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Biomedical subjects

C Frey

Publications and source records attributed to C Frey.

At least 19 recordsLinked to original sources
PubMed2003

[Age as a predictor of everyday environmental demands in old age].

Across the lifespan, different environmental contexts may, in the long term, affect health and well-being. Exactly which contextual demands translate into different aspects of self-reported everyday demands has hardly been examined. In this telephone-based study with 365 adults between 51 and 80 years, we assessed (a) age differences in the existing everyday demands, (b) relations between different measures of everyday demands, and (c) the correlational patterns between measures of everyday contexts and everyday demands. Results demonstrate age effects in all measures of everyday demands, and differences between measures. The findings suggest age-related differences in the correlational patterns between specific everyday contexts and the levels of everyday demands.

Activities of Daily Living↗
PubMed2003

Epidural versus intrathecal morphine for postoperative analgesia after Caesarean section.

BACKGROUND: Perispinal anaesthesia for Caesarean section allows injection of epidural (ED) or intrathecal (i.t.) morphine to provide long-lasting postoperative analgesia. To compare these two routes, a prospective, randomized, double-blinded study of 53 patients undergoing elective Caesarean section was performed. METHODS: Combined spinal-epidural anaesthesia with 6 mg of i.t. hyperbaric bupivacaine plus sufentanil 5 microg, and additional ED lidocaine was used. Additionally, each patient received either 2 mg (2 ml) of ED morphine plus 1 ml of i.t. normal saline (ED group, n=28), or 0.075 mg (1 ml) of i.t. morphine plus 2 ml of ED normal saline (i.t. group, n=25). Additional postoperative analgesia was given in the form of propacetamol and ketoprofen, plus self-administered i.v. morphine. RESULTS: No major respiratory depression occurred. Time to first demand of morphine was similar in the ED (307.5 min) and i.t. (310 min) groups, as was the incidence of side-effects such as sedation, pruritus, nausea, and vomiting. During the first 24 postoperative hours, VAS pain scores were greater in the i.t. group (P=0.032), as was additional morphine consumption (4 vs 1.5 mg) (P=0.03). CONCLUSIONS: The ED protocol was more effective than the i.t. protocol, whilst side-effects were similar.

Adult↗
PubMed2001

Non-occlusive small bowel necrosis during gastric tube feeding: a case report.

Small bowel necrosis is known as a rare, but serious complication of jejunal tube feeding. We report a case of non-occlusive small bowel necrosis with gastric tube feeding. The patient had a moderate multiple trauma with head injury. Abdominal distension developed after several days of uneventful nasogastric tube feeding. At laparotomy patchy necrosis of the small bowel was found without signs of bowel obstruction or impaired mesenteric perfusion. The patient recovered after a prolonged ICU stay. In this case the large doses of clonidine, given due to an alcohol withdrawal syndrome, were suspected to be a major contributing factor to the development of the small bowel necrosis by impairing gut motility and mucosal perfusion. We conclude that, first, small bowel necrosis can occur after primarily uneventful enteral feeding, even with gastric feeding; second, clonidine can dramatically impair gastrointestinal function in critically ill patients by impairing gut motility and mucosal perfusion.

Adrenergic alpha-Agonists↗
PubMed2001

Ankle sprains.

Explore the source record for details and available documents.

Ankle Injuries↗
PubMed2000

Enzymatic microtiter plate-based nitrate detection in environmental and medical analysis.

Our microtiter plate assay is based on the enzymatic reduction of nitrate by dissimilatory nitrate reductase from Pseudomonas stutzeri [EC 1.7.99.4]. Exogenous redox mediators like methyl viologen, methylene blue, and cibachron blue were applied to reduce nitrate reductase. Concentrations of 0.02-0.9 mM nitrate can be detected with +/-6% standard deviation, by using a photometric Griess reaction for the formed nitrite. Nitrate reductase is stable in the pH range 6.5-9.0 and works in the temperature range 4-76 degrees C. The assay shows no interferences with salt content up to 1 M chloride or 11 mM chlorate, and serum albumin content up to 50 mg/ml. The time demand of our two-step procedure is 20 min/100 samples. Nitrate reductase could be conserved on site of the wells of microtiter plates for at least 6 months at room temperature. The nitrate assay was applied in environmental and consumer goods analysis, and for medical diagnostics in human plasma samples.

Autoanalysis↗
PubMed2000

An exercise in improving suicide reporting in print media.

This study was conducted to support the publication of guidelines for media reporting on suicide. First, quantitative and qualitative aspects of suicide reporting in Swiss print media were surveyed over a time span of 8 months. The results were presented at a national press conference, and written guidelines for suicide reporting were sent out to all newspaper editors. The results of the survey and the guidelines were discussed in a personal meeting with the Editor-in-Chief of the main tabloid. After the publication of the guidelines a second, identical survey was conducted. The main variables regarding frequency, form, and content of the newspaper reports before and after the press conference were compared. The number of articles, on the one hand, increased over the 3 years between the first and second survey, but the quality of reporting clearly improved on the other. The personal contact with the editor of the tabloid was probably the most effective means of intervention.

Guidelines as Topic↗
PubMed2000

Foot health and shoewear for women.

Females are different from males in structure and biomechanics. The foot in the female tends to have a narrower heel in relationship to the forefoot and overall is narrower than a man's foot relative to length. Females tend to pronate their feet more and have smaller Achilles tendons than males, both factors having implications for shoe fit. Although shoes have been worn for thousands of years for the main purpose of protecting feet from the environment, recent studies have implicated shoes as the principal cause of forefoot disorders seen in females. Several authors have reported the harmful effects of shoewear and the greatest factor is a shoe that is improperly fit. With respect to foot disorders in the female, the current study will explore anatomy, biomechanics, common forefoot disorders, and shoewear through the ages, athletic shoewear, and a toe strengthening program.

Accidental Falls↗
PubMed2000

Arthroscopic ankle arthrodesis.

The obvious socioeconomic advantages are quite dramatic, with early weight-bearing and AFO immobilization allowing patients an early return to work. Outpatient surgery is a cost-effective benefit. Patient satisfactions as well as comfort are greatly enhanced, requiring only oral pain medication. All patients have tolerated their postoperative regimen and same-day discharge. Arthroscopic subtalar arthrodesis is a technically demanding procedure that requires some rather advanced arthroscopic skills to perform. Joint access is tight, restricted, and requires small instrumentation. Deformities cannot be corrected; therefore, at this stage, a fusion in situ must be considered. The learning curve is certainly far steeper because of the smaller patient population available for enhancing surgical skills. Overall, this procedure has stood the test of time and follow-up. The results appear to be excellent in terms of patient satisfaction, fusion rate time until union, and postoperative morbidity. The recognition and enhancement of this technique as well as the development of more advanced technology will certainly allow this arthroscopic subtalar arthrodesis technique to mature even further over time.

Ankle Injuries↗
PubMed2000

[Comments on deinstitutionalization].

Following a historic introduction the development of the chronics' departments of the big psychiatric hospitals in Saxony since 1990 is described: the goal of ending the care of the chronic mentally ill younger than 65 years in these departments, the newly restructured care of the mentally ill in Saxony and the problems attached to these processes.

Adult↗
PubMed1999

L-arginine binding to nitric-oxide synthase. The role of H-bonds to the nonreactive guanidinium nitrogens.

Nitric-oxide synthase (NOS) catalyzes the oxidation of L-arginine to nitric oxide and L-citrulline. Because overproduction of nitric oxide causes tissue damage in neurological, inflammatory, and autoimmune disorders, design of NOS inhibitors has received much attention. Most inhibitors described to date include a guanidine-like structural motif and interact with the guanidinium region of the L-arginine-binding site. We report here studies with L-arginine analogs having one or both terminal guanidinium nitrogens replaced by functionalities that preserve some, but not all, of the molecular interactions possible for the -NH(2), =NH, or =NH(2)(+) groups of L-arginine. Replacement groups include -NH-alkyl, -alkyl, =O, and =S. Binding of L-canavanine, an analog unable to form hydrogen bonds involving a N(5)-proton, was also examined. From our results and previous work, we infer the orientation of these compounds in the L-arginine-binding site and use IC(50) or K(i) values and optical difference spectra to quantitate their affinity relative to L-arginine. We find that the non-reactive guanidinium nitrogen of L-arginine binds in a pocket that is relatively intolerant of changes in the size or hydrogen bonding properties of the group bound. The individual H-bonds involved are, however, weaker than expected (<2 versus 3-6 kcal). These findings elucidate substrate binding forces in the NOS active site and identify an important constraint on NOS inhibitor design.

Animals↗
PubMed1999

Arthroscopic evaluation of the subtalar joint: does sinus tarsi syndrome exist?

This is a retrospective review of 49 subtalar arthroscopies performed between 1989 and 1996. Patients were evaluated in the following areas: (1) preoperative diagnosis, (2) preoperative tests and clinical evaluation, (3) intraoperative findings, (4) postoperative diagnosis,(5) complications, and (6) clinical outcome. Particular attention was paid to the accuracy of the preoperative diagnosis, subtalar instability, intraoperative findings in sinus tarsi syndrome, and clinical outcome. Overall, this study demonstrated a success rate of 94% good and excellent results in the treatment of various types of subtalar pathologic conditions with arthroscopic techniques. The Workers' Compensation cases reported 90% good and excellent results. The complication rate was low, with five minor complications reported. The most common complication was a transient neuropraxia involving branches of the superficial peroneal nerve. Of the 14 feet that had a preoperative diagnosis of sinus tarsi syndrome, all the diagnoses were changed at the time of arthroscopy. The postoperative diagnoses included 10 interosseous ligament tears, two cases of arthrofibrosis, and two degenerative joints. Based on these findings, "sinus tarsi syndrome" seems to be an inaccurate term that should be replaced with a specific diagnosis. Arthroscopy is the tool that will allow the orthopaedic surgeon to make a more accurate diagnosis.

Adolescent↗
PubMed1999

Comparison of custom and prefabricated orthoses in the initial treatment of proximal plantar fasciitis.

Fifteen centers for orthopaedic treatment of the foot and ankle participated in a prospective randomized trial to compare several nonoperative treatments for proximal plantar fasciitis (heel pain syndrome). Included were 236 patients (160 women and 76 men) who were 16 years of age or older. Most reported duration of symptoms of 6 months or less. Patients with systemic disease, significant musculoskeletal complaints, sciatica, or local nerve entrapment were excluded. We randomized patients prospectively into five different treatment groups. All groups performed Achilles tendon- and plantar fascia-stretching in a similar manner. One group was treated with stretching only. The other four groups stretched and used one of four different shoe inserts, including a silicone heel pad, a felt pad, a rubber heel cup, or a custom-made polypropylene orthotic device. Patients were reevaluated after 8 weeks of treatment. The percentages improved in each group were: (1) silicone insert, 95%; (2) rubber insert, 88%; (3) felt insert, 81%; (4)stretching only, 72%; and (5) custom orthosis, 68%. Combining all the patients who used a prefabricated insert, we found that their improvement rates were higher than those assigned to stretching only (P = 0.022) and those who stretched and used a custom orthosis (P = 0.0074). We conclude that, when used in conjunction with a stretching program, a prefabricated shoe insert is more likely to produce improvement in symptoms as part of the initial treatment of proximal plantar fasciitis than a custom polypropylene orthotic device.

Adult↗
PubMed1999

Arthroscopy of the great toe.

The few available reports of arthroscopic treatment of the first MTP joint in the literature indicate favorable outcome. However, arthroscopy of the great toe is an advanced technique and should only be undertaken by experienced surgeons.

Endoscopy↗
PubMed1999

The effect of topical ciprofloxacin on postoperative otorrhea after tympanostomy tube insertion.

OBJECTIVE: This study aimed to evaluate the effectiveness of prophylactic ciprofloxacin drops in decreasing the incidence of otorrhea after tympanostomy tube insertion. STUDY DESIGN: The study design was a single-blind, randomized clinical trial. SETTING: The study was conducted at a tertiary care referral center. PATIENTS: One hundred fifty-four patients aged 6 months to 14 years undergoing tympanostomy tube insertion participated. INTERVENTION: For each subject, one ear was randomly assigned to receive topical ciprofloxacin, placed in the middle and external ear after surgery, while the contralateral ear served as a control. MAIN OUTCOME MEASURE: Posttympanostomy otorrhea occurring during the period from 24 hours after surgery until 2 weeks after surgery was measured. RESULTS: Topical ciprofloxacin application after tympanostomy tube insertion was associated with a significantly lower incidence of early posttympanostomy otorrhea. The rates of otorrhea for control and treatment ears were 9.1% and 3.9%, respectively (p = 0.029). CONCLUSIONS: The topical administration of a single dose of ciprofloxacin solution after surgery is an effective treatment for the prevention of early posttympanostomy otorrhea.

Administration, Topical↗
PubMed1998

Development of an intrinsic P-glycoprotein-mediated doxorubicin resistance in quiescent cell layers of large, multicellular prostate tumor spheroids.

Growing multicellular prostate tumor spheroids develop quiescent cell subpopulations in central regions with features of intrinsic multicell-mediated drug resistance. Doxorubicin (dox) uptake was significantly reduced in large spheroids (diameter 400+/-70 microm), which consist predominantly of quiescent cells, as compared to small spheroids (diameter 100+/-50 microm), which consist entirely of proliferating cells. After removal of dox from the incubation medium, dox fluorescence declined more efficiently in large spheroids, which led to a decreased dox toxicity as revealed by colony-forming assays. Verapamil significantly increased dox retention in large spheroids and, consequently, augmented dox toxicity. At a depth 80 microm from the spheroid periphery, a significantly decreased dox fluorescence was observed in the deep, quiescent cell layers of large spheroids. The P-glycoprotein-mediated multidrug resistance (MDR)-reversing agents verapamil, cyclosporin A, quinidine, sodium orthovanadate and tamoxifen significantly increased dox fluorescence at this depth, whereas genistein, indomethacin, probenecid and brefeldin A, which reverse multidrug-resistance-associated protein (MRP) function, exerted no effect. Anti-P-glycoprotein immunohistochemistry of multicellular tumor spheroids revealed an increase of P-glycoprotein expression in large speroids as compared to small spheroids, which was most prominent in the Ki-67-negative, quiescent cell layers 60 to 100 microm distant from the periphery of the spheroid, indicating that the MDR phenotype is related to cell quiescence. This was corroborated by whole-cell patch-clamp experiments, where the C219 antibody, which is directed against the ATP-binding site of P-glycoprotein, significantly inhibited P-glycoprotein-associated, volume-activated chloride currents in quiescent, but not proliferating cells from multicellular tumor spheroids.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed1998

Analysis of early outcome: Burch procedure versus pubovaginal sling.

The Burch vesicourethral suspension (BUVS) has long been the procedure of choice for female stress urinary incontinence (SUI) because of its low complication rate and high success rate for all but those patients with type 3 SUI. The pubovaginal sling (PVS) procedure yields a high success rate in those with type 3 SUI but has not gained wide use for all types of SUI, owing to initial reports of a higher complication rate. A retrospective review of early effectiveness and complications associated with BUVS performed on 36 women without type 3 SUI compared to that for PVS performed on 42 women (24 with and 18 without type 3 SUI) at our institution was carried out. To ensure reasonable comparability between groups, homogeneous subsets of 18 women undergoing BUVS and 18 women undergoing PVS were defined. Using conservative criteria for early complications, PVS patients experienced half the complications of BUVS patients with a comparable rate of success.

Cost-Benefit Analysis↗
PubMed1998

Risk and clinical significance of developing antibodies induced by topical thrombin preparations.

OBJECTIVE: TO determine the clinical relevance, prevalence, and risk of antibody development in patients exposed to topical bovine thrombin preparations. DESIGN: A prevalence study of individuals previously exposed to topical bovine thrombin was done by screening using Western blot assay to detect antibodies against bovine thrombin preparations. SETTING: A large tertiary care center. PATIENTS: A convenience sample of 120 stored blood specimens from patients previously exposed to topical bovine thrombin was identified from hospital records. A control sample of 114 stored blood specimens from nonexposed patients was used. Case reviews for 2 exposed patients with severe bleeding complications and difficult clinical management are presented. RESULTS: Twelve of the bovine thrombin-exposed patients were found to have antibodies directed against bovine thrombin and other coagulation factors (95% CI, 4.6%-15.4%). Patients receiving multiple exposures were 8 times more likely to develop antibodies than were patients with a single exposure (P < .001). CONCLUSIONS: (1) Topical bovine thrombin is associated with formation of antibodies to coagulation factors; (2) Patients receiving multiple exposures are more likely to develop antibodies to coagulation factors; and (3) Topical bovine thrombin use may cause severe bleeding problems and should be avoided if there has been previous exposure.

Administration, Topical↗