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Biomedical subjects

W Lehmacher

Publications and source records attributed to W Lehmacher.

66 records · Page 4Linked to original sources

Studies of heart rate oscillations in diabetics at rest.

Variation in electrocardiographic R-R intervals during rest was investigated as a measure of autonomic function and as a diagnostic tool in diabetes. Diabetics (106) of both sexes with different duration of the disease were compared with 116 metabolically healthy control subjects of the same age range. Diabetic retinopathy was diagnosed using fundus photography, and classified in stages O-II. Coefficient of variation (CV) of R-R intervals in controls is age-dependent. The negative correlation between CV and age in diabetics applied only when retinopathy was absent; in diabetics with late complications, CV was significantly lower (p less than 0.0001) than in the healthy or in uncomplicated diabetic state. The CV decreased with increasing severity of retinopathy permitting routine differentiation of progressive stages of retinopathy and peripheral neuropathy.

Adolescent↗

Mutagenicity testing of vincristine sulfate in germ cells of male mice.

Vincristine sulfate (VCR) affects the fertilization ability of all germ-cell stages in male mice. The reduced fertilization ability leads to a pseudo-dominant-lethal effect and sterile matings. The frequency of these effects is dose-dependent. The frequency of specific-locus mutations was not increased by VCR in male mice following 2 mg/kg bw treatment.

Animals↗

Morbidity, mortality, and albuminuria in type 2 diabetic patients: a three-year prospective study of a random cohort in general practice.

In a 3-year prospective study, the prevalence of albuminuria and its relationship to macrovascular disease, pre-existing vascular risk factors and mortality rate were studied in a random cohort of 290 patients with Type 2 diabetes mellitus in general practice. Newly occurring micro- or macroalbuminuria was associated with significantly (p less than 0.05) higher systolic blood pressure: median (IQ range) 157 (140-170) vs 150 (130-160) mmHg, in addition to higher serum triglycerides: median (IQ range) 2.71 (1.84-4.25) vs 1.84 (1.35-3.14) mmol l-1, and C-peptide levels: median (IQ range) 1.30 (0.98-2.16) vs 1.10 (0.82-1.58) nmol l-1, at 3-year follow-up. Patients with macroalbuminuria at final examination had significantly higher systolic and diastolic blood pressure, serum triglyceride and beta 2-microglobulin levels, decreased HDL-cholesterol, and a significantly higher prevalence of carotid artery stenoses and peripheral vascular disease. Patients dying from vascular causes showed significantly higher urinary albumin levels at entrance as compared to the surviving patients: median (IQ range): 42.2 (11-249.7) vs 10.4 (4.6-28.0) mg l-1, p less than 0.008, and overall mortality rate was significantly linked with the presence of macroalbuminuria (26% vs 5% in normoalbuminuric patients). A comparison between the results of the initial and the final examination indicated an overall worsening of renal variables (albuminuria: median (IQ range): female 9.5 (4.5-21) vs 13.4 (5.1-39.7) mg l-1, (p less than 0.05); male 13.8 (4.7-34.1) vs 32.6 (8.1-78.7) (p less than 0.001), despite a significant improvement in metabolic variables.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗

The standardised mistletoe extract PS76A2 improves QoL in patients with breast cancer receiving adjuvant CMF chemotherapy: a randomised, placebo-controlled, double-blind, multicentre clinical trial.

Patients with breast cancer receiving adjuvant chemotherapy frequently suffer from a restricted quality of life (QoL) due to the side-effects of chemotherapy and the consequences of coping with the diagnosis. Therefore, the objective of this clinical study was to investigate the impact of PS76A2, an aqueous mistletoe extract standardised to the galactoside-specific mistletoe lectin, on QoL by performing a placebo-controlled trial. Overall, 272 patients with breast cancer receiving adjuvant CMF chemotherapy (cyclophosphamide-methotrexate-fluorouracil) were enrolled and randomised to groups receiving placebo or PS76A2 at concentrations of 10, 30 or 70 ng mistletoe lectin (ML) per ml. The patients received 0.5 ml study medication twice weekly subcutaneously for 15 consecutive weeks (4 CMF cycles). Primary variables were the self-assessment QoL scores GLQ-8 (Global Life Quality) and Spitzer's uniscale. As a result, statistically significant effects on QoL were obtained with the medium dose (15 ng ML/0.5 ml). The treatment difference between the medium dose and placebo with regard to the GLQ-8 sum was 60.8 mm (95% confidence interval: 19.3 to 102.0 mm). The treatment effect for Spitzer's uniscale between the medium dose and placebo was 16.4 mm (95% confidence interval: 6.3 to 26.6 mm). The results on QoL were supported by an increase of T helper lymphocytes (CD4+) and the CD4+/CD8+ ratio (p<0.05). Overall, PS76A2 was well tolerated. Local reactions at the injection sites occurred dose-dependently, but were mild at the low and medium dose levels.

Adult↗

The validation of cervical cytology. Sensitivity, specificity and predictive values.

Statistics and methods for the validation of the results of cytologic screening for cervical cancer and its precursors were examined. Many of the methods commonly used, including the calculation of sensitivity and specificity on raw data, contain flaws that undermine their conclusions. Using a large computerized database of 748,871 cytologic screenings of 277,842 women over a ten-year period, the value of screening was examined. Only subsequent histologic examinations within one year were accepted to validate positive initial cytologic diagnoses; only two subsequent cytologic screenings within the next three years were accepted to validate negative initial cytologic diagnoses that had not been followed by a histologic examination. Cases not meeting these criteria were excluded from the initial analysis. From these data, the predictive value of a negative cytologic examination was determined to be 99.8%; the predictive value of a positive cytologic examination was 73.4% for an initial diagnosis of mild-to-moderate dysplasia, 90.6% for a diagnosis of severe dysplasia/carcinoma in situ, 94.5% for a diagnosis of carcinoma in situ or microinvasive carcinoma and 95.5% for an initial diagnosis of invasive carcinoma. Cases with an initial "questionable" cytologic diagnosis had a positive predictive value of only 64.0%. Extrapolation from the validated cases to the entire screened population showed an overall sensitivity of 80% and a specificity of 99.4% for cytologic screening for cervical cancer. The sensitivity was slightly lower for mild and moderate dysplasia (78.1%) and slightly higher for carcinoma in situ and severe dysplasia (81.4%) and invasive carcinoma (82.3%).

Adult↗

[Epidemiologic pattern of Salmonella enteritidis and Salmonella typhimurium in man--analysis of Salmonella cases in the Brandenburg federal territory].

It is the aim of this study (a study that is part of several investigations suggested and coordinated by the WHO) to highlight the characteristics of transmission of Salmonella in humans. To achieve this, the data collected on the basis of the Federal German Law governing Epidemic Diseases as well as additionally available data (sex, serovar, differentiation between diseased and symptomatic, allocation to the respective place of residence) have been evaluated. In this manner it became possible to determine different patterns of incidence of the presently most frequently occurring salmonella serovars S. enteritidis and S. typhimurium in respect of distribution according to age and sex, as well as the dynamics of distribution and incidence in terms of time. The incidence is particularly remarkable among children, where S. enteritidis is not so frequent as S. typhimurium. There is a distinct trend towards the male sex among children in respect of the infestation. The fact that women are particularly often asymptomatic carriers points to the special nature of the sources and paths of infection. In respect of seasonal dynamics S. typhimurium does not have a specific summer peak, contrary to S. enteritidis, and this too indicates that the mechanisms of transmission or multiplication differ from one another. The study presented here is supplemented by the evaluation of further parameters to support and promote on-target epidemiological investigation into the various problems raised by this and other studies.

Adolescent↗