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  • 1
    Electronic Resource
    Electronic Resource
    Effect of supplemental pre-operative fluid on postoperative nausea and vomiting (2003)
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 58 (2003), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In a prospective, double-blind, randomised controlled trial, we studied the effects of pre-operative fluid load on post-operative nausea and vomiting. Eighty patients attending for laparoscopic cholecystectomy or gynaecological surgery were randomly allocated to receive 2 ml.kg−1 (conservative) or 15 ml.kg−1 (supplemental) Hartmann's solution intravenously, shortly before induction of anaesthesia. During the operation, fluid management was identical in both groups. During the first post-operative 24 h, post-operative nausea and vomiting occurred in 29 patients (73%) in the conservative fluid group and nine patients (23%) in the supplemental fluid group (p = 0.01). Supplemental pre-operative fluid is an inexpensive and safe therapy for reducing post-operative nausea and vomiting.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2044.2003.03262.x
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  • 2
    Electronic Resource
    Electronic Resource
    The effect of auricular acupuncture on anaesthesia with desflurane (2002)
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 57 (2002), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In most acupuncture studies it is difficult or even impossible to conduct a truly double-blind trial. However, this is possible when treatments are carried out on anaesthetised patients. Because acupuncture provides analgesia, we tested the hypothesis that needle stimulation of a combination of four ear acupoints would significantly reduce anaesthetic requirement. Ten healthy volunteers were anaesthetised with desflurane and randomly assigned to no treatment or acupuncture; the alternative treatment was given on a subsequent study day. Auricular acupuncture was performed with needles placed at the Shen Men, Thalamus, Tranquiliser and Master Cerebral Points on the right ear. Anaesthetic requirement, determined by the Dixon up-and-down method, was defined by the average desflurane concentration that prevented purposeful movement of the extremities in response to noxious electrical stimulation. Volunteers required a greater desflurane concentration to prevent movement on the control than on the acupuncture day: 4.9 (0.7; SD) vs. 4.4 (0.8) vol. %, p = 0.003. Acupuncture thus reduced anaesthetic requirement by 8.5 (7)%.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2044.2002.02832.x
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  • 3
    Electronic Resource
    Electronic Resource
    Heat loss during major orthopaedic surgery (1998)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 53 (1998), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1998.tb15150.x
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  • 4
    Electronic Resource
    Electronic Resource
    Paternal age is a risk factor for Alzheimer disease in the absence of a major gene (1998)
    Springer
    Neurogenetics 1 (1998), S. 277-280 
    Details
    ISSN: 1364-6753
    Keywords: Key words Alzheimer disease ; Risk factors ; Parental age ; Genetics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: ABSTRACT We compared the parental age at birth of patients with Alzheimer disease (AD) with that of cognitively healthy control subjects. Within 206 carefully diagnosed AD patients, two groups were distinguished according to the likelihood of carrying a major gene for AD (MGAD). This likelihood was calculated by applying a Bayesian approach which incorporates data on aggregation of the disease, age at onset, and "censoring" ages within the family. All AD patients were ranked by MGAD probability. According to the sample's quartiles, two subgroups were defined representing the 52 individuals with the lowest and the 52 with the highest MGAD probability. Age at onset of dementia, education, and apolipoprotein E ε  4 allele frequencies were not statistically different between the two groups. Fathers of patients with a low MGAD probability were significantly older (35.7±8.1 years) than fathers of both other groups (high MGAD probability 31.3±6.9 years, P =0.004; controls 32.6±6.8 years, P =0.04, n=50). The differences for mothers were less pronounced and not statistically significant. These findings suggest that increased paternal age is a risk factor for AD in the absence of a major gene, whereas increased maternal age and AD are associated only weakly and independently of genetic disposition.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s100480050041
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  • 5
    Electronic Resource
    Electronic Resource
    „BPSSD”: Verhaltens- störungen bei Demenz Ein neues diagnostisches und therapeutisches Konzept? (1998)
    Springer
    Der Nervenarzt 69 (1998), S. 269-273 
    Details
    ISSN: 1433-0407
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001150050270
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  • 6
    Electronic Resource
    Electronic Resource
    Tau-Protein Ein potentieller biologischer Indikator zur Früherkennung der Alzheimer-Krankheit (1998)
    Springer
    Der Nervenarzt 69 (1998), S. 379-385 
    Details
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Alzheimer-Krankheit ; Tau-Protein ; Liquor cerebrospinalis ; Früherkennung ; Key words Alzheimer’s disease ; Protein tau ; Cerebrospinal fluid ; Early recognition
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In 40 patients with Alzheimer’s disease (AD), in 5 patients with non-AD dementia and in 36 cognitively normal controls the concentration of protein tau was determined in the cerebrospinal fluid (CSF). Of the AD patients, 19 were very mildly demented (MMSE score from 25 to 28). Even in these patients, CSF tau was significantly more elevated than in controls. In the non-AD patients protein tau was less increased. Among the AD patients there was no association between CSF tau and severity of cognitive impairment or deficit in cerebral blood flow, determined by SPECT. Our findings suggest that CSF tau may be elevated even at the predementia stage of AD and be useful as a biological marker for the early recognition of the disease.
    Notes: Zusammenfassung Bei 40 Alzheimer-Patienten, 5 Patienten mit Demenzen anderer Ursache und 36 kognitiv unauffälligen Kontrollpersonen wurde das Tau-Protein im Liquor cerebrospinalis bestimmt. Von den Alzheimer-Patienten befanden sich 19 in einem sehr leichtgradigen Stadium der Krankheit (Summenwert im Mini-Mental-State-Test 25 bis 28 Punkte). Auch bei diesen wurde gegenüber den Kontrollpersonen eine signifikante Erhöhung von Tau gemessen. Eine weniger ausgeprägte Erhöhung von Tau zeigte sich bei den Patienten mit anderen Demenzen. Bei den Alzheimer-Patienten fand sich kein quantitativer Zusammenhang zwischen der Erhöhung von Tau und dem Schweregrad der Demenz oder dem zerebralen Perfusionsdefizit, bestimmt mit SPECT. Die Ergebnisse sind ein Hinweis, daß Tau auch im prädementiellen Stadium der Alzheimer-Krankheit erhöht sein könnte und sich als biologischer Indikator für die Früherkennung eignet.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001150050286
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  • 7
    Electronic Resource
    Electronic Resource
    Erbliche Ursachen und Risikofaktoren der Alzheimer-Krankheit (1999)
    Springer
    Der Nervenarzt 70 (1999), S. 195-205 
    Details
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Alzheimer-Krankheit ; Genetik ; Risikofaktoren ; Genetische Beratung ; Key words Alzheimer’s disease ; Genetics ; Risk factors ; Genetic counseling
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary A multifactorial etiology underlies the majority of cases of Alzheimer’s disease (AD). Both ill-defined environmental and genetic factors contribute to the development of the disease. Allele ɛ4 of ApoE is a genetic risk factor. Its presence increases the risk of developing AD. However, presence of e4 is neither necessary nor sufficient for the disease to arise. Apart from the common multifactorial forms of the disease, there are rare variants which are inherited as Mendelian traits. To date three genes are known that can be mutated in these rare forms of AD. Of these, mutations in the gene presenilin 1 on chromosome 14 are most frequent. In addition, mutations in the gene presenilin 2 on chromosome 1 and in the amyloid precursor protein gene (APP on chromosome 21) occur in autosomal dominant AD. This article reviews our present knowledge of the genetics of AD and discusses its relevance for patients with AD and their relatives.
    Notes: Zusammenfassung Der Großteil der Fälle von Alzheimer-Krankheit (AK) hat eine multifaktorielle Ätiologie. Das bedeutet, bisher nicht genauer bekannte Umwelteinflüsse und genetische Faktoren spielen bei der Entwicklung der Krankheit eine wesentliche Rolle. Von seiten der Genetik unterscheidet man bei der AK gegenwärtig genetische Risikofaktroren und Mutationen. Der einzige bisher gesicherte genetische Risikofaktor ist das Allel ɛ4 des Gens für Apolipoprotein E auf Chromosom 19. Dieses Allel erhöht die Wahrscheinlichkeit, an der AK zu erkranken, ist jedoch weder eine notwendige noch eine hinreichende Bedingung. Neben den häufigen Formen mit multifaktorieller Ätiologie kommen seltene Varianten der Krankheit vor, die nach Mendelschen Regeln vererbt werden. Bisher sind 3 Gene bekannt, die bei diesen seltenen, in der Regel früh auftretenden und autosomal dominant vererbten Formen mutiert sein können. Am häufigsten findet sich bei den autosomal-dominanten Fällen eine Mutation im Gen präsenilin 1 auf Chromosom 14, seltener liegen Mutationen im Gen präsenilin 2 auf Chromosom 1 und im Gen des Amyloid- Vorläuferproteins auf Chromosom 21 vor. In diesem Beitrag geben wir eine Übersicht über gegenwärtige Befunde zur Genetik der AK und diskutieren die Bedeutung dieses Wissens für Patienten und deren Verwandte.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001150050423
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  • 8
    Electronic Resource
    Electronic Resource
    Sind negative Kognitionen Symptome einer Depression oder auch Ausdruck von Persönlichkeitszügen? (1997)
    Springer
    Der Nervenarzt 68 (1997), S. 563-568 
    Details
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Dysfunktionale Einstellungen ; Automatische Gedanken ; Selbstkonzept ; Persönlichkeit ; Neurotizismus ; Key words Dysfunctional attitudes ; Automatic thoughts ; Self-concepts ; Personality ; Neuroticism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary This study examined the changes from hospital admission to discharge of different categories of cognitive distortions – automatic thoughts, self-concepts and dysfunctional attitudes – in 67 patients with an ICD-10 diagnosis of a depressive episode. Furthermore, the relationships were analyzed between cognitive distortions, degree of depression, and personality dimensions (isolation tendency, extraversion, rigidity, schizoidia, frustration tolerance and neuroticism). There was a significant correlation between automatic thoughts and negative self-concepts on the one hand, and severity of depression on the other upon admission. There was a significant reduction of automatic thoughts and the negativity of self-concepts from admission to discharge. No significant association was observed, however, between the severity of depression and dysfunctional attitudes. In addition, dysfunctional attitudes showed a significant decrease until discharge only in patients with a full remission of depressive symptoms. These results underline the fact that automatic thoughts and self-concepts are more state-dependent than dysfunctional attitudes. Moreover – even taking into account the degree of depression – there was a significant relationship between the personality dimension neuroticism and all cognitive scales upon admission. This indicates that a high degree of neuroticism may facilitate the emergence of negative cognitions during a depressive episode.
    Notes: Zusammenfassung An 67 stationären Patienten mit der Diagnose einer depressiven Episode wurden mittels Selbstbeurteilungsinstrumenten die Veränderungen in verschiedenen Kategorien von kognitiven Verzerrungen – automatische Gedanken, Selbstkonzepte und dysfunktionale Einstellungen – von der Aufnahme bis zur Entlassung untersucht. Ferner wurden die Beziehungen der kognitiven Verzerrungen zu Depressivität und Persönlichkeitsdimensionen (Isolationsneigung, Extraversion, Rigidität, Schizoidie, Frustrationstoleranz und Neurotizismus) erfaßt. Automatische Gedanken und das Ausmaß der Negativität der Selbstkonzepte standen bei der Aufnahme mit der Depressivität signifikant in Beziehung und bildeten sich bis zur Entlassung signifikant zurück. Die dysfunktionalen Einstellungen hingegen korrelierten bei der Aufnahme nicht signifikant mit der Depressivität, auch bildeten sie sich nur bei den zum Entlassungszeitpunkt vollremittierten Patienten signifikant zurück. Die Ergebnisse sprechen dafür, daß automatische Gedanken und Selbstkonzepte im Vergleich zu dysfunktionalen Einstellungen zustandsbezogener sind. Ferner zeigte sich auch unter Berücksichtigung der Depressivität ein Zusammenhang zwischen der Persönlichkeitsdimension Neurotizismus und allen kognitiven Skalen bei der Aufnahme. Dies deutet darauf hin, daß ein stark ausgeprägter Neurotizismus die Ausbildung negativer Kognitionen während depressiver Erkrankungen möglicherweise begünstigt.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001150050161
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  • 9
    Electronic Resource
    Electronic Resource
    Determination of treatment disposal for parasuicide patients in a German university hospital (1985)
    Springer
    Social psychiatry and psychiatric epidemiology 20 (1985), S. 145-151 
    Details
    ISSN: 1433-9285
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Within the framework of a psychiatric liaison service attached to a medical emergency unit, initial assessment, immediate crisis intervention and referral to subsequent psychiatric after-care were provided for parasuicide patients. Of a total of 485 such cases admitted in 1981, 7% were discharged without a treatment recommendation, 74% were referred to psychiatric out-patient care and 18% were admitted to psychiatric hospitals. The characteristics of these three categories of patients were compared in order to examine the criteria of treatment disposal. The characteristics found to be associated with a recommendation for psychiatric treatment included old age, previous suicidal behaviour, previous or current psychiatric treatment and a strong intent to die, as inferred from the nature and circumstances of the suicidal behaviour. Sex, addictive behaviour and severity of intoxication were of minor importance in this respect. The treatment disposition revealed a liberal interpretation of the requirements for psychiatric treatment. As regards the outcome of this strategy of care, the frequency of repeated parasuicidal behaviour, though not of completed suicide, was lower than in comparable studies reported in the literature. The implications of these findings for future evaluative research are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00583581
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  • 10
    Electronic Resource
    Electronic Resource
    Vergleichende Untersuchung von 295 Patienten mit erstmaligem und wiederholtem Suizidversuch (1982)
    Springer
    European archives of psychiatry and clinical neuroscience 232 (1982), S. 427-438 
    Details
    ISSN: 1433-8491
    Keywords: Attempted suicide ; Singular and repeated acts ; Comparative study
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Im Hinblick auf soziodemographische, biographische und psychopathologische Variablen wurden 169 Patienten nach erstmaligem und 109 Patienten nach wiederholtem Suizidversuch miteinander verglichen. Die erheblichen, zum Teil statistisch hochsignifikanten Unterschiede kennzeichnen die Patienten mit mehrfachen Selbstmordversuchen als einen Personenkreis mit häufigeren Verlust- oder Trennungserlebnissen in Kindheit und Jugend sowie mit konfliktreicheren und instabileren sozialen Beziehungen im privaten wie im beruflichen Bereich. Diese Patienten kamen häufiger als die Vergleichsgruppe in psychiatrische und psychotherapeutische Behandlung, wurden häufiger als persönlichkeitsgestört oder suchtkrank diagnostiziert und prognostisch ungünstiger beurteilt. Die Übereinstimmung der Ergebnisse mit der vorliegenden Literatur, Fragen der typologischen Interpretation und versorgungspraktische Konsequenzen werden diskutiert.
    Notes: Summary After their first suicide attempts 169 patients were compared to 109 repeated suicide attempters regarding sociodemographical, biographical, and psychopathological variables. The differences between the groups characterize the repeaters as persons with more broken-home situations in childhood and youth and with more tension and instability in private and occupational relationships. These patients received more psychiatric or psychotherapeutic treatment, were more often classified as suffering from a personality disorder or addiction and their prognosis was estimated less favourable. These findings are consistent with the results of other investigations. Questions of typological interpretation and practical consequences are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00345598
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