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Biomedical subjects

C Frey

Publications and source records attributed to C Frey.

At least 37 records · Page 2Linked to original sources
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↗
PubMed1997

[The treatment of torture and war victims].

Torture is a means of repression in non democratic societies. Although banned, it is widely practised. About 30% of the refugees recognized 1987 in Switzerland were tortured. Torture and war lead to severe bio-psycho-social sequels which are described as "post traumatic stress disorder" (PTSD). This can be treated. Several centres for treatment of torture victims were recently established in many countries since health workers and health care providers felt helpless facing the consequences of torture and asked for professional support. The foundation of the Swiss Red Cross Therapy Centre for victims of torture was the response to their demand in Switzerland. The centre offers a wide range of therapies for victims of torture and training for health personnel. It further aims to facilitate the establishment of more institutions of this kind.

Adolescent↗
PubMed1997

Footwear and stress fractures.

Causal factors associated with stress fractures include training errors, exercise surfaces, footwear, and anatomic abnormalities. Logically, footwear can play an important role in the development and treatment of stress fractures because foot loading, structure, and stability have a significant impact on the development of stress fractures. The important characteristics of athletic shoes in the development and treatment of stress fractures are reviewed in this article.

Biomechanical Phenomena↗
PubMed1997

Nutrition risk screening characteristics of rural older persons: relation to functional limitations and health care charges.

This study was intended to characterize a rural population of older persons through nutrition screening and relate screening items to functional limitations and health care charges. There were 5373 participants (2522 males and 2851 females, mean age 71 y) screened over a 22-mo period by using a self-administered questionnaire adapted from the Nutrition Screening Initiative. Height and weight and cholesterol and albumin concentrations were measured, and health care claims data were obtained. The most frequent screening items reported were use of > or = 3 medications (41%) and food group intakes below recommended frequencies (> 50%). There were significant (P < 0.05) sex differences in affirmative responses to screening items and in likelihood of exceeding proposed threshold values for risk status assigned for body mass index (BMI; in kg/m2), albumin, or cholesterol. Overweight status was notable, with one-half of all subjects having BMIs > 27. Stepwise modeling procedures were used to identify screening items with the ability to predict self-reported functional limitation (logistic regression) and monthly average recorded health care charges (linear regression on logged charges). Age > or = 75 y, use of > or = 3 medications, and an albumin concentration < 35.0 g/L were significant predictors of both functional limitation and health care charges. Poor appetite, eating problems, income < $6000/y, eating alone, and depression were significant predictors of functional limitation but not health care charges. Being male, loss of 10 lb (4.5 kg), BMI > 27, cholesterol concentration < 4.14 or > 6.21 mmol/L, and functional limitation were significant predictors of health care charges only. These findings suggest that selected screening items may have be useful in the identification of subjects at potential risk for these outcomes.

Activities of Daily Living↗
PubMed1996

A comparison of MRI and clinical examination of acute lateral ankle sprains.

Because of its excellent soft tissue contrast and ability to demonstrate soft tissue structures, magnetic resonance imaging is ideally suited to the evaluation of the soft tissues surrounding the ankle, including the lateral collateral ligaments. This study was undertaken to compare the clinical evaluation of 15 patients who suffered inversion injuries of the ankle with the results found on magnetic resonance imaging within 48 hours of the injury. Physical examination was found to be 100% accurate in the diagnosis of grade III ligament injuries but only 25% accurate in the diagnosis of grade II injuries. Clinicians most often underestimate the damage with a grade II ligament tear. Furthermore, other associated injuries, such as significant capsule ruptures and tendon damage, were often overlooked at physical examination.

Acute Disease↗
PubMed1996

Plantarflexion injury to the metatarsophalangeal joint ("sand toe").

This is a retrospective study of 12 cases of hyperplantarflexion injuries to the great toe and the lesser toes sustained in professional beach volleyball players. The hyperplantarflexion injury to the metatarsophalangeal joint, referred to as "sand toe," can result in significant functional disability. Push-off, forward drive, running, and jumping are compromised. The average player in this series took 6 months to fully recover from the injury, and the most common problem after injury was the loss of dorsiflexion, seen in six players. Five players had residual discomfort in the injured toe, and two demonstrated an unstable toe. Individuals who experience sand toe injuries should be treated conservatively, with taping, anti-inflammatory medications, shoe wear modification, ice, and rest. A toe strengthening program is also presented.

Adult↗
PubMed1996

[Family practice management of risk patients with reference to preclinical emergency medicine].

Chances of surviving myocardial infarction or cardiocirculatory arrest depend on an early and appropriate emergency call as well as on bystander CPR. This study uses a questionnaire to assess to what extent these factors guide the private practitioners caring for high-risk cardiac patients. Almost all physicians responding (44%) treat such patients. More than 70% try to include the patients' relatives in a medical briefing. Recognition of early warning signs is discussed with 80% of the patients and 70% of relatives. How to identify acute life-threatening conditions is discussed with 60% of patients and relatives. In case of sudden chest pain and dyspnoea, physicians commonly advise calling the family doctor, a hospital or a regional physician on call. Calling 112, the emergency physician/rescue service, is rarely recommended. Initiating CPR is recommended for an emergency by 30% of the physicians, whereas 20% encourage relatives of patients at risk to take a CPR course. CPR instruction is judged to be generally useful by 50% of physicians, of limited use by 40% and of no use by 10%. When asked why they do not encourage CPR, 15% of physicians said they have no time, 25% cited the inefficiency of the courses, 40% said CPR is psychologically too stressful for laypersons, and 50% felt it was physically too stressful. This study points out the necessity of additional, appropriate instruction of laymen regarding cardiac emergencies.

Cardiopulmonary Resuscitation↗
PubMed1995

Characterization by electron paramagnetic resonance of the interactions of L-arginine and L-thiocitrulline with the heme cofactor region of nitric oxide synthase.

Nitric oxide synthase (NOS) catalyzes sequential NADPH- and O2-dependent mono-oxygenase reactions converting L-arginine to N omega-hydroxy-L-arginine and N omega-hydroxy-L-arginine to citrulline and nitric oxide. The homodimeric enzyme contains one heme/monomer, and that cofactor is thought to mediate both partial reactions. Here we show by electron paramagnetic resonance spectroscopy that binding of substrate L-arginine to neuronal NOS perturbs the heme cofactor binding pocket without directly interacting as a sixth axial heme ligand; heme iron is exclusively high spin. In contrast, binding of L-thiocitrulline, a NOS inhibitor, produces both high and low spin iron spectra; L-thiocitrulline sulfur is a sixth axial heme ligand in one, but not all, of the low spin forms. The high spin forms of the L-thiocitrulline NOS complex display a distortion in the opposite direction to that caused by L-arginine binding. The findings elucidate the binding interactions of L-arginine and L-thiocitrulline to neuronal NOS and demonstrate that each causes a unique perturbation to the heme cofactor pocket of NOS.

Animals↗
PubMed1995

Effects and mode of action of 1,4-naphthoquinones isolated from Calceolaria sessilis on tumoral cells and Trypanosoma parasites.

The naphthoquinones 2-hydroxy-3-(1,1-dimethylallyl)-1,4-naphthoquinone (CS-1), (-)-2,3,3-trimethyl-2-3-dihydronaphtho[2,3-b]furan-4,9-quinone (CS-3), and 2-acetoxy-3-(1,1-dimethylallyl)-1,4-naphthoquinone (CS-5) isolated from Calceolaria sessilis were tested against Trypanosoma cruzi epimastigotes, the TA3 tumor cell line and the methotrexate-resistant subline TA3-MTX-R. Naphthoquinone CS-3 was the most active; the 50% culture growth inhibition (I50) on T. cruzi (Tulahuén and LQ strain and DM28c clone) was at concentrations ranging from 2.1 to 5.2 mumolar. Also CS-3 inhibited TA3 and TA3-MTX-R culture growth with an I50 of 2.1 and 3.8 mumolar, respectively. Naphthoquinone CS-3 inhibited the respiration of the tumor cells by interfering with the electron transport at some point between NADH and ubiquinone. The respiration of T. cruzi was not inhibited by naphthoquinone CS-3. Naphthoquinone CS-3 produced a temporary increase of oxygen consumption in T. cruzi and tumor cells, suggesting the generation and participation of free radicals.

Animals↗
PubMed1995

Update on women's footwear.

Shoes have been implicated as being responsible for the majority of foot deformities and problems that physicians encounter in women. In our original study of 356 women, the majority of women studied wore shoes that were too small for their feet, had foot pain and deformity, and had increased in shoe size since the age of 20. The women without foot pain or deformities also wore shoes that were smaller than their feet but to a lesser degree. In the present study, data on 255 of the original 356 women are evaluated. Tracings were made of the standing foot and the shoe. Measurements were made of forefoot and the heel width. An index of forefoot width to heel width was developed. The indices do not vary much among women. Based on linear measurements, as forefoot width increases, so does heel width. As foot length increases, forefoot width increases to a greater extent than heel width.

Adult↗
PubMed1995

[Subjective evaluation by parents and objective findings in former perinatal risk children].

Several studies have shown no correlation between individual perinatal risk factors and outcome. Rather, the children's development depends more on social factors. In our retrospective study we compared the development of 26 at-risk newborns with that of a same-sex healthy sibling 10 to 16 years later. Data were collected by interview, questionnaires and neuropsychological tests. In the parents' view, the children who were at-risk newborns had a special position in the family (close mother-child relationship, overprotectiveness, child cause for concern). They had more educational and behavioral problems and their social network was limited. With one exception (d2 test), the neuropsychological tests showed no significant differences between the two groups of children. However, overall the at-risk children had more attention deficit disorders with hyperactivity (ICD-10, F90.0) and more selected learning disturbances (F81). A division of the children into those with minor and major perinatal risk factors was not of predictive value for outcome. There was only a low correlation between the parent's assessments of the at-risk children and more objective criteria (need for professional help or special schooling). The authors discuss the types of support that should be provided to parents with at-risk newborns.

Adolescent↗
PubMed1994

L-thiocitrulline. A stereospecific, heme-binding inhibitor of nitric-oxide synthases.

Nitric-oxide synthase (NOS) catalyzes the oxidation of L-arginine to citrulline and nitric oxide (NO). The enzyme is inhibited by a variety of N omega-monosubstituted L-arginine analogs, and some of these compounds are useful in reversing pathologies associated with the overproduction of NO (e.g. the hypotension of septic shock). We report here that L-thiocitrulline (gamma-thioureido-L-norvaline) is a potent, stereospecific inhibitor of the constitutive brain and endothelial isoforms of NOS as well as the isoform induced in vascular smooth muscle cells by lipopolysaccharide and interferon-gamma. Steady state kinetic studies show L-thiocitrulline inhibition is competitive with L-arginine (Ki approximately 4-20% of KArgm), indicating that initial binding is as a substrate/product analog. In contrast to L-arginine and N omega-methyl-L-arginine, the prototypic NOS inhibitor, L-thiocitrulline binding elicits a "Type II" difference spectrum, indicating a high spin to low spin transition of the iron in the heme cofactor. This finding suggests that L-thiocitrulline is contributing the sixth ligand to heme iron, probably through the thioureido sulfur. Such interaction with heme iron neither stimulates nor inhibits the direct flavin-mediated cytochrome c reduction activity of the enzyme, but it does inhibit heme-dependent superoxide formation. In vivo, L-thiocitrulline is a potent pressor agent in both normal and endotoxemic rats, the latter finding suggesting utility in treating the hypotension of septic shock.

Amino Acid Oxidoreductases↗
PubMed1994

Arthroscopy of the subtalar joint.

The purpose of this study was to determine the position and relative safety of the anterior, posterior, and newly defined middle portals by measuring their distance from the neurovascular structures and tendons on the lateral side of the foot and ankle. Furthermore, this study demonstrates specific components of the posterior subtalar joint and arthroscopic access to each utilizing a technique that allows direct anatomic correlation. The 15 specimens were divided into three groups of five feet each, with one arthroscopic portal site and one instrumentation portal site per group. Group I used the anterior portal for the arthroscope and the posterior portal for the curette. Group II used the posterior portal for the arthroscope and the anterior portal for the curette. In group III, the arthroscope was inserted through the anterior portal and the curette through the middle portal. The sural nerve and small saphenous vein were at risk with posterior portal placement. The anterior portal presented a minor risk of injury to the dorsal intermediate cutaneous branch of the superficial peroneal nerve. The middle portal was without risk to surrounding structures. Group I provided the best access to the posterior facet of the subtalar joint. Group II provided excellent arthroscopic visualization of the posterior facet, but poor access for instrumentation via the anterior portal. Group III provided the best access to the sinus tarsi. No combination of portals allowed visualization or instrumentation of the middle or anterior facets.

Ankle Joint↗
PubMed1994

A review of ankle arthrodesis: predisposing factors to nonunion.

The purpose of this study was to review 15 years of experience with ankle fusions, specifically addressing the underlying etiology of ankle pathology, incidence of nonunion, and associated predisposing conditions that can lead to nonunion. Seventy-eight ankle fusions, performed between 1975 and 1990, were reviewed for this study. The average follow-up was 4 years. Patients with nonunion were evaluated separately to look at the predisposing factors that may have lead to nonunion. Factors associated with nonunion included fracture type, evidence of avascular necrosis, infection, major medical problems, and open injuries. Factors that were not associated with nonunion included age, past history of subtalar or triple arthrodesis, and technique.

Adolescent↗
PubMed1994

Anatomic study of arthroscopic debridement of the ankle.

To this date, there have been no published studies correlating gross intra-articular anatomy and the compartments of the ankle that can be instrumented under arthroscopic visualization. The purpose of this study was to demonstrate which areas of intra-articular surface were accessible to the standard portals using a technique that allows direct anatomic correlation. Six fresh cadaver specimens and 12 fresh-frozen, below-knee amputations were used in this study. The 18 ankles were divided into six groups using only one arthroscopic portal site and one instrumentation site per group. Arthroscopic curettes were used to debride only the visualized talar, tibial, and fibular articular cartilage surfaces. After debridement, excision of the distal tibiofibular joint and the talus was performed. The total area of articular cartilage removed with each combination of arthroscope and instrument portal sites was noted, photographed, and recorded graphically. Use of the various combinations of the anteromedial, anterolateral, and posterolateral portals allowed complete access to all surfaces of the tibial plafond, anterior and posterior rims, and the talar dome. Areas that were not accessible by any portal combination were the distal half of the anterior colliculus of medial malleolus, the majority of the lateral talar articular surface, and the inferior half of the lateral malleolar articular surface.

Ankle Joint↗
PubMed1994

Marine injuries. Prevention and treatment.

Penetrating wounds, stings, and inoculation of venom are common marine injuries to unwary walkers during the summer season. In many circumstances, foreign bodies such as wood splinters or small shards of glass can be removed readily with fine-pointed forceps. Other times, objects may not be noticed until radiographic examination of the injured area. With deeply penetrated foreign bodies, attempts at removal must often be weighed against the likelihood of continued symptoms and damage should the object be left in the foot. This review presents methods of prevention and treatment for common sources of marine foot injuries.

Accidents↗