acid (TFA) in acetonitrile, and injected onto a 50 x 3.0 mm I.D. 5 microm, silica column with an aqueous-organic mobile phase consisted of acetonitrile, water, and TFA (90:10:0.1, v/v/v). The chromatographic run time was 3.0 min per injection and flow rate was 0.5 ml/min. The retention time was 1.2 and 2.0 min for LOR and DCL, respectively. The tandem mass spectrometric detection was by monitoring singly charged precursor-->product ion transitions: 383-->337 (m/z) for LOR, 311-->259 (m/z) for DCL, 388-->342 (m/z) for LOR-d(3), and 316-->262 (m/z) for DCL-d(3). The low limit of quantitation (LLOQ) was 10 pg/ml for LOR and 25 pg/ml for DCL. The inter-day precision of the quality control (QC) samples was 3.5-9.4% relative standard deviation (R.S.D.). The inter-day accuracy of the QC samples was 99.0-107.9% of the nominal values.

Chromatography, Liquid↗
PubMed2003

Treatment of penile curvature--how to combine the advantages of simple plication and the Nesbit-procedure by superficial excision of the tunica albuginea.

Different treatment options for penile curvature exist, such as the Nesbit procedure with complete excision of the tunica albuginea or the simple plication. We prefer a modification with only superficial excision, not opening the corpora cavernosa. From January 1997 to June 2000, 68 patients were treated surgically due to penile curvature. Data was obtained from 48 patients by telephone interview. The mean penile deviation was 46 degrees. Excision of the tunica was performed only superficially and non-absorbable inverted sutures were used. The mean follow-up time in this study was 25 months. A total of 36 (75%) patients were satisfied postoperatively, 12 were unsatisfied. Eleven (23%) patients described a complete straightening, 37 (77%) a rest-curvature of 5-50 degrees (mean 14 degrees ) and 21 (44%) described a shortening of 0.5-5 cm (mean 1.2 cm). Six patients reported a recurrence. No new erectile dysfunction occurred. Superficial excision of the tunica albuginea offers the advantage of tissue-contraction due to scarring without destroying the integrity of the corpora, leading in combination with non-absorbable inverted sutures to good functional and cosmetic results.

Adolescent↗
PubMed2003

[HIV positive patient with pancytopenia and massive splenomegaly].

A 30-year-old homosexual man presented with anemia and a several months history of recurrent fever, night sweats and weakness. His travel history included several stays in mediterranean countries during the recent years. Abdominal ultrasound showed massive splenomegaly, hepatomegaly and abdominal lymphadenopathy. A bone marrow aspirate revealed the presence of numerous Leishmania amastigotes, and bone marrow culture and polymerase chain reaction were also positive for Leishmania. In this case report epidemiological, immunological, diagnostic and therapeutic aspects of HIV-Leishmania coinfection are discussed with special emphasis on the impact of liposomal amphotericin B and highly active antiretroviral therapy on the treatment of HIV-leishmania-coinfection.

AIDS-Related Opportunistic Infections↗
PubMed2003

[The prosthesis nail -- a new stable fixation device for periprosthetic fractures and critical fractures of the proximal femur].

Increasing numbers of total hip arthroplasties in combination with increasing age and growing daily activities of the elderly lead to increasing numbers of periprosthetic fractures and revision arthroplasties in osteoporotic bone. The prosthesis nail is a hybrid of a hip prosthesis and an intramedullary nail allowing immediate full weight bearing and early rehabilitation. The prosthesis nail consists of three self-locking components: a distally locked intramedullary nail, different lengthening modules, and a hip prosthesis module. From 1992 to 1999, 28 prosthesis nails were implanted in 26 patients (40-88 years, mean age: 71 years). The indications were 21 peri- and subprosthetic fractures caused by trauma, 2 fractures of the proximal femur in combination with a fracture of the femoral head or severe degenerative arthritis, and 4 revision arthroplasties associated with poor bone quality. A combination of the prosthesis nail and bone cement was used in one patient suffering from a pathological fracture of the distal femur. Patients were additionally treated with wire cerclage (six patients) and autogenous bone grafting (ten patients). All patients-except those who received a reconstruction of the acetabulum in the same session (four patients)-were mobilized with full weight bearing on the operated side as soon as wound pain diminished. Bone healing was observed in all periprosthetic fractures. In three patients the prosthesis nail had to be revised: one patient suffered from recurrent dislocations and in one patient weighing 350 pounds limb shortening occurred after the distal locking screw broke. Intramedullary infection was observed once after treatment of a periprosthetic fracture. When bone union was achieved the prosthesis nail was removed and the patient was mobilized with a girdlestone situation. The idea of the prosthesis nail is based on the logical consequence of treating femur fractures with the most efficient procedure, which is intramedullary nailing. The prosthesis nail can be applied according to the requirements of the fracture as a reamed or unreamed nail and immediate full weight bearing is possible. Considering the high average age of the patients, low morbidity, short rehabilitation time, and low costs are the major advantages of this new device. Taking into account the unfavorable preoperative conditions associated with elderly and multimorbid patients, the rate of complications is relatively low.

Acetabulum↗
PubMed2003

[The medication-induced dysfunction of the urinary bladder].

Bladder dysfunction can result from pathological changes in the bladder itself, of its central neurological regulation, (BPS), or of non-urological diseases such as diabetes or heart failure. Medication-induced bladder dysfunction can mostly be treated by simple changes in the pharmacological therapy. Bladder dysfunction can be induced pharmacologically by activating or inhibitory influences on adrenergic, sympathetic, beta-receptor-induced relaxation of the detrusor, alpha-receptor-induced contraction of the bladder neck, or cholinergic, parasympathetic, muscarinic receptor-induced contraction of the detrusor. Diuretics can increase urine production, thus possibly leading to incontinence. If incontinence occurs in patients, treatment should be stopped if possible and additional pharmacological therapy should not be started before medication-induced bladder dysfunction is excluded.

Diagnosis, Differential↗
PubMed2003

Inhibition of tumor growth by DT-A expressed under the control of IGF2 P3 and P4 promoter sequences.

The human IGF2 P3 and P4 promoters are highly active in a variety of human cancers. We here present an approach for patient oriented therapy of TCC bladder carcinoma by driving the diphtheria toxin A-chain (DT-A) expression under the control of the IGF2 P3 and P4 promoter regulatory sequences. High levels of IGF2 mRNA expression from P3, P4 or both promoters were detected in 18 TCC samples (n = 29) by ISH or RT-PCR. Normal bladder samples (n = 4) showed no expression from either promoter. The activity and specificity of the IGF2 P3 and P4 regulatory sequences were established in human carcinoma cell lines by means of luciferase reporter gene assay. These sequences were used to design DT-A expressing, therapeutic vectors (P3-DT-A and P4-DT-A). The activity of both was determined in cell lines (in vitro) and the activity of P3-DT-A was determined in a heterotopic animal model (in vivo). The treated cell lines highly responded to the treatment in a dose-response manner, and the growth rate of the developed tumors in vivo was highly inhibited (70%) after intratumoraly injection with P3-DT-A compared to non-treated tumors (P < 0.0002) or tumors treated by luciferase gene expressing LucP3 vector (P < 0.002).

Carcinoma, Transitional Cell↗
PubMed2003

Determination of fungal spore release from wet building materials.

The release and transport of fungal spores from water-damaged building materials is a key factor for understanding the exposure to particles of fungal origin as a possible cause of adverse health effects associated to growth of fungi indoors. In this study, the release of spores from nine species of typical indoor fungi has been measured under controlled conditions. The fungi were cultivated for a period of 4-6 weeks on sterilized wet wallpapered gypsum boards at a relative humidity (RH) of approximately 97%. A specially designed small chamber (P-FLEC) was placed on the gypsum board. The release of fungal spores was induced by well-defined jets of air impacting from rotating nozzles. The spores and other particles released from the surface were transported by the air flowing from the chamber through a top outlet to a particle counter and sizer. For two of the fungi (Penicillium chrysogenum and Trichoderma harzianum), the number of spores produced on the gypsum board and subsequently released was quantified. Also the relationship between air velocities from 0.3 to 3 m/s over the surface and spore release has been measured. The method was found to give very reproducible results for each fungal isolate, whereas the spore release is very different for different fungi under identical conditions. Also, the relationship between air velocity and spore release depends on the fungus. For some fungi a significant number of particles smaller than the spore size were released. The method applied in the study may also be useful for field studies and for generation of spores for exposure studies.

Air Microbiology↗
PubMed2003

'EUROPART'. Airborne particles in the indoor environment. A European interdisciplinary review of scientific evidence on associations between exposure to particles in buildings and health effects.

The relevance of particle mass, surface area or number concentration as risk indicators for health effects in non-industrial buildings has been assessed by a European interdisciplinary group of researchers (called EUROPART) by reviewing papers identified in Medline, Toxline, and OSH. Studies dealing with dermal effects or cancer or specifically addressing environmental tobacco smoke, house dust-mite, cockroach or animal allergens, microorganisms and pesticides were excluded. A total of 70 papers were reviewed, and eight were identified for the final review: Five experimental studies involving mainly healthy subjects, two cross-sectional office studies and one longitudinal study among elderly on cardiovascular effects. From most studies, no definite conclusions could be drawn. Overall, the group concluded that there is inadequate scientific evidence that airborne, indoor particulate mass or number concentrations can be used as generally applicable risk indicators of health effects in non-industrial buildings and consequently that there is inadequate scientific evidence for establishing limit values or guidelines for particulate mass or number concentrations.

Air Pollution, Indoor↗
PubMed2003

[Initial medical treatment by paramedics in combined first aid operations of paramedics and emergency physicians].

OBJECTIVE: The present study was conducted to evaluate the quality of paramedic care and the feasibility and cost-effectiveness of sending a well-trained paramedic team to the sight of a medical emergency to initiate active medical treatment prior to the arrival of the mobile intensive care unit (MICU). METHODS: We examined 200 cases of medical treatment initiated by paramedics before arrival of the MICU team at the site of the medical emergency. Using a questionnaire, all emergency procedures performed by the paramedic team on scene were recorded and defined as "required", "carried out", and "accurately performed". The documented emergency procedures were divided into three categories: basic procedures (e. g. positioning, CRP, oxygen administration), additional procedures (e. g. placement of iv-lines, application of intravenous medication), and routine emergency diagnostic measures (e. g. monitoring of cardiopulmonary status). Further documented were the time of onset of emergency physician treatment, and the definitive transport vehicle used. To evaluate the time required for the measures performed, three different groups were identified according to the time gap between the arrival of the paramedic and the emergency physician teams (< 3 min, 3 - 5 min and > 5 min). RESULTS: In the 200 emergencies included in the study, 76 - 95 % of the required procedures were accurately performed prior to the arrival of the MICU team, at a success rate ranging from 87 to 100 %. CONCLUSIONS: In this study, a large number of emergency procedures could be performed by the paramedic team within a short period of time (in some cases < 3 min), and adequate effectiveness. Based on our results, the activation of paramedic-staffed first-tier ambulances with shorter response times is recommended in addition to the MICU system.

Allied Health Personnel↗
PubMed2003

[Audits across state borders for medical consulting agencies within the German healthcare insurance system].

UNLABELLED: The Medizinischer Dienst der Krankenversicherung (MDK) is a non-profit medical consulting organisation serving the German Healthcare Insurance System. Despite its uniform commission throughout Germany, organisation and structure differ considerably between Provincial States which is reflected by differing results. A common nationwide system of key figures and indicators aims at analysing results and learning from one another. AIM: Development of an audit concept for analysing key figures and indicators within the MDK aiming at quality improvement. METHODS: Development of a system of key figures and indicators covering five spheres (products, staff, costs, data analysis, structure). Analysis by means of audits carried out across provincial state borders in five steps (audit manual, training of auditors, visitation, audit report, repetition audit). RESULTS: The system of key figures and indicators assures relevant and comparable data. Audit manual, training of auditors, visitation, and audit report meet the needs of all people and institutions involved. Preparation of auditors as well as openness, and flow of information within audited organisations offer areas for improvement. There is as yet no assessment of the cost-benefit ratio of audits. CONCLUSION: The concept presented in this article consists of two parts: A system of key figures and indicators as well as a concept for audits. The concept is suitable for a) generating and analysing relevant key figures and indicators for each MDK, and b) providing information for benchmarking between different MDK. Further development of the concept to a comprehensive management concept is necessary.

Benchmarking↗
PubMed2003

Health-related quality of life in chronic pancreatitis: a psychometric assessment.

BACKGROUND: Measurement properties of a generic instrument to assess health-related quality of life in patients with chronic pancreatitis have not been described. METHODS: We assessed the health-related quality of life in 314 patients with chronic pancreatitis using the generic Medical Outcomes Study Short Form-36 Health Survey. Data were compared with age- and gender-matched general population norms and the psychometric properties of the instrument were evaluated. RESULTS: Patients with chronic pancreatitis reported considerably worse scores on all Short Form-36 scales compared with the general population. Decrements were most pronounced in role limitations caused by physical (-29%) and emotional health problems (-20%), and general health perceptions (-19%). Test-retest reliability coefficients were > or = 0.82 for all subscales and internal consistency coefficients ranged from 0.78 to 0.92. Floor effects were negligible for all but the two role subscales, but there were substantial ceiling effects for five of the eight subscales. Construct validity was supported by the findings that the Short Form-36 discriminated well between patients of different age, burden of chronic illness and severity of symptoms. CONCLUSIONS: Patients with chronic pancreatitis experience substantial deteriorations in health-related quality of life compared with the general population. The Short Form-36 proved to be a feasible, reliable and valid measure for descriptive studies of patients with chronic pancreatitis, but ceiling effects may limit its usefulness as an outcome measure in the assessment of treatment effects.

Adult↗
PubMed2003

Cellulosic building insulation versus mineral wool, fiberglass or perlite: installer's exposure by inhalation of fibers, dust, endotoxin and fire-retardant additives.

A task-specific exposure matrix was designed for workers installing building insulation materials. A priori, a matrix element was defined by type of task (installer or helper), type of work area (attic spaces or wall cavities) and type of insulation material (slabs from mineral wool, fiberglass or flax; loose-fill cellulosic material or perlite). In the laboratory a mock-up (full scale) of a one-family house was used for simulated installation of insulation materials (four replicates per matrix element). Personal exposure to dust and fibers was measured. The dust was analyzed for content of endotoxin and some trace elements (boron and aluminum) from fire-retardant or mold-resistant additives. Fibers were characterized as WHO fibers or non-WHO fibers. In support of the exposure matrix, the dustiness of all the materials was measured in a rotating drum tester. For installers in attic spaces, risk of exposure was low for inhalation of dust and WHO fibers from slab materials of mineral wool or fiberglass. Slab materials from flax may cause high risk of exposure to endotoxin. The risk of exposure by inhalation of dust from loose-fill materials was high for installers in attic spaces and for some of the materials risk of exposure was high for boron and aluminum. Exposure by inhalation of cellulosic WHO fibers was high but little is known about the health effects and a risk assessment is not possible. For the insulation of walls, the risk of installers' exposure by inhalation of dust and fibers was low for the slab materials, while a high risk was observed for loose-fill materials. The exposure to WHO fibers was positively correlated to the dust exposure. A dust level of 6.1 mg/m3 was shown to be useful as a proxy for screening exposure to WHO fibers in excess of 10(6) fibers/m3. In the rotating drum, slabs of insulation material from mineral wool or fiberglass were tested as not dusty. Cellulosic loose-fill materials were tested as very dusty, and perlite proved to be extremely dusty.

Aluminum Oxide↗