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Biomedical subjects

A Apel

Publications and source records attributed to A Apel.

9 recordsLinked to original sources

[Stress and progression in multiple sclerosis].

The hypothesis that stress might be connected to causation or exacerbation of multiple sclerosis has been under discussion for a long time. The current studies indicate that there is a coincidence between stress and disease progression. Besides the state of art in research different stress models will be introduced in the paper and the relations between disease, resources and coping will be discussed. Besides the influence of distressing life events on disease, the effect of illness-related characteristics on the coping behaviour will be considered in this regard. From the results of the presented studies and the described stress models it was concluded that the possibilities of stress avoiding intervention programs should be taken into account more strongly in the future.

Adaptation, Physiological↗

Arithmetic fact retrieval and working memory in schizophrenia.

Despite its importance in every-day life and vocational rehabilitation, arithmetic ability has rarely been investigated in schizophrenic patients. Those few studies reporting arithmetic deficits in schizophrenia, however, administered complex calculation tasks which drew not only on arithmetic abilities, but also on working memory resources known to be impaired in schizophrenia. In the present study, arithmetic abilities and working memory functions were investigated in schizophrenic patients (n=24) and healthy control subjects (n=24). Arithmetic fact retrieval was assessed in single-digit multiplication and corresponding division problems using a result verification task which minimized working memory demands. Problem size and the disparity of the proposed result were manipulated. The storage component of working memory was tested with a digit span forward task and the executive control component with a digit span backward as well as with verbal fluency tasks. Schizophrenic patients performed worse than controls only in the executive tasks. Digit span forward was preserved. In the arithmetic tasks, groups did not differ from each other, and a similar pattern of task manipulations was obtained. Hence, despite the executive control deficit retrieval of arithmetic facts is preserved in schizophrenia. Moreover, the same underlying cognitive processes as in control subjects are involved.

Adult↗

Immunoglobulin G crystalline keratopathy associated with monoclonal gammopathy.

PURPOSE: Two cases of corneal crystal deposition are reported, both caused by a benign monoclonal gammopathy METHODS: Similar corneal pathology is identified in these two patients, both of whom presented with visual acuities of 6/6 or better Consideration of possible causes involved biochemical and haematological testing and assessment. RESULTS: Potential for malignant transformation of monoclonal gammopathy was recognized, hence the need for ongoing haematological follow-up. CONCLUSION: Corneal crystals may be the initial presentation in a patient with monoclonal gammopathy, a rare, but significant, clinical finding.

Blood Sedimentation↗

Early intraocular pressure after phacoemulsification combined with trabeculectomy.

BACKGROUND AND OBJECTIVE: To determine the efficacy of combined phacoemulsification--trabeculectomy in preventing early postoperative increases in intraocular pressure (IOP). PATIENTS AND METHODS: Eighty patients were enrolled in a prospective cohort study. Thirty-six patients with cataracts and uncontrolled glaucoma underwent combined phacoemulsification--trabeculectomy, and 44 patients with cataracts underwent phacoemulsification alone. The operations were performed in a standardized manner by one surgeon. IOP was measured at 4 hours, 1 day, and 7 days after surgery. The need for intervention (digital massage, medications) and the presence of complications were documented. RESULTS: Four hours after surgery, 5.5% of patients undergoing the combined procedure had IOPs greater than 30 mm Hg, compared with 22.7% of phacoemulsification patients (P < .05). No significant difference in IOP was found between the groups at postoperative day 1 or day 7. CONCLUSION: These results suggest that combined phacoemulsification-trabeculectomy protects against early postoperative elevations in IOP. This finding may influence the surgical management of cataracts in patients with poorly controlled glaucoma and significant compromise of visual field or optic nerve.

Adrenergic beta-Antagonists↗

Infectious crystalline keratopathy following trabeculectomy and low-dose topical steroids.

A case of infectious crystalline keratopathy in a patient who had undergone trabeculectomy without 5-fluorouracil is described. Chronic low-dose topical steroids were employed. Crystalline keratopathy occurring in this setting has not been previously described. A 73-year-old diabetic women presented with feathery crystal-like corneal infiltrates. These were cultured and treated with antibiotics based on the sensitivities. The cultures showed a nutritional variant of Streptococcus that was difficult to grow on routine culture plates. It was sensitive to vancomycin. Resolution of the infection occurred with topical treatment. Infectious crystalline keratopathy is a rare but classical corneal infection. The microbiological characteristics that give rise to its clinical appearance and laboratory characteristics are discussed. A rationale for diagnosis and treatment is suggested.

Administration, Topical↗

A subconjunctival degradable implant for cyclosporine delivery in corneal transplant therapy.

The effect of local cyclosporine therapy upon corneal transplant survival was investigated. A high risk rabbit model with vascularized corneas was used to assess the efficacy of subconjunctivally implanted degradable devices for cyclosporine therapy. Animals were divided into four groups, receiving either no therapy, a placebo PLGA device, or drug containing devices implanted either at the time of transplantation or two weeks previous. The mean survival times of animals in the control and placebo groups were statistically equivalent (21 +/- 4 days vs 18 +/- 4 days). Devices containing CsA improved the survival time of grafts. Predosing the animals with CsA improved the survival time to 28 +/- 7 days, and CsA devices implanted at the time of transplantation increased the survival time to 35 +/- 7 days. The improvement in survival times was consistent with the in vitro drug release profiles. No systemic CsA was detected, suggesting that the effect may have been local. Histological assessment indicated that devices were well tolerated.

Animals↗

Releasable "U" suture for trabeculectomy surgery.

Overfiltration after glaucoma surgery can lead to significant complications. Tight suturing of the trabeculectomy flap reduces this problem but can lead to higher pressure and poor drainage of aqueous. Releasable sutures often leave irritating exposed suture ends. We describe a simple two-arm releasable suture technique that leaves no exposed suture ends until one arm of the suture is removed. Good control of postoperative pressure with few complications was achieved in 28 cases using this technique, which allows manipulation at the slit lamp of the trabeculectomy flap, obviating laser lysis of the sutures.

Glaucoma↗

Single-injection peribulbar local anaesthesia--a study of fifty consecutive cases.

Peribulbar anaesthesia is becoming an increasingly popular alternative to retrobulbar anaesthesia for local anaesthesia in intraocular surgery. The results of 50 consecutive single-injection peribulbar anaesthetics performed by the same surgeon are reported. A description of the procedure is included. The technique produced adequate conditions for surgery in all cases. Only 4% (two cases) were considered to have inadequate akinesia five minutes after the injection and required additional injections. None of the complications described with retrobulbar and other forms of peribulbar anaesthesia were observed. The procedure is relatively easy to master. It can be performed by surgeons or anaesthetists and can be used in the in-patient or day surgery setting. The study shows it to be a safe and reliable alternative to previously described methods of local anaesthesia.

Anesthesia, Local↗