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Biomedical subjects

A Frei

Publications and source records attributed to A Frei.

At least 19 recordsLinked to original sources
PubMed1990

[Catamnesis of psychiatrically evaluated automobile drivers].

The present catamnestic study covers 100 petitioners, who either applied for the first time for a driving licence or for readmission to traffic after confiscation of their license by the police. 99 of them were former inpatients or still inpatients at the time of judgement. For all of them, the decision of the police depended upon our expertise. For the judgement we considered our psychiatric investigation, the clinical report and the police traffic record. Normally, our mode of admission was quite generous. The duration of catamnesis lasted at least two years. Our of the 100 petitioners, 88 were considered to be fit for driving; 67 unconditionally and 21 under the condition of regular survey or treatment. Subsequently seven of the petitioners showed a poor probation, i.e. their licenses were taken away by the police, one due to a severe and two due to minor accidents. Nobody was injured. In comparison to the experience of other authors about probation in traffic of former psychiatric inpatients, we think we can report a favourable result. A rather generous mode of admission to traffic seems to be justified in these patients.

Accidents, Traffic↗
PubMed1987

Bolus injection of cimetidine and hypotension in patients in the intensive care unit. Incidence and mechanisms.

Incidence and mechanisms of cimetidine-induced hypotension were investigated during the first intravenous injection of cimetidine (200 mg over three minutes) in 68 consecutive patients in the intensive care unit. Systolic pressure decreased more than 5 mm Hg (average, 14 mm Hg) in 50 patients, exceeding 30 mm Hg in nine (13%), while heart rate and pulmonary artery pressure (seven patients) did not change. Blood pressure decreased significantly more in patients requiring vasoconstrictor drug support. The arterial vasodilator properties of cimetidine were demonstrated in 12 normal volunteers in whom brachial artery cimetidine infusions caused a significant decrease of forearm vascular resistance. This effect was more pronounced when forearm vessels were preconstricted with dopamine hydrochloride (n = 6) or norepinephrine (n = 6), pointing toward an interference of cimetidine with sympathetically mediated vasoconstriction. Thus, intravenous injection of cimetidine in critically ill patients, presumably through arterial vasodilatation, is frequently associated with decreases of blood pressure, particularly in patients requiring vasoconstrictor drug support.

Adolescent↗
PubMed1986

Diffuse peritonitis and chronic ascites due to infection with Chlamydia trachomatis in patients without liver disease: new presentation of the Fitz-Hugh-Curtis syndrome.

Two women were admitted for increasing abdominal pain, vaginal discharge, and severe or moderate chronic ascites. Diffuse peritonitis without evidence of liver disease was found in both cases, and in one the ascites and vaginal discharge contained Chlamydia trachomatis. Both patients responded to doxycycline, and this and the laboratory findings pointed strongly to C trachomatis as the aetiological agent. C trachomatis may cause severe peritoneal infections with chronic ascites formation in the absence of liver disease in women with the Fitz-Hugh-Curtis syndrome. Prompt diagnosis and antibiotics lead to rapid cure.

Adult↗
PubMed1986

Cerebral blood flow and antihypertensive treatment with enalapril.

The intravenous 133Xenon method was used to measure regional cerebral blood flow (rCBF) in 20 patients with moderate hypertension. Regional cerebral blood flow under pretreatment, in the placebo period and after 8 weeks of enalapril treatment were compared. The rCBF values [(F1), and initial slope, (IS)] showed no statistical difference during the three periods in spite of significantly higher blood pressure values in the placebo period. It is concluded, that with enalapril good blood pressure control is achieved without any adverse effect on rCBF.

Adrenergic beta-Antagonists↗
PubMed1984

[Quality control of liver diagnosis in newly admitted patients].

The evaluation of pathological clinical findings or abnormal laboratory tests in the liver was prospectively investigated. Pathological findings were used for diagnosis or differential diagnosis in only 40% of 102 patients investigated. Further investigations, mainly laboratory tests, resulted in definitive diagnosis only in 20%. The yield of pathological results when routinely ordering liver-specific tests is not more than 20%. Fewer, but perhaps more invasive, investigations would lower costs and improve the diagnostic yield.

Diagnosis, Differential↗
PubMed1983

[Intensive surveillance in poisoning caused by tricyclic antidepressive agents].

Monitoring in an intensive care unit after intoxication with tricyclic antidepressants for 48-72 hours was reevaluated in a retrospective study of 57 patients. As described in the recent literature, severe neurologic (coma grade III and IV, seizure or respiratory insufficiency) or cardiovascular complications (bradycardia, ventricular tachycardia, hypotension, were not found after 24 hours of intensive monitoring. More prolonged monitoring control no longer appears necessary.

Antidepressive Agents, Tricyclic↗
PubMed1982

[Use of physical therapy and ergotherapy in the day hospital].

The therapeutic possibilities of a day hospital orientated towards active rehabilitation are described. A survey revealed that 11 of the 34 patients were treated with active individual physiotherapy, 8 were attending remedial therapy and 5 regular individual speech therapy. The remaining patients followed physical or occupational therapy in groups. The patients receiving intensive individual procedures were mostly stroke patients with a history of less than two years or patients with chronic joint diseases. The accurate indication for the use of a staff- and time-consuming individual therapy is of great importance both in physiotherapy and occupational therapy. Treatment should be programmed for a carefully defined purpose and has to be adjusted continuously to the changing functional status of the patient.

Aged↗
PubMedDate not supplied

The N-terminal propeptide of collagen type III in serum reflects activity and degree of fibrosis in patients with chronic liver disease.

To evaluate the diagnostic significance of the collagen Type III (Col 1-3) N-terminal propeptide of procollagen Type III, with respect to activity and degree of liver fibrosis, Col 1-3 serum concentrations were measured in 111 patients with chronic liver diseases and in 60 patients were correlated with liver histology and morphometry. Col 1-3 was measured by a specific radioimmunoassay. Biopsies were read without knowledge of diagnosis. Periportal and intralobular lesions were assessed semiquantitatively by allocating 1 of 4 severity grades to each parameter. All portal areas were measured morphometrically. Compared to 27 normal controls, Col 1-3 concentrations were significantly elevated in patients with untreated chronic active hepatitis, cirrhosis and primary biliary cirrhosis, but not in chronic persistent hepatitis or fatty liver. Morphometrically measured portal tract area significantly correlated with Col 1-3 plasma levels. Among the semiquantitatively measured periportal lesions, the number of fibroblasts exhibited the closest relationship with Col 1-3 levels; there was no relationship between Col 1-3 levels and intralobular lesions. These data suggest that Col 1-3 serum levels reliably reflect the activity and degree of liver fibrosis and are useful along with liver biopsy in follow-up of patients with chronic liver disease.

Adult↗
PubMedDate not supplied

Long-term follow-up of serum N-terminal propeptide of collagen type III levels in patients with chronic liver disease.

To evaluate the diagnostic and prognostic significance of the N-terminal propeptide of collagen Type III (Col 1-3) in chronic liver disease, the peptide level was measured in the serum of 4 patients with primary biliary cirrhosis, 5 with chronic persistent hepatitis, 12 with chronic active hepatitis, and 1 with autoimmune hepatitis, for a period of 2 to 10 years and compared with liver function and histology. In primary biliary cirrhosis, Col 1-3 peptide levels were always elevated, regardless of medical therapy; however, after liver transplantation in one patient, the Col 1-3 peptide level decreased. In chronic persistent hepatitis, the peptide level fluctuated around the upper limit of normal. Among patients with chronic active hepatitis, the Col 1-3 peptide level normalized in 2 patients during remission, but was elevated in 7 patients who developed cirrhosis. Only in a patient with autoimmune hepatitis was the Col 1-3 peptide level normal, although the patient developed cirrhosis during prednisone therapy. When prednisone was withdrawn, the Col 1-3 peptide level increased. The data suggest that the serum Col 1-3 peptide may estimate the course of liver fibrosis in chronic liver disease and has prognostic value, particularly in chronic active hepatitis. Persistent elevation suggests ongoing fibrosis and development of cirrhosis; normalization suggests remission.

Adult↗
PubMedDate not supplied

Glycerol and dextran combined in the therapy of acute stroke. A placebo-controlled, double-blind trial with a planned interim analysis.

The results of clinical trials investigating various therapies in acute ischemic stroke have been inconsistent. The effect of glycerol therapy and a combination therapy of glycerol and dextran was evaluated in a double-blind, placebo-controlled study. Repeated neurologic examinations (Day 0, Weeks 1, 6, 12, and 24) according to a modified Mathew score were performed on 62 patients. Statistical analysis showed no superiority of either treatment compared with placebo in acute ischemic stroke. A retrospective estimation of the Type II error of the study yielded approximately p = 0.25. A major side effect was hemolysis in 98% of patients treated with glycerol.

Acute Disease↗