Biomedical subjects

E Claus

Publications and source records attributed to E Claus.

16 recordsLinked to original sources

PubMed2001

The chemistry and biology of ratjadone.

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Antineoplastic Agents, Phytogenic↗

PubMed2001

The first total synthesis of +-ratjadone.

The first total synthesis of ratjadone was achieved using a highly convergent approach joining three subunits together with a Wittig olefination and a selective Heck reaction as the pivotal steps. Besides establishing a robust and reliable route for the synthesis of this orphan ligand, the configuration of unknown stereocenters could also be determined. This synthesis not only provides an additional access to a biologically important compound but also enables the synthesis of structural analogues for biological target identification.

Models, Chemical↗

PubMed1996

Does multiple risk factor reduction explain the reduction in fall rate in the Yale FICSIT Trial? Frailty and Injuries Cooperative Studies of Intervention Techniques.

In a recent study of fall prevention in 301 community-living older persons (the Yale FICSIT Trial, 1990-1993), participants in the multifactorial targeted intervention (TI) group experienced significantly fewer falls than participants in the social visit (SV) control group. In the present paper, the authors explore the relation between changes in the studied risk factors and the occurrence of falling. In comparison with SV participants, TI participants showed significantly greater improvements in postural blood pressure change (p = 0.01), step length (p = 0.004), use of > or = 4 medications (p = 0.003), and unsafe tub and toilet transfers (p = 0.05), while change in balance was of borderline significance (p = 0.08). Reduction in the occurrence of falling, in turn, was at least marginally associated with improvements in balance, postural blood pressure change, step length, lower extremity strength/range of motion, and transfers. When participants were divided into tertiles based on a composite risk factor change score, a significantly higher percentage of TI participants (42%) than SV participants (22%) were in the greatest risk factor reduction tertile. Among TI participants, there was a progressively lower fall rate per person per year in the tertiles with the least, intermediate, and greatest risk reduction (0.832, 0.624, and 0.260), respectively. A similar but weaker relation between risk factor reduction and fall rate was seen in the SV group. When compared within tertiles, essentially adjusting for the amount of risk factor reduction, the fall rates among TI and SV participants in the greatest risk factor reduction tertile were identical (0.260 falls per person per year), and the rates in the least reduction tertile were similar (0.832 vs. 1.040 falls per person per year); this suggests that risk factor reduction at least partially mediated the treatment effect. These results support the feasibility of implementing and analyzing the effectiveness of a multiple risk factor reduction strategy in the aged.

Accidental Falls↗

PubMed1995

Risk factors for serious injury during falls by older persons in the community.

BACKGROUND: Serious fall injury represents a little studied, yet common and potentially preventable, cause of morbidity and mortality among older persons. We determined the frequency of, and risk factors for, experiencing serious fall injury events among older persons in the community. SUBJECTS: A representative sample of 1103 community-living persons aged 72 years and older underwent comprehensive baseline and 1-year evaluations. MAIN OUTCOME MEASURES: During a median 31 months of follow-up, fall data were obtained using fall calendars. Injury data were obtained from telephone interviews and from surveillance of emergency room and hospital records. RESULTS: At least one fall was experienced by 546 (49%) participants. A total of 123 participants, representing 23% of fallers and 12% of the cohort, experienced 183 serious fall injury events. The factors independently associated with experiencing a serious injury during a fall included cognitive impairment (adjusted odds ratios 2.2; 95% confidence interval 1.5, 3.2); presence of at least two chronic conditions (2.0; 1.4, 2.9); balance and gait impairment (1.8; 1.3, 2.7); and low body mass index (1.8; 1.2, 2.5). In a separate analysis, including only subjects who fell, female gender (1.8; 1.1, 2.9) as well as most of the above factors were associated with experiencing a fall injury. CONCLUSIONS: Several readily identifiable factors appeared to distinguish the subgroup of older fallers at risk for suffering a serious fall injury. These factors should help guide who and what to target in prevention efforts.

Accidental Falls↗

PubMed1994

[Sore throat patients as the topic of a general practice quality circle. Determination and development of a practice guideline. Quality Assurance Study group for General Medicine].

UNLABELLED: The present paper describes the institutionalization of a general practitioners' quality circle and the development of management guidelines for the treatment of patients with sore throat. Doctors participating: An invitation to attend an "information meeting" on the subject quality control and a quality circle sent to 200 general practitioners and internists, evoked a response by 18 physicians, ten of whom participated in the first meeting of the quality circle. Practical procedure: Stocktaking of the procedure in the doctor's office on the basis of a documentation questionnaire, the discussion of a video of the counselling of a patient with a sore throat, interviews with patients and the personal experience of the participating physicians was compared with a current analysis of the literature. The results of the comparison were taken as a basis for the development of management guidelines following the Dutch NHG Standard (Nederlands-Huisartsen-Genootschap-Standarden). RESULTS AND CONCLUSIONS: A wide variation was found in the treatment offered to patients with sore throats in the doctor's office. Deviation from text book information does not indicate a priori any quality deficit in the GP's practice. With respect to the management guideline worked out, it was agreed that in the individual case, a wellfounded deviation can be justified.

Family Practice↗

PubMed1989