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  • 1
    ISSN: 1436-6215
    Keywords: verzweigtkettige Aminosäuren ; Aminosäurenspiegel ; Stickstoffbilanz ; Ammoniakprofile ; psychometrische Teste
    Source: Springer Online Journal Archives 1860-2000
    Topics: Agriculture, Forestry, Horticulture, Fishery, Domestic Science, Nutrition , Medicine
    Description / Table of Contents: Summary In a doubleblind cross-over placebo-controlled trial the efficiency of oral treatment with branched chain amino acids was investigated in 22 inpatients with liver cirrhosis. In all patients evidence of latent (subclinical) portalsystemic encephalopathy was obtained by using an extensive psychometric test programme. Patients received a defined diet of 35 cal/kg/day containing 1 g of protein. In addition, branched chain amino acids or casein in a dosage of 0.25 g/kg/day was administered in a cross-over fashion, each for 1 week. Semiquantitative nitrogen balance increased during both treatments, with a tendency towards a larger increase during branched chain amino acid treatment. At the same time ammonia concentration tended to decrease during branched chain amino acid treatment. Taking into account the cross-over design, significant improvements attributable to branched chain amino acid treatment could be demonstrated in psychomotor functions (line tracing, tapping, steadiness, auditory reaction time), attention (digit table), and practical intelligence (digit symbol, number connection test).
    Notes: Zusammenfassung In einer placebokontrollierten Doppelblind-Cross-over-Studie an 22 stationären Kranken mit Leberzirrhose wurde die Wirksamkeit der oralen Zufuhr von VKAS geprüft. Mit Hilfe eines ausführlichen psychometrischen Test-programms war bei diesen Patienten eine latente (subklinische) portosystemische Enzephalopathie nachgewiesen worden. Die Kranken erhielten eine definierte Diät mit 35 kcal und 1 g Protein pro kg/Tag. Zusätzlich wurden verzweigtkettige Aminosäuren bzw. Kasein in einer Dosierung von 0,25/kg/Tag im Cross-over-Verfahren für jeweils eine Woche verabreicht. Die semiquantitative Stickstoffbilanz erhöhte sich unter beiden Behandlungen, wobei die Tendenz zu einem stärkeren Anstieg unter der Behandlung mit VKAS bestand. Gleichzeitig tendierte die Ammoniakkonzentration unter der Behandlung mit VKAS zu einer Abnahme. Unter Berücksichtigung des Cross-over-Modells konnten signifikante, auf die Behandlung mit VKAS zurückzuführende Verbesserungen der psychomotorischen Funktionen (Liniennachfahren, Tapping, Steadiness, akustische Reaktionszeit), der Aufmerksamkeit (Zahlentafel) und der praktischen Intelligenz (Zahlensymboltest, Zahlenverbindungstest) nachgewiesen werden.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Journal of neurology 196 (1969), S. 331-342 
    ISSN: 1432-1459
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Es wird über statistische und faktorenanalytische Untersuchungen an 182 HAWIE-Protokollen männlicher Patienten von vier Krankheits-gruppen (Commotio cerebri, Contusio cerebri, symptomatische Epilepsie, sonstige hirnorganische Erkrankungen) und drei Altersgruppen (20–34 Jahre, 35–49 Jahre, 50–64 Jahre) berichtet. Zur Auswertung kamen sowohl die einzelnen Untertests als auch die Intelligenzquotienten des HAWIE. Als Vergleichsgruppe wurden die Standardisierungsstichproben von Wechsler u. Riegel herangezogen. Die Untersuchung ergab: 1. Der HAWIE vermag Beeinträchtigungen intellektueller Leistungs-funktionen zu objektivieren und zu qualifizieren, erlaubt aber keine Aussage über die Art der zugrundeliegenden hirnorganischen Störung und Schädigung. 2. Die sogenannte Hirnleistungsschwäche mit Verlangsamung und Umstellungserschwerung der Denk- und Handlungsabläufe scheint weniger in einer generellen Intelligenzminderung oder einer Störung in bestimmten Intelligenzbereichen als vielmehr in einer Störung der Integration mit Umstrukturierung des Funktionsgefüges und stärkerer Trennung einzelner Leistungsfunktionen bedingt zu sein. Weitere Untersuchungen zu dieser Frage sind angelaufen.
    Notes: Summary We discuss the statistical and factor-analytical evaluation of 182 HAWIE records obtained from patients suffering from 4 different cerebral disorders (Commotio cerebri, contusio cerebri, symptomatic epilepsy, and other organic diseases of the brain). These patients are divided into 3 different age groups (20 to 34 years, 35 to 49 years, 50 to 64 years). The results of 10 subtests and of the HAWIE intelligence quotient were evaluated. Conclusion: 1. HAWIE may verify and substantiate impairments of functions related to intellectual performance, but it does not permit any statement about the nature of the underlying organic lesion or injury of the brain. 2. The so-called insufficiency of mental performance comprises sluggish thinking and acting as well as adaptive difficulties. This insufficiency appears to be caused by an impaired integration resulting in altered functional structures and a stricter separation of individual functions maintaining mental performance rather than by a general decrease in intelligence. Further studies on this subject are in progress.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    European archives of psychiatry and clinical neuroscience 234 (1984), S. 74-77 
    ISSN: 1433-8491
    Keywords: Carotid endarterectomy ; Neuropsychological changes ; Endarterektomie ; Carotisstenose ; Neuropsychologische Veränderungen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Wir führten bei 23 Patienten mit uni- oder bilateralen hämodynamisch relevanten Carotisstenosen vor und zehn Monate nach einer Endarterektomie testpsychologische Untersuchungen durch. Präoperativ hatten die meisten Patienten TIA (15), fünf hatten einen leichten Schlaganfall erlitten, drei waren asymptomatisch. Die Nachuntersuchung zeigte leicht verbesserte intellektuelle Funktionen, während die mnestischen Funktionen eher schlechter waren als vor der Operation. Die psychomotorischen Funktionen zeigten — ebenso wie die persönlichkeitsbezogenen Tests — keine wesentlichen Unterschiede. Die prophylaktische Wirkung der Endarterektomie zur Vorbeugung von Schlaganfällen ist unumstritten; eine wesentliche Verbesserung der neuropsychologischen Veränderung ist aber in der Regel nicht zu erwarten
    Notes: Summary Psychological testing was performed on 23 patients (mean age 60.7 years) with unilateral or bilateral stenoses of the carotid arteries prior to and 10 months after carotid endarterectomy. Intellectual functions were slightly improved, mnemic functions impaired, psychomotor functions and dimension of personality remained unchanged. Carotid endarterectomy, although improving neuropsychological functions in a few cases, on average does not cause a significant improvement. This underscores the preventive character of the surgical intervention.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    European archives of psychiatry and clinical neuroscience 234 (1984), S. 69-73 
    ISSN: 1433-8491
    Keywords: Extracranial vascular disease ; Neuropsychological deficit ; Carotisstenose ; Neuropsychologische Veränderungen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In der vorliegenden Studie wurden 33 Patienten mit hämodynamisch relevanten Carotisstenosen oder -verschlüssen psychodiagnostisch untersucht. 22 litten an transitorisch ischdmischen Attacken, 6 hatten einen leichten Schlaganfall erlitten, 5 waren asymptomatisch. Patienten mit hämodynamisch relevanten Carotisstenosen Im Vergleich mit der altersentsprechenden Normalpopulation waren die intellektuellen Funktionen intakt; es bestanden aber deutliche Einschränkungen im mnestischen Bereich, in der Aufmerksamkeit und im Bereich psychomotorischer Reaktionen. Für die Ausprägung der neuropsychologischen Ausfälle war es irrelevant, ob uni- oder bilatere Stenosen im Carotiskreislauf vorlagen. Die Untersuchung zeigt, daß auch bei asymptomatischen Patienten und solchen mit reversiblen neurologischen Ausfdllen bereits manifeste neuropsychische Störungen bestehen können.
    Notes: Summary A total of 33 patients with a relevant stenosis or occlusion of extracranial arteries were tested for a number of neuropsychological functions. Most of them [22] suffered from transient ischemic attacks, 6 from strokes, 5 were asymptomatic. Compared to an age-matched population of normals, patients showed an impairment in their mnemic functions, and attention under stress as well as in their psychomotor function. The degree of neuropsychological impairment was independent of the unilaterality or bilaterality of carotid stenoses. The results illustrate the neuropsychological deficit even in asymptomatic patients and those with complete recovery from transient neurological deficits.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Metabolic brain disease 13 (1998), S. 361-377 
    ISSN: 1573-7365
    Keywords: Liver cirrhosis ; portal-systemic encephalopathy ; psychometry ; alcohol consumption
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract An extensive psychometric test program was performed in 96 patients with proven liver cirrhosis and clinical signs of portal hypertension as well as in 20 patients with alcoholic pancreatitis, in 19 patients without cirrhosis but with alcoholic cerebral atrophy and in 163 normal controls. The study population comprised six groups of subjects as follows: Group 1. 27 patients with non-alcoholic cirrhosis and normal EEG pattern " 2. 48 patients with alcoholic cirrhosis and normal EEG pattern " 3. 21 patients with cirrhosis and minimal EEG changes " 4. 20 patients with alcoholic pancreatitis " 5. 19 patients without cirrhosis but with alcoholic cerebral atrophy " 6. 163 normal controls. A one way analysis of variances comparing asymptomatic patients (group 1, 2 and 4) with controls (group 6) revealed no significant differences between patients with alcoholic and non-alcoholic cirrhosis, both cirrhotic groups scoring significantly lower than patients with alcoholic pancreatitis and normal controls, who did not differ significantly. Comparing symptomatic patients (group 3 and 5) with normal controls both patient groups scored significantly lower than controls, the cirrhotic group (group 3) scoring significantly lower than patients with alcoholic cerebral atrophy. A two way analysis of variances revealed that in clinically asymptomatic patients cerebral functional defects revealed by psychometry are only due to cirrhosis and that in patients with clinical evidence of cerebral impairment the factors alcohol and cirrhosis are additive - not synergistic. A multiple group stepwise discriminant analysis revealed that tests evaluating psychomotor functions contributed most to the discrimination. Especially “line tracing ” proved to be most sensitive and most specific followed by dexterity, steadiness, aiming, digit symbols in sensitivity and by reaction time, steadiness and dexterity in specificity. A test program for clinical use is proposed.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Digestive diseases and sciences 26 (1981), S. 622-630 
    ISSN: 1573-2568
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Forty patients with chronic liver disease and portal hypertension but without clinical signs of portasystemic encephalopathy (15 patients with nonalcoholic cirrhosis, 15 patients with alcoholic cirrhosis, and 10 patients with minimal EEG changes) and a control group of 12 patients with chronic alcoholic pancreatitis were studied using an extensive psychometric program, which, in the same form, is used for expert reports on driving capacity. Of the cirrhotic patients, 60% were considered unfit to drive; in 25% driving capacity was questionable, 15% (only nonalcoholic cirrhotics) were considered fit to drive. In contrast 75% of the patients with alcoholic pancreatitis were considered fit to drive. Major defects were found only in three heavy alcoholics. Patients with alcoholic cirrhosis scored lower than patients with nonalcoholic cirrhosis. This was due, to differences in liver function rather than to the effect of alcohol consumption. Patients with minimal EEG changes were practically all considered unfit to drive.
    Type of Medium: Electronic Resource
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