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Biomedical subjects

S Sperber

Publications and source records attributed to S Sperber.

9 recordsLinked to original sources

[Disease Management Program for diabetes mellitus type 2: cooperation or resistance of the general practitioner].

AIM: of the study was to seize the attitudes of General Practitioners (GPs) towards the disease management program (DMP) for type 2 diabetes implemented in summer 2003 in Germany. Moreover we were interested in the way GPs realise the program in daily practice, e. g. how many patients and which patients they include. METHOD: A postal questionnaire was sent twice to all GPs in the region of Hamburg (n = 1.230), in November 2003 and in December 2004. Response rate without reminder was 20 respective 16 percent. RESULTS: In 2004 81 percent of the GPs taking part in the survey participate in the DMP. These doctors include a third of their patients with type 2 diabetes into the program. 65 percent of the GPs nevertheless do not believe, that the patients will benefit from the program. 47 percent of the participating GPs object to DMP in general. Only 66 percent say they follow the DMP guidelines for pharmacotherapy. Half of the doctors state they actively canvass patients for the program, while one fifth says they advice patients against participation. The GPs participate in first line to supply the demand of the patients and because of the public pressure less because they think the DMP is good in respect of content. In 2003 critics and pessimism regarding benefit for patients were even stronger than in 2004. CONCLUSIONS: GPs participate in the DMP diabetes half-heartedly and with doubts. The results suggest selections in the inclusion of patients. Further research should find out whether patients being likely to profit from the DMP are systematically not included.

Attitude of Health Personnel↗

Role of DHEA and growth factors in chromaffin cell proliferation.

Dehydroepiandrostreone (DHEA) is a neuroactive steroid produced by the inner layer of the adrenal cortex close to the adrenomedullary cells. Chromaffin cell growth and proliferation are under the control of insulin-like growth factor II (IGF-II) and basic fibroblast growth factor (bFGF). The aim of the present study was to examine the role of DHEA on chromaffin cell proliferation induced by IGF-II and bFGF. In our model, DHEA significantly decreased IGF-II-induced proliferation by 48.7%, whereas it did not affect the proliferation induced by bFGF. These data suggest that DHEA exerts a paracrine function in the control of chromaffin cell growth.

Cell Proliferation↗

[Effectiveness of an outpatient disease management programme for chronic heart insufficiency patients].

The effectivity of a disease management programme (DMP) for outpatients suffering from chronic heart insufficiency (CHI) in primary care is presented. The programme is predominantly based on a weekly telephone monitoring by a case manager using a standardised questionnaire that scores CHI-relevant information of the patient. If the score exceeds a predefined limit the patient's general practitioner is alarmed. An observational study including a total of 115 patients indicates a significant decline of the hospital admission rate (p < 0.0001), as the primary outcome measure, whereas the total length of hospitalization remained constant. The findings are compared with other studies' results and the aims of a randomised controlled trial on the efficacy of DMP on patients with chronic heart failure are discussed.

Aged↗

Evaluation of a monoclonal antibody-based enzyme immunoassay for early detection of herpes simplex virus genital infection.

A monoclonal antibody-based enzyme immunoassay test for detection of herpes simplex virus (HSV) type-common antigen was evaluated in 40 women with vulvar lesion suspicious for genital HSV infection. The assay gave interpretable readings in 90% of the cases, with sensitivity and specificity of 100% and 92% respectively, a negative predictive value of 100%, and a positive predictive value of 75%. With a few limitations, the assay may be used for early diagnosis of genital HSV infection.

Adolescent↗

Bee sting anaphylaxis in an urban population of South Australia.

The clinical manifestations and circumstances of bee sting anaphylaxis have been studied retrospectively in 98 subjects. Most reactions occurred in children but the most severe reactions were seen in adult males, of whom 7 lost consciousness and 2 required cardiopulmonary resuscitation. Most stings causing anaphylaxis occurred on the unprotected feet whilst the subject was on lawn in the afternoons in December, January and February when the maximum daily temperature was between 20 and 30 degrees C. This is the temperature range when bees are particularly active in gathering pollen. However, a significantly greater frequency of anaphylactic reactions occurred at higher temperatures when bees are less active, suggesting that high environmental temperature may predispose the individual to greater exposure to bees or possibly to anaphylactic reactions per se. The presence of atopy did not appear to predispose subjects to bee venom hypersensitivity. Considerable anxiety and lifestyle alteration were identified in some subjects. The alleviation of this anxiety is considered an appropriate indication for bee venom immunotherapy.

Adolescent↗

Bee-sting mortality in Australia.

Death as a result of a bee sting is uncommon in Australia. During the 22 years from 1960 to 1981, 25 individuals have been recorded by the Australian Bureau of Statistics as having died shortly after a bee sting. This gives a mortality incidence of 0.086/1 000 000 population per year, but may be an underestimate, as we report two additional fatalities that did not appear in the records of the Bureau of Statistics. South Australia has the highest mortality rate from bee stings of all the Australian States, with a recorded fatality rate of 0.26/1 000 000 population per year. As in other surveys, fatalities occur predominantly in men over 40 years of age, which suggests that there may be other contributory risk factors, for example, coronary atherosclerosis. No deaths were reported in individuals aged from six to 19 years, the age group in which bee-sting anaphylaxis is particularly common. It thus appears that the prevention of death per se is not a strong rationale for routine bee-venom immunotherapy in schoolchildren and young adults.

Adolescent↗

Serum IgG antibodies to gliadin in children with celiac disease as measured by an immunofluorescence method.

Antigliadin antibodies (AGAs) were studied in sera from 190 patients divided into five clinical groups. Group I included 28 sera from children with newly diagnosed celiac disease on a normal diet. Group II consisted of 43 sera from children with celiac disease who were fed a gluten-free diet (GFD). Group III included 25 sera from children with celiac disease who had been in remission but exposed to a gluten-containing diet (GCD). Group IV consisted of 46 sera from children with chronic diarrheal disorders other than celiac disease. Group V included 43 sera from healthy children. The observed p values proved that (a) mean titer levels of AGAs in Groups I and III were significantly higher than the mean values for all other groups (p less than 0.001), and (b) the mean titer level of AGAs in Group II was significantly higher than the mean values for Groups IV and V. A good correlation between the AGA titers and the morphology of the duodenal mucosa was found in children with celiac disease. The examination of IgG AGAs by the immunofluorescence technique used in our study appears to be a useful tool in the follow-up of individual patients to determine adherence to a GFD.

Animals↗