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Biomedical subjects

B Trommer

Publications and source records attributed to B Trommer.

6 recordsLinked to original sources

Diffusible, nonfibrillar ligands derived from Abeta1-42 are potent central nervous system neurotoxins.

Abeta1-42 is a self-associating peptide whose neurotoxic derivatives are thought to play a role in Alzheimer's pathogenesis. Neurotoxicity of amyloid beta protein (Abeta) has been attributed to its fibrillar forms, but experiments presented here characterize neurotoxins that assemble when fibril formation is inhibited. These neurotoxins comprise small diffusible Abeta oligomers (referred to as ADDLs, for Abeta-derived diffusible ligands), which were found to kill mature neurons in organotypic central nervous system cultures at nanomolar concentrations. At cell surfaces, ADDLs bound to trypsin-sensitive sites and surface-derived tryptic peptides blocked binding and afforded neuroprotection. Germ-line knockout of Fyn, a protein tyrosine kinase linked to apoptosis and elevated in Alzheimer's disease, also was neuroprotective. Remarkably, neurological dysfunction evoked by ADDLs occurred well in advance of cellular degeneration. Without lag, and despite retention of evoked action potentials, ADDLs inhibited hippocampal long-term potentiation, indicating an immediate impact on signal transduction. We hypothesize that impaired synaptic plasticity and associated memory dysfunction during early stage Alzheimer's disease and severe cellular degeneration and dementia during end stage could be caused by the biphasic impact of Abeta-derived diffusible ligands acting upon particular neural signal transduction pathways.

Alzheimer Disease

Nosocomial respiratory syncytial virus infections in a paediatric department.

The seasonal problem of respiratory infections in children caused by respiratory syncytial virus (RSV) is worldwide. A number of these infections are known to occur by nosocomial acquisition. In order to reduce the risk, measures, such as cohort nursing and handwashing, have been used in the paediatric department of Odense University Hospital for three years. In a retrospective evaluation of this routine practice the incidence of nosocomial RSV infections was recorded. The overall rate of nosocomial infection was low, but was proportionally highest in the unit for children aged under 6 months; no change in incidence was seen over the three-year period. In the infectious disease unit, where the majority of RSV infected children were admitted, the rate of nosocomial infection decreased despite an unchanged routine. This difference cannot be explained simply on the basis of longer hospital admission of the children under 6 months of age, but might relate to acquired immunity in children of all ages in the infectious diseases unit or better facilities for segregation within that unit.

Adolescent

Attention-deficit hyperactivity disorder and thyroid function.

Attention-deficit hyperactivity disorder (ADHD) is thought to have a biologic basis, but the precise cause is unknown. It is one of the neurodevelopmental abnormalities frequently observed in children with generalized resistance to thyroid hormone (GRTH), suggesting that thyroid abnormalities may be related to ADHD. We report a prospective screening study for thyroid abnormalities in 277 children with ADHD by measurement of serum levels of total thyroxine, free thyroxine index, and thyrotropin. Fourteen children with ADHD had thyroid function test abnormalities: six had a normal free thyroxine index and elevated thyroxine level (group 1); three had a high free thyroxine index and a normal thyrotropin level (group 2); and five had a low free thyroxine index with a normal thyrotropin level (group 3). GRTH could not be demonstrated in a detailed study of four of the subjects in whom it was suspected (groups 1 and 2). Although the prevalence of ADHD in subjects with GRTH has been reported to be 46%, the overall prevalence of GRTH must be less than 1:2500 because we failed to detect GRTH in the 277 children with ADHD studied. We conclude that the prevalence of thyroid abnormalities is higher (5.4%) in children with ADHD than in the normal population (< 1%).

Attention Deficit Disorder with Hyperactivity

Dental chair apoplexy.

We have reported two cases of intracranial bleeding shortly after a dental procedure. We argue that administration of hypochlorite in gum debridement, application of dental cement, or mechanical stimulation of the alveolar branches of the trigeminal nerve at the pulp may not only result in acute systemic hypertension, but also in the release of vasodilatory neurotransmitters. The combination of a local increase in intracerebral blood flow and simultaneously developing systemic hypertension in an occasional patient may lead to intracranial hemorrhage.

Acute Disease

Evaluating medication response in ADHD: cognitive, behavioral, and single-subject methodology.

Although evidence supports the use of double-blind placebo medication trials to evaluate methylphenidate (MPH) effects on the core behavioral symptoms of attention-deficit/hyperactivity disorder (ADHD), few studies have demonstrated their utility in examining MPH effects on the cognitive deficits associated with ADHD. This article presents a technique for evaluating behavioral and cognitive dose-response relationships at the single-subject level of analysis. Case study results and multivariate analyses suggest that systematic evaluation of behavioral and cognitive MPH dose-response relationships could lead to more accurate MPH titration and greater long-term multimodal treatment efficacy.

Adolescent