[Increased life expectancy--a risk?].
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Aged↗
Biomedical subjects
C Sieger
Publications and source records attributed to C Sieger.
State practice variations in the use of tube feeding for nursing home residents with severe cognitive impairment.
OBJECTIVE: To describe the differences in prevalence of tube feeding among states and to examine possible factors that could explain practice patterns. DESIGN: Analysis of random samples from an interstate data bank comprised of the Minimum Data Set (MDS), a standardized, federally mandated assessment instrument for nursing home residents. SETTING: Nursing homes in four states participating in a federal demonstration project of case mix payment plus five others with existing MDS data systems. PARTICIPANTS: Individuals 65 years of age and older (N = 57,029), who had very severe cognitive impairment, including total dependence in eating, and who resided in nursing homes during 1994, the most recent year for which uniform data were available. MEASUREMENTS: State-by-state differences in prevalence of tube feeding, controlling for demographic and clinical variables. RESULTS: The prevalence of tube feeding ranged from 7.5% in Maine to 40.1% in Mississippi. Each state had a significantly elevated prevalence of tube feeding compared with Maine, with odds ratios (ORs) ranging from 1.50 to 5.83, P < .001. Specific directives not to provide tube feeding (OR 0.41, P < .001), and white race (OR 0.45, P < .001) were strongly and negatively associated with tube feeding. CONCLUSIONS: Wide regional variations exist in the use of tube feeding of nursing home residents with equivalent impairments. Sociodemographic factors could be important, but more study is needed to determine whether physician characteristics, such as race, attitudes, or knowledge, have an impact and to clarify medical standards for the use of tube feeding in this population.
Advance Directives↗
[Evaluation of residual working capacity with lung function studies].
Lung diseases are one of the most frequent causes of permanent occupational disability. The assessment of the insured person's remaining ability to work by evaluating the respiratory parameters is by no means trivial. Nevertheless, no clear overview has been published yet. In this paper tables and evaluation schemes are presented for the quick and reliable assessment of the degree of the occupational disability of persons with respiratory diseases.
Disability Evaluation↗
[NAAGA versus disodium cromoglycate in perennial allergic rhinopathy: results of a multicenter study].
The efficacy and tolerability of Naaga (the magnesium salt of N-acetyl-aspartyl-glutamate) and of sodium cromoglycate after intranasal application were tested and compared in 100 patients suffering from chronic allergic rhinitis. The study was conducted according to a randomized, double-blind design in four centers. The intensity and frequency of typical allergic symptoms such as nasal obstruction, sneezing, runny and itching nose, conjunctivitis, ocular itching and tear flow were recorded on a 4-point scale (absent, light, moderate and severe). The intensity of nasal and ocular symptoms was found to be marked for patients in two centers. For the patients in the other two centers the drugs' efficacy was difficult to assess because symptoms were not marked (rated either as absent or light) at the beginning of the study. Thus the assessment of efficacy was based on 60 patients (centers 1 and 2), while the assessment of tolerability was based on the whole patient sample (n = 100). There was no statistically significant difference between the two compounds in terms of efficacy. A total of five patients in each of both groups complained of moderate untoward effects (all patients from the same center).
Adolescent↗
[Effectiveness and tolerance of the C3 convertase inhibitor, N-acetyl-aspartyl-magnesium glutamate with anti-allergic action. Results of a double-blind study].
N-Acetyl-aspartyl magnesium glutamate (Rhinaaxia, NAAGA) is a topically active antiallergic dipeptide. The compound acts in two different ways. On the one hand NAAGA inhibits the mast cell-degranulation, on the other hand this compound blocks the activation of the C3-convertase, subsequently followed by a blocked cleavage of the fragments C3a and C5a, respectively. 20 patients suffering from pollinosis were treated for 2 weeks according to a randomized double-blind placebo-controlled study. Besides subjective complaints nasal obstruction was objectively documented via rhinomanometria. 9 out of 10 patients under placebo had to use the rescue drug tritoqualine, a histidine decarboxylase inhibitor, compared to none in the verum group (p less than 0.01). After 14 days of treatment with NAAGA the nasal peak flow rate increased by 21.5 l/min and 21.8 l/min in the tritoqualine/placebo group, respectively (not significant). Nasal obstruction improved statistically significantly after 7 and 14 days of treatment in both groups. Tolerance was reported to be good in either group.
Adolescent↗
[Effectiveness and tolerance of the C3 convertase inhibitor, N-acetyl-aspartyl-magnesium glutamate in perennial rhinitis. Results of a double-blind, placebo-controlled study].
N-Acetyl-aspartyl magnesium glutamate (Rhinaaxia, NAAGA) is a new antiallergic substance for topical use. The compound covers a bilateral way of action. There is inhibition of the mast cell-degranulation and blocking of the C3-convertase, subsequently followed by a blocked cleavage of the fragments C3a and C5a, respectively. 20 patients suffering from perennial allergic rhinitis were treated according to a randomized double blind placebo-controlled study design. Apart from a nominal documentation of subjective complaints the degree of nasal obstruction was objectively rated via rhinomanometria. The nasal flow rate improved significantly in patients treated with NAAGA and subjective complaints decreased markedly. NAAGA showed to be well tolerated although 6 of 10 patients observed transient "nasal burning".
Adolescent↗
[NAAGA and cromoglycate. A comparison in the treatment of seasonal allergic rhinitis].
A multicentre double-blind clinical trial comparing two nasal solutions of naaga (magnesium salt of N-acetyl aspartyl glutamic acid-rhinaaxia) and of disodium cromoglycate (LOMUPREN) has been performed on 91 patients suffering from an acute symptomatic seasonal rhinitis treated for 28 days. Nasal, ocular and bronchial symptoms as well as side effects were recorded by the physician at the control visits and daily by the patient in a diary. Haematological parameters, blood chemistry and serum levels of non specific IgE were also measured. The results show: On the whole, there was no significant difference between groups, neither for the global appreciation of the therapeutic effect as assessed by the physician and the patient, nor for the daily evolution of the symptoms based on the patient's daily notebook. Both treatments were very well tolerated. In a selected population with IgE greater than 150 U/ml, there was a significantly better activity of naaga (p less than 0.05) on the disappearance of the ocular symptoms. The nasal symptoms appeared to improve significantly better in the cromoglycate group (p less than 0.05).
Adolescent↗
Binding of biosynthetic human insulin to erythrocytes of normal and insulin-dependent diabetic subjects: comparison with pork and human pancreatic insulin.
Biosynthetic human insulin (BHI) was compared with highly purified human pancreatic and pork insulin with regard to its ability to bind to erythrocytes of normal and insulin-dependent diabetic subjects (type I diabetes). The binding affinity or capacity of erythrocyte from both normal and diabetic subjects were comparable for biosynthetic and pancreatic human insulin. In contrast, binding of pork insulin to erythrocytes was significantly decreased at low insulin concentrations in normal as well as in diabetic subjects due to a reduced receptor affinity. The affinity of the "empty sites" was 5.25 x 10(-8) M-1 with pork insulin in normal subjects and 6.1 x 10(-8) M-1 in diabetic subjects; with both human insulins, the affinities were 6.9 x 10(-8) M-1 in normal subjects and 8.6 x 10(-8) M-1 in diabetic subjects. The number of insulin receptors per erythrocyte was calculated as being 30 in normal subjects and 35 in diabetic patients.
Animals↗