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Biomedical subjects

R Bohn

Publications and source records attributed to R Bohn.

12 recordsLinked to original sources
PubMed1999

Nonoccupational risk factors for carpal tunnel syndrome.

OBJECTIVE: To examine the relation between selected nonoccupational risk factors and surgery for carpal tunnel syndrome. DESIGN: Case-control study using an administrative database. PARTICIPANTS: Enrollees of New Jersey Medicare or Medicaid programs during 1989 to 1991. MEASUREMENTS: The outcome of interest was open or endoscopic carpal tunnel release. We examined the relation between carpal tunnel release and diabetes mellitus, thyroid disease, inflammatory arthritis, hemodialysis, pregnancy, use of corticosteroids, and hormone replacement therapy. MAIN RESULTS: In multivariate models, inflammatory arthritis was strongly associated with carpal tunnel release (odds ratio [OR] 2.9; 95% confidence interval [CI] 2.2, 3.8). However, corticosteroid use also appeared to be associated with a greater likelihood of undergoing carpal tunnel release, even in the absence of inflammatory arthritis (OR 1.6; 95% CI 1.2, 2.1). Diabetes had a weak but significant association with carpal tunnel release (OR 1.4; 95% CI 1.2, 1.8), as did hypothyroidism (OR 1.7; 95% CI 1.1, 2.8), although patients with hyperthyroidism did not have any change in risk. Women who underwent carpal tunnel release were almost twice as likely to be users of estrogen replacement therapy as controls (OR 1.8; 95% CI 1.0, 3.2). CONCLUSIONS: Although inflammatory arthritis is the most important nonoccupational risk factor for carpal tunnel release, these data substantiate the increase in risk associated with diabetes and untreated hypothyroidism. Further investigation in detailed clinical studies will be necessary to confirm whether changes in corticosteroid use and hormone replacement therapy offer additional means of risk reduction for this common condition.

Age Distribution↗
PubMed1999

Laparoscopically assisted performance of gastrostomy--a simple, safe and minimal invasive technique.

We developed a new and simple technique for a gastrostomy, which combines the benefits of the laparoscopic and open approach: under visual control, the correct site at the gastric wall is defined laparoscopically and, via a second trocar, the stomach is pulled out onto the abdominal wall to insert a Kasper catheter and place the sutures. Evaluated in a rat model, this procedure demonstrates safety and surgical feasibility on the grounds of a minimal invasive access. The case report of a 1-year-old boy may also prove the clinical benefit.

Animals↗
PubMed1997

How do older persons define constipation? Implications for therapeutic management.

This study examined the relation between bowel-related symptoms and self-report of constipation in 10,875 subjects aged 60 years and over, who participated in the 1989 National Health Interview Survey. Subjects reporting constipation "always" or "mostly" over the past 12 months (n = 594) were compared with those who reported never having the symptom (n = 4,192). Straining (adjusted odds ratio 66.7; 95% confidence interval 31.5, 142.4) and hard bowel movements (25.6; 16.7, 38.7) were most strongly associated with self-report of constipation. These findings suggest that treatment for constipation in the older population should be directed as much or more at facilitating comfortable rectal evacuation, as increasing bowel movement frequency.

Aged↗
PubMed1996

Bowel habit in relation to age and gender. Findings from the National Health Interview Survey and clinical implications.

BACKGROUND: Constipation is widely considered to be a common problem among the elderly, as evidenced by the high rate of laxative use in this population. Yet, age-related prevalence studies of constipation generally do not distinguish between actual alteration in bowel movement frequency and subjective self-report of constipation. OBJECTIVE: To determine the relationship between advancing age and bowel habit. METHODS: We employed data collected on 42,375 subjects who participated in the National Health Interview Survey on Digestive Disorders based on interviews with a random nationwide sample of US households. We examined the following characteristics reported by this population according to selected age groupings by decade: constipation, levels of laxative use, and two bowel movements per week or less. RESULTS: Contrary to conventional wisdom, there was no age-related increase in the proportion of subjects reporting infrequent bowel movements. Nonetheless, the prevalence of self-report of constipation increased with advancing age, with a greater proportion of women reporting this symptom than men across all age groups. Laxative use also increased substantially with aging; while women were more likely to use laxatives than men, this effect attenuated with advancing age. A U-shaped relationship was observed between advancing age and bowel habit in men and women; 5.9% of individuals younger than 40 years reported two bowel movements per week or less compared with 3.8% of those aged 60 to 69 years and 6.3% of those aged 80 years or older. This relationship persisted after adjusting for laxative use. CONCLUSION: These findings suggest that a decline in bowel movement frequency is not an invariable concomitant of aging. In elderly patients who report being constipated, it is essential to take a careful physical, psychological, and bowel history rather than to automatically assume the need for laxative use.

Adult↗
PubMed1983

The microanatomy of human islets of Langerhans, with special reference to somatostatin (D-) cells.

The arrangement of the various endocrine cells within mammalian islets of Langerhans indicates that the regulation of insulin and glucagon secretion by pancreatic somatostatin may occur mainly by paracrine mechanisms. In the present study, the relationship of somatostatin-containing D-cells to blood vessels and to other endocrine cells in the islets of the human pancreas were investigated using immunohistochemically stained serial semithin sections (0.5-1.0 micron). Morphologic features of 335 D-cells were examined and their anatomical relationship to other endocrine cell types and capillaries was determined by morphometric analysis and graphic or three-dimensional reconstructions. The majority of D-cells (84%) was located in close proximity to the capillaries. The intracellular immunoreactive material was accumulated in those cell parts facing the capillaries or their perivascular spaces. The remaining D-cells did not come into contact with the capillaries and showed only moderate or weak immunoreactivity.--A further characteristic feature of islet D-cells, pertinent to about 67% of these cells, is their tendency to be arranged in contiguity to other D-cells. The present findings indicate that somatostatin after its release from the D-cell reaches other islet cells mainly via the intrainsular circulation or along the perivascular space. Concerning the general microarchitecture of human islets of Langerhans, the present data are not sufficient to give a conclusive morphological description, because heterogeneities among the islets were observed. These variations appear to be related to the type of vascular supply which differs among islets.

Aged↗