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Biomedical subjects

P Schmidt

Publications and source records attributed to P Schmidt.

At least 19 recordsLinked to original sources

Pervasive fitness trade-offs revealed by rapid adaptation to shifting population densities in large experimental populations of Drosophila melanogaster.

Trade-offs are an inherent feature of organismal biology that are expected play a fundamental role in the evolution of natural populations. Efforts to quantify trade-offs are largely confined to phenotypic measurements and the identification of negative genetic-correlations among fitness-relevant traits. Here, we use time-series genomic data collected during experimental evolution in large, genetically diverse populations of Drosophila melanogaster to directly measure the manifestation of trade-offs in response to fluctuating selection on ecological timescales. Specifically, we first conducted a lab-based selection experiment to quantify a genome-wide signal of antagonistic pleiotropy elicited in response to shifting population densities and associated with reproduction and stress tolerance selection. In doing so, we identified a putative role of two cosmopolitan inversions in these trade-offs. We then conducted an independent experiment to show that a simple manipulation of increasing population density under controlled lab-based conditions identified loci that are relevant to selection during population expansion and collapse in a complex, semi-natural setting. In concert, our results reveal how adaptation in complex, natural environments can be coarse-grained in such a manner to drive repeatable and predictable patterns of genomic variation, and further add credence to models positing a role of generic fitness trade-offs in the maintenance of variation in natural populations.

Drosophila melanogaster↗

Immunohistochemical screening for viral agents in cheetahs (Acinonyx jubatus) with myelopathy.

Numerous cases of acute-onset progressive ataxia, hindlimb paresis and paralysis of unknown aetiology occurred during 1993 to 2003 in cheetahs (Acinonyx jubatus) within the European Endangered Species Programme (eep). This study describes the immunohistochemical investigation of a possible viral aetiology of the "cheetah myelopathy". Antibodies to feline herpesvirus type 1, canine distemper virus, canine parvovirus and Borna disease virus were applied to formalin-fixed and paraffin-embedded brain and spinal cord sections from 25 affected cheetahs aged between three-and-a-half months and 13 years. Using the avidin-biotin complex technique, none of the antibodies gave positive immunosignals in either the brain or the spinal cord tissue.

Acinonyx↗

A rare case of massive ovarian edema in an uncomplicated singleton pregnancy.

Massive Ovarian Edema (MOE) is a rare cause of ovarian enlargement. Only 77 cases have been reported in the world literature so far, merely three of which were observed during pregnancy. Two of these showed additional pathological changes of the affected ovary (torsion) or were found in twin pregnancy. The patient presented on hand is therefore only the second report of MOE in an uncomplicated singleton pregnancy. In this case, a therapeutical resection of the affected ovary was performed at 16 + 4 weeks of gestation. The further course of the pregnancy was uncomplicated.

Adult↗

[Patients in forensic and general psychiatry. Do risk assessment measures detect differing risks of future violence?].

BACKGROUND: The aim of this study was to assess the potential for future violent behaviour comparing patients recruited from forensic and general psychiatric wards in Germany. PATIENTS AND METHODS: Fifty patients were recruited from a forensic hospital and 29 from a general psychiatric hospital. In the weeks preceding discharge, structured assessments of the future risk of violent behaviour were completed using the HCR-20. RESULTS: There was little difference in the risk presented by the two groups. Forensic patients presented an elevated risk of violence because of historical factors, while the risk among patients from general psychiatry was due to clinical symptoms. CONCLUSION: Some criminal offences could be prevented if more time and effort were spent in general psychiatric practice in identifying patients at high risk for violence and in reducing symptoms of psychoses before discharge.

Forensic Psychiatry↗

Efficacy and safety of outpatient alcohol detoxification with a combination of tiapride/carbamazepine: additional evidence.

BACKGROUND: Few medications have been tested for outpatient alcohol detoxification. Previously we had shown a combination of carbamazepine and tiapride to be effective in an open study. This database is an extension of our previous work. METHODS: This was an open prospective study to examine the efficacy, practicability and medical safety of a combination of tiapride and carbamazepine in outpatient detoxification of alcohol dependent patients. Patients were carefully screened for relevant neuropsychiatric disorders and then seen on a daily outpatient basis. RESULTS: A total number of 116 consecutively admitted patients entered the programme; 107 (92%) successfully ended the treatment. The mean initial dose for tiapride was 289 mg and for carbamazepine 502 mg. No serious medical complications or adverse events were observed except for one case of delirium tremens. Only four patients dropped out because of side effects. In general medication was well tolerated. Withdrawal symptomatology as indicated by CIWA-A-scores decreased over time. CONCLUSIONS: Results from this study give further evidence for a combination of tiapride and the anticonvulsant carbamazepine as an effective and safe treatment for outpatient alcohol detoxification in patients with moderate severity of withdrawal syndrome. Further randomized trials are warranted to examine the efficacy of this combination in outpatient alcohol withdrawal.

Adult↗

[References values for the fetal nasal bone in the first trimenon of pregnancy in a normal collective. A prospective study].

BACKGROUND: Examination of the fetal nasal bone by ultrasound between 11 and 14 weeks gestation has been proposed as an additional tool in the detection of trisomy 21. However, the variability in the identification and the normal length of the fetal nasal bone have not been investigated sufficiently as yet. The aim of this study was to evaluate this parameter and to establish normal ranges for nasal bone length. METHOD: Ultrasound examinations were carried out in 122 fetuses at 9, 10, 11, 12 and 20 weeks gestation. On the scans, the fetal profile was examined for the possibility of identification of the nasal bone. Normal nasal bone length reference ranges were generated using prenatal measurements. RESULTS: The fetal profile was successfully examined in all cases. The nasal bone could first be visualised at 9 weeks gestation. The identification of the fetal nasal bone in all cases was achieved at 12 weeks gestation. The median nasal bone length was 0.29 mm at 9 weeks gestation, 0.96 mm at 10 weeks gestation, 1.73 mm at 11 weeks gestation, 2.25 at 12 weeks gestation, and 6.18 mm at 20 weeks gestation. CONCLUSION: The reference ranges for the measurement of the fetal nasal bone length are similar to the findings in the published literature. Only with a knowledge of reference ranges for nasal bone length in normal fetuses can conclusions be drawn about the presence/absence of the bone or the presence of a hypoplastic nasal bone. Further studies are necessary to confirm these results and to obtain larger datasets to assess nasal bone as a quantitative marker.

Anthropometry↗

Gliomatosis cerebri in a dog.

Gliomatosis cerebri is a rare tumourous disease of the central nervous system consisting of glial cells characterized by diffuse widespread infiltration and preservation of preformed brain structures. This report describes a case of gliomatosis cerebri in a 9-year-old, male, flat-coated retriever dog with central nervous symptoms. Magnetic resonance imaging of the brain demonstrated ill-defined hyperintense zones of paramedian white matter within the right cerebral hemisphere, brainstem and cerebellum. Histological examination showed a proliferation of tumour cells in the brain structures mentioned. Glial fibrillary acidic protein-immunohistochemistry revealed a lot of fibres positively stained. Based on these findings, the alteration was diagnosed as gliomatosis cerebri.

Animals↗

"Safe" Coulomb excitation of 30Mg.

We report on the first radioactive beam experiment performed at the recently commissioned REX-ISOLDE facility at CERN in conjunction with the highly efficient gamma spectrometer MINIBALL. Using 30Mg ions accelerated to an energy of 2.25 MeV/u together with a thin (nat)Ni target, Coulomb excitation of the first excited 2+ states of the projectile and target nuclei well below the Coulomb barrier was observed. From the measured relative deexcitation gamma-ray yields the B(E2;0(+)gs-->2(+)1) value of 30Mg was determined to be 241(31)e2 fm4. Our result is lower than values obtained at projectile fragmentation facilities using the intermediate-energy Coulomb excitation method, and confirms the theoretical conjecture that the neutron-rich magnesium isotope 30Mg resides outside the "island of inversion."

Journal Article↗

Localized reversible reduction of apparent diffusion coefficient in transient hypoglycemia-induced hemiparesis.

BACKGROUND AND PURPOSE: The pathophysiology of hypoglycemia shares a common mechanism with cerebral ischemia, but so far, little is known regarding MRI of humans with hypoglycemia. METHODS: We report a patient with left hemiparesis and dysarthria associated with a blood glucose level of 1.7 mmol/L. The patient recovered completely after glucose infusion. RESULTS: The initial diffusion-weighted imaging (DWI) showed increased signal intensities and a reduction of apparent diffusion coefficient (ADC) values localized in the corpus callosum (splenium) and asymmetrically in the corona radiata. After 48 hours, follow-up revealed complete recovery of DWI and ADC signal abnormalities. CONCLUSIONS: To our knowledge, this is the first presentation of a case with transient hypoglycemia-induced focal neurological deficits revealing completely reversible MRI changes in terms of disturbed DWI and ADC with a peculiar as yet undescribed topography.

Aged↗

[Modified ECG-guidance for optimal central venous catheter tip positioning. A transesophageal echocardiography controlled study].

BACKGROUND: Intraatrial electrocardiography (ECG) is a well-established method for central-venous catheter (CVC) placement and an intraatrial position is assumed, when a significantly increased P-wave is registered. However, an increase in P-wave amplitude also occurs in other positions. Therefore we evaluated CVC tip positioning by means of transesophageal echocardiography (TEE) at a maximum P-wave amplitude. PATIENTS AND METHODS: In this prospective randomized study the right or left internal jugular vein was cannulated with 100 patients in each group and catheter tip positioning was guided by means of ECG. The catheter was fixed at the position of maximum P-wave amplitude and the insertion depth was registered. The relationship of the CVC tip position to the superior edge of the crista terminalis was demonstrated with the help of TEE. RESULTS: In all patients the catheter tip was found +/- 0.5 cm from the superior edge of the crista terminalis at the transition from the superior vena cava to the right atrium. On x-ray control, all catheters ran along the length of the vessel wall of the superior vena cava. CONCLUSIONS: A maximum P-wave is derived even at the entrance to the right atrium. This explains why ECG-guided CVC placement -- based on the largest P-wave amplitude -- consistently resulted in correct positioning of the CVC tip at the transition from the superior vena cava to the right atrium.

Adult↗

[Infectious mononucleosis].

The primary infection with Epstein-Barr virus in an immunocompetent individual leads to infectious mononucleosis with symptoms of diphtheroid angina, lymph node swelling in the neck and hepatosplenomegaly. The most common age of infection lies between 15 and 25 years. The illness can affect a number of organs simultaneously and thus requires interdisciplinary diagnostics. For differential diagnosis, a differential blood analysis and a EBV quick test are required. The presence of IgM antibodies demonstrates the presence of the infection. Ultrasound of the abdomen can be made to determine the involvement of additional organs. In most cases, recovery occurs without complications. Acute cases can usually be handled successfully with medication. If symptomatic treatment fails, pharyngeal airway obstruction is possible and a tonsillectomy may be necessary. Otherwise, surgical treatment is obsolete. Generally, the prognosis is good. Severe courses and complications are rare.

Humans↗

Influence of ovarian steroid hormones or platelet-activating factor on mRNA of platelet-activating factor receptor in endometrial explant perfusion cultures from ovariectomized bovine.

Platelet-activating factor (PAF) and its receptors are involved in inflammatory-like processes of the uterus associated with increased vascular permeability. PAF is supposed to be influenced by ovarian steroid hormones. The present study was undertaken to examine whether progesterone (P(4)), estradiol (E(2)) or PAF influence the PAF receptor gene expression in perfused endometrial explants derived from ovariectomized bovine. Furthermore, we identified the cell types in which the PAF receptor gene and protein are expressed. In endometrial explants, applications of 10 nM P(4) or 10nM P(4) plus 10 nM E(2) for 24 h induced elevated transcript levels of PAF receptor in comparison to the controls or after treatment with 1 nM E(2). When explants were administered 10 nM E(2), a slight decrease in the transcript level was recorded. After treatment of explants with PAF, no significant changes in PAF receptor mRNA expression was observed compared to the control group. We demonstrate that PAF receptor immunoreactivity and mRNA are detected mainly in the luminal epithelium, epithelial cells of the superficial glands and to a lesser degree in stroma. Levels of PAF receptor mRNA in bovine endometrial explants were correlated with PAF receptor protein localization assessed by immunohistochemistry. The regulation of PAF receptor by progesterone in bovine endometrial explants suggests that PAF is involved in the physiological process of reproduction.

Animals↗

The use of routine laboratory data to predict in-hospital death in medical admissions.

The ability to predict clinical outcomes in the early phase of a patient's hospital admission could facilitate the optimal use of resources, might allow focused surveillance of high-risk patients and might permit early therapy. We investigated the hypothesis that the risk of in-hospital death of general medical patients can be modelled using a small number of commonly used laboratory and administrative items available within the first few hours of hospital admission. Matched administrative and laboratory data from 9497 adult hospital discharges, with a hospital discharge specialty of general medicine, were divided into two subsets. The dataset was split into a single development set, Q(1) (n=2257), and three validation sets, Q(2), Q(3) and Q(4) (n(1)=2335, n(2)=2361, n(3)=2544). Hospital outcome (survival/non-survival) was obtained for all discharges. An outcome model was constructed from binary logistic regression of the development set data. The goodness-of-fit of the model for the validation sets was tested using receiver-operating characteristics curves (c-index) and Hosmer-Lemeshow statistics. Application of the model to the validation sets produced c-indices of 0.779 (Q(2)), 0.764 (Q(3)) and 0.757 (Q(4)), respectively, indicating good discrimination. Hosmer-Lemeshow analysis gave chi(2)=9.43 (Q(2)), chi(2)=7.39 (Q(3)) and chi(2)=8.00 (Q(4)) (p-values of 0.307, 0.495 and 0.433) for 8 degrees of freedom, indicating good calibration. The finding that the risk of hospital death can be predicted with routinely available data very early on after hospital admission has several potential uses. It raises the possibility that the surveillance and treatment of patients might be categorised by risk assessment means. Such a system might also be used to assess clinical performance, to evaluate the benefits of introducing acute care interventions or to investigate differences between acute care systems.

Adult↗

[Increased fetal nuchal translucency as a predictor of Cantrell's pentology--case report].

Increased fetal nuchal translucency (NT) is not only associated with chromosomal aberrations such as Down syndrome but is also predictive for fetal malformations such as cardiac anomalies or an omphalocele. Conversely, an omphalocele can be associated with other structural or chromosomal abnormalities. Cantrell's pentalogy is a rare congenital syndrome involving a midline supraumbilical abdominal wall defect, a defect of the lower part of the sternum, a deficiency of the anterior diaphragm, a defect in the diaphragmatic pericardium and congenital heart malformation. Its prevalence amounts to 5.5 per 1 million neonates. The aetiology is still unknown. We present a case with a pentalogy of Cantrell detected by an increased NT. A 23-year-old woman, primigravida, was referred to our unit at 10 + 3 weeks gestation with an increased NT. Ultrasound scan revealed a CRL of 31.1 mm and an NT of 3.2 mm. In addition to this an omphalocele with a herniac sac involving a part of the liver was suspected. Because of these sonographic findings a chromosomal analysis (CVS) was performed. The karyotype of the fetus showed to be normal (46 XX). A follow-up scan at 13 + 3 weeks gestation demonstrated the foetal abdomen with a supraumbilical midline abdominal wall defect with a large omphalocele containing the liver and stomach as well as an ectopia cordis. The extremities, head and spine seemed to be normal. After detailed counselling about the severity of the syndrome and its dismal prognosis the couple decided for a termination of pregnancy. Autopsy confirmed the prenatal sonographic findings. Measurement of foetal nuchal translucency at first-trimester screening has become a routine procedure in the early targeted search for foetal Down syndrome and other aneuploides. Investigations showed that increased NT is also associated with cardiac malformations. As a special form of a cardiac abnormality in conjunction with an omphalocele, it seems that the pentalogy of Cantrell is facultatively also associated with an increased NT at the end of the first trimenon and should be considered in the differential diagnosis as a cause of increased NT.

Abnormalities, Multiple↗

Measuring clinical performance using routinely collected clinical data.

Following the well-publicized problems with paediatric cardiac surgery at the Bristol Royal Infirmary, there is wide public interest in measures of hospital performance. The Kennedy report on the BRI events suggested that such measures should be meaningful to the public, case-mix-adjusted, and based on data collected as part of routine clinical care. We have found that it is possible to predict in-hospital mortality (a measure readily understood by the public) using simple routine data-age, mode of admission, sex, and routine blood test results. The clinical data items can be obtained at a single venesection, are commonly collected in the routine care of patients, are already stored on hospital core IT systems, and so place no extra burden on the clinical staff providing care. Such risk models could provide a metric for use in evidence-based clinical performance management. National application is logistically feasible.

Cardiology Service, Hospital↗

Identification of genetic evidence for dobrava virus spillover in rodents by nested reverse transcription (RT)-PCR and TaqMan RT-PCR.

A survey of 158 rodents caught in the Czech Republic identified Dobrava virus sequences closely related to that of the Dobrava virus type strain in Apodemus sylvaticus and Mus musculus rodents. The identity of A. sylvaticus was unequivocally confirmed by random amplified polymorphic DNA analysis. The data seem to indicate hantavirus spillover from Apodemus flavicollis to other rodents.

Animals↗

Do canine parvoviruses affect canine neurons? An immunohistochemical study.

In cats (most of which died from panleukopenia), cerebral neurons have recently been shown to be susceptible to canine parvovirus infection. In addition to positive immunostaining and distinct in situ hybridization signals, signs of neurodegeneration were identified by histopathology, mainly in the diencephalic area. Similar histological lesions of the diencephalic regions in dogs have also attracted attention; therefore, an immunohistochemical study was initiated to determine the possible infection of canine neurons with canine parvoviruses. The study was carried out on formalin-fixed and paraffin-embedded brain tissue, with and without signs of neurodegeneration, from 40 dogs, most of them dying from parvovirus enteritis. Immunohistochemistry, using polyclonal antiserum against canine parvoviruses, was negative in all 40 cases, suggesting that, unlike cats, canine parvoviruses do not seem capable of infecting canine neurons.

Animals↗