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Biomedical subjects

L Schmidt

Publications and source records attributed to L Schmidt.

At least 19 recordsLinked to original sources
PubMed1992

Gender disparities in treatment for alcohol problems.

OBJECTIVE: To examine women's access to treatment for alcohol problems in terms of the prevalence, characteristics, and treatment-seeking patterns of problem drinkers in a range of alcohol-specific and nonspecialized health care systems. DESIGN: In-person survey. SETTING: A Northern California county. PARTICIPANTS: Consecutive samples of admissions in public alcohol treatment (n = 381), drug treatment (n = 210), mental health treatment (n = 406), emergency health services (n = 2626), primary health clinics (n = 394), and adults in the county general population (n = 3069). PRIMARY OUTCOME MEASURES: Prevalence and relative risk (RR) of problem drinking and rates of alcohol-related treatment episodes. RESULTS: Rates of problem drinking were higher among men than women across all samples. However, after accounting for gender differences in general population rates, women in all of the non-alcohol-specific clinical samples were at greater risk than men for problem drinking (eg, RR = 5.6 for women and RR = 2.1 for men in the mental health sample). Men reported a greater variety in types of services sought in past alcohol-related treatment encounters, but women experienced greater symptom severity. CONCLUSIONS: Female problem drinkers were more likely than male problem drinkers to use non-alcohol-specific health care settings, particularly mental health treatment services, and to report greater symptom severity. Future research on women's access to services for alcohol problems should consider a range of health care systems and gender differences in seeking help.

Adolescent↗
PubMed1992

Pharmacokinetics of high-dose etoposide after short-term infusion.

The pharmacokinetics of high-dose etoposide (total dose, 2100 mg/m2 divided into three doses given as 30-min infusions on 3 consecutive days) were studied in ten patients receiving high-dose combination chemotherapy followed by autologous bone marrow transplantation. In addition to etoposide, all subjects received 2 x 60 mg/kg cyclophosphamide and either 6 x 1,000 mg/m2 cytosine arabinoside (ara-C), 300 mg/m2 carmustine (BCNU), or 1,200 mg/m2 carboplatin. Plasma etoposide concentrations were determined by 252Cf plasma desorption mass spectrometry. In all, 27 measurements of kinetics in 10 patients were analyzed. According to graphic analysis, the plasma concentration versus time data for all postinfusion plasma etoposide values were fitted to a biexponential equation. The mean values for the calculated pharmacokinetic parameters were: t1/2 beta, 256 +/- 38 min; mean residence time (MRT), 346 +/- 47 min; AUC, 4,972 +/- 629 micrograms min ml-1 (normalized to a dose of 100 mg/m2); volume of distribution at steady state (Vdss), 6.6 +/- 1.2 l/m2; and clearance (CL), 20.4 +/- 2.4 ml min-1 m-2. A comparison of these values with standard-dose etoposide pharmacokinetics revealed that the distribution and elimination processes were not influenced by the dose over the range tested (70-700 mg/m2). Also, the coadministration of carboplatin did not lead to significant pharmacokinetic alterations. Although plasma etoposide concentrations at the time of bone marrow reinfusion (generally at 30 h after the last etoposide infusion) ranged between 0.57 and 2.39 micrograms/ml, all patients exhibited undelayed hematopoietic reconstitution.

Adult↗
PubMed1992

A genetic linkage map of 96 loci on the short arm of human chromosome 3.

We constructed a genetic map of 96 loci on the short arm of human chromosome 3 (3p) in 59 families provided by the Centre d'Etude du Polymorphisme Humaine (CEPH). Twenty-nine continuously linked loci were placed on the map with likelihood support of at least 1000:1; one locus, D3S213, was placed on the map with likelihood support of 871:1; D3Z1, an alpha satellite centromeric repeat probe, was placed on the map with likelihood support of 159:1; 65 loci were assigned regional locations. The average heterozygosity of the uniquely ordered markers was 49%. The map extends from 3p26, the terminal band of 3p, to the centromere (from D3S211 to D3Z1). Multipoint linkage analysis indicated that the male, female, and sex-averaged maps extend for 102, 147, and 116 cM, respectively. The mean genetic distance between uniquely ordered loci on the sex-averaged map was 4.0 cM. Probe density was greatest for the region of 3p between D3F15S2e and the telomere. The sex-averaged map contained two intervals greater than 10 cM. Seventeen probes were localized by fluorescence in situ hybridization. The loci described in this report will be useful in building an integrated genetic and physical map of this chromosome.

Chromosome Mapping↗
PubMed1992

Length and variation in the menstrual cycle--a cross-sectional study from a Danish county.

OBJECTIVE: To investigate the current epidemiology of menstrual patterns among women of fertile age. DESIGN: Cross-sectional postal questionnaire study. SETTING: County of Copenhagen, Denmark. SUBJECTS: 3743 women, aged 15-44, selected at random from a Danish county, who were asked to provide information on menstrual pattern during the preceding year, 1981. The response rate was 78%. Information from non-responders was obtained via telephone interviews. RESULTS: In women with regular menstrual cycles, the 5th-95th centile range of usual cycle length decreased from 23-35 days in the 15-19 years age group to 23-30 days in the 40-44 years age group. Only 0.5% of regular menstruating women had a usual cycle length of less than 21 days and 0.9% had a usual cycle length of greater than 35 days. At least one cycle length of less than 21 days was experienced by 18.6%, whereas 29.5% had at least one cycle of greater than 35 days. Menstrual cycle variation of greater than 14 days was present in 29.3% of all women. Cycle length variation of greater than 14 days was 2.7 times more frequent in women from lower social groups (controlled by age). CONCLUSION: The study confirmed the normally used definitions of polymenorrhoea (cycle length less than 21 days) and oligomenorrhoea (cycle length between 36 and 90 days), as these very short or long menstrual cycle lengths were very seldom recorded for a longer period. However, the high frequency in a normal population of large menstrual cycle length variation challenges the view that an intra-individual variation of greater than 5 days should be regarded as a sign of disease in the woman.

Adolescent↗
PubMed1992

Secondary amenorrhoea: prevalence and medical contact--a cross-sectional study from a Danish county.

OBJECTIVE: To examine the prevalence of secondary amenorrhoea and the patterns of seeking medical advice for secondary amenorrhoea in an unselected population. DESIGN: Cross-sectional postal questionnaire study. SETTING: County of Copenhagen, Denmark. SUBJECTS: 3743 women, aged 15-44, selected at random from a Danish county who were asked to provide information on menstrual patterns for the preceding year, 1988. The response rate was 78%. Information from non-responders was obtained via telephone interviews. RESULTS: One-year period prevalence of secondary amenorrhoea of more than 3 months duration was 4.6% and was 7.6%, 3.0%, and 3.7% in women aged 15-24, 25-34, and 35-44 respectively. The duration of secondary amenorrhoea was 6 months or less in 75% aged 15-34 years, but longer than 6 months in 55% of those aged 35-44 years. A social gradient was found of the prevalence of secondary amenorrhoea (odds ratio 3.3, 95% CI 1.5-8.3) in the lowest social group compared with the highest social group; controlled by age. Only 39% of women with secondary amenorrhoea had contacted a doctor. Educational level or social status did not seem to influence the frequency of medical contact in women with amenorrhoea. CONCLUSION: Spontaneous return of the menstrual cycle occurs within 6 months in many amenorrheic women below the age of 35. The detailed investigation of secondary amenorrhoea in this age group can be postponed until it is of 6 months duration, unless there is clinical suspicion of disease. The relative infrequency with which women with secondary amenorrhoea seek medical advice constitutes an important source of selection bias in hospital-based clinical research on this topic.

Adolescent↗
PubMed1992

Rabbit esophageal cell cytoplasmic pH regulation: role of-antiport and-dependenttransport systems.

Regulation of cytoplasmic pH (pHi) of esophageal cells assumes importance as these cells can be exposed to mucosally absorbed acid during gastroesophageal reflux episodes. In this study, we examined whether esophageal cells possess pHi transport systems. Esophageal cells were harvested utilizing a gentle trypsin technique that yieldedcells per esophagus. Cells were attached to a glass cover slip that had been pretreated with rat-tail collagen, and pHi was measured continuously in a spectrofluorometer utilizing 2',7'-bis(2-carboxyethyl)-5(-6)- carboxyfluoroscein acetoxymethyl ester as a pH-sensitive fluorescent probe.The basal pHi of cells exposed to a-containing solution averaged 7.52 ± 0.20 (n = 6). The pHi declined slightly but not significantly to 7.46 ± 0.12 with the addition of 5%and 28 mMWhen H2 4,4'-diisothiocyanatostilbene- 2,2'-disulfonic acid (DIDS; 0.5 mM) was added, pHi was unchanged. However, addition ofM amiloride caused pHi to decrease to 7.29 ± 0.18 (P less than 0.01). When cells were acidified (pHi 6.3-7.0) using a(20 mM) pulse technique, pHi was rapidly restored toward neutrality in the presence of a-free externalconcentration ([]o)-containing solution (pH units/min = 0.26 ± 0.12; n = 8). Alkalinization was completely blocked withM amiloride. In the presence ofM amiloride, 28 mM, and 5%, acidified cells also alkalinized, although at a slower rate (0.11 ± 0.04 pH units/min; n = 16).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

A profile of problem drinkers in public mental health services.

Psychiatric patients with alcohol problems are generally considered more challenging to treat and more demanding of public psychiatric services than other patients. This study of new admissions to a county mental health system in California examined differences between problem drinkers and nonproblem drinkers in clinical and demographic characteristics and in the demands they placed on services. Problem drinkers experienced more severe emotional distress at intake; were more likely to have financial, legal, and employment problems; and were more likely to be involved with illicit drugs. They made greater demands on clinical resources and also required more social services, such as income supports, case management, and vocational services. The study indicates that to meet the varied needs of psychiatric patients with drinking problems, public mental health services should develop stronger ties not only with substance abuse services but also with social service and criminal justice agencies.

Adult↗
PubMed1992

Effects of the implementation of a smoke-free policy in a medical center.

The implementation of a smoke-free policy in this medical center was associated with a decrease in the prevalence of regular cigarette smoking from 16.7 percent to 13.8 percent and a smoking cessation rate of 22.5 percent among regular smokers over the 2 1/2 years since the policy was announced. This decrease in prevalence is the result of both smoking cessation among existing employees and less frequent regular smoking among new employees. At two-year follow-up, the policy was overwhelmingly endorsed by medical center staff overall but was viewed less favorably by those who continued to smoke. Nevertheless, over the 2 1/2 years, many of these smokers have been in the action stage of cessation (37.1 percent made a serious attempt to stop smoking, 20.7 percent had used nicotine polacrilex in a smoking-cessation effort, and 13.8 percent had attended a formal cessation program). The implementation of a smoke-free policy has made a significant contribution toward providing a healthful work environment and toward encouraging nonsmoking behavior in staff and patients.

Adult↗
PubMed1992

Cough induced by ACE-inhibitors. A kinin related phenomenon?

Cough induced by ACE-inhibitors may be related to bronchial hyperreactivity and/or to an accumulation of kinins. In a placebo-controlled, double-blind randomized study in asthmatic and hypertensive patients lung function and bronchial reactivity to histamine and bradykinin remained unaltered although in hypertensive patients with cough, reactivity to histamine tended to be more pronounced and bronchial hyperreactivity to be more frequent than in those without cough. The findings do not support a major role of kinins in ACE inhibitor-induced cough.

Adult↗
PubMed1992

Airway responsiveness and cough induced by angiotensin converting enzyme inhibition.

Dry cough is one of the most common side-effects of angiotensin converting enzyme inhibitors. The mechanism of cough induced by ACE inhibitors is not completely understood and may be related to bronchial hyperreactivity and/or an accumulation of kinins. In a placebo-controlled, double-blind randomised study, the effect of captopril on lung function and bronchial reactivity to histamine and bradykinin was investigated in eight asthmatic and 12 hypertensive patients (six with and six without cough during previous ACE inhibition). Lung function did not change in any patient after a single (25 mg) or short-term (2 x 25 mg for two weeks) administration of captopril. Bronchial reactivity to histamine and bradykinin remained unaltered in all groups. In hypertensive patients with cough, reactivity to histamine tended to be more pronounced and bronchial hyperreactivity to be more frequent than in those without cough. In conclusion, the present results do not support a major role for kinins in cough induced by ACE inhibition. On the other hand, bronchial hyperreactivity may be important in some patients. Additionally, these results demonstrate that treatment with ACE inhibitors is safe in most patients with bronchial asthma.

Adult↗
PubMed1991

Estimation of the spontaneous abortion risk in the presence of induced abortions.

We propose a method of estimating the miscarriage risk in a setting where counts of births, miscarriages and induced abortions are available, and also the gestational week of each induced abortion. Unlike previously proposed methods, ours takes into account the fraction of the miscarriage risk to which each interrupted pregnancy has been exposed. For this purpose, we draw on an extraneous standard foetal survival curve and stipulate that the survival curve of the study population is a scaled version thereof. Three such scaling models are discussed, and it is shown that the choice is largely a matter of computational convenience. Separate attention is given to a competing-risk model of miscarriages and interruptions, and examples are given of reasons why the crucial assumption that these two sources of termination operate independently is unlikely to be met. Finally, it is argued that pregnancy wishes, especially those of habitual aborters, shape the miscarriage rate to the extent that it becomes as much a cultural parameter as a marker of biological hazards.

Abortion, Habitual↗
PubMed1991

Improvements in detection of antibody to hepatitis B core antigen by treating specimens with reducing agent in an automated microparticle enzyme immunoassay.

A fully automated microparticle enzyme immunoassay (EIA), IMx Core, was developed for the detection of antibody against hepatitis B core antigen (anti-HBc). IMx Core sensitivity was less than 0.5 Paul Ehrlich Institut units per ml and was greater than that of the commercial radioimmunoassay (RIA) or EIA, Corab and Corzyme, respectively. Specimens from blood donors and diagnostic and hospital patients, which included individuals with a variety of infectious and immune diseases, were tested in parallel by the IMx Core and EIA. Overall agreement of 99.1% (4,797 of 4,841) was obtained. Prevalence of anti-HBc tested by IMx Core ranged from 1.2% in volunteer blood donors to 9.1% in hospital laboratories. Discordant specimens reactive by IMx Core but negative by Corzyme or Corab resulted from the increased sensitivity of the IMx Core assay, since other hepatitis B markers were usually present. However, most discordant specimens were positive by the EIA or RIA but negative by IMx Core. No other hepatitis B markers could be detected in these discordants, and after addition of reducing agent, these specimens also became negative by EIA or RIA. In clinical trials, 30% (14 of 47) of volunteer blood donors and 8% (9 of 119) of hospital patients testing repeatedly reactive by the EIA had reduction-sensitive (unspecific) anti-HBc reactivity. The reducing agent, dithiothreitol, was added to each specimen automatically in the IMx assay to eliminate these unspecific reactions without significantly affecting anti-HBc reactivity resulting from hepatitis B virus infection as judged by the correlation with other hepatitis B markers.

Evaluation Studies as Topic↗
PubMed1991

[Enteral anastomosis with the biofragmentable Valtrac ring. A prospective study].

In a prospective study, 150 enteral anastomoses using the new Valtrac biofragmentable anastomosis ring (BAR) are described. The manipulation involved was simple to learn and standardised intestinal anastomoses could be created at various bowel segments. No stenoses or postoperative bleeding occurred, the suture dehiscence rate was low. The use of these rings can be recommended to achieve a high level of standardisation for colon anastomoses and small bowel-colon anastomoses without restriction, whereas for other localisations the number of cases is too small to allow a final assessment to be made.

Anastomosis, Surgical↗
PubMed1991

[Combined injury to the median and ulnar nerves].

Reexamination of 19 reconstructive operations for common injuries of the median and ulnar nerves performed during 15 years was carried out. The localization of the injuries, the joined injuries, the method of nerve reconstruction and the treatment of the other injuries are given in details. 13 patients could be reached for the late follow-up, their clinical, EMG and ENG results are described.

Fascia↗