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At least 199 records · Page 11Linked to original sources

[Surgical correction of astigmatism after perforating keratoplasty].

Microsurgical control of astigmatism after perforating keratoplasty has widely remained an unsolved problem in spite of many sophisticated suggestions and inventions. The frequent irregularity in the recipient cornea and poor predictability with respect to wound healing are the major obstacles. If spectacles or contact lenses cannot provide useful vision, postoperative surgical correction is needed. Ablative or thermal laser techniques have not been sufficiently tried for such cases to be justified, and one may hesitate anyway to apply destructive methods in transplants. We therefore still use T-incisions and wedge resections, which are said to be rather imprecise. Only 3 out of more than 700 keratoplasties performed in our clinic from 1987 through July 1991 required such procedures. Two more cases were referred by surgeons outside the hospital. All five surgical corrections resulted in a good longterm effect with considerable improvement of vision. Thus, as long as alternative methods for surgical correction of postkeratoplasty astigmatism have not proved to be superior, we should continue to practice these "old" methods, which, indeed, are not bad if properly applied.

Adolescent↗

Selective inhibition of beta-globin RNA transcripts by antisense RNA molecules.

Inhibition of beta-globin gene expression by antisense nucleic acids is a potentially powerful therapeutic strategy for sickle cell disease. To develop clinically relevant beta-globin antisense agents we created nine stable mouse erythroleukemia cell lines expressing unique anti-beta-globin RNA transcripts with different potentials for cross-hybridization with gamma-globin mRNA. We observed variable inhibition of beta-globin expression independent of the hybridization potential of the respective antisense beta-globin RNA transcript. Similarly, inhibition of gamma-globin expression by anti-beta transcripts varied widely in the nine stable cell lines. Three neighboring regions in the beta-globin gene with low RNA folding potentials conferred significantly stronger antisense effect toward beta-globin while sparing the homologous targets in gamma-globin. We have identified for the first time targets in the beta-globin gene for which the homologous regions in gamma-globin are relatively inaccessible to antisense attack. Our findings offer the prospect of using this approach to reduce the proportion of intracellular hemoglobin S. Gene therapy strategies which combine gamma-globin induction along with beta-globin inhibition using antisense vectors may yield more favorable anti-sickling effects longterm.

Animals↗

Radiological progression in established rheumatoid arthritis.

Radiographic progression in established rheumatoid arthritis (RA) gives an objective measure of anatomical damage that defines the course of the disease and the longterm effects of treatment. This review defines the rate of joint damage, progression in individual joints, and predictive factors. Six longitudinal prospective studies of 103-378 RA patients followed for up to 20 years show that initially patients had less than 3% maximum possible damage, this rose to 11% maximal damage by 5 years and over 40% by 20 years. The rate of progression changed from an initial rate of 1.6% maximal progression annually to a later rate of 2.0% annually. Between 1977 and 1998 5 prospective studies of 40-147 hospital-based RA cases seen within 12 months of developing RA showed 60-73% of cases developed one or more erosions in the hands and wrists. However a community-based cohort of early RA patients reported, more recently showed 41% of 335 cases developed erosions. There are marked differences between joints. The wrists show most damage and in one series of 103 cases, by 20 years 18% of wrists were completely destroyed and only 25% were nonerosive. The same series showed ankle joints are rarely involved; at 20 years only 7 patients had major abnormalities with minor changes in 17 cases. Rheumatoid factor (RF) positivity is the dominant predictor of erosive damage. In one survey of 439 cases who presented with inflammatory polyarthritis, patients with an initial high RF had over twice the radiographic progression of seronegative cases. A further 8 studies, which enrolled 1395 patients, all show a strong link between radiolographic damage and RF status. The other key clinical predictor is disease activity indicated by surrogate measures such as the C-reactive protein (CRP) level. Suppressing disease activity judged by CRP levels not only decreases the progression of joint damage, but also may reduce new joint involvement to a greater extent than progression in already damaged joints. New potential markers of damage such as anticyclic citrullinated peptide ELISA tests may further improve the identification of those RA patients most at risk of erosive damage and, by implication, most in need of suppressive therapy.

Arthritis, Rheumatoid↗

[Surgical treatment of obstructive sleep-apnoea syndrome].

5 patients, 4 males aged 41, 32, 52 and 49 years and 1 female aged 57 years, suffered from socially unacceptable snoring and hypersomnolence in the daytime. They were evaluated for obstructive sleep-apnoea syndrome. After polysomnography and sleep endoscopy was performed to establish the severity of the sleep-apnoea syndrome and the level(s) of upper airway obstruction, a patient-specific treatment was performed. Conservative therapy with continuous positive airway pressure (CPAP) was refused by 4 patients, while 1 patient discontinued therapy after complaints of nose obstruction. This patient underwent radiofrequency thermotherapy (RFTT) of the inferior turbinates. The other patients underwent uvulopalatopharyngoplasty (UPPP), RFTT of the soft palate, hyoidthyroidpexia (HTP) and 'multilevel' surgery: UPPP, HTP and RFTT of the tongue base, respectively. All patients showed improvement after surgery. Although its longterm effects are not yet known, surgical treatment is an option for patients with obstructive sleep-apnoea syndrome who cannot or will not undergo CPAP.

Adult↗

[Coercion in the treatment of anorexia nervosa].

Anorexia nervosa (AN) is a complex disorder of unclear aetiology, nowadays one of the most serious chronic diseases of adolescent girls and young women. Severe weight loss and associated behaviours may endanger anorexic patients' lives. A characteristic for the disorder the reluctance in accepting treatment can lead in such situations to the necessity of involuntary treatment. The authors have presented indications for hospitalization as well as have discussed consequences, short- and longterm effectiveness of coercion measures in therapy of anorexia. The necessity of further investigations on this problem has been stresssed, particulary connected with good prognosis in the involuntary treatment. The lack of one-valued legal bases for involuntary treatment of anorexia in polish legislation has been mentioned as well as the lack of proper medical outposts providing them complex treatment.

Anorexia Nervosa↗

[Prevalence, genetic diversity and multiplicity of Plasmodium falciparum infection in school children in central Cote d'Ivoire].

A study was carried out in the village of Taabo, located in the vicinity of a large man-made lake in central Côte d'Ivoire. The objectives were (i) to determine the level of prevalence, genetic diversity and multiplicity of Plasmodiumfakiparum infection in schoolchildren and (ii) to compare the diagnostic performance of light microscopy and polymerase chain reaction (PCR). A total of 424 schoolchildren ranging in age from 5 to 15 years underwent diagnostic testing using both light microscopy of blood smears and PCR. Multiplicity of P. falciparum infection was investigated in 196 children (46.2%). The prevalence of malaria was 54.7% based on light microscopy and 83.9% based on PCR. Genotyping based on polymorphism in the length of the restriction fragment of the gene encoding the merozoite surface protein-2 (msp2) showed that 86.5% of cases involved multiple infection with a geometric mean of 3.87 genotypes per positive child. There was a strong positive correlation between multipcity of infection and parasite density in the 56-year old age group. A total of 50 genotypes including six observed for the first time were identified and classified into families with similar-sized sequence groups: 26 x FC27 (52%) and 24 x 3D7 (48%). In comparison with PCR, the sensitivity and specificity of light microscopy for diagnosis of P. falciparum was 81.3% and 88.2% respectively. Data are discussed in the light of similar studies carried out in sub-Saharan Africa and elsewhere. These findings can serve as a basis for monitoring the longterm effect of major water resource management projects on the prevalence, genetic diversity and multiplicity of P. falciparum infection.

Adolescent↗

[Extremely Low Birthweight Infants in Iceland. Neurodevelopmental profile at five years of age.].

OBJECTIVE: This study was part of a geographically defined national study on survival, health, development, and longterm outcome of extremely low birthweight infants (ELBW; birthweight < 1000g) in Iceland focusing on development and neurodevelopmental measures in comparison to a reference group. METHODS: All 35 ELBW longtime survivors born in 1991-95 and 55 children as matched reference group were enrolled in a prospective study on longterm health and development. The children underwent medical examinations and neurodevelopmental testing at five years of age in 1996-2001, and their parents answered a questionnaire on their behavior. Comparison was made between ELBW infants and the reference group. Revised (WPPSI-R) showed significantly lower full scale IQ scores for the ELBW group compared to the reference group (p<0.001). More difference was apparent between the groups for the performance IQ than the verbal IQ. Scores on Test of Language Development (TOLD-2P) showed differences between the ELBW group and the reference group on the total language quotient (p=0.025). Significant differences were not obtained between the groups on TOLD-2P s individual subtests, languistic features nor linguistic systems. Total Scores on the Miller Assessment for Preschoolers (MAP) with emphasis on sensory motor development, were significantly lower for the ELBW group compared to the reference group (p<0.001). Additionally, significant differences were found on three of five subscales of the MAP. Evaluation of fine motor skills with the Finmotorisk utvecklingsstatus 1-7aar (FU) revealed significant differences (p<0.001), favoring the reference group. Parental answers on the Child Behavior Checklist (CBCL) showed differences between the groups on three of eight factors in favor of the reference group (p<0.001). CONCLUSIONS: Developmental testing at five years of age indicates that the performance of 25% of the ELBW children in this study, is consistent with that of same age peers. However, as a group, the ELBW children performed significantly poorer regarding cognitive development and sensory-motor skills when compared to the reference group. The most prominent neurodevelopmental difficulties of the ELBW children were within perceptual organization, coordination, and executive skills. Behavior problems were not rated as significant according to parental answers, although there were some differences between the groups. Since a large portion of ELBW children experiences developmental problems, it is important to provide early intervention during preschool years and support services and special education during school years, to reduce the longterm effects of developmental deficits.

English Abstract↗

[Hemorheologic and clinical changes in ankylosing spondylitis during hyperthermia].

In this controlled study the short- and longterm effects of whole body hyperthermia in ankylosing spondylitis were investigated. Longitudinal and cross-sectional analyses show positive effects: reduction in blood and plasma viscosity, normalization of red cell deformability, reduction of analgetics' use, increase in motility and subjective improvement of well-being. Clinical and rheological changes correlate which might imply (but does not prove) a causal relationship between the two.

Adult↗

[Long-term effect of hormonal contraceptives on the behavior of serum lipids].

In order to check the long-term effects of oral contraceptives used in the GDR on certain serum-lipid-fractions, triglycerides, phospholipids, total and free cholesterol, and beta-lipoproteins were determined in four groups of 15 women each, taking the contraceptive preparations Ovosiston, Nonovlon, Gravistat, and Deposiston. Determinations were carried out before and following 3, 6, 12, and 18 month of drug administration. Statistically significant increases of triglycerides occurred under the combined preparations, of phospholipids under Ovosiston and Deposiston and of the beta-lipoproteins under Ovosiston and Gravistat. Total cholesterol showed a slight decrease under all preparations tested. At present the prognostic significance of these slight alterations of serum-lipid-concentrations cannot be estimated completely.

Adult↗

Physiological significance of hormones and related substances in milk with special reference to prolactin: an overview.

Hormones from hypothalamus, pituitary, thyroid, adrenals, pancreas, gonads and the related substances such as prostaglandins and growth factors have been detected in milk from various species. Despite their influence on human health either directly and indirectly through animal products including artificial formulas, the physiological significance of these components still remains poorly understood. Among them, prolactin is one of the first hormones detected in milk and so far much more informations on this hormone were obtained than on any other one. Furthermore, the presence of prolactin receptor and prolactin antagonist in milk has been reported. It has also been proved that perinatal exposure to prolactin occasionally shows deleterious longterm effects on mammary glands of offspring. The accumulated data suggest that milk prolactin may retard the preweaning growth, hasten the puberty, control prepubertal tuberoinfundibular dopaminergic neuronal activity and influence the fluid and ion absorption from the jejunum of offspring. Moreover, intraalveolar milk prolactin may improve the lactogenesis when the quantity of blood-born prolactin is inadequate.

Animals↗