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Biomedical subjects

R Peter

Publications and source records attributed to R Peter.

At least 19 recordsLinked to original sources
PubMed2006

Immunogold-labeled S-phase neoblasts, total neoblast number, their distribution, and evidence for arrested neoblasts in Macrostomum lignano (Platyhelminthes, Rhabditophora).

Neoblasts in Platyhelminthes are the only cells to proliferate and differentiate into all cell types. In Macrostomum lignano, the incorporation of 5'-bromo-2'-deoxyuridine (BrdU) in neoblasts confirmed the distribution of S-phase cells in two lateral bands. BrdU labeling for light and for transmission electron microscopy (TEM) identified three populations of proliferating cells: somatic neoblasts located between the epidermis and gastrodermis (mesodermal neoblasts), neoblasts located within the gastrodermis (gastrodermal neoblasts), and gonadal S-phase cells. In adults, three stages of mesodermal neoblasts (2, 2-3, and 3) defined by their ultrastructure were found. Stage 1 neoblasts where only seen in hatchlings. These stages either were phases within the S-phase of one neoblast pool or were subsequent stages of differentiating neoblasts, each with its own cell cycle. Regular TEM and immunogold labeling provided the basis for calculating the total number of neoblasts and the ratio of labeled to non-labeled neoblasts. Somatic neoblasts represented 6.5% of the total number of cells. Of these, 27% were labeled in S-phase. Of this fraction, 33% were in stage 2, 46% in stage 2-3, and 21% in stage 3. Immunogold labeling substantiated results concerning the differentiation of neoblasts into somatic cells. Non-labeled stage 2 neoblasts were present, even after a 2-week BrdU exposure. Double labeling of mitoses and FMRF-amide revealed a close spatial relationship of mesodermal neoblasts with the nervous system. Immunogold-labeled sections showed that nearly 70% of S-phase cells were in direct contact or within 5 microm from nerve cords.

Animals↗
PubMed2006

Comparison of the pharmacokinetics and pharmacodynamics of biphasic insulin aspart and insulin glargine in people with type 2 diabetes.

AIMS/HYPOTHESIS: The pharmacokinetic and pharmacodynamic properties of biphasic insulin aspart (BIAsp 30) (30% soluble, 70% protaminated insulin aspart [IAsp]) and insulin glargine (IGlarg) were compared. METHODS: Twelve people with type 2 diabetes took part in two 24-h isoglycaemic clamp studies, 1 week apart. Patients were randomised to treatment with 0.5 U/kg of BIAsp 30 (0.25 U/kg at 08.30 h and 0.25 U/kg at 20.30 h) or 0.50 U/kg IGlarg at 08.30 h. Both insulins were given by subcutaneous injection into the anterior abdominal wall. The plasma glucose, glucose infusion rates, plasma insulin and C-peptide concentrations were measured. RESULTS: All 12 patients were men; mean (+/-SD) age was 58.8 (8.9) years, BMI 31.0 (3.0) kg/m2 and HbA(1c) 7.1 (0.6)%. Plasma glucose was constant throughout the 24-h clamp period. After each injection of BIAsp 30, glucose infusion rates increased, reaching a distinct peak approximately 3-5 h after injection. A much flatter postinjection profile was observed following IGlarg administration. Plasma insulin concentrations rose rapidly after each injection of BIAsp 30, reaching a distinct peak after approximately 2-3 h. A flatter plasma insulin profile reached a plateau approximately 6-16 h after IGlarg administration. Plasma C-peptide fell below baseline after both injections of BIAsp 30 but remained unaltered after IGlarg injection. CONCLUSIONS/INTERPRETATION: The pharmacodynamic and pharmacokinetic profiles were 34 and 28%, respectively, higher following equivalent doses (0.5 U/kg) of BIAsp 30 given as two split doses than following IGlarg given as a single daily dose.

Aged↗
PubMed2006

Relationship between HbA1c and indices of glucose tolerance derived from a standardized meal test in newly diagnosed treatment naive subjects with Type 2 diabetes.

AIMS: To determine the relationship between HbA1c and other indices of glycaemic status derived during a standardized meal tolerance test (MTT) in newly diagnosed treatment-naive subjects with Type 2 diabetes (T2DM). METHODS: T2DM subjects (n = 262) consumed a standard MTT in the morning after a 10-h overnight fast. Frequent samples for plasma glucose (PG) were collected over the 4-h test period. The relationship between HbA1c and other glycaemic indices derived from the MTT were explored. The postprandial glucose exposure was calculated as the area under the incremental plasma glucose curve above the fasting level for the test period (AUC1). Excess hyperglycaemia was calculated as the AUC0-4 h above the arbitrary PG concentrations of 6.0 mmol/l (AUC2) and 5.5 mmol/l (AUC3), respectively [upper limit of fasting normoglycaemia according to World Health Organization (WHO) and American Diabetes Association (ADA), respectively]. Fasting hyperglycaemia was also estimated, being the difference between each of the above and the postprandial excursion. The participants were divided into three subgroups according to HbA1c (Group 1, 9.0%) and the relative contribution calculated of the postprandial glucose and fasting hyperglycaemia to the excess hyperglycaemia above the designated international thresholds for fasting plasma glucose. RESULTS: HbA1c was more strongly correlated with the fasting plasma glucose (r = 0.85, P < 0.001) than the overall postprandial glucose exposure (r = 0.539, P = 0.003). The contribution of fasting hyperglycaemia to excess hyperglycaemia using the WHO criteria for normal fasting plasma glucose for the three groups (Groups 1, 2 and 3) was 50.4%, 54.3% and 69.8%, respectively, and 57.8%, 58.8% and 71.4% using the ADA criteria. CONCLUSIONS: The contribution of fasting hyperglycaemia to excess hyperglycaemia increases as glycaemic control deteriorates, becoming dominant with an HbA1c in excess of 7.0%. These findings indicate which therapeutic approach needs to be adopted based on the HbA1c of the person with T2DM.

Adult↗
PubMed2006

The use of a pour-on and spray dip containing Amitraz to control ticks (Acari: Ixodidae) on cattle.

Knockdown and persistence efficacies of a pour-on containing Amitraz 1% and Cypermethrin 1% and a spray dip containing 12.5% Amitraz were compared. Knock-down and persistence efficacies of the Amitraz spray dip against Rhipicephalus (Boophilus) decoloratus and Amblyomma hebraeum were significantly higher for the duration of the trial than those of the pour-on. In the case of Rhipicephalus appediculatus and Rhipicephalus evertsi evertsi, efficacy was significantly higher on Days 2 and 5. Resistance testing prior to the start of the trial indicated that R. (B.) decoloratus was resistant to both Cypermethrin and Amitraz, yet in the case of the spray dip excellent efficacy results were obtained. It is thought that the cattle's scruffy winter coat may have hindered the spread of the pour-on, but that the thorough wetting and especially the higher concentration of active ingredient applied via the spray dip allowed this formulation to be effective. These results show that under certain conditions a spray dip containing 12.5% Amitraz may be more effective than a pour-on containing 1% Amitraz and 1% Cypermethrin, despite apparent in vitro resistance.

Administration, Topical↗
PubMed2005

Stripe-hexagon competition in forced pattern-forming systems with broken up-down symmetry.

We investigate the response of two-dimensional pattern-forming systems with a broken up-down symmetry, such as chemical reactions, to spatially resonant forcing and propose related experiments. The nonlinear behavior immediately above threshold is analyzed in terms of amplitude equations suggested for a 1:2 and 1:1 ratio between the wavelength of the spatial periodic forcing and the wavelength of the pattern of the respective system. Both sets of coupled amplitude equations are derived by a perturbative method from the Lengyel-Epstein model describing a chemical reaction showing Turing patterns, which gives us the opportunity to relate the generic response scenarios to a specific pattern-forming system. The nonlinear competition between stripe patterns and distorted hexagons is explored and their range of existence, stability, and coexistence is determined. Whereas without modulations hexagonal patterns are always preferred near onset of pattern formation, single-mode solutions (stripes) are favored close to threshold for modulation amplitudes beyond some critical value. Hence distorted hexagons only occur in a finite range of the control parameter and their interval of existence shrinks to zero with increasing values of the modulation amplitude. Furthermore, depending on the modulation amplitude, the transition between stripes and distorted hexagons is either subcritical or supercritical.

Journal Article↗
PubMed2004

[Surgical treatment for distal rupture of the biceps tendon].

PURPOSE OF THE STUDY: Avulsion of the distal biceps brachii tendon at the elbow is uncommon. We analyzed cases operated in our department in order to define etiological factors and surgical treatment outcome. MATERIAL AND METHODS: We reviewed retrospectively eleven patients, ten male patients, average age 43 years (range 37-59) with distal biceps tendon ruptures repaired anatomically with a double-incision technique and one other male patient whose tendon was attached to the brachialis anterior. Nine patients were seen for clinical assessment at least two years after operation. RESULTS: Average follow-up was 7 years (range 1-10). Patient satisfaction was good and all stated they would opt for surgical treatment again. The most common mechanism of injury was heavy weight lifting with the elbow at 90 degrees flexion or excentric loading on a flexed elbow. The dominant limb was injured in all patients. Eight patients had sustained injury during domestic activities and three during sports activities. Clinical diagnosis was the rule. MRI was useful in patients seen late after injury. We found nine cases of avulsion located at the bicipital tuberosity. All subjective results were good. Strength testing of the injured limbs revealed a loss of 30% supination strength and 40% supination endurance for the anatomic reinsertions. For the non-anatomic reinsertion, there was a 50% decrease in strength and 60% decrease in endurance. Clinical follow-up after seven years showed no nerve damage or heterotopic bone formation. DISCUSSION: Anatomic repair of distal biceps tendon rupture provides consistently good results. Attachment of the brachial tendon to the brachial anterior muscle cannot restore supination force. The two-incision technique with the extensor mass-splitting approach described by Boyd and Anderson lessens the risk of radial nerve plasty. CONCLUSION: Early anatomic reconstruction can restore more strength and endurance for supination. Attachment of the brachialis muscle must be considered in the event of late reconstruction. Subjective satisfaction with functional outcome has been excellent for all patients.

Adult↗
PubMed2004

Gender variation in PTH sensitivity and rhythmicity following growth hormone replacement in adult growth hormone-deficient patients.

BACKGROUND: Adult GH deficiency (AGHD) is associated with osteoporosis and reduced bone turnover; factors improved by GH replacement (GHR), with men gaining greater benefit than women. Reduction in sensitivity of bone and kidney to the effects of PTH may underlie AGHD changes in bone turnover. We determined the gender difference in PTH target-organ sensitivity following GHR in AGHD patients. DESIGN, PATIENTS AND MEASUREMENTS: Twenty AGHD patients (10 men) were admitted to hospital before and after GHR initiation. Half-hourly blood samples were collected for PTH, calcium, nephrogenous cyclic AMP (NcAMP, marker of PTH activity), type-I collagen C-telopeptide (CTX, bone resorption marker) and procollagen type-I amino-terminal propeptide (PINP, bone formation marker). RESULTS: The 24-h mean PTH concentration decreased in both genders (P < 0.001), with maximal changes seen 6 and 12 months following GHR in men and women, respectively. Increases in 24-h mean NcAMP (P < 0.05), calcium (P < 0.001) and bone turnover markers (P < 0.001) occurred in both genders following GHR, with maximal changes at 1 month in men, but at 3 months for NcAMP, calcium and CTX and 12 months for PINP in women. Maximal NcAMP increase was higher in men (P = 0.009). CONCLUSIONS: Following GHR, PTH target-organ sensitivity increased in both genders, demonstrated by simultaneous reduction in PTH concentration and increase in NcAMP, calcium and bone turnover. In women, improvement in renal PTH sensitivity was delayed and reduced, and changes in bone turnover were delayed, with increase in bone resorption preceding bone formation. Both factors may contribute to the reduced bone mineral density (BMD) response to GHR observed in women.

Adult↗
PubMed2004

Fractures of the calcaneum. A review of 70 patients.

We have assessed the long-term results after operative and non-operative treatment of undisplaced and displaced calcaneal fractures. At a mean of 6.5 years, we reviewed 70 patients with a calcaneal fracture who were divided into four groups: group 1, 18 patients with undisplaced fractures and a normal Böhler's angle (BA) who had been treated non-operatively; group 2, 23 with intra-articular fractures and a BA < 10 degrees who had been treated non-operatively; group 3, 13 with intra-articular fractures and a BA > 10 degrees who had been treated surgically; and group 4, 16 with intra-articular fractures and a BA < 10 degrees who had been treated surgically. The results were assessed by a clinical score considering pain, return to work, return to physical activity, change in shoe-wear and the requirement for subtalar arthrodesis. Patients with undisplaced calcaneal fractures had a good outcome. Those with displaced fractures treated surgically who presented at follow-up with a BA > 10 degrees had a satisfactory functional outcome and those with displaced fractures who had non-operative treatment had a poor outcome. The poorest outcome was consistently seen in patients who were treated operatively without restoration of BA. Open reduction and internal fixation of intra-articular calcaneal fractures can only be expected to benefit those patients in whom nearly anatomical reconstruction is obtained.

Adult↗
PubMed2003

Urinary excretion of salicyluric and salicylic acids by non-vegetarians, vegetarians, and patients taking low dose aspirin.

AIM: To compare amounts of salicyluric acid (SU) and salicylic acid (SA) excreted daily in the urine of non-vegetarians and vegetarians not taking salicylate drugs, and patients taking 75 or 150 mg aspirin/day. METHODS: Urine excreted over 24 hours was collected from volunteers in the four groups. The volumes were recorded and the concentrations of SU and SA were determined electrochemically after separation by high performance liquid chromatography. RESULTS: Significantly more SU was excreted daily by vegetarians (median, 11.01; range, 4.98-26.60 micro mol/24 hours) than by non-vegetarians (median, 3.91; range, 0.87-12.23 micro mol/24 hours), although amounts were significantly lower than those excreted by patients taking aspirin. Median amounts of SU excreted by patients taking 75 and 150 mg/day of low dose aspirin were 170.69 (range, 13.15-377.18) micro mol/24 hours and 165.17 (range, 5.61-429.12) micro mol/24 hours, respectively. The amount of SU excreted by patients taking either 75 or 150 mg of aspirin/day was not significantly different. Significantly more SA was excreted by vegetarians (median, 1.19; range, 0.02-3.55 micro mol/24 hours) than by non-vegetarians (median, 0.31; range, 0.01-2.01 micro mol/24 hours). The median amounts of SA excreted by vegetarians and the patients taking aspirin were not significantly different. CONCLUSIONS: More SU and SA is excreted in the urine of vegetarians than in non-vegetarians, consistent with the observation that fruits and vegetables are important sources of dietary salicylates. However, significantly less SU was excreted by vegetarians than patients taking aspirin, indicating that the daily intake of bioavailable salicylates by vegetarians is considerably lower than that supplied by a single 75 or 150 mg dose of aspirin.

Adolescent↗
PubMed2002

Socioeconomic differences in children's and adolescents' hospital admissions in Germany: a report based on health insurance data on selected diagnostic categories.

STUDY OBJECTIVE: The extent of social inequalities in children's hospitalisation risks was examined in terms of socioeconomic status and parents' nationality. This was considered in terms of inpatient treatment attributable to a number of diagnoses (ICD-9), especially infectious diseases and psychiatric disorders. DESIGN AND SETTING: Analyses were performed with records of a German statutory health insurance comprising 48 412 (52.8% male and 47.2% female) children and adolescents of 15 years of age or younger who were co-insured between 1987 and 1996. Classification of socioeconomic position was based on parental occupational position. RESULTS: Social inequalities in terms of hospital admissions attributable to acute diseases were rather small. The only exception were infections of the respiratory organs: in the highest status positions as compared with the lowest one the relative risk for being admitted was RR=0.22 (95% CI 0.06 to 0.89). However, length of stay in hospital was significantly related to socioeconomic position for infections of the upper respiratory tract and infections of the respiratory organs, with children and adolescents with the lowest socioeconomic background having spent the longest periods in hospital. With regard to nationality, pneumonia/flu was the only diagnostic category where relative risks for being admitted were higher in non-German children and adolescents (RR=1.5; 95% CI 1.2 to 1.8). Conversely, hospital admissions attributable to psychiatric diagnoses were significantly lower among non-German patients (RR=0.43; 95% CI 0.30 to 0.61), thus suggesting differential utilisation patterns according to nationality. CONCLUSIONS: Health inequalities in children's and adolescents' hospital admissions in Germany are small and inconsistent if parents' socioeconomic status and nationality are taken as criterion. Yet, children of lower status background stay longer in hospital if suffering from highly prevalent infectious diseases. This last observation may be attributable to more severe disease conditions.

Adolescent↗
PubMed2002

Psychosocial work environment and myocardial infarction: improving risk estimation by combining two complementary job stress models in the SHEEP Study.

OBJECTIVES: Associations between two alternative formulations of job stress derived from the effort-reward imbalance and the job strain model and first non-fatal acute myocardial infarction were studied. Whereas the job strain model concentrates on situational (extrinsic) characteristics the effort-reward imbalance model analyses distinct person (intrinsic) characteristics in addition to situational ones. In view of these conceptual differences the hypothesis was tested that combining information from the two models improves the risk estimation of acute myocardial infarction. METHODS: 951 male and female myocardial infarction cases and 1147 referents aged 45-64 years of The Stockholm Heart Epidemiology (SHEEP) case-control study underwent a clinical examination. Information on job stress and health adverse behaviours was derived from standardised questionnaires. RESULTS: Multivariate analysis showed moderately increased odds ratios for either model. Yet, with respect to the effort-reward imbalance model gender specific effects were found: in men the extrinsic component contributed to risk estimation, whereas this was the case with the intrinsic component in women. Controlling each job stress model for the other in order to test the independent effect of either approach did not show systematically increased odds ratios. An improved estimation of acute myocardial infarction risk resulted from combining information from the two models by defining groups characterised by simultaneous exposure to effort-reward imbalance and job strain (men: odds ratio 2.02 (95% confidence intervals (CI) 1.34 to 3.07); women odds ratio 2.19 (95% CI 1.11 to 4.28)). CONCLUSIONS: Findings show an improved risk estimation of acute myocardial infarction by combining information from the two job stress models under study. Moreover, gender specific effects of the two components of the effort-reward imbalance model were observed.

Aged↗
PubMed2002

[Talar neck fracture: 9-year follow-up of 40 cases].

PURPOSE OF THE STUDY: Complication rate is high after talar neck fractures. Avascular osteonecrosis and post-traumatic joint degeneration could be avoided by proper management. We analyzed long-term outcome in a series of 40 talar neck fractures treated in our unit from 1979 to 1995. MATERIAL AND METHODS: Mean follow-up was 9 years. Orthopedic and surgical management by Hawkins classification group was, respectively, type I=10 (7 and 3), type II=17 (3 and 14), type III=11 (1 and 10) and type IV=2 (both surgery). Two patients had bilateral fractures and 7 fractures were open. Among the 29 fractures treated surgically, the anteromedial approach was used for open reduction and fixation for 18. A dual approach was needed for 1 patient with a type III fracture. Fixation was achieved with cancelous screws for 17/29 fractures including 3 fluted screw fixations, cortical screws for 9, K-wires for 2 and staples for 1. RESULTS: According to the AOFAS classification, mean function score at last follow-up was 94.4/100 for type I, 78.5 for type II, 69.5 for type III, and 57.5 for type IV. Signs of osteoarthritis were observed in 68% of the cases with clinical expression in 9 out of 10 cases. DISCUSSION: The results show that conservative treatment is indicated for type I fractures while open reduction and fixation should be used for types II, III, and IV. Subsequent joint degeneration was correlated with the type of fracture and clearly influenced functional outcome. In our long-term follow-up, we only had two cases of osteonecrosis which finally necessitated arthrodesis. This low rate would be related to the fact that most of the patients were able to avoid weight bearing for several months.

Adolescent↗
PubMed2001

Quality of life study in prostate cancer patients treated with three-dimensional conformal radiation therapy: comparing late bowel and bladder quality of life symptoms to that of the normal population.

PURPOSE: The goals of this study were twofold. First, differences were quantified for symptoms that impact bowel and bladder quality of life (QOL) in prostate cancer patients treated with three-dimensional conformal radiotherapy (3DCRT) alone to the prostate vs. whole pelvis with prostate boost. Second, bowel and bladder QOL measures for these patients were compared to those of the normal population of men with a similar age distribution. MATERIAL AND METHODS: Two health status surveys evaluating bowel and bladder functioning, along with the AUA Symptom Problem Index and the BPH Impact Index, were mailed to 195 prostate cancer patients treated with 3DCRT between 12/92 and 11/95 at Fox Chase Cancer Center by a single clinician (GH). No patient received hormonal management as part of his treatment. Ninety-five patients had pretreatment PSA levels <10 ng/ml, T1/T2A tumors with Gleason scores 2-6, and no perineural invasion. They were treated to the prostate alone and are referred to as Group I. The remaining 100 patients had one or more of the following characteristics: pretreatment PSA levels > or =10 ng/ml, T2B/T3 tumors, Gleason scores 7-10, or perineural invasion. These patients were treated to the whole pelvis followed by a boost to the prostate and are referred to as Group II. Frequencies were tabulated, and differences in percentages for the two groups were evaluated using the two-tailed Fisher's Exact Test. Overall percentages were compared to those for equivalent measures reported by Litwin (1999) based on a normal population of men with a mean age of 73 years (range 47-86). Comparisons to the normal population were also evaluated using two-tailed Fisher's Exact p values. RESULTS: The mailing yielded a high response rate of 71% (n = 139, 66 in Group I and 73 in Group II). The mean age was 67 (range 49-82), and the median ICRU dose levels for Groups I and II were 73 and 76 Gy, respectively. Responses relating to bladder symptoms were similar for Groups I and II, except for the degree of bother associated with trouble in urination over the last month. Percentages for no bother at all were 66% and 56% for Groups I and II, respectively. Observed differences in bowel functioning related to rectal urgency over the past year (22% vs. 40% for Groups I and II, p = 0.03), the use of pads for protection against bowel incontinence (0% vs. 10% for Groups I and II, p = 0.01), and bowel satisfaction (88% vs. 72% for Groups I and II, p = 0.03). There was no significant difference in the degree of bother bladder symptoms cause men treated with radiotherapy as compared to men without cancer. Few patients reported bowel dysfunction bother as a big problem, but patients do tend to have more very small to moderate bother from bowel dysfunction than the normal population (55% vs. 33%, p < 0.001). CONCLUSION: This is the first long-term study of QOL in men treated with high-dose 3DCRT for prostate cancer. It demonstrates that these men enjoy QOL related to bladder function similar to that of the normal population. Few patients report bother from bowel symptoms as a big problem but tend to have more very small to moderate bother than the normal population. Treatment of prostate cancer patients to the whole pelvis may result in decreased QOL as defined by rectal urgency, the use of pads for bowel incontinence, and satisfaction with bowel functioning. However, regardless of field size, men are generally satisfied with their bowel and bladder functioning three to six years post treatment.

Aged↗
PubMed2001

Social inequality in the utilization of in- and outpatient treatment of non-psychotic/non-organic disorders: a study with health insurance data.

BACKGROUND: This study deals with the utilization of in- and outpatient care due to non-psychotic/non-organic disorders (ICD-9 300-307: neuroses, personality disorders, sexual disturbances, alcohol and substance dependencies, drug abuse and functional disorders). Specifically, it examines whether social gradients to the detriment of individuals from lower social positions appear. This is dealt with both in terms of in- and outpatient treatment. Secondly, it examines whether the likelihood of being treated as an inpatient rather than an outpatient differs between occupational status positions. Finally, the study considers whether the hospital department a given patient is most likely to be assigned to differs between occupational status positions. METHOD: Analyses were performed with records from a statutory health insurance in West Germany. The database consists of 124,917 men and women between 20 and 60 years of age. We included only subjects with employment periods, as otherwise outpatient treatment could not be assessed completely. The data had been recorded between 1987 and 1996. In total, 9129 persons had one of the above mentioned diagnoses, 6115 of them received outpatient treatment and 3014 were inpatients only. RESULTS: The relative risk (RR) for outpatient diagnoses was RR=4.41 for the male unskilled/semi-skilled insured in comparison with men in the highest occupational position, the equivalent RR for women was 2.1. The respective results for inpatient treatment were RR=7.3 for men and RR=2.3 for women. In men, the relative risks were considerably reduced after cases with alcohol- and substance-related diagnoses had been excluded. For the assignment to in- and outpatient treatment, no consistent differences between individuals with different occupational positions emerged. Once diagnosed, higher-status individuals had the longest treatment periods as in- and outpatients. Only a small proportion of diagnosed subjects received medical care in psychiatric wards; this held especially for the group with higher occupational positions. CONCLUSIONS: Social inequalities in the treatment of psychogenic disorders emerged for outpatients as well as for inpatients. Inpatients tended to avoid treatment in psychiatric departments, and it can be concluded that individuals holding higher positions may be more successful in their attempts to avoid stigmatization.

Adult↗
PubMed2001

Quantitation of human herpes virus 8 DNA in paraffin-embedded biopsies of HIV-associated and classical Kaposi's sarcoma by PCR.

BACKGROUND: Kaposi's sarcoma occurs in patients seropositive and seronegative for the human immunodeficiency virus (HIV) and has been associated with human herpes virus 8 (HHV8). The purpose of this study was to determine and to compare the amount of HHV8 DNA in formalin-fixed tissue sections of Kaposi's sarcoma. METHODS: From 27 biopsies of Kaposi's sarcoma patients, tissue sections were taken and deparaffinized. Four patients were HIV seronegative and 13 were HIV seropositive. After extraction of DNA copy numbers of HHV8 and beta-globin were determined in every sample by quantitative PCR ELISA using an internal quantitation standard. Results were expressed as HHV8 per beta-globin. RESULTS: No significant differences were found between biopsies from HIV-positive and HIV-negative patients (14.8+/-19.6 HHV8 per 1000 beta-globin in HIV-positive versus 18.0+/-23.5 in HIV-negative patients). CONCLUSIONS: These data suggest that HHV8 viral load in Kaposi's sarcoma is relatively low and does not differ in HIV-positive and HIV-negative samples. The importance of viral load determination for prognosis or treatment monitoring remains to be elucidated.

AIDS-Related Opportunistic Infections↗
PubMed2001

Malignancy of the larynx in a child.

Squamous cell carcinoma of the larynx in children is rare. The management of laryngeal malignancy is more difficult in children than adults for several reasons: the aggressive nature of a tumor that is often diagnosed late in children; the delicacy of pediatric anatomic structures; intraoperative blood loss; long-term post-treatment complications; and psychological factors particular to children. A tracheostomized 13-year-old boy came to us with a 4-month history of hoarseness, breathing difficulty, and swelling in the neck. A detailed examination revealed that a transglottic tumor had infiltrated the thyroid and cricoid cartilage, the upper two tracheal rings, and the thyroid gland. Such an infiltration has not been previously reported. The lesion proved to be a well-differentiated squamous cell carcinoma. We performed a wide-field total laryngectomy, which was followed by radiotherapy. Unfortunately, the child survived only 3 years postoperatively.

Adolescent↗
PubMed2000

Psychosocial work environment and the risk of coronary heart disease.

OBJECTIVES: Remarkable changes in the working situation have led to the increasing importance of psychomentally and socio-emotionally demanding conditions at work. With the help of theoretical models, those highly prevalent psychosocial work environments were conceptualized which influence the risk of coronary heart disease by enhanced activation of the autonomic nervous system. One of the most prominent theoretical approaches, the job strain model, and a more recent approach, the effort-reward imbalance model, are discussed in the paper. EMPIRICAL EVIDENCE: Findings from prospective and cross-sectional studies indicate that job strain and effort-reward imbalance at work define specific conditions of chronic work stress that are associated with an elevated risk of coronary heart disease (CHD). Respective multivariate odds-ratios range from 1.2 to 5.0 with respect to job strain, and from 1.5 to 6.1 with respect to effort-reward imbalance. These associations are explained neither by established behavioral or biomedical risk factors nor by physical and chemical hazards at work, rather they define independent, new work-related risk conditions. There is additional evidence that effort-reward imbalance may mediate the association of some traditional occupational exposures, such as shift work, with cardiovascular risk: in a cross-sectional study, prevalence odds ratios of hypertension and atherogenic lipids attributable to effort-reward imbalance were relatively highest among shiftworkers as compared to daytime workers. Preliminary results from intervention programs based on the theoretical models document favorable effects on health. CONCLUSIONS: Information derived from theoretical models on psychosocial work environment may help to better identify populations at risk and to develop and apply specific, theory-guided preventive activities in the future.

Coronary Disease↗