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Biomedical subjects

M Kramer

Publications and source records attributed to M Kramer.

At least 271 records · Page 15Linked to original sources

Evaluation of tonsils and adenoids in Sleep Apnea syndrome.

Peripheral Sleep Apnea syndrome has been associated with enlarged tonsils and adenoids as well as other abnormalities which may cause upper airway obstruction in children. A multidisciplinary approach is used at the Step Disorder Center of Cincinnati General Hospital to evaluate the role of tonsils and adenoids in sleep apnea. Polysomnographic techniques combined with cine sleep studies of the upper airway document the degree, site and type of obstruction. This presentation highlights the entity of obstructive sleep apnea and provides a rational clinical approach in the management of these patients.

Adenoids↗

Exacerbation of upper-airway sleep apnea by lymphocytic lymphoma.

A 55-year-old obese man was evaluated for excessive daytime sleepiness and found to have upper-airway sleep apnea. Evaluation discovered a lymphocytic lymphoma with head and neck involvement. Treatment of the lymphoma resulted in improvement in the sleep apnea and the sleepiness.

Head and Neck Neoplasms↗

Leukocyte interferon-induced tumor regression in human metastatic breast cancer, multiple myeloma, and malignant lymphoma.

Thirty-eight patients with advanced breast cancer, multiple myeloma, and malignant lymphoma were treated with partially purified (about 0.1%) leukocyte interferon. Patients were treated with a remission-induction schedule of 3 million to 9 million antiviral units daily intramuscularly for 4 to 26 weeks. Responding patients were maintained on a schedule of 3 million U three times weekly. Tumor regression was observed in seven of 17 patients with breast cancer. Six of 10 patients with multiple myeloma responded with a decrease of at least 50% in serum myeloma protein levels or Bence Jones protein excretion. Six of the 11 lymphoma patients achieved tumor regression. Complete remissions occurred in two patients. Of the 19 responding patients, five remain on study for 52 to 63 weeks. Toxicity included low-grade fever, fatigue, anorexia, and partial alopecia. Myelosuppression (lowest median leukocyte count, 2500/mm3; granulocytes, 1300/mm3) occurred in most patients. On the basis of this pilot study, we conclude that leukocyte interferon can induce tumor regression in patients with advanced cancer.

Adult↗

Hemodialysis without heparin infusion using Cordis Dow 3500 hollow fiber.

1) Hemodialysis for 3-4 hrs with C-3500 without heparin infusion is possible. 2) Hemodialysis without heparin with C-3500 may be preferred for patients with active or potential bleeding. 3) Excessive clotting may occur when blood flow is less than 250 ml/min, blood transfusion is used during dialysis or dialysis is longer than 3.5-4 hrs.

Blood Coagulation↗

Effects of temazepam, flurazepam and quinalbarbitone on sleep: psychomotor and cognitive function.

1 The effect of temazepam 15 and 30 mg, flurazepam 15 and 30 mg, quinalbarbitone 100 and 200 mg and placebo were studied in 14 healthy male volunteers according to a Latin-square design. At 14-d intervals subjects received capsules 30 min before bedtime on 2 consecutive nights and were evaluated for objective sleep characteristics, for morning estimates of sleep characteristics, and for cognitive and psychomotive performance and subjective state at 3.5, 10.0 and 22.5 h after ingestion. 2 Changes in sleep induction and sleep maintenance were observed with temazepam 30 mg and flurazepam 30 mg had the greater effect on cognitive performance, whereas quinalbarbitone 20 mg had the greater effect on psychomotive performance. Subjective assessments of alertness were most affected by flurazepam, and by quinalbarbitone 200 mg. 4 The results suggest that temazepam produces less residual effects and is shorter acting than quinalbarbitone and flurazepam.

Adult↗

The effect of a single dose of quazepam (Sch-16134) on the sleep of chronic insomniacs.

The present study evaluated the efficacy of 25 mg of quazepam, a new benzodiazepine hypnotic, in a population of chronic insomniacs. The results indicate that a single dose (25 mg) administered for one night was efficacious when measured both objectively by polysomnographic recording and subjectively by questionnaire with no reported side-effects. The change in the objective measures paralleled the direction of change in subjective measures. Sleep efficiency and sleep maintenance were improved without EEG changes in Stages 2, 3-4, and REM. Further study is needed to evaluate the effects of chronic administration of different doses of quazepam in chronic insomniacs.

Adolescent↗

Bicultural training: a cost-effective program.

The effects of a bicultural training program in easing adjustment to the work world were studied on new graduate nurses working in eight medical center hospitals. Data from that study are used to examine program costs per new graduate-head nurse dyad. The cost effectiveness of the bicultural program is illustrated by comparing program costs with savings resulting from decreased turnover among new graduates who receive bicultural training. The mean time and cost estimates for the program may be used by others to determine cost effectiveness of bicultural training in their own institutions.

Costs and Cost Analysis↗

An analysis of behavioral contingencies in clinical teaching.

Principles of a contingency management were applied in analyzing student reports on clinical instruction. In behavioral science, a contingency is a relationship between a behavior and its effect. The analysis identifies contingencies arranged by clinical instructors that unintentionally interfere with learning. The faculty responded to the findings by planing changes to overcome the problems identified. Prior to the study, many of the problems uncovered were not recognized by the faculty. Students are usually not open about such sensitives areas of feedback. If dental faculty members of other institutions do not feel that similar findings apply to their schools, the authors recommend that they conduct an analogous study.

Attitude↗