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Biomedical subjects

A Haass

Publications and source records attributed to A Haass.

At least 55 records · Page 3Linked to original sources
PubMed1994

[The value of various transcranial color doppler tests for determining cerebrovascular reserve capacity].

One of the techniques for the assessment of the cerebrovascular reserve capacity is the so-called "breath-holding" test. In order to minimise haemodynamic changes following deep inspiration the patients should hold their breath at the end of a normal inspiration. We studied three different ways (breath holding following normal inspiration [NI], deep inspiration [DI], hyperventilation [HV]), of performing this test in 20 healthy volunteers. The acetazolamide test was taken as a reference. The mean flow velocity (FVmean) in the middle cerebral artery was recorded continuously using a TCD monitoring system. Blood pressure, cardiac output and heart rate were measured simultaneously. Breath holding after deep inspiration resulted in longer apnoea (DI: 68.1 +/- 24.1 s; NI: 44.8 +/- 18.4 s; p < 0.01), produced the highest increase of FVmean (DI: +72.2 +/- 29.8%; NI: +69.2 +/- 29.0%) and was the least inconvenient to the patients. Following HV apnoea was longest (93.0 +/- 33.5 s; p < 0.01), but resulted in the lowest increase of FVmean were not significant. A significantly lower increase of FVmean (44.2 +/- 13.4%, p < 0.01 resp.) could be observed after intravenous injection of 1 g acetazolamide. There were no significant haemodynamic changes in any case. Thus, this bedside test does not appear to be influenced by variations in breath holding.

Acetazolamide↗
PubMed1993

Beta-blockade in acute aneurysmal subarachnoid haemorrhage.

The effects of beta-blockade to prevent autonomic disorders after acute aneurysmal subarachnoid haemorrhage were prospectively investigated. 11 patients were treated with the beta-1-selective beta-blocker metoprolol (up to 200 mg/die intravenously). 14 patients received standard therapy as controls. Pulse rate, blood pressure and dosage of the additional antihypertensive medication as signs of sympathetic disturbance were registered. The main result was the normalizing of the pulse rate especially during the first two weeks in contrast to the control group. The patients in the beta-blocker group did not need further antihypertensive medication. This was mainly a result of the reduction in sympathetic activation. No severe side-effects were documented and the survival was better in the treated group. Thus, beta-blockade is able to prevent and reduce autonomic disorders, especially activation of the sympathetic tone, in subarachnoid haemorrhage. Metoprolol as a so called cardioselective beta-blocker seems to be one of the suitable agents and is considered superior to the non-selective agents.

Adult↗
PubMed1993

[Schizophreniform psychosis in paraneoplastic limbic encephalitis].

Paraneoplastic limbic encephalitis is seldom mentioned in the psychiatric literature and premortem diagnosis is rare. Affective symptoms, agitation, and memory impairment are the core features, which can predate the diagnosis of carcinoma. We report the case of a patient with bronchial carcinoma, whose clinical picture could hardly be distinguished from that of endogenous schizophrenia.

Adult↗
PubMed1991

[Hemodilution, when and how -- in acute cerebral ischemia?].

Despite some criticism hemodilution is still the first choice therapy in stroke. The last trials have shown that not only the hematocrit had to be decreased but also the cardiac output had to be increased. The isovolemic hemodilution has the disadvantage that it does not carefully performed. This possible negative hemodynamic effect seems to be the reason for the unsatisfactory clinical outcome in some trials. Due to the disturbed autoregulation in the penumbra only the hypervolemic and not the isovolemic hemodilution is able to increase the cerebral blood flow in this area. The volume of hemodilution should be exactly adapted to the cardiac situation of the patients.

Brain Ischemia↗
PubMed1989

[Acute multifocal placoid pigment epitheliopathy with inflammatory CSF findings. A special form of borreliosis?].

A 24-year-old woman with acute multifocal placoid pigment epitheliopathy in both eyes had no signs or symptoms other than the impaired vision. Visual evoked potentials demonstrated prolonged latency. Lumbar CSF showed inflammatory changes. Serum antibody titres against Borrelia burgdorferi were markedly elevated. Cortisone treatment was without success, but intravenous penicillin quickly brought about improvement in vision. Borrelia infection may thus have been the cause of the multifocal placoid pigment epitheliopathy.

Acute Disease↗
PubMed1989

Amantadine sulphate in treating Parkinson's disease: clinical effects, psychometric tests and serum concentrations.

Intravenous administration of amantadine has been shown to be a quick-acting and highly effective method of treating patients with Parkinson's disease. The duration of this therapeutic effect during long-term oral treatment has, however, remained controversial. Therefore, the effect of intravenous treatment was compared with long-term oral treatment over a period of 6 months. Clinical scores and psychometrically determined dexterity improved significantly during 10-day infusion therapy (200 mg amantadine sulphate/day). This improvement was successfully maintained by oral treatment (600 mg/day). A decrease in effectiveness was not observed. Reaction times were within the normal range for the age group involved and did not change significantly during the course of the study. Amantadine serum concentration during the infusion period ranged between 500 and 1000 micrograms/l and produced values nearly half as high as those obtained during oral treatment (600 mg/day). There was a constant relationship (quotient: 1.3) between serum and cerebrospinal fluid concentration. Considerable inter-individual variations were noted. A significant inter-individual correlation between serum concentration and clinical and psychological improvement was not discernible.

Administration, Oral↗
PubMed1989

Platelet scintigraphy in cerebrovascular diseases.

The benefit of platelet scintigraphy using 99mTc-phytate as a method to detect atherosclerotic lesions in extracranial neck vessels was tested on 143 patients. 29 patients had an abnormal scan of the neck vessels. The scintigraphic results were critically evaluated, taking clinical observations and the angiograms performed on 88 patients into consideration. Platelet scintigraphy can be useful as an additional examination in some patients. Generally, however, the value and reliability of platelet scintigraphy must be seen as insufficient, making further prospective studies with histological examinations imperative.

Adult↗
PubMed1988

High-dose steroid therapy in Guillain-Barré syndrome.

In a pilot study, high-dose steroid therapy in acute Guillain-Barré syndrome (GBS) proved to be successful. The pharmacodynamic aspects of this approach appear interesting and worthy of further investigation. An initial dose of 1000 or 500 mg methylprednisolone is recommended which should be given in four divided doses per day. A very slow reduction in the dose is necessary to avoid a relapse. Lack of response correlated with late onset of therapy and high age of the patients.

Adolescent↗
PubMed1988

[Intravenous and oral treatment with amantadine sulfate in Parkinson disease].

The rapid efficacy of amantadine on akinesia and rigidity in Parkinson's disease is generally known. The duration of this therapeutic result is however controversial. Some authors have reported a loss of efficacy after only a few weeks of therapy. The success of a short-term parenteral and subsequently oral long-term treatment with amantadine sulphate in 8 Parkinsonian patients was tested by means of clinical and neuropsychological examinations and by monitoring the serum concentration over the course of half a year. A ten-day intravenous treatment with amantadine sulphate (200 mg daily) led to a significant improvement in the clinical and psychological test results. This attained improvement could be maintained for 6 months with oral therapy consisting of 600 mg amantadine sulphate. There were strong interindividual variations in serum concentration.

Administration, Oral↗
PubMed1988

[Disorders of microcirculation in subarachnoid hemorrhage and intracerebral hemorrhage].

The pathophysiological notions of hemodilution treatment of ischemic seizures with plasma expanders indicates the significance of microcirculation. Microcirculation disorders arise from the interrelations of hemodynamic, vascular, and hemorrheologic factors. It seems that hemodilution with hydroxyethyl starch reduces peripheral microcirculation disorders, thus inhibiting the development of cerebral edema. In the case of subarachnoid hemorrhage, the hemorrheologic factors deteriorate less severely when given antifibrinolytic treatment with Aprotinin. Simultaneous hemodilution with hydroxyethyl starch can counterbalance the already existing changes.

Blood Coagulation Tests↗
PubMed1987

Haemodilution therapy in ischaemic stroke: plasma concentrations and plasma viscosity during long-term infusion of dextran 40 or hydroxyethyl starch 200/0.5.

In 21 patients with ischaemic strokes we have monitored plasma viscosity, total plasma concentration, numeric average molecular weight (Mn), and weight average molecular weight (Mw) of Dextran 40 (dextran) and hydroxyethylstarch 200/0.5 (HES) during 10 days of treatment (days 1-4, 2 X 500 ml; days 5-10, 1 X 500 ml). Plasma concentrations of dextran increased during the first 4 days (8.3 mg X ml-1 on the first day to 18.0 mg X ml-1 on the fifth day), reached an apparent steady state of 17.2 mg X ml-1 during the next 6 days, and declined subsequently with a half-time (t1/2) of 4.03 days. After ten days treatment Mn and Mw were shifted towards higher values. Plasma viscosity increased from 1.26 mPas to 1.69 mPas on Day 10 (p less than 0.01) and was linearly correlated with the total plasma concentration of dextran (p less than 0.001; r = 0.88). Total plasma concentrations of HES averaged 11.7 mg X ml-1 on Day 1 and 12.4 mg X ml-1 on Day 5. The molecular weight distribution did not change during the infusions but decreased in comparison with the administered solution. Plasma viscosity fell from 1.40 mPas to 1.30 mPas at Day 10 (p less than 0.05) and was not related to the concentration of HES. The haemodiluting effect, as indicated by a decrease of the haematocrit, was 22% and 16.8% for dextran and HES respectively. These data suggest several advantages of HES compared with dextran in haemodilution therapy of ischaemic stroke.

Aged↗
PubMed1987

[Intracranial pressure-controlled treatment of brain edema with glycerin and sorbitol in intracerebral hemorrhage].

The continuous epidural registration of intracerebral pressure showed that the pronounced brain edema which develops during the 4th to 14th day of an intracerebral hemorrhage could lead to an increase in intracerebral pressure (ICP greater than 25 mmHg) requiring treatment. During the therapy extensive ICP crises (ICP greater than 35 mmHg), lasting for 1 to 3 days and only controllable through high doses of glycerol and sorbitol, developed. Glycerol (50 g orally) and sorbitol (50 g i.v.) lowered the pressure during this phase for approximately 3 h and 1.5 h respectively. These time intervals were in accordance with the changes in plasma osmolality through the administration of both substances. Due to its longer efficacy, glycerol provides an important supplement or alternative to sorbitol therapy, especially as the permitted maximum dosage would have to have been exceeded in a treatment consisting exclusively of sorbitol. The duration of the decrease in intracerebral pressure lasted longer during the remainder of the treatment in the case of both substances, being decisively dependent on the intracerebral pressure intensity. The relatively harmless epidural measurement of intracerebral pressure allowed an optimal control of the brain edema therapy as the dosage of the hyperosmolar substances could be given exactly in accordance with the intracerebral pressure intensity and subsequently varying efficacy.

Administration, Oral↗
PubMed1986

[Dextran 40 or HES 200/0.5? Hemorheology of the long-term treatment of ischemic cerebral attacks].

Haemorheological parameters on long-term treatment of ischaemic stroke were measured in two groups of 12 patients receiving dextran 40 or hydroxyethyl starch (HES 200). Both substances similarly lowered haematocrit and whole-blood viscosity. Dextran produced a clear-cut increase in plasma viscosity and red-cell aggregation. The effects were due to a marked increase in the plasma concentration of dextran caused by an accumulation of large molecules. HES 200 improved plasma viscosity and red-cell aggregation. Since these haemorheological parameters are of special importance for improving a disordered microcirculation as would occur at the margins of the ischaemic lesion, HES 200 would seem to be the appropriate plasma expander in long-term treatment with haemodilution. The differences between dextran 40 and HES 200 become the more marked the higher the volume infused.

Blood Viscosity↗