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Biomedical subjects

E Decker

Publications and source records attributed to E Decker.

At least 19 recordsLinked to original sources

Vital microorganisms in early supragingival dental plaque and in stimulated human saliva.

The aim of this study was to compare the percentage of vital microorganisms (= microbial vitality) of saliva with that of supragingival plaque both collected at various times during the early phases of de novo plaque formation. Between intervals of optimal oral hygiene, 14 healthy participants refrained from all oral hygiene measures for periods of 1, 4, 8 and 72 h. Stimulated whole saliva was collected at the beginning (= baseline) and the end of each period. Vestibular plaque was removed from teeth 13-16, and 23-26. Analysis of the pooled plaque (p) and saliva (s) samples comprised the total number of bacterial counts and colony-forming units to estimate the percentage of viable microorganisms (PEp; PEs). The microbial vitality (VFp; VFs) was determined by using a fluorescence staining to differentiate vital from dead bacterial cells. The bulk of the PEs values reached 5-30%. At baseline VFs ranged between 70% and 90%. The VFs values recorded at baseline or in the presence of 1 h and 4 h-old plaque, were significantly (alpha = 0.05) higher than the corresponding VFp values ranging from 5% to 30%. It was concluded that there is a considerable discrepancy between the microbial vitality of a very early dental plaque and that of whole surrounding saliva sampled at the same time. Unfavourable local environmental conditions prevailing at cervical tooth surfaces are suggested to restrain the survival of the majority of the first bacteria adhering to a particular tooth area during the early phases of supragingival plaque formation.

Adult

[Spinal tuberculosis].

The cases of 32-year-old man and 42-year-old women are presented. Their history illustrates difficulties in the diagnosis of tuberculosis of the vertebral column. The patients suffered significant pains in the lumbar region lasting one year. Despite the presence of some abnormalities in lumbar vertebrae on x-rays no examinations were ever performed to establish the diagnosis. Lumbago and osteoporosis were considered as the cause of complaints. Aetiology was confirmed only when patients developed disseminated tuberculosis of the lungs. Antituberculous chemotherapy was successful and brought a fast improvement in general status of the patients.

Adult

[Are lung choriocarcinoma and giant cell carcinoma producing chorionic gonadotropins just variants of the same neoplasm?].

An article presents two cases of choriocarcinoma lung metastases. One case revealed the primary mediastinal choriocarcinoma and the second one had unknown primary localisation of the tumor, which could be suggestive of a spontaneously regressed primary gonadal choriocarcinoma. Authors discuss the clinico-pathological aspects of extragonadal choriocarcinomas, theories of their histogenesis and the morphological similarities to anaplastic giant cell lung carcinoma.

Adult

[A case of bronchial carcinoid diagnosed after 21 years of recurrent lung infections].

A case of 59 year old woman with a 21 year history of recurrent pneumonias of the upper left lobe is presented. When she at last agreed for the diagnosis her chest X-rays revealed atelectasis and cirrhosis with bronchiectases of the left lung. Tumor of the left main bronchus and severe inflammation of the surrounding mucosa with purulent secretion were found during bronchofiberoscopy. The patient underwent left pneumonectomy. Histological examination of the specimen revealed presence of carcinoid in the main left bronchus without involvement of the regional lymphnodes, with signs of irreversible damage of other bronchi and pulmonary tissue. The very long period of observation since the first symptoms, no metastases in the bronchopulmonary lymphonodes and no distant metastases indicate the low-grade malignancy of the carcinoid in the presented case.

Bronchial Neoplasms

Risk of late recurrence and/or second lung cancer after treatment of patients with small cell lung cancer (SCLC).

The aim of this study was to illustrate some difficulties in distinguishing late recurrence of small cell lung cancer (SCLC), from second primary lung cancer. Three-hundred fourteen SCLC patients were observed at the Institute of Tuberculosis and Chest Diseases in Warsaw, during the period 1976-1985. All patients were treated with chemotherapy and 125 were also treated with radiotherapy on the tumour and mediastinum. Nineteen patients (6%) survived 3 years. This group consisted of eight females (9%) and 11 males (5%). In all of them a complete remission was obtained. In six patients from this group no progression of lung cancer was observed. Four of them are still living, 7.9-16.2 years after the start of treatment. Two patients died of heart infarct. In the remaining 13 patients, progression of SCLC or development of new cancer was noted in the course of observation. In seven of them, histological proof of the character of progression was obtained. In four cases non-small cell lung cancer (NSCLC) was diagnosed after 3-11 years of observation. In one of them SCLC metastases in the liver were unexpectedly found in the autopsy, although adenocarcinoma in the lung diagnosed during bronchoscopy was also confirmed in the autopsy. In three cases SCLC was diagnosed. In one case, 2.7 years from the beginning of treatment, only SCLC metastases were found during laparoscopy. SCLC was found in two other cases after a 7-year cancer-free period. In one of those patients, a new lesion was found in the other lung while the second patient developed a new lesion exactly in the place of the former cancer. In six other patients no histological proof of the character of progression was obtained. Two of the six are still living, 8.2 and 15.1 years later. In the first of these two, a new lesion developed very early in the course of treatment in the same place as the primary tumour and it was regarded as the progression of SCLC. In the second patient, who probably had NSCLC the lesion developed in the contralateral lung after 12.5 years of remission and disappeared after radiotherapy. Four patients died of cancer after 3.2-6.4 years of observation. The cumulative risk of a second primary lung cancer after a 3-year survival period oscillated in our SCLC patients between 4% and 6% for every patient/year of observation. It was concluded that prognosis in SCLC patients is still doubtful, nevertheless, some patients made a complete recovery.

Adult

Brachial plexus injury caused by impalement.

Open injuries of the brachial plexus are rare. One such case, that of a 68-year-old impaled on a fence spike, is presented here. Certain principles to guide evaluation and treatment are discussed. Concomitant injury to the pleura or to vascular structures requires immediate attention; the extent and type of plexus damage may be determined from physical findings and the nature of injury. The results of plexus reconstruction are variable and routine exploration may be detrimental. The Brooks classification is reviewed.

Aged

Effect of controlled release salbutamol on nocturnal cough in asthma.

Sixteen asthmatic children completed a double blind placebo controlled crossover study of controlled release salbutamol (CRS) to assess its efficacy in controlling night time cough. Children with asthma were enrolled into the study on the basis of a history of persistent cough confirmed by two overnight tape recordings at home. Outcome was measured by two overnight tapes on each medication. Other treatment was unaffected. There was no significant fall in cough counts on CRS. Median scores were 14.5 and 12.0 coughing episodes per night for CRS and placebo respectively. Mean overnight oxygen saturation was identical in both treatment periods but morning peak flow showed a trend towards improvement on CRS. Treatment with CRS does not have a significant effect in control of night cough although it may improve objective measurements of lung function.

Adolescent

[Many-year observations of 4 cases of Wegener's granulomatosis].

Four cases of Wegener's granulomatosis were presented. Pathologic lesions and symptoms were observed in numerous organs but in all patients upper airways, lungs and kidneys were involved. Patients were observed from 3 to 12 years and two patients are still alive after more than 10.5 years.

Adolescent

[Wegener's granulomatosis--evaluation of diagnostic problems and the progress in its treatment based on the review of 54 cases published in Poland in 1959-1990].

54 cases of Wegener's granulomatosis published in Polish literature in 1959-1990 are presented. There were 37 women and 17 men from 17 to 70 years of age. The diagnosis was histologically proved during life in 30 cases and by autopsy in 14 others. In 10 patients it was based on clinical symptoms only. Diagnosis was established after 1 months to 4 years of symptoms, mean equals 10.3 months. The delay of diagnosis was caused by the ineffectiveness of biopsy, usually from the upper airways and also by the wrong interpretation of histopathological pictures. All patients had upper airways disease, 56% of patients had lung involvement, 66% renal lesions, 37%--eye changes, 35% skin lesions and 11%--nervous system involvement. In addition in 83% of patients systemic symptoms were observed. The prognosis of WG ameliorate with the time of publications due to cyclophosphamide and other cytotoxic drugs introduction to WG treatment.

Adolescent

Growth of abused children. Contrasted with the non-abused in an urban poor community.

While the identification of a growth-retarded or otherwise undernourished child suggests a diagnosis of child abuse or neglect, it is not certain that abused children from poor communities are less well nourished than children living in similar environments. The setting of this study--day care centers in an urban poor city--provided an opportunity to make this comparison with appropriate community-based controls. Measures of height, weight, and weight/height (Body Mass Index (BMI] were compared for 196 children, 2 to 6 years of age, 53 of whom were victims of physical abuse. The data was adjusted for age, sex, and ethnicity using logistic regression analysis to determine occurrence of wasting (weight for height less than 5th percentile) and stunting (height for age less than 5th percentile). Significantly more abused children (16.3%) showed wasting as compared to non-abused (0.7%) with abused children 16.6 times more likely to show wasting than non-abused (95% confidence limits on the Odds Ratio 1.9-145.0). While 11.6 percent of abused children showed stunting compared to 5.6 percent of non-abused, this difference was not significant when the data was adjusted for demographic factors. The BMI (15.02 kg/m2) for abused children was significantly less than that (15.9 kg/m2) for non-abused children (F = 8.11; p = 0.0049). In the present study, significant wasting as seen in acute malnutrition was found among abused children at diagnosis, suggesting that within an urban poor community the growth of children so identified does differ from the growth of children who are not abused.

Child

Early adolescent pregnancy: a comparative study of pregnancy outcome in young adolescents and mature women.

Thirty-two adolescents were matched to mature controls for a study of variables known to influence the course and outcome of pregnancy. These included: ethnicity; clinic payment status; year of delivery; parity; and presence or absence of alcohol and tobacco use. The comparative factors examined included: age of menarche; gynecologic age; admission hemoglobin; prepregnant weight and height; weight gain during pregnancy; complications of pregnancy; length of gestation; birth weight; 1- and 5-minute apgar scores; and the presence or absence of congenital defects. There was no significant difference between young adolescents and matched controls in infant birth weight or apgar scores when the above confounding factors were controlled. Young gravidae, however, had significantly shorter gestations, earlier menarche, lower hemoglobin levels, and poorer weight gain during pregnancy than mature women. Multiple-regression analysis suggests that 1) pregnancy weight gain was associated with the trimester the gravida enrolled in the Supplemental Food Program for Women, Infants, and Children (WIC) (p = 0.008) and maternal stature (p = 0.012); 2) length of gestation was associated with maternal stature (p = 0.022) and prepregnant weight (p = 0.011); and 3) maternal hemoglobin was associated with birth weight (p = 0.087). Alternative interpretations are discussed.

Adolescent