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Biomedical subjects

G Stern

Publications and source records attributed to G Stern.

At least 37 records · Page 2Linked to original sources
PubMed1995

Lower urinary tract dysfunction in Parkinson's disease: changes relate to age and not disease.

Lower urinary tract symptoms are frequency report in Parkinson's disease. Whether these are causally related to Parkinson's disease rather than the known effects of age on the urinary tract is unknown. In this study we compared urodynamic data from 1864 women and 357 men with no neurological disease with data from 34 women and 42 men with Parkinson's disease, 96 women and 75 men with cerebrovascular disease and 42 women and 16 men with dementia. We examined isometric and isotonic detrusor contractile function and urethral outflow. Bladder capacity was reduced in both men and women with Parkinson's disease in comparison with patients of similar to that measured in patients without neurological disease and we found no evidence of obstruction in patients with Parkinson's disease. Disease-specific changes were not identified in patients with cerebrovascular disease or dementia. These findings contradict previous reports suggesting specific changes in lower urinary tract function in association with Parkinson's disease.

Aged↗
PubMed1995

Beyond the freedom to choose. Medicaid, managed care, and family planning.

In this article we examine the federal freedom-of-choice statute, which was enacted in the mid-1980s to protect Medicaid beneficiaries' access to timely and confidential family planning services. We also examine how these provisions have been implemented in 15 jurisdictions and provide a case study of 5 family planning programs. We found that this attempt to "carve out" family planning services from managed care has led to numerous problems. First, there is virtually no federal guidance concerning to which services and supplies the exemption applies. Second, there are no guidelines as to how carve-outs are to function. Therefore, if managed care systems are inaccessible or nonresponsive to reasonable community care seeking patterns, then a carve-out carve-out may be the only answer. Carve-outs should be used as a last resort, however, because they are so difficult to design.

Choice Behavior↗
PubMed1993

Platelet monoamine oxidase B activity in Parkinson's disease: a re-evaluation.

An increase in platelet monoamine oxidase (MAO) B activity in drug-free parkinsonians (n = 6) compared with healthy controls (n = 10) has been confirmed using both phenylethylamine (PEA) and dopamine as substrates, reaching statistical significance in the case of PEA oxidising activity (p < 0.05). Thus, certain reports of raised platelet MAO B activity towards PEA but decreased activity towards dopamine in parkinsonians, raising the possibility of the existence of an abnormal form of MAO B in this condition, cannot be supported.

Aged↗
PubMed1993

Die Pathoklise [Parkinson's disease].

The history of the concept of selective vulnerability of the basal ganglia with particular respect to the substantia nigra is briefly reviewed. During the past century attention has gradually focussed down from gross lesions of the basal ganglia through cell morphometry and presently to the level of the intracellular neurobiology. Despite an abundance of reported morphological and neurochemical changes it remains unresolved whether these findings indicate primary aetiological factors or secondary consequences of nigral cell death. In this debate, while MPTP has proven to be a most amenable model for the study of secondary parkinsonism it has not resolved the dilemma; equally uncertain are the claims derived from the MPTP hypothesis of nigral vulnerability that selective MAO inhibition has a protective effect on the natural history of Parkinson's disease. Some of the evidence, past and present, will be reviewed in so far that it reflects upon the concept of pathoclisis and the selective vulnerability of nigral cells and recent evidence from clinical trials and from the study of human foetal nigral cells in tissue culture will be presented.

Animals↗
PubMed1993

Preclamol and parkinsonian fluctuations.

Preclamol, the (-)enantiomer of 3-PPP (= 3(3-hydroxyphenyl)-N-n-propyl piperidine), has a selective dopamine autoreceptor- and postsynaptic mixed agonist-antagonist profile. Its action on patients with disabling on-off parkinsonian fluctuations has been studied and compared with those of placebo and subcutaneous apomorphine. Preclamol had a mild but unequivocal antiakinetic effect, less than that caused by subcutaneous apomorphine, but it provoked less dyskinesia. Further studies to explore the therapeutic potential of preclamol seem justified.

Antiparkinson Agents↗
PubMed1990

[The effect of the vertical bracket position on the orthodontic finish].

As during orthodontic treatment and in particular during the phase of the precise adjustment of occlusion by applying the "straight-wire technique" problems arise as far as the vertical dimensions are concerned, the usual distances between the bracket slots and the edges of the incisors respectively the top of the cusps have been verified. Measurements were done on models at the end of treatment of ten patients treated with fixed attachments who may represent ideal occlusion as far as profile radiographs and gnathology were concerned. After regulation of the plane of occlusion the vertical distances between the slot base plane (parallel to the plane of occlusion) and the edge of the incisors respectively tops of cusps were measured by means of a modified parallelometer in connection with a special slot and tube support as well as a specially developed dial test indicator, while a maximum fit between bracket base and buccal crown surface was given. In case of the upper front brackets (torque + 22 degrees) large vertical measurement to the edge of the incisors were recorded, 8.25 respectively 8.33 mm). This may be attributable to excessive torque of the applied brackets. Only approximate figures for the vertical positioning for other teeth could be given, as anatomical variations have to be considered.

Adolescent↗
PubMed1989

[Different applications of various wire alloys in fixed appliance technic].

Steel, beta-Titanium and NiTi archwires (0.016 inch) as well as twisted steel wires (0.0175 inch) were subjected to a bending test. The results were presented graphically. Steel (Tru-Chrome), beta-Titanium (TMA), the twisted steel wires and only one NiTi wire (Nitinol) showed linear force-deflection-diagrams. The other NiTi alloys showed a curved line with a constant force in the middle part. The superelastic wires delivered the same initial force, whether 2 or 4 mm activated. The larger the deformation the longer became the range with a constant force (superelasticity). With an activation of 1 mm a conventional force deflection diagram was found. The steel wire (Tru-Chrome) showed the steepest curve, followed by TMA, Nitinol, some superelastic wires, Twistflex and Respond as well as Pentacat. The last two wires showed an identical diagram. The NiTi-alloy Sentalloy yellow was comparable to Wild Cat, Sentalloy blue to Respond. Some examples of the application of the different arch wires in patients are presented.

Alloys↗
PubMed1988

Could Parkinson's disease follow intra-uterine influenza?: a speculative hypothesis.

Patients with idiopathic Parkinson's disease do not appear to be distributed smoothly with respect to year of birth. Individuals born within the years 1892, 1904, 1909, 1918, 1919 and 1929 appear to have had an increased risk of developing idiopathic Parkinson's disease in later life. These years are close to those of the influenza pandemics of the period 1890-1930. The estimated risk of an individual developing idiopathic Parkinson's disease shows a significant correlation with the crude influenza mortality for the year of his birth, within the range 1900 to 1930. It is suggested that intra-uterine influenza may be cytotoxic to the developing foetal substantia nigra, and that an affected individual may be born without evident disability but with limited striatal neurochemical reserves and a reduced nigral cell count. In later life normal cellular involution with ageing or exposure to environmental neurotoxic factors may further erode these reserves to a level where the substantia nigra fails and idiopathic Parkinson's disease becomes clinically apparent.

Aged↗
PubMed1987

Central stridor from an ependymoma.

Described herein is the case of one patient who presented with manifestations of an acquired obstructive hydrocephalus and hiccups. After shunting, this patient developed paroxysmal laryngeal stridor and other noises refractory to medications. At autopsy he was found to have a calcified ependymoma.

Cerebral Ventricle Neoplasms↗
PubMed1986

MPTP: clinical implications.

The concept of selective vulnerability of the basal ganglia is briefly reviewed historically, with respect to the possible implications of MPTP and also the possible protective effects of selective MOA inhibition in the treatment of Parkinson's disease.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine↗
PubMed1985

The symptoms of patients treated for Parkinson's disease.

One hundred and eighty-one patients with treated Parkinson's disease completed a self-administered questionnaire on symptoms, and their responses were compared with those of 263 control subjects randomly selected from a general practice population. Nine symptoms were reported by the patients with more than a fivefold excess when compared with the controls. These included jerking of the limbs, shaking of the hands, excessive salivation, poor mental concentration, grimacing, being frozen or rooted to the spot, and hallucinations. Compared with the general control population, the patients did not have an excess of stomach or limb pain, indigestion, headache, or any decrease of interest in sex. This observational survey, unlike a randomised controlled trial, could not ensure that the different treatment groups were comparable in important respects. However, certain associations were apparent; for example, patients receiving both a decarboxylase inhibitor and levodopa tended to report fewer attacks of being frozen to the spot, fewer problems with salivation, and a reduced frequency of defaecation. Patients receiving anticholinergic drugs reported an excess of dry mouth, faintness, and dyskinesia, and fewer hot flushes.

Adult↗