PubMed Health⌕ Search

Biomedical subjects

L Schmidt

Publications and source records attributed to L Schmidt.

At least 127 records · Page 7Linked to original sources
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↗
PubMed1990

Measurement of total risk of spontaneous abortion: the virtue of conditional risk estimation.

The concepts, methods, and problems of measuring spontaneous abortion risk are reviewed. The problems touched on include the process of pregnancy verification, the changes in risk by gestational age and maternal age, and the presence of induced abortions. Methods used in studies of spontaneous abortion risk include biochemical assays as well as life table technique, although the latter appears in two different forms. The consequences of using either of these are discussed. It is concluded that no study design so far is appropriate for measuring the total risk of spontaneous abortion from early conception to the end of the 27th week. It is proposed that pregnancy may be considered to consist of two or three specific periods and that different study designs should concentrate on measuring the conditional risk within each period. A careful estimate using this principle leads to an estimate of total risk of spontaneous abortion of 0.33.

Abortion, Induced↗
PubMed1990

Randomized prospective study of self-management training with newly diagnosed diabetic children.

This study was designed to evaluate the effects of a self-management training (SMT) program on metabolic control of children with insulin-dependent diabetes mellitus (IDDM) in the first 2 yr after diagnosis. After standard in-hospital diabetes education, 36 children (mean age 9.3 yr, range 3-16 yr) were randomized to conventional follow-up, conventional and supportive counseling (SC), or conventional and SMT, which emphasized use of data obtained from self-monitoring of blood glucose. SC and SMT interventions consisted of seven outpatient sessions with a medical social worker during the first 4 mo after diagnosis and booster sessions at 6 and 12 mo postdiagnosis. Groups were similar with respect to age, sex, body mass index, socioeconomic status, C-peptide, and severity of illness at diagnosis. Metabolic control, measured quarterly by glycosylated hemoglobin (HbA1), improved substantially in all three treatment groups during the first 6 mo. SMT patients had significantly lower HbA1 levels than conventional patients at 1 yr (P less than 0.01) and 2 yr (P less than 0.05) postdiagnosis. SMT patients also had lower HbA1 levels than SC patients, but this did not reach statistical significance. The lower HbA1 levels of SMT patients were not explained by severity of illness at diagnosis, or insulin dose, body mass index, and C-peptide levels at 2 yr. These results suggest that an SMT program during the first few months after diagnosis helps avoid the deterioration in metabolic control often seen in children with IDDM between 6 and 24 mo after diagnosis.

Adolescent↗
PubMed1989

[An evaluation of the National Patient Register. A study of validity of some abortion diagnoses].

The object of this study was to describe the use of some specific diagnoses for abortion and to study the validity of data in the Danish National Hospital Discharge Register by comparison with data in the discharge records. The study is based on 359 discharge records from 31 hospitals in 1984. Accordance between the two data sources was 92-100% for administrative data (personal identification number, hospital identification, date of hospitalization, and ICD-diagnosis code). Accordance was poorer (31-54%) with the diagnosis in latin and the number code of the diagnosis in the discharge records. This is partly because most of the discharge records include a diagnosis which is difficult to use (ICD-code 644: abortion, not specified as induced or spontaneous) and partly because classification of diagnoses is given low priority in the hospital doctor's job. The article proposes teaching medical students how to use the ICD-classification of diagnoses and surgical procedures. Further, we suggest exclusion of the ICD-code 644 since it is always possible to distinguish a spontaneous from an induced abortion in Denmark. It is proposed that the ICD-code 644 is used for complications following spontaneous and induced abortions (retention, haemorrhage, endometritis etc.).

Abortion, Induced↗
PubMed1989

Meal associated changes in brown fat thermogenesis and glycogen.

Data indicate a close association between a decrease in feeding-induced brown adipose tissue (BAT) thermogenesis and an increase in food consumption. The present study examines the hypothesis that feeding-induced BAT thermogenesis, or feeding-induced changes in BAT glycogen, a mobile form of energy store and a correlate of BAT thermogenesis, may modulate feeding behavior. We report that propranolol, which completely abolished meal-induced BAT thermogenesis, did not evoke intake of a larger meal. Though BAT glycogen concentration is a sensitive measure of the state of feeding, on a meal to meal basis it does not correlate with hunger and satiety. Hence the hypothesis is not supported by the current data. We also report that meal-induced BAT hypertrophy and glycogen deposition can be dissociated from meal-induced BAT thermogenesis.

Adipose Tissue, Brown↗
PubMed1989

Evaluation of cementless acetabular component migration. An experimental study.

Roentgenograms of two human cadaveric pelves with three implanted acetabular components were taken in anatomic, tilted, and rotated positions to determine their effect on the measurement of cup migration. The best landmark for measuring migration along a vertical axis was the distance between the center of the cup and the teardrop line. The best measurement for cup migration along an horizontal axis was the distance between the center of the cup and the vertical line through the teardrop. When the teardrop is not visible, one should use the distance between the bottom of the cup and the obturator line, and the distance between the center of the cup and Kohler's line. Guidelines for roentgenographic comparability are as follows: at 10% magnification, the variation in distance between the obturator line and the teardrop line should be less than 5 mm, and the distance between the middle of the sacroiliac line and the vertical line through the pubis should be less than 0.5 cm.

Acetabulum↗
PubMed1989

Short-term group therapy with depressed adolescent outpatients.

A selected review of the literature about short-term therapy and social skills as they may apply to depressed adolescents is presented. Two forms of group therapy are described. These are social skills and a traditional discussion group format. Some of the difficulties in establishing and evaluating a group therapy program are outlined.

Adolescent↗
PubMed1987

Drug monitoring of etoposide (VP16-213). Correlation of pharmacokinetic parameters to clinical and biochemical data from patients receiving etoposide.

Pharmacokinetic parameters established in 15 patients receiving parenterally administered etoposide (80-120 mg . m-2) are reported. The etoposide assay by means of mass spectrometry after sample separation by thin-layer chromatography or high-pressure liquid chromatography used in this study has been described elsewhere. Peak plasma levels (9.5-63.3 micrograms . ml-1), the area under the curve (AUC) (2707-10192 micrograms . ml-1 . min-1), the mean transit time MTT (2.7-10.6 h), etoposide half-lives t1/2 alpha (0.10-0.52 h) and t1/2 beta (2.18-8.17 h), the volume of distribution at steady state (Vdss) (2.5-15.1 . l/m-2) and the systemic clearance (Cls) (10.1-35.1 ml min-1 . m-2) with the resulting mean values and standard deviations were determined. Our findings are compared with those of other authors, especially with regard to the method of detection used. This comparison indicates similar individual deviations and shorter half-lives with increasing specificity of the employed assay. Four patients studied on 3 consecutive days and, in one instance, during two different cycles of chemotherapy showed no sign of accumulation or of accelerated excretion of etoposide. There was little intrapatient variability. The pharmacokinetic parameters were correlated to clinical and laboratory findings. Statistical analysis indicated that the AUC was increased by prior cisplatin therapy and in patients with elevated levels of alkaline phosphatase. The Cls was decreased by prior cisplatin therapy, in obese patients, and by elevated alkaline phosphatase. The t1/2 beta of etoposide was increased in older patients. Linear regression analysis yielded a greater Vdss in patients with lower serum albumin levels, but this correlation has not yet been found to be statistically significant.

Adult↗