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  • 1
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. Blood flow velocities were recorded in the external iliac artery (EIA) and umbilical artery (UA) in 94 normal pregnancies and in 14 with intrauterine growth retardation (IUGR) between 25 and 36 weeks gestation. In normal pregnancy the pulsatility index (PI) in both vessels decreased significantly with advancing gestational age, reflecting a reduction in lower extremity and placental vascular resistance. The EIA PI/UA PI ratio also decreased significantly with gestational age suggesting that vascular resistance is more pronounced in the lower extremities. In the pregnancies with IUGR, PI values from both vessels were nearly always above the upper limit (+2 SD) of the normal curve reflecting increased vascular resistance at lower extremity and placental level. In two pregnancies, absent end-diastolic flow velocities in the umbilical artery were associated with reversed end-diastolic flow velocities in the external iliac artery.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 47 (1992), S. 0 
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The relationships between patients' height, weight, age, body mass index, gender and presence of maxillary incisors and a series of laryngoscopic factors have been studied. These included the duration of laryngoscopy, maximally applied force, mean applied force and the integral of force over time. There was a positive correlation between height and weight and laryngoscopic factors. Sex and age also showed a positive correlation but these could be explained by differences in height, weight and the presence of maxillary incisors. This latter factor was the dominant patient characteristic influencing the measured laryngoscopic factors. Use of these laryngoscopic factors as a measure of difficulty of laryngoscopy is discussed.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: It has been demonstrated that during routine use of the Macintosh blade, great forces are exerted on the maxillary incisors. The aim of this study was, by using biomechanical modelling, to modify a standard Macintosh blade in order to reduce these forces. This resulted in a Macintosh blade with a reduced proximal flange. Five anaesthetists performed tracheal intubation in 46 patients using the modified (n =24) or the standard blade (n = 22). The mean (SD) maximal forces exerted on the maxillary incisors were 12.7 (8.8) N in patients in the modified Macintosh group compared to 25.5 (17.8) N in the standard Macintosh group (p =0.008). These results demonstrate that reducing the proximal step of the Macintosh laryngoscope results in a reduction of the forces exerted on the teeth and suggest that laryngoscope blades with a high proximal step might be more traumatic than blades in which the proximal step is reduced.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We determined the forces on the maxillary incisors during routine laryngoscopy in 65 adult patients. The forces were measured by a strain gauge based sensor positioned between the handle and the blade of the laryngoscope. The mean maximal force acting on the maxillary incisors was 49 N. In patients without maxillary incisors, the force acting on the gums was significantly lower at 21N (p 〈 0.001). These results suggest that, despite traditional advice to the contrary, a levering movement of the laryngoscope, using the maxillary incisors (or gums) as a fulcrum, is common practice. Biomechanical analysis revealed that, although levering is not the preferred movement, it is an efficient way of bringing the glottis into view. These results may have implications for future laryngoscope design.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 47 (1992), S. 0 
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The relationship between the forces applied during laryngoscopy and cardiovascular changes were studied in patients undergoing laryngoscopy with or without intubation. This enabled us to differentiate between the cardiovascular effects of laryngoscopy and the effects of tracheal intubation. The forces applied during laryngoscopy were only weakly related to the cardiovascular changes, whereas tracheal intubation had a major influence. The many difficulties encountered in interpreting results from these studies are discussed. It is concluded that tracheal intubation causes more cardiovascular changes than laryngoscopy in routine uncomplicated procedures.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 21 (2005), S. 0 
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background : Current guidelines for stopping treatment of chronic hepatitis C are based on hepatitis C ribonucleic acid measurements at 12 and 24 weeks.Aim : To explore an alternative approach for making individualized recommendations about treatment duration, based on simple alanine aminotransferase tests and on cost-per-cure.Methods : We analysed individual patient data from 13 randomized, controlled trials with interferon alone or combined with ribavirin. Using multiple logistic regression, we built a model that estimated the probability of sustained virological response for treatment durations of 24 and 48 weeks. Decisions to prolong treatment were based on an increase in probability of sustained virological response. If the increase was 10%, the cost-per-cure became decisive with a limit of 50 000 €.Results : Noncirrhotics with genotype 2 or 3 did not benefit when treatment was continued beyond 24 weeks. Sustained virological response rates in cirrhotic patients increased by 14–47% if treatment was continued up to 48 weeks. In noncirrhotic genotype 1 or 4 patients who had elevated alanine aminotransferase levels at week 4, the probability of sustained virological response increased by 〈10% if treatment was continued up to 48 weeks; the cost-per-cure for these patients would exceed 50 000 €.Conclusion : The dynamics of alanine aminotransferase levels and cost-per-cure provides a useful alternative to determine the duration of therapy in chronic hepatitis C.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1437-160X
    Keywords: Rheumatoid factors ; ELISA ; Vasculitis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To study the occurrence of rheumatoid factors (RF) in relation to the activity of rheumatoid arthritis and the occurrence of vasculitis, RF of IgM, IgA, and IgG classes were measured in sera from 35 patients with definite or classic rheumatoid arthritis (RA) using ELISA. For 26 patients, the RF levels were studied longitudinally and compared with changes in the articular index. Although IgM RF was occasionally found in patients without RA, IgA and/or IgG RF were almost exclusively associated with RA. The titers of IgM, IgA, and IgG RF were significantly higher in sera from patients with clinically diagnosed rheumatoid vasculitis than in sera from patients without vasculitis. No significant correlation between changes in the articular index and changes in titer of any class-specific RF could be found for the group of RA patients as a whole. However, in individual patients, increases or decreases in IgM and IgG RF titer were significantly correlated with an increase or decrease in the articular index.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-0584
    Keywords: Bone marrow transplantation ; Graft-versus-host-disease ; Herpes viruses
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effects of pretransplant herpes virus serology on the occurrence of grades II–IV acute graft-versus-host disease (GVHD) were studied in 262 recipients and their HLA-identical family donors. In 131 recipients on standard GVHD prophylaxis (either methotrexate or cyclosporin A) significant effects were observed for donor HSV serology (seropositivity associated with increased risk for GVHD) and donor EBV serology (seronegativity associated with increased risk). However, these effects were nonsignificant in the other 131 recipients on intensified GVHD prophylaxis (i.e., methotrexate combined with cyclosporin A, in vivo anti-T-cell monoclonal antibodies, or various procedures to reduce the T-cell numbers in the transplants).
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-0428
    Keywords: Diabetes mellitus ; glucose intolerance ; insulin ; cognition ; aged ; epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Cognitive impairment is highly prevalent among the elderly. Subjects with disturbed glucose metabolism may be at risk of impaired cognitive function, as these disturbances can influence cognition through atherosclerosis, thrombosis and hypertension. We therefore studied the cross-sectional association of cognitive function with hyperinsulinaemia, impaired glucose tolerance and diabetes mellitus in a population-based cohort of 462 men aged 69 to 89 years. Cognitive function was measured by the 30-point Mini-Mental State Examination. Results were expressed as the rate ratio (95% confidence interval) of the number of erroneous answers given on the Mini-Mental State Examination by the index compared to the reference group. Compared to subjects with normal glucose tolerance, known diabetic patients had a rate ratio of 1.23 (1.04–1.46), newly-diagnosed diabetic patients of 1.16 (0.91–1.48) and subjects with impaired glucose tolerance of 1.18 (0.98–1.41), after adjustment for confounding due to age, occupation and cigarette smoking (p-trend=0.01). Non-diabetic subjects in the highest compared to the lowest quartile of the area under the insulin curve had a rate ratio of 1.24 (1.03–1.50), after adjustment for confounding (p-trend=0.02). The results did not change appreciably when potentially mediating factors, including cardiovascular diseases and risk factors associated with the insulin resistance syndrome, were taken into account. These results suggest that diabetes, as well as impaired glucose tolerance and hyperinsulinaemia in non-diabetic subjects are associated with cognitive impairment.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-0428
    Keywords: Key words Diabetes mellitus ; glucose intolerance ; insulin ; cognition ; aged ; epidemiology.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Cognitive impairment is highly prevalent among the elderly. Subjects with disturbed glucose metabolism may be at risk of impaired cognitive function, as these disturbances can influence cognition through atherosclerosis, thrombosis and hypertension. We therefore studied the cross-sectional association of cognitive function with hyperinsulinaemia, impaired glucose tolerance and diabetes mellitus in a population-based cohort of 462 men aged 69 to 89 years. Cognitive function was measured by the 30-point Mini-Mental State Examination. Results were expressed as the rate ratio (95 % confidence interval) of the number of erroneous answers given on the Mini-Mental State Examination by the index compared to the reference group. Compared to subjects with normal glucose tolerance, known diabetic patients had a rate ratio of 1.23 (1.04–1.46), newly-diagnosed diabetic patients of 1.16 (0.91–1.48) and subjects with impaired glucose tolerance of 1.18 (0.98–1.41), after adjustment for confounding due to age, occupation and cigarette smoking (p-trend = 0.01). Non-diabetic subjects in the highest compared to the lowest quartile of the area under the insulin curve had a rate ratio of 1.24 (1.03–1.50), after adjustment for confounding (p-trend = 0.02). The results did not change appreciably when potentially mediating factors, including cardiovascular diseases and risk factors associated with the insulin resistance syndrome, were taken into account. These results suggest that diabetes, as well as impaired glucose tolerance and hyperinsulinaemia in non-diabetic subjects are associated with cognitive impairment. [Diabetologia (1995) 38: 1096–1102]
    Type of Medium: Electronic Resource
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