Biomedical subjects

S Beer

Publications and source records attributed to S Beer.

At least 19 recordsLinked to original sources

PubMed1996

The perception of movements elicited by magnetic cortex stimulation depends on the site of stimulation.

Previous reports suggest that magnetic cortical stimulation (MCS) of the motor cortex can elicit a sensation of movement (kinaesthesia) in paralysed limbs. To assess this sensory effect of MCS, we examined the accuracy of kinaesthetic perception of stimulus-induced right elbow flexion in six blindfolded, healthy subjects. Matching of movements elicited by MCS was compared with matching of passive elbow movements. Small flexion movements between 1.5 and 5 degrees of angle were regularly overestimated by 50-100% when induced by MCS over the parietal cortex, whereas movements elicited by MCS over the frontal cortex or by passive elbow flexion were accurately estimated. Our results provide data compatible with the hypothesis of the existence of a "central sense of movement". Activation of collateral branches projecting from the motor cortex to the sensory could be the underlying mechanism to this phenomenon.

Adult↗

PubMed1995

Diagnostic value of paraclinical tests in multiple sclerosis: relative sensitivities and specificities for reclassification according to the Poser committee criteria.

The yield of paraclinical tests was evaluated in a prospective study of 189 consecutive patients referred for suspected multiple sclerosis (142 patients with multiple sclerosis, 47 non-multiple sclerosis patients on discharge). Patients were first classified according to the Poser criteria by the clinical findings. Subsequently, the results of paraclinical tests (cranial MRI, visually evoked potentials (VEPs), somatosensory evoked potentials by tibial nerve stimulation (SSEPs), motor evoked potentials (MEPs), and analysis of CSF for oligoclonal banding and IgG-index (CSF)) were taken into account. The percentage of reclassified patients (reclassification sensitivity, RS) was always lower than the percentage of abnormal results (diagnostic sensitivity, DS), and the divergence of RS v DS differed between the tests (60% v 84% in MRI, 31% v 77% in CSF, 29% v 37% in VEPs, 20% v 68% in MEPs, and 12% v 46% in SSEPs respectively). False reclassifications of non-multiple sclerosis patients to multiple sclerosis would have occurred with all tests (MRI: six of 47 patients, (reclassification specificity 88%); CSF: one (98%); VEPs: two (96%); MEPs: two (96%); SSEPs: four (91%); P < 0.05). Although MRI had superior diagnostic capacity, 57 of the 142 patients with multiple sclerosis were not reclassified by the MRI result, 12 of whom were reclassified by CSF and 18 by one of the evoked potential (EP) studies. Of the 98 patients not reclassified by CSF, 53 were reclassified by MRI and 39 by EPs. The results suggest that for the evaluation of paraclinical tests in suspected multiple sclerosis, comparison of diagnostic sensitivities is inappropriate. In general, a cranial MRI contributes most to the diagnosis; however, due to its comparatively low specificity and its considerable number of negative results, EP or CSF studies are often useful to establish the diagnosis of multiple sclerosis.

Adolescent↗

PubMed1995

[Serodiagnosis of atypical bacterial respiratory infections].

Since prevalence of antibodies to bacteria causing atypical respiratory infections in Israel is as yet unknown, a 5-year antibody prevalence study was performed. Seroreactivity to Chlamydia pneumoniae (TWAR), with titers > or = 1:16 by microimmunofluorescence assay (MIF) was detected in 725/1305 (55.5%) of patients. 47/1012 ((4.6%) of adult patients had MIF results indicating recent infection with TWAR, (IgG titers of > or = 1:512, and/or IgM titers of > or = 1:16, and/or seroconversion). Antibody prevalence and titers were low in children aged 1-10 years, increased in teenagers, and peaked in adults and the elderly, in whom prevalence was up to 79% and mean geometric titer up to 1:163. Unlike the consistency in TWAR antibody prevalence and serological evidence of recent infection during the study period, a significant decrease in those variables was observed for Chlamydia trachomatis during the first 3 study years. Antibodies to M. pneumoniae were detected in 53 and to Legionella sp. in 47 out of 763 patients. There was serological evidence of recent infection with M. pneumoniae in 10 (including 7 children) and with Legionellae in 8. Improved diagnosis of atypical respiratory infection might be achieved by the combined use of these proposed serological procedures.

Adolescent↗

PubMed1994

Prevalence of Chlamydia pneumoniae antibodies in patients with acute respiratory infections in Israel.

AIMS: To evaluate the prevalence of antibodies to Chlamydia pneumoniae (TWAR) in relation to other aetiological agents of acute respiratory infections in Israeli patients. METHOD: Serum samples from 604 patients (183 children and 421 adults) were collected over three years. Antibodies to C pneumoniae, C trachomatis, and Legionella sp were evaluated using the microimmunofluorescence (MIF) assay. Antibodies to Mycoplasma pneumoniae were detected using the Serodia Myco II test. RESULTS: Antibodies to TWAR were detected in 319 (51.3%) sera. Twenty one patients had MIF results indicative of recent infection. TWAR prevalence and antibody titres in children (aged 1-10 years) were low, gradually increased in teenagers (11-18 years), and were highest in adults and elderly patients. In contrast to the consistently noted TWAR antibody prevalence and serological evidence of recent infection during the study period, a significant decrease in those variables was recorded for C trachomatis. Six patients had serological evidence of recent infection with both C pneumoniae and C trachomatis. The presence of antibodies to Mycoplasma pneumoniae and Legionella sp was tested in 473 of the patients; 29 had antibodies to M pneumoniae and 23 to Legionella sp. Six patients (including five children) had serological evidence of recent infection with M pneumoniae and four with Legionella sp. CONCLUSION: C pneumoniae should be considered in patients with acute respiratory diseases. MIF is the preferred method for monitoring the presence of antibodies to this organism.

Acute Disease↗

PubMed1994

High prevalence of multiple sclerosis in Switzerland.

Prevalence of multiple sclerosis (MS) was determined in the Canton of Berne, Switzerland. This canton is a geographically diverse region at 47 degrees northern latitude with 920,000 inhabitants. Epidemiological data were obtained from the case records of the University Department of Neurology, from the Swiss MS Society, from practising neurologists and from regional hospitals. Diagnostic accuracy was ascertained in retrospect, and only those cases fulfilling the criteria proposed by the Poser Committee were included. Of the patients provided by the Swiss MS Society, only those who had been diagnosed by a neurologist were accepted as definite cases. Changes of population due to migration or death were traced at governmental registry offices, and the place of residence was determined. Using the 1,016 cases of definite and probable MS identified, the minimal prevalence rate was 110 MS cases/100,000 inhabitants in the Canton of Berne on January 1, 1986. The increase in MS in this region since the 1950s was due mainly to the increase in life duration of MS patients rather than an increase in incidence rates over the last 20 years.

Adolescent↗

PubMed1994

A membrane-located polypeptide of Ulva sp. which may be involved in HCO3- uptake is recognized by antibodies raised against the human red-blood-cell anion-exchange protein.

Polypeptides present in a membrane fraction of the marine macroalga Ulva sp. were separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and tested for cross-reactivity with antibodies raised against the human red-blood-cell anion exchanger (AE1). A polypeptide of ca. 95 kDa was identified with a monoclonal, as well as two polyclonal (one against the C-terminus and one against the whole protein) antibodies, indicating that it shares homologous domains with AE1. These findings complement an earlier study which indicated that a plasmalemma-bound, disulfonic stilbene-sensitive, protein was functionally involved in HCO3- transport into the photosynthesizing cells of Ulva (Z. Drechsler et al. 1993, Planta 191, 34-40). It is thus suggested here that a similar protein has evolved, and has been conserved, in marine photosynthetic organisms and mammalian red blood cells for the purpose of HCO3- transport.

Anion Exchange Protein 1, Erythrocyte↗

PubMed1992

Tomographic myocardial perfusion imaging with technetium-99m teboroxime during adenosine-induced coronary hyperemia: correlation with thallium-201 imaging.

Single-photon emission computed tomographic imaging with technetium-99m teboroxime during exercise has been found to be feasible and the results correlate with those obtained with thallium-201. This study examined the feasibility of this technique and compared tomographic imaging with technetium-99m teboroxime during adenosine-induced coronary hyperemia with thallium-201 imaging. With the patient positioned on the imaging table, adenosine was infused at a rate of 140 micrograms/kg per min for 6 min. At 4 min, 20 to 25 mCi (740 to 925 MBq) of technetium-99m teboroxime was injected intravenously and imaging was started as soon as the infusion was completed with use of a 180 degrees anterior arc and 32 stops at 10 s/stop (total imaging time 7.8 min). Rest images were obtained 60 to 90 min later with use of a similar dose of technetium-99m teboroxime. Exercise tomographic thallium images were obtained within 2 weeks of the teboroxime studies. In the 20 patients studied, the teboroxime images were normal in 2 (50%) of 4 normal subjects and abnormal in 15 (94%) of 16 patients with coronary artery disease; 4 of the 15 had a fixed defect and 11 a reversible defect. There was agreement between teboroxime and thallium studies in 16 patients (80%), in 319 (80%) of 400 segments and in 50 (83%) of 60 vascular segments (p less than 0.05). In two normal subjects, an apparent fixed defect involving the inferior wall was seen on the teboroxime but not the thallium images and was thought to be due to an attenuation artifact secondary to extracardiac activity in the left lobe of the liver.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine↗

PubMed1991

[Steroid therapy in multiple sclerosis].

Since the 1950s steroids have been known to have a beneficial effect on recovery from acute exacerbations of multiple sclerosis. The main effect is a more rapid improvement after acute relapses due to resolution of edema in the central nervous system. Long-term steroid therapy showed no benefit in patients with a progressive course and involves dangerous side effects (Cushing's habitus, hyperglycemia, increased susceptibility to infections, peptic ulcers, osteoporosis, cataract). Intrathecal steroid administration offered no advantage over the conventional i.v. route. On the basis of a multicentre trial, ACTH therapy became the standard regime in the treatment of acute exacerbations. Recent reports have demonstrated a beneficial effect of therapy with high-dose methylprednisolone. Taking into account the restrictions and possible side effects, this therapy is a safe and efficient alternative to the standard ACTH regimen in the treatment of acute exacerbations in multiple sclerosis.

Adrenocorticotropic Hormone↗

PubMed1991

[Sequelae of severe craniocerebral injuries. An epidemiological study in the Canton of St. Gallen].

Severe head injuries often lead to serious medical and socioeconomic sequelae. The incidence rate indicated in other studies shows a wide variation due to differences in selection criteria. Based upon an unselected population, the incidence of severe head injury was calculated and the surviving patients were interviewed and clinically examined 3 years after the accident in order to describe the course, rehabilitation and psychosocial sequelae after severe head injury. Retrospectively we collected 80 patients living in the canton of St. Gallen who had a severe head injury requiring hospitalization in 1987, indicating an incidence of 20 per 100,000 inhabitants. 22 (28%) of these patients died as a consequence of the head trauma. The best predictor was the Glasgow coma score at admission, which showed a highly significant direct correlation with survival rate. Regarding the degree of impairment of survivors the duration of posttraumatic amnesia was the best predictive parameter. Of the 45 patients controlled 3 years after the head trauma only 11% were severely impaired in daily activities. 79% of the patients who were gainfully employed before the accident were working full- or at least part-time. However, only 3 patients (7%) were absolutely free of symptoms. Most patients suffered from cognitive and emotional deficits. Based on an estimated incidence for minor head trauma of 174 per 100,000 inhabitants, a total annual incidence for all head traumas of 194 per 100,000 inhabitants is calculated, with severe head injury representing about 1/9 of all head injuries.

Adolescent↗

PubMed1991

The effects of human proinsulin on glucose turnover and intermediary metabolism.

We compared the effects of human proinsulin and human insulin on glucose disposal, suppression of hepatic glucose production (HGP), and intermediary carbohydrate and lipid metabolism. Six young, lean, subjects underwent eight separate euglycemic clamps with low-dose intravenous (IV) infusions of insulin and proinsulin (four each). The insulin infusions gave steady-state levels of 0.08 +/- 0.004 (I1), 0.12 +/- 0.003 (I2), 0.18 +/- 0.07 (I3), and 0.25 +/- 0.06 nmol/L (I4). The proinsulin infusions were chosen to give steady-state levels approximately 20-fold higher on a molar basis than insulin, based on previous findings that proinsulin has only 5% to 10% the biological potency of insulin. Steady-state proinsulin levels were 1.2 +/- 0.04 (P1), 2.8 +/- 0.07 (P2), 4.5 +/- 0.3 (P3), and 6.9 +/- 0.3 nmol/L (P4). HGP was suppressed equally by proinsulin and insulin at the four dose levels. Percentage elevation of glucose disposal was significantly increased during each of the insulin infusions compared with proinsulin: I1 107% +/- 4%, P1 87% +/- 4% (P = .03); I2 143% +/- 7%, P2 125% +/- 12% (P = .01); I3 238% +/- 38%, P3 173% +/- 22% (P = .03); I4 283% +/- 17%, P4 178% +/- 11% (P = .002). Dose-response curve analysis demonstrated that proinsulin stimulated glucose disposal approximately 3.3% compared with insulin. The effectiveness of proinsulin in suppressing HGP was approximately 5% compared with insulin. Plasma nonesterified fatty acids, blood glycerol, and 3-hydroxybutyrate were suppressed by similar amounts during each of the four insulin and proinsulin doses.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1988

[Multiple sclerosis in the Bern canton (Switzerland). An epidemiologic study].

We conducted a study on the prevalence of multiple sclerosis in the canton of Berne (Switzerland) at the Department of Neurology (inpatient and outpatient sections) of the Inselspital hospital (University of Berne) in Berne. The canton of Berne is a heterogeneous region, geographically speaking, extending from the foot of the Jura mountains to high Alpine regions. There are approximately 920,000 inhabitants in an area of 6,000 square kilometers. Sources of our study were, besides the Department of Neurology of the University and the practising neurologists of Berne, the Association of Swiss Hospitals (VESKA) and the Swiss Multiple Sclerosis Society. For ensuring a safe diagnosis we employed a diagnosis score suggested by C. M. Poser et al (1983). This covered only safely established and probable cases of MS. To make sure of the actual residence of the retrospectively assessed patients we conducted a checkup with the relevant authorities. Besides personal data it was also possible, in a majority of patients, to obtain data on the onset and course of the disease. On 1, 1, 1986 1,016 MS patients were residents in the canton of Berne, according to our investigations. This corresponds to a prevalence rate of 110 MS patients for every 100.000 inhabitants. The sex ratio (female/male) is about 1.8: 1. The average age of the MS patients covered by the study was 50 years with an average duration of the disease of 18 years. From the data concerning the course of the disease our study was able to gain further pointers on the beginning of the disease, on the pattern of symptoms, course of the disease, and progression of multiple sclerosis.

Adolescent↗

PubMed1988

Heredofamilial syndrome of mesodermal hamartomas, macrocephaly, and pseudopapilledema.

A 4 1/2-year-old boy with macrocephaly, pseudopapilledema, lipoangiomatosis, macropenia, and spotted pigmentations of the glans is reported. Lipoid masses were found in the subcutaneous tissue, tonsils, and probably the left lung. Some of these findings are consistent with features already reported by Riley and Smith, later by Bannayan, and recently by Ruvalcaba et al. We propose to unify the features of this syndrome and name it macrocephaly, hamartomas, and papilledema syndrome. The inheritance in our described case seems to be autosomal dominant.

Child, Preschool↗

PubMed1987

Prodromal features of asthma.

One hundred and thirty four ambulatory children with bronchial asthma were investigated in the Pediatric Pulmonary-Allergic Service. In 95 patients an interval characterised by prodromal respiratory symptoms (cough, rhinorrhoea, and wheezing), behavioural changes (irritability, apathy, anxiety, and sleep disorders), gastrointestinal symptoms (abdominal pain and anorexia), fever, itching, skin eruptions, and toothache preceded the onset of the attack of asthma. Each child had his own constant set of prodromal findings. A significant age related increase in serum IgE concentrations was observed in these patients. No such relation was observed in children with an acute onset of attack of asthma without any preceding symptoms. We suggest that awareness of these prodromal symptoms may lead to an early introduction of treatment, thus avoiding or abbreviating some of the acute attacks of asthma.

Adolescent↗

PubMed1987

Clinical data bank at the University Department of Neurology, Bern, Switzerland: basis for an epidemiological study of multiple sclerosis in a high prevalence area.

Clinical and laboratory data for over 1000 patients with definite multiple sclerosis living on prevalence day January 1st, 1986 in the Swiss Canton of Bern, a geographically heterogeneous region, are analysed retrospectively by means of a specially developed computer system. The consequent application of the "Minimal Record of Disability" (MRD) as proposed by the IFMSS forms the basis of data sampling. Details of clinical aspects gained from these records are presented together with an account on the applicability of this system in collaborative epidemiological investigations, for which the now ongoing prospective study based on the aforementioned retrospective one at our Institution may serve as an example.

Adolescent↗

PubMed1986

Predisposition of the asthmatic child to legionellosis?

The prevalence of seropositivity to Legionella spp. was studied in 184 children with bronchial asthma and in 80 control children, age- and sex-matched, without respiratory tract infections. The sera were examined by indirect immunofluorescence with antigens of six Legionella spp. The asthmatic children showed a significantly higher percentage of seroreactions to L. pneumophila than did the control children. In the asthmatic children, no association was found between age, sex, onset of asthmatic symptoms, living conditions, corticosteroid treatment, or exposure to aerosols and seropositivity to Legionella. No correlation could be found between the asthma severity score and the titer of serum antibodies to L. pneumophila. None of the 32 sera with titers of 256 or higher were reactive for Legionella-specific IgE antibodies. L. pneumophila antigen was detected in the urine of three children by an enzyme-linked immunosorbent assay (ELISA). The high prevalence of antibodies to L. pneumophila found in children with bronchial asthma, together with the detection of antigen in the urine of some of them, suggest that this group of children are highly susceptible to Legionnaires' Disease.

Adolescent↗

PubMed1985

Serum antibodies to Legionella agents in bronchial asthma.

The prevalence of seropositivity to Legionella species was studied in 184 children with bronchial asthma and 80 control children, age and sex matched, without respiratory tract infections. The sera were examined by indirect immunofluorescence with antigens of six Legionella species. The asthmatic children showed a significantly high percentage of seroreactions to L pneumophila compared with the control children. In the asthmatic children, no association was found between age, sex, onset of asthmatic symptoms, living conditions, corticosteroid treatment, or exposure to aerosols and seropositivity to Legionella. No relation could be found between the asthma severity score and the titre of serum antibodies to L pneumophila. None of the 32 sera with titres of 1:256 or higher were reactive for Legionella specific IgE antibodies. A high prevalence of antibodies to L pneumophila was found in children suffering bronchial asthma. Further studies are necessary to clarify the clinical relevance.

Adolescent↗

PubMed1985

A fatal case of Q fever hepatitis in a child.

A two-year-old boy of Arabic extraction presented with progressive jaundice and prolonged pyrexia. Both IgM and IgG immunofluorescent antibody titers for Q fever were 1:1280. Two goats and one cow of the domestic animals owned by the family also had positive antibody titers against Q fever. In spite of antibiotic treatment with tetracyclines and chloramphenicol, the hepatic involvement progressed gradually. On the twentieth day of admission the child succumbed from hepatic failure. This child presents a rare case of fatal hepatic failure due to Q fever.

Antibodies, Bacterial↗

PubMed1984

Bacteraemia among children in hospital--a four year prospective study.

The incidence of bacteraemia in children (excluding newborn babies) admitted to a general hospital during the period 1978 to 1981 was 3.2 patients per 1000 admissions. Of the total, nosocomial bacteraemia comprised 0.7 patients per 1000 admissions. Analysis of some probable risk factors showed that the chance of acquiring bacteraemia in the first year of life was 6.8 times that for older children, the difference being statistically significant (P less than 0.001). The male to female ratio was 1.7: but this difference was not statistically significant. Overall the case mortality rate was 4.5%. For nosocomial bacteraemia the rate was much higher (14.3%) than that of community acquired bacteraemia (1.9%) with a risk of dying 7.5 times greater (P less than 0.01). Of the pathogens isolated 71.2 per cent were Gram-negative, Escherichia coli being the most common followed by Salmonella typhi. Among the Gram-positive organisms isolated, as well as overall, the pneumococcus was the most common pathogen. Pneumonia and gastroenteritis were the underlying conditions most often found. Since the pneumococcus was the most common pathogen, and in all of our patients originated in the community, physicians who treat in out-patient clinics as well as emergency rooms should be aware of this and look especially for the early symptoms and signs of disease likely to be caused by this organism.

Adolescent↗