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B Kramer

Publications and source records attributed to B Kramer.

167 records · Page 10Linked to original sources
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Pain perception and serum beta-endorphin in trauma patients.

Acute traumatic injury engenders the production of beta-endorphin (BE) and other endogenous opioids. Elevated BE concentration putatively correlates with pain perception in trauma patients. The authors examined traumatic injury severity, pain perception, and BE concentration in patients admitted to an urban trauma center. Brief rating instruments for pain and unpleasantness were administered, and blood was drawn for BE analysis in 48 trauma admissions and 33 age-, gender-, and race-matched control subjects for comparison. The authors found no correlation between severity of pain perception and BE, but a significant correlation was found between BE and patient body weight (P < 0.05), physician pain rating (P < 0.01), and Injury Severity Score (P < 0.001). The results suggest that past findings associating trauma pain perception and BE concentration are spurious.

Adolescent↗
PubMedDate not supplied

[Lung hypoplasia: an underestimated diagnosis?].

BACKGROUND: Lung hypoplasia is a complex disease which is probably an underestimated problem in newborns. The diagnosis may be missed since the clinical features are highly varying. Histologic counting of alveoli is necessary to ensure the diagnosis. PATHOGENESIS: Risk factors for lung hypoplasia are oligohydramnios, absent fetal breathing movements, and thoracal tumors. Under these conditions physical stimuli are absent on which lung growth mainly depends. In the case of preterm rupture of membranes the gestational age and the degree of oligohydramnios are decisive for the risk of hypoplasia. Postnatal growth can compensate in less severe cases. However, in severe cases persistent pulmonary hypertension is associated with a poor outcome. THERAPY AND DIAGNOSIS: New therapeutic options for persistent pulmonary hypertension are currently under evaluation. Prenatal measurement of lung volume and flow profile in pulmonary vessels are new issues to improve prenatal diagnosis. CONCLUSIONS: Lung hypoplasia is usually not adequately taken into account. High clinical suspicion is necessary in order to understand this disease and to develop therapeutic strategies.

Female↗
PubMedDate not supplied

Race, treatment, and long-term survival from prostate cancer in an equal-access medical care delivery system.

OBJECTIVE: To evaluate long-term survival of black and white prostate cancer patients in an equal-access medical care system to help distinguish biological from medical and social explanations of mortality differences. DESIGN AND SETTING: Retrospective study of US Department of Defense tumor registry patients with prostate cancer. Ethnicity, age, diagnosis, staging, risk factors, treatment, and survival end points were extracted. PATIENTS: Prostate cancer patients (N = 1606; 7.5% black, 92.5% white) who were active-duty personnel, dependents, or retirees eligible for care in the military medical system. MAIN OUTCOME MEASURES: Racial differences in tumor stage and grade, risk factors, recurrence, and treatment wait time (time between initial diagnosis and initial treatment); influence of stage, grade, treatment, wait time, age, and race on survival. RESULTS: No differences were found in behavioral risk factors or tumor grade or size, but blacks entered active treatment (P < .001) and exhibited a higher relative risk of cancer (P = .01) in younger age groups, presented with higher stage (P < .001), and demonstrated increased progression in distant metastatic disease (P = .01). No significant differences were detected in overall wait time. When adjusted for stage, no difference was found in type of treatment. Overall, stage, grade, and age were found to affect survival (P = .04 to P < .001), but race did not. When analyzed by stage, blacks demonstrated a clear trend of longer survival for distant metastatic disease (P = .04 to P = .06). This trend was confirmed using Kaplan-Meier estimates (P = .04, likelihood ratio). CONCLUSIONS: This analysis suggests that in an equal-access medical care system there are no stage-specific differences in treatment between black and white prostate cancer patients. Survival among blacks is similar to that among whites and may surpass it for high-stage disease.

Adult↗