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Biomedical subjects

E Ullmer

Publications and source records attributed to E Ullmer.

15 recordsLinked to original sources
PubMed2001

Chest pain early after percutaneous coronary intervention: incidence and relation to ECG changes, cardiac enzymes and follow-up events.

To investigate the incidence of chest pain early after percutaneous coronary interventions and its correlation with ECG changes, cardiac enzymes, clinical and procedural variables and follow-up events, we prospectively studied 199 patients (84% male; mean age, 60.1 +/- 9.4 years) after primary successful percutaneous coronary interventions (21% PTCA; 79% additional stent implantation). During the first 16 hours following the intervention, the occurrence of chest pain was noted, ECGs were recorded and serial measurements of cardiac enzymes were performed. Seventy-six patients (38%) with elevated enzyme levels at time 0 were excluded. A clinical follow-up was obtained at 6 months. Forty patients (32.5%) experienced chest pain; new ECG changes were detected in 3 (2.5%). The mean levels of all enzymes were significantly higher in patients with chest pain 16 hours after the intervention. In patients with chest pain versus those without, CK-MB mass and troponin I levels higher than twice the upper normal limit were seen in 43.6% versus 11.0% (p < 0.0001) and 45.0% versus 17.3% (p < 0.002), respectively. Elevated troponin I (< 0.004) and CK-MB mass (< 0.04) as well as presumed ischemic chest pain (< 0.03) could be identified as risk factors for recurrent chest pain during follow-up. In conclusion, chest pain was common early after percutaneous coronary interventions and correlated with elevated cardiac enzymes, suggesting peri-interventional myocardial necrosis. Elevated levels of CK-MB mass and troponin I, as well as presumed ischemic chest pain, were associated with recurrent chest pain during follow-up.

Aged↗
PubMed2000

[From simple snoring to sleep apnea syndrome--clinical spectrum].

About 40% of adults are habitual snorers. 2% of women and 4% of men between 30 and 60 years of age present additional sleep disordered breathing. There is a continuous spectrum from simple to disease-causing snoring ranging from merely disturbing noises to pharyngeal obstructions and breathing pauses. Repetitive episodes of upper airway obstructions lead to frequent arousals from sleep. Sleep fragmentation is responsible for non-refreshing sleep and subsequent excessive daytime sleepiness resulting in reduced performance at work, social problems and a higher risk for accidents. Furthermore there is a correlation between arousals and cardiovascular abnormalities. Anatomic narrowing of the upper airway or hypotonia of the orpharyngeal dilator muscles favour collapse of the oropharyngeal walls. Obstructive sleep apnea syndrome is characterized by repetitive oxyhemoglobin desaturations during sleep recorded by pulseoximetry. Polygraphy quantifies the average number of apneas and hypopneas which occur during one hour of sleep (apnea-hypopnea index = AHI). In upper airway resistance syndrome (= UARS), upper airway resistance is increased, but pharyngeal obstruction is not complete. Saturation doesn't decrease significantly, but arousals with consecutive sleep disruption still occur. Polysomnography is a comprehensive study including EEG-, EOG- and EMG-recordings. Sleep stages and events can be scored to evaluate sleep architecture, sleep efficiency and sleep fragmentation.

Adult↗
PubMed2000

Granulomatous Pneumocystis carinii pneumonia in Wegener's granulomatosis.

This study reports on a first case of granulomatous Pneumocystis carinii pneumonia (PCP) in a human immunodeficiency virus-negative patient with antineutrophil cytoplasmic antibody-positive Wegener's granulomatosis whilst receiving immunosuppressive treatment. The patient presented with diffuse alveolar haemorrhage, pauci-immune rapid progressive glomerulonephritis and leukocytoclastic vasculitis of the skin. Granulomatous Pneumocystis carinii pneumonia developed under immunosuppressive treatment with cyclophosphamide and prednisone. At the time Pneumocystis carinii pneumonia developed, there was a marked lymphopenia with a very low CD8+ cell count in the blood. Grocott staining in bronchoalveolar lavage fluid revealed no Pneumocystis carinii. The diagnosis was made via a video-assisted thoracoscopic lung biopsy which showed granulomas containing high numbers of Pneumocystis carinii cysts.

Biopsy↗
PubMed1999

[Tobacco: ashes, smoke and carbon].

This review discusses the epidemiology, health effects and economic aspects of the tobacco epidemic. Smoking-related disorders have been known for decades and adverse effects of cigarette smoking are well documented. Nevertheless, tobacco use has increased dramatically in our century to become a global pandemic. Tobacco advertising attracts teenagers and encourages them to experiment with an addictive drug. To decrease uptake of smoking by adolescents, tobacco opponents propose advertising bans. They demand better protection for both active and passive smokers. These demands are in obvious contrast to the interests of the tobacco companies. Restriction of tobacco production and marketing could result in a substantial decrease in profits for tobacco manufacturers. Therefore, bills or regulations to control nicotine products are resisted by a strong tobacco lobby, especially in the USA. This article explains the marketing strategies of the tobacco industry and cost calculations of smoking. We describe preventive measures not only to stop adolescents taking up smoking but also to promote successful nicotine cessation.

Cause of Death↗
PubMed1999

[Etiology, diagnosis and therapy of COPD].

COPD is a disorder characterized by chronic exspiratory airflow limitation in patients with chronic bronchitis and/or emphysema. The obstruction is generally progressive, but may be partially reversible and may be accompanied by airway hyperreactivity. In this review we discuss the epidemiology, Pathophysiology, clinical features, diagnostic approaches and therapeutic management in patients with COPD. Cigarette smoking is the main risk factor for the development and progression of COPD; environmental or occupational exposure to dust or fumes and genetic factors are further contributing factors. Therefore, smoking cessation is the most important therapeutic approach. Better knowledge of neutrophilic inflammation led to the development of new drugs for the treatment of COPD. The new long-acting inhaled beta 2-agonists fundamentally improved antiobstructive therapy. They are useful to control night-time or early morning symptoms. The role of steroids and theophylline is still unclear. Their value and efficient use are discussed.

Administration, Inhalation↗
PubMed1998

[Pleural effusion: what next?].

This article gives an overview of the aetiology, diagnostic evaluation and treatment of pleural effusions. A systematic approach including radiological and sonographic examinations and pleural fluid analysis is proposed with a view to selecting the most appropriate therapy. Common forms of exudative pleural effusions are explained in detail. For complicated parapneumonic effusions, new therapeutic options such as the use of fibrinolytics or thoracoscopic debridement are discussed. Talc slurry and thoracoscopic talc poudrage provide effective methods for pleurodesis in case of malignant effusions.

Diagnosis, Differential↗
PubMed1991

AuthorBase: a database of authoring systems software.

A working prototype database of authoring system software was developed as part of a study of authoring software conducted by the National Library of Medicine. The database and development issues ranging from the scope of the database to what information to document are described. The protype demonstrates that records of reasonable integrity can be derived from vendor supplied information as long as users understand the database is only an initial starting point in searching for authoring software and a resource for becoming generally familiar with the technology.

Authorship↗
PubMed1989

The activity of GD3 synthase modulates the ganglioside pattern in rat liver.

Variations of the ganglioside composition in the livers of Wistar rats correlated with the activity of GD3 synthase in the corresponding liver homogenates. With increasing enzyme activity, higher proportions of b-series gangliosides (GD3, GD1b, GT1b) were detected. No significant changes in the activity of GM2 synthase or GM1 synthase were observed, indicating a regulatory function for GD3 synthase in this tissue. Young animals showed an average GD3 synthase activity of 0.5-0.6 nmol.h-1.mg protein-1 without sex-dependent variations. Among the older animals, however, males expressed an activity five-fold higher than females, suggesting that this enzyme might be affected by hormones.

Aging↗