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At least 1,711 records · Page 95Linked to original sources
PubMed1997

[Infection or epidemic? On the problem of mono-causal thinking in medicine. The contribution of Adolf Gottstein (1857-1941)].

Robert Koch (1843-1910) had by the end of the 1870 invented a definite and reproducible method of determine bacteria. During the first decades after the origin of bacteriology he and his disciples developed in practice a strictly monocausal theory: where there is a specific germ, only the specific disease occurs. The importance of Adolf Gottstein (1857-1941) must be viewed against this background. As a general practitioner Gottstein noticed that there are considerable differences between the single specific infection and its massive spread as an epidemic. As one of the first clinical epidemiologists he learnt how to verify his experience and presumptions by systematical, quantitative analyses. His epidemiologically founded publications were a key factor in the process of abandoning the monocausal theory of illness of the early period of the Koch era and giving way to a multicausal view. The dynamic aetiology of Gottstein was a major contribution to the development of social hygiene and public health care.

Causality↗
PubMed2000

Blood levels of homocysteine and increased risks of cardiovascular disease: causal or casual?

BACKGROUND: Accumulating data from epidemiological studies suggest that individuals with elevated blood levels of homocysteine have increased risks of cardiovascular disease. We reviewed the currently available evidence of an association between homocysteine and cardiovascular disease and examined whether the strength of the evidence varies according to study design. METHODS: We used a computerized MEDLINE literature search, 1966 through September 1998, to identify all epidemiological studies that examined the relationship of homocysteine level with risks of coronary heart or cerebrovascular disease. Two measures of plasma homocysteine level and its association with risk of cardiovascular disease were extracted: mean homocysteine level in cases and controls, and relative risk of cardiovascular disease for elevated homocysteine level. RESULTS: A total of 43 studies were reviewed. Most crosssectional and case-control studies indicated higher mean homocysteine levels (either fasting or after methionine load) and/or a greater frequency of elevated homocysteine level in persons with cardiovascular disease as compared with persons without cardiovascular disease. Results of most prospective studies, however, indicated smaller or no association. The few prospective studies that reported a positive association between homocysteine level and risks of cardiovascular disease included patients with preexisting vascular disease. CONCLUSIONS: In contrast to cross-sectional and case-control studies, results of prospective studies indicated less or no predictive ability for plasma homocysteine in cardiovascular disease. Instead, elevated homocysteine level may be an acute-phase reactant that is predominantly a marker of atherogenesis, or a consequence of other factors more closely linked to risks of cardiovascular disease. Randomized trials are necessary to test reliably whether lowering homocysteine levels will decrease risks of cardiovascular disease.

Adolescent↗
PubMed1981

Pyogenic granuloma of the larynx and trachea. A causal and pathologic misnomer for granulation tissue.

Pyogenic granuloma has a diagnostic, lobular arrangement of capillaries that clearly distinguishes it, histologically, from granulation tissue. Recently, the accurate term, "lobular capillary hemangioma" (LCH), has been introduced to emphasize this characteristic appearance. A review of 639 vascular lesions of the oral cavity, upper respiratory tract, larynx, and trachea yielded 73 LCHs. All were located in nasal or oral mucous membranes. Conversely, every one of 62 vascular lesions from the trachea or larynx consisted of granulation tissue, without evidence of LCHs. There were clinical as well as pathologic differences. The LCHs arose spontaneously, whereas each patient with laryngeal or tracheal granulation tissue had a specific history of trauma. Pyogenic granuloma (ie, LCH) does not occur in the larynx or trachea.

Adolescent↗
PubMed1998

Blepharophimosis: a causally heterogeneous malformation frequently associated with developmental disabilities.

We report on 22 individuals referred for genetic evaluation because of blepharophimosis. Fourteen of these patients had the blepharophimosis syndrome: 5 familial and 9 sporadic. Mental retardation or developmental delay was seen in 8 of the 12 children in whom this could be assessed. Eight of 22 children had a malformation syndrome other than the blepharophimosis syndrome. All 8 of these children were mentally retarded or developmentally delayed. Two of these 8 had recognized disorders (branchio-oto-renal syndrome and a ring 4 chromosome); the remaining 6 had unrecognized malformation syndromes. Based on this information, it is suggested that children with blepharophimosis be evaluated carefully for underlying conditions and that they be observed for developmental disabilities because of the frequent association.

Blepharophimosis↗