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Biomedical subjects

H Oster

Publications and source records attributed to H Oster.

At least 19 recordsLinked to original sources

[Traumatological risk in ambulatory cardiological rehabilitation].

BACKGROUND: In Israel in 1956 Gottheiner introduced outpatient rehabilitation programs in patients who had survived a myocardial infarction. In Germany one decade later these WHO phase III activities were established as well. At present any patient with cardiovascular disease is included unless suffering from acute illnesses or presenting with symptoms at rest. Gymnastics, stretching and the "historic" volleyball are completed by jogging, soccer, basketball and anaerobic exercise. Thus, a notable trauma rate would be expected especially in the elderly and those who are on anticoagulation. METHODS: A retrospective analysis evaluated questionnaires of 903 patients in 116 outpatient coronary care groups covering approximately equal to 270,000 patient exercise hours. RESULTS: 101 of 123 injuries (approximately equal to 1/2 200 patient exercise hours) occurred during games the majority of which having been distortions (53.7%), hematomas, or bruises (15.4%). Severe traumas included bone fractures (11.4%) and ruptured muscles, tendons, or ligaments (12.2%). One patient lost the sight of one eye due to a broken spectacle frame. Patients who had felt exercise as too exhausting (p < 0.001) or complained of cardiovascular symptoms (p < 0.01) showed a significantly elevated trauma rate. CONCLUSIONS: Thus, in outpatient cardiac rehabilitation the trauma rate is within the range of healthy sports men. To prevent injuries sports should be limited to the patient's level of activity. Improved skills in techniques and strategies as well as unbreakable glasses are recommended.

Aged

Effects of psychologic intervention on psoriasis: a preliminary report.

BACKGROUND: Case reports have indicated that psychologic treatments may have a beneficial effect on psoriasis activity. OBJECTIVE: Our purpose was to further investigate the hypothesis that psychologic intervention has a beneficial effect on psoriasis activity in a blinded, controlled manner. METHODS: Fifty-one patients with psoriasis vulgaris were randomly assigned to a treatment or a control group. Patients in the treatment group participated in seven individual psychotherapy sessions in 12 weeks. Intervention techniques included stress management, guided imagery, and relaxation. The Psoriasis Area Severity Index (PASI), Total Sign Score (TSS), and Laser Doppler Skin Blood Flow (LDBF) of a selected reference plaque was measured in a blinded fashion at baseline (week 0), week 4, week 8, and after treatment (week 12). RESULTS: Slight, but significant, changes in TSS and LDBF were found in the treatment group but not in the control group. When analyses were performed for both groups separately, the treatment group displayed significant reductions for all three psoriasis activity measures, whereas no changes were seen in the control group. CONCLUSION: Our preliminary results suggest that psychologic intervention may have a moderate beneficial effect on psoriasis activity.

Adult

Hearing loss in Turner syndrome.

A retrospective study was undertaken to answer the following questions: Is the sensorineural hearing loss (SNHL) in Turner syndrome progressive? Can the occurrence of hearing loss be explained by the parental origin of the intact X chromosome? Twenty-four individuals recruited through the Turner Syndrome Society completed a questionnaire and submitted sufficient medical records to determine their otologic status. The majority (21/24) have had problematic otitis media (OM), and two thirds (16/24) have SNHL. In seven of the Turner subjects (age range: 12 to 51 years), gradual progressive SNHL began in late childhood or early adulthood. Molecular techniques showed no correlation between parental origin of the retained X chromosome and hearing status in 17 Turner subjects and at least one of their parents. SNHL and frequent OM appear to be independent variables that are both present in Turner syndrome. It is postulated that the presence of unpaired genes on the X chromosome may account for hearing loss and other phenotypic abnormalities seen in this syndrome.

Adolescent

Cost of medical care for postoperative spinal infections.

The movement towards managed care has raised the awareness of health care costs in today's society. The additional expense involved in treating patients with deep postoperative spinal infections after lower back fusion increases the total cost of care more than four times. Three areas of greatest increase in cost are room and board, pharmacy and laboratory charges. Decreasing the expense of this complication can best be effected through use of home nursing care, choice, and duration of antibiotic treatment and prudent laboratory testing.

Adult

Smiling and fussing in seven-month-old preterm and full-term black infants in the still-face situation.

We investigated emotional responses to the still-face paradigm in 7-month-old preterm and full-term black infants. Baby FACS criteria were used to code the duration and intensity of infant smiles and the presence or absence of cry faces and fussy vocalizations within each episode. Infants in both groups showed the still-face effect: a significant reduction in smiling from episode 1 (baseline) to episode 2 (maternal still-face) and partial return to baseline in episode 3 (recovery). A multivariate analysis of covariance (MANCOVA) for big smiles yielded significant main effects for group and episode and a significant group x episode interaction. Preterm infants spent less time than full-term infants displaying big smiles in episode 1 and a less pronounced decrease in big smiles in episode 2. Maternal depressive symptoms did not differ significantly between groups. Counter to our expectations, depressive symptoms were positively associated with small-to-medium smiles in the baseline episode but not with big smiles in any episode. These findings confirm the robustness of the still-face paradigm and its potential usefulness for research on individual as well as group differences in affective communication in infants.

Affect

Effects of hypnotic suggestions on ultraviolet B radiation-induced erythema and skin blood flow.

Results from both animal and human studies have indicated that inflammatory skin reactions such as the flare response to histamine prick test involve a neurogenic regulatory component. It is still unknown to which degree inflammation induced by ultraviolet (UV) radiation may be mediated by the central nervous system. To investigate this, the effect of hypnotic suggestions to increase and decrease the response to UVB radiation on erythema and cutaneous blood flow was investigated in 10 highly hypnotizable subjects. The results showed a significant effect of hypnotic suggestions on cutaneous blood flow compared with the responses of a control group. For erythema no conclusive evidence was found. The results indicate the possibility of separate regulatory mechanisms behind central nervous system influence on UVB-induced erythema and skin blood flow respectively, and further investigations are needed.

Adult

[Capillary hemangioma of the heart: a case report].

In a 52-year-old man, within the left ventricle, a globular mass 1.5 cm in diameter was detected incidentally by echocardiography. Selective coronary angiography showed a mobile patch of hypervascularity suggesting the vascular nature of the cardiac mass. The patient was operated and a pedunculated tumor originating from the anterolateral papillary muscle was removed. Histological examination revealed a benign capillary hemangioma. Six months after surgery the patient was reevaluated by echocardiography. There was no evidence of tumor recurrence.

Coronary Angiography

[Reopening of chronic coronary occlusions--initial references for prognostic indications].

Today indication for percutaneous transluminal coronary angioplasty is based on typical chest pain and objective signs of myocardial ischemia during exercise. Especially in chronic coronary occlusions, however, prognostic implications may play an increasing role in the future. The case report describes long-term follow-up of a patient in whom a chronic complete occlusion of the right coronary artery could be reopened successfully back in September 1988. At this time, the peripheral part of the occluded RCA was filled retrogradely by septal collaterals from the LAD. After reopening the patient remained symptom-free for more than two years. In January 1991 again severe angina recurred and ECG showed a non-transmural anterior myocardial infarction. The LAD was occluded proximal and the peripheral part was filled retrogradely by septal collaterals coming from the right coronary artery which was still open (flow reversal). Left ventricular function was only slightly impaired and the LAD occlusion could be reopened successfully too. The case suggests that prognostic implications should be taken into consideration in addition to symptoms especially in complete coronary occlusions.

Aged

Olfactory identification deficits in Down's syndrome and idiopathic mental retardation.

We investigated olfactory identification in children and adults with Down's syndrome (DS) and idiopathic mental retardation (IMR) and in age-matched normal controls (NC). Identification was assessed with a four alternative-forced-choice task modified from the University of Pennsylvania Smell Identification Test (M-UPSIT) and a yes/no task yielding measures of discrimination and response bias for the same stimulus material. Control tactile identification tasks were also administered. Results were that odor identification performance on both tasks was specifically impaired in DS compared to IMR and NC. Accuracy of identification on the M-UPSIT correlated inversely with age in DS only. When uncertain, DS and IMR subjects guessed "yes" more often than "no" on the Yes/No task (liberal decision bias) and guessed the last response alternative on the M-UPSIT (recent position bias), whereas the normal subjects had neutral decision bias on the Yes/No task and matched the objective position presentation probabilities on the M-UPSIT. Decision bias correlated with accuracy of identification in both tasks for the DS subjects only.

Adolescent

[Coronary bypass with arteries].

The internal mammary artery (IMA) and the right gastroepiploic artery are increasingly used for myocardial revascularization. The postoperative results are much better than those of the saphenous vein regarding mortality, patency rate, and relief of symptoms. The IMA can be used as an in-situ-graft or as a free transplant, either as a single graft or using sequential anastomoses. Ten years postoperative 90% of the IMA-bypasses are patent and risk of reoperation is significantly lower in patients with IMA-grafts. From August 10, 1989 until January 31, 1991, 1515 patients were operated for coronary artery disease in our center. There were 1219 men and 296 woman with a mean age of 58.9 years (26-83 years). In 1050 patients (69.3%), either one or both IMA-arteries were used. 75% of the men and 47.7% of the women received an IMA-graft. 981 patients had an in-situ-graft, and in 69 patients the IMA was used as a free transplant. In 74 cases both IMAs were used. In 315 patients sequential anastomoses with one IMA and several coronary arteries were performed. According to our experience, the IMA is an ideal bypass conduit and should be used predominantly.

Coronary Angiography

Multiple-dose safety study of ibuprofen/codeine and aspirin/codeine combinations.

This multiple-dose, double-blind, placebo-controlled, randomized, normal volunteer study compared formulations of ibuprofen/codeine and aspirin/codeine for systemic safety. Vital signs, hematologic, biochemical and urinary parameters, side effects, mood and mental alertness, were monitored. The placebo group had less gastrointestinal side effects and more frequent stools than the active treatment groups. There was statistical evidence for greater adverse effects of aspirin/codeine on mood and mental alertness in comparison to ibuprofen/codeine and placebo. Ibuprofen/codeine had a more favorable adverse effect profile than aspirin/codeine. A mild respiratory and cardiac depressant effect attributable to codeine was evident in all active treatment groups after 7 days of frequent therapy. More work needs to be done to elucidate the factors regulating the development of tolerance to the respiratory and cardiovascular depressant effects of opiates in general, and for codeine in particular.

Adult

Differential facial responses to four basic tastes in newborns.

The distinctiveness and recognizability of taste-elicited facial expressions in newborns were examined in 2 studies. Sucrose, sodium chloride, citric acid, and quinine hydrochloride solutions were presented to 12 infants at 2 hours of age. In Study 1, the anatomically based Facial Action Coding System adapted for infants (Baby FACS) was used to obtain detailed, objective descriptions of the infants' videotaped facial responses to each solution. Facial responses to sucrose were characterized primarily by facial relaxation and sucking. The responses to salty, sour, and bitter solutions shared the same hedonically negative upper- and midface components but differed in the accompanying lower-face actions: lip pursing in response to sour and mouth gaping in response to bitter. There was no distinctive facial expression for sodium chloride. These findings demonstrate that newborns differentiate sour and bitter from each other and from salt, as well as discriminating sweet versus nonsweet tastes. In Study 2, untrained adults viewing videotapes of the infants' facial reactions made forced-choice judgments identifying the stimuli presented and rated the hedonic tone of the infants' responses. While the judges accurately identified the newborns' responses to sucrose, there were systematic errors in their judgments of the 3 nonsweet stimuli. The judges' hedonic ratings, on the other hand, clearly differentiated between the infants' responses to the bitter stimulus and the other 3 tastes. The findings are discussed in terms of the possible functional origins and communicative value of taste-elicited facial expressions in infants.

Discrimination Learning

[Coronary spasm immediately following coronary revascularization].

Of 2,600 coronary operations performed from August 1983, to December 1988, two ischemic reactions of the inferior wall immediately after operation were observed. In both patients the right coronary artery was either dissected or revascularized intraoperatively. Under the diagnosis of postoperative spasm both patients had reangiography three hours after surgery. Right coronary artery spasm was demonstrated in both patients. After intracoronary injection of calcium channelblockers the spasm resolved completely. Patient 1 demonstrated a small inferior infarction during control angiography, patient 2 remained free of a myocardial infarction. The possible causes of coronary spasm during or after surgery are discussed. The diagnosis and an approach to therapy are outlined.

Coronary Artery Bypass

Use of the left internal thoracic artery to correct a left main coronary atresia.

Dyspnea with a slightly enlarged heart was noticed in a five year old girl at a checkup. The cardiological investigation revealed an enlarged left ventricle with slight mitral regurgitation. The right coronary artery was enlarged and filled the entire left arterial system via collaterals. The left main coronary artery could not be detected. In addition, outflow of contrast medium into the large vessels was absent. With the diagnosis of left main coronary atresia, the left internal thoracic artery was implanted on to the proximal left anterior descendent in October 1985. In the control angiogram, the anastomosis conditions were normal, the left ventricle had decreased in size and contracted almost normally. The collaterals from the right could no longer be demonstrated. The child (now six years old) has full exercise tolerance today. In the ultrasonogram, the ventricle shows normal contraction behavior. Up to know, four cases with congenital main coronary atresia have been reported in the literature.

Child, Preschool

[Use of the mammary artery in coronary revascularization].

From August 1983 through December 1985 1088 patients underwent coronary surgery. 406 (37%) received a single or bilateral internal mammary artery (IMA) graft with single or sequential anastomoses. The youngest patient was 6 years old, the oldest 75, with a mean age of 55.7 years. A total of 672 IMA anastomoses was constructed. In addition 348 patients received 610 saphenous vein grafts. 83% of the IMA were anastomosed to the LAD and its branches, 12% to the circumflex and 5% to the right coronary artery. 4 patients (0.98%) died postoperatively, 402 survived and are free of angina. In our experience the IMA can be used routinely with low operative risk and good results.

Adolescent

The child's conception of food: differentiation of categories of rejected substances in the 16 months to 5 year age range.

Children (N = 54) ranging in age from one year four months to five years were offered over 30 items to eat. The items included normal adult foods and exemplars of different adult rejection categories: disgust (e.g. grasshopper, hair), danger (liquid dish soap), inappropriate (e.g. paper, leaf) and unacceptable combinations (e.g. ketchup and cookie). We report a high to moderate level of acceptance (item put into mouth) of substances from all of these categories in the youngest children. Acceptance of disgusting and dangerous substances decreases with increasing age, while acceptance of inappropriate substances remains at moderate levels across the age range studied. Although the youngest children accepted more disgust items, the majority rejected most of the disgust choices. Almost all children at all ages tested accept combinations of foods which, although individually accepted by adults, are rejected in combination. No significant differences were observed between 'normal' children and those with a history of toxin ingestion, although there was a tendency of ingesters to accept more inedible items. In general, the results suggest that a major feature of the development of food selection is learning what not to eat.

Adult

Thermographic evaluation of myocardial temperature during infusion of cold cardioplegia.

Delay in myocardial cooling during an infusion of cold cardioplegic solution may occur in patients with coronary artery disease. Forty patients with significant stenosis of the left anterior descending coronary artery (LAD) were divided into 3 groups according to the extent of the LAD stenosis. Group A consisted of 12 patients with 70% stenosis. Group B included 23 patients with 90% stenosis, and in group C there were 5 patients with LAD occlusion. Myocardial temperature was measured with a thermocamera during infusion of 2000 ml 8 to 10 degrees C cold Bretschneider's cardioplegic solution and compared to 10 other patients without coronary artery disease undergoing mitral valve replacement (group D). In group A the myocardium cooled to 15 degrees C after 4 1/2 minutes and to 12 degrees C after 10 minutes. In group B the myocardial temperature was 15 degrees C after 5 minutes and 12 degrees C after 10 minutes. In group C the temperature reached 18 degrees C after 5 minutes and 14 degrees C after 10 minutes. In group D the myocardial temperature was 12 degrees C after 3 minutes and 10 degrees C after 7 minutes. This study shows far better myocardial cooling rates in patients with unobstructed coronary arteries.

Body Temperature