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Biomedical subjects

G Renner

Publications and source records attributed to G Renner.

At least 19 recordsLinked to original sources
PubMed2003

Indicators of quality of in-patient psychiatric treatment: the patients' view.

OBJECTIVES: The object of this study was to find out from psychiatric in-patients which aspects of care and treatment they considered important and how satisfied they were with these. DESIGN: One hundred and ninety-four in-patients were asked to rate the importance of, and their satisfaction with, 22 different aspects of in-patient care and treatment. The questionnaire, developed for the purpose of the study after a pilot phase including professional care givers and patients, contained 92 items and was returned by 52% of all discharged patients from the Psychiatric university hospital during a 3-month period. RESULTS: Patients made a clear distinction between aspects of treatment they considered important and aspects they were satisfied with. Ranked of highest importance were various therapeutic relationships, and respect for their rights and privileges. They were satisfied with their relationships with clinical staff but dissatisfied with medication. CONCLUSION: A well differentiated assessment of importance and satisfaction has implications for the evaluation of the quality of psychiatric care, for specific methods of treatment, and for the improvement of in-patient psychiatric care.

Health Services Research↗
PubMed2003

Psychiatric commitment: patients' perspectives.

OBJECTIVE: The literature pertaining to patients' perceptions of commitment and its consequences is limited. The object of this study was to learn more about these experiences from the patient's perspective. MATERIAL AND METHODS: 108 court-committed patients (78% of whom were schizophrenic) were identified for inclusion in a retrospective follow-up study. After an interval varying from one to 4.5 years from time of commitment to follow-up, 76 patients could be contacted, of whom 47 were included in the follow-up. RESULTS: The majority of patients felt that their court commitment had not been justified and could have been avoided. Events and circumstances identified as particularly stressful about commitment were confinement in a locked ward, side effects of medication, feelings of helplessness, and certain staffbehaviors. Adverse psychological, somatic, and social consequences were common. Coercive measures during hospitalization were strongly associated with negative feelings about the effect of commitment on mental health and about subsequent treatment. The majority, however, also remained in treatment after commitment was terminated, said they would return to hospital in event of future crisis, and had pertinent comments about how commitment could have been avoided. CONCLUSIONS: Many patients who had been court-committed reported negative feelings about their experiences, but the great majority had continued in treatment, both at the termination of commitment and later. They also had ideas about how to reduce the negative impact of commitment that are worth including in future contingency plans.

Adult↗
PubMed2000

[Community psychiatric management of severely ill schizophrenic patients. An exemplary case study].

Psychiatric care for chronic schizophrenic patients has improved in recent years, but for severely ill patients, often with multiple comorbid psychiatric conditions and in great need of care, the situation remains unsatisfactory. Community-based psychiatric care is limited and psychiatric hospitals are now cutting back on inpatient care. The quality of care that chronically mentally ill patients receive at independent psychiatric nursing homes removed from population centers is undetermined, and many patients end up in asylums or homeless shelters unable to provide for their psychiatric needs. Neither a reliable way to assess the needs of these complicated patients nor a scientific basis for therapeutic intervention exists yet. The case study presented here illustrates an interdisciplinary approach to the care and treatment of a chronic schizophrenic patient with several comorbid conditions. Based on the individual needs of the patient and developed over the last 4 years, this approach had positive effects on the course and outcome of treatment and resulted in an impressive reduction of costs. The average annual number of days of hospitalization over a 3-year period was reduced from 206 to two and the total cost of care was reduced from US$70,000 annually to $8000. The results from this single case study are promising. Further investigation of the development and evaluation of highly individualized treatment plans for severely disturbed schizophrenic patients is warranted.

Case Management↗
PubMed2000

Pilot study to evaluate the efficacy of hyperbaric oxygen therapy in improving the survival of reattached auricular composite grafts in the New Zealand White rabbit.

OBJECTIVE: This investigation is a prospective, randomized, blinded study seeking to evaluate the efficacy of hyperbaric oxygen (HBO) therapy in improving the survival of the reattached auricular composite graft. STUDY DESIGN: Twenty New Zealand White rabbits were randomly assigned to control (10) and treatment (10) groups in a prospective fashion. After amputation and reattachment of measured segments of each ear, the treatment group received 14 HBO treatments for 10 days. The control group received only standard postoperative care. On postoperative day 18, the surviving composite grafts were measured, recorded, and statistically analyzed. RESULTS: The mean percentage of graft survival for the control group was 0.31% (range 0%-2.5%), and the mean for the group receiving HBO was 15.94% (range 0%-38%). A median test was used to evaluate this difference, which was found to be statistically significant (P = 0057). CONCLUSION: Our study appears to indicate a possible survival benefit for the composite grafts in those rabbits that received HBO treatments. We believe that there are several significant difficulties with the rabbit as a model for this study, but we are encouraged at this point that a limited measurable benefit was observed. Further investigations with HBO appear to be warranted at this time.

Animals↗
PubMed2000

What is the benefit of involuntary short-term psychiatric hospitalisation?

In Germany, psychiatric patients considered to be a danger to themselves or others may be detained involuntarily for 24 hours, after which the court must be consulted. Only Baden-Württemberg, of all the German states, allows for 72 hours confinement. In a study of 70 patients who were involuntarily hospitalized at a university hospital, it was found that when patients are subject to a 72 hour doctors' court hold, as compared to the 24 hour hold, the number of patients committed to treatment by the court was reduced by about 50%. This applies particularly to younger patients with addiction or neurotic disorders. Schizophrenic patients and older patients with organic brain disease were more likely to be detained on court order. Two-thirds of the patients who were involuntarily hospitalized said that they felt adequately informed about their legal rights, but only about a third felt that involuntary hospitalisation was justified.

Commitment of Persons with Psychiatric Disorders↗
PubMed2000

[Does modification of documentation result in a reduction of medication to involuntary patients?].

OBJECTIVE: The effects of modification of documentation on the administration of psychotropic medication to involuntary patients in hospital were investigated. METHODS: The charts of 414 inpatients on the acute-ward were reviewed two months before and two months after a new form for documentation of rationales for medication administration to involuntary patients was instituted. A follow-up was carried out for a two-month period a year later. RESULTS: The percentage of patients who received medication involuntarily, 70% of whom were schizophrenic, fell by over half, from 12% to 5%, after additional standardized documentation for the use of such medications was instituted. The number of medications administered to involuntary patients fell from 80 to 21, a reduction of 74%. The effects were stable over the course of one year. CONCLUSIONS: Modification of documentation seems to reduce the use of medication with involuntary patients.

Acute Disease↗
PubMed1999

[Effects of regional obligatory health care exemplified by a university clinic].

OBJECTIVE: Local care provision for the chronically mentally ill entails responsibility to be taken by all institutions involved in the care system of their respective area. In the clinical sphere regional responsibility is implement-ed to a large extent apart from a few university clinics. The University Psychiatry and Psychotherapy Clinic Tuebingen look after an area with obligatory provision of care consisting of 140,000 inhabitants in 1995. RESULTS: The comparative evaluation of the basic documentation showed minimal overall changes but an increase of older patients, of patients who are frequently hospitalised, and of addicts. The number of emergencies remained unchanged. The concomitant questioning of colleagues indicated delayed acceptance of the change. According to experiences made to date, the conditions for research and teaching have improved in certain areas thanks to the obligatory provision of care.

Adolescent↗
PubMed1998

Molecular cloning, sequencing and expression in Escherichia coli of the poly(3-hydroxyalkanoate) synthesis genes from Alcaligenes latus DSM1124.

Fragments of chromosomal DNA from Alcaligenes latus DSM1124 were cloned into Escherichia coli and transformants were screened for poly(D(-)-3-hydroxybutyrate) [P(3HB)] production during excess carbon supply. A plasmid harboring a 5.5-kb insert of A. latus DNA was isolated from a P(3HB)-producing bacterial colony. The insert was partially sequenced and three major open reading frames (ORFs) were found, representing the PHA synthase (phaC), beta-ketothiolase (phaA) and acetoacetyl-CoA reductase (phaB) genes. They show striking homology to the Ralstonia eutropha (formerly Alcaligenes eutrophus) phaC (71%), phaA (77%) and phaB (80%) genes, and are organized in the same way. The only major difference is the replacement of 560 nucleotides by 160 non-homologous nucleotides in the 5' region of phaC in A. latus. The phaC ORF lacks 29 amino acids at the N-terminus, compared to that of R. eutropha, and starts with a GTG codon. The transcription start points of the operon were determined. P(3HB) production of recombinant E. coli strains harboring the pha operons of A. latus DSM1124 or R. eutropha H16 was investigated. Both operons gave rise to less than 5% P(3HB) formation during exponential growth. At the end of the growth phase, the P(3HB) content reached approximately 20% of cell dry mass. Under nitrogen-depleted conditions, the A. latus pha genes gave rise to 50-52% P(3HB), compared to 33-38% for the R. eutropha pha genes. No NADH oxidase activity was detectable in A. latus, indicating an impaired respiratory pathway and a dependence on PHA synthesis for storing reduction equivalents during growth.

Acyltransferases↗
PubMed1998

[Cooperation guidelines--a contribution to the development of process quality in psychiatric community management].

Cooperation in the provision of care to individuals with chronic psychiatric illnesses represents a significant criterion for quality. In the Tuebingen administrative district, guidelines for cooperation in the handover of patients to facilities providing follow-up care and in parallel care of patients have been developed. Elements of the guidelines include handover standards, case conferences and case management. The results of accompanying research are encouraging, while indicating the necessity of continued discussion in the individual facilities and in the relevant authorities: The acceptance of the guidelines is high and they are considered useful in concrete practice, but implementation is sometimes hesitant and the instrument provided for documentation is barely used due to time limitations. Only by means of compulsory basic documentation will it be possible to evaluate the guidelines and secure the criteria for quality on a long-term basis. As with other models, integration of neurologists and psychiatrists in private practice into the cooperation with inpatient and outpatient facilities is a problem that must yet be resolved.

Case Management↗
PubMed1992

High-level expression of a recombinant antibody from myeloma cells using a glutamine synthetase gene as an amplifiable selectable marker.

We report a method for introducing a glutamine synthetase (GS) selectable marker into myeloma cells in which transfectants are selected by growth in a glutamine-free medium. Vector amplification can subsequently be selected using the specific inhibitor of GS, methionine sulphoximine (MSX). Using this system, DNA sequences encoding a chimeric B72.3 IgG4 antibody were expressed from hCMV-MIE promoters in NSO myeloma cells. A cell line was isolated after a single round of selection for vector amplification which contains approximately 4 copies of the vector, secretes 10-15 pg/cell/day cB72.3 antibody during exponential growth and can accumulate 560 mg/l antibody in a fed-batch air-lift fermentation system. Productivity is stable in the absence of MSX selection.

Animals↗
PubMed1992

Bilateral aberrant internal carotid arteries.

This case report represents the first well-documented case of aberrant internal carotid arteries in both middle ears. CT and DSA can establish the diagnosis before surgical intervention. Aberrant internal carotid artery represents a rare finding in the differential diagnosis of middle ear masses. Most patients manifest either vertigo, tinnitus, or a variable hearing loss. Clinical findings include a red or blue mass behind the eardrum that may or may not be pulsatile. The otolaryngologist should be aware that this potential landmine may be obscured by serous otitis media. Once suspected, the mass should be evaluated by radiographic studies before surgical intervention.

Carotid Artery, Internal↗
PubMed1990

Infant botulism: case report and clinical update.

Infant botulism occurs in infants between 1 week and 11 months of age and results from the in vivo production of neurotoxin by Clostridium botulinum. The clinical spectrum ranges from asymptomatic carriers, through various degrees of paralysis, to sudden death. The classic clinical presentation is an afebrile child with constipation and generalized weakness manifested by poor head control, poor suck, and weak cry. Symptoms can progress to include cranial nerve palsies, respiratory arrest, and adynamic ileus. Treatment is supportive in an intensive care setting. Antibiotics and antitoxin are not indicated. The morbidity and mortality is less than 3% in hospitalized patients and complete recovery can be expected. The environmental and dietary factors associated with infection are discussed.

Botulism↗
PubMed1990

Tenacious goal pursuit and flexible goal adjustment: explication and age-related analysis of assimilative and accommodative strategies of coping.

Crises and critical life transitions activate 2 distinct but complementary modes of coping, (a) transforming developmental circumstances in accordance with personal preferences (assimilative tendency) and (b) adjusting personal preferences to situational constraints (accommodative tendency). Assimilative and accommodative tendencies were measured by a questionnaire comprising 2 independent scales (Tenacious Goal Pursuit and Flexible Goal Adjustment). Both scales predict high life satisfaction and low depression and are positively related to generalized internal control beliefs. The scales evinced an opposite relation to age: Cross-sectional analyses on a sample of 890 Ss in the age range from 34 to 63 years revealed a gradual shift from an assimilative to an accommodative mode of coping. Implications for theories of depression and successful aging are discussed.

Adaptation, Psychological↗
PubMed1990

Metabolic studies on pentachlorophenol (PCP) in rats.

1. The metabolism of pentachlorophenol in rats was studied. 2. Metabolites isolated from rat urine and identified were: 2,3,4,5-tetrachlorophenol, 2,3,4,6-tetrachlorophenol, 2,3,5,6-tetrachlorophenol, tetrachlorocatechol, tetrachlororesorcinol, trichlorohydroquinone, tetrachlorohydroquinone, and traces of trichloro-1,4-benzoquinone, and tetrachloro-1,4-benzoquinone.

Animals↗
PubMed1987

Effects of pentachlorophenol and some of its known and possible metabolites on different species of bacteria.

The antibacterial activity of pentachlorophenol and 35 of its known or possible metabolites against 30 different species of bacteria was tested. In comparison with pentachlorophenol, no increase of inhibitory activity was found for any of the chlorinated anisoles tested (except for pentachloroanisole against Streptomyces spp.), 2-chlorophenol, 2,6-dichlorophenol, 2,3,6- and 2,4,6-trichlorophenol, 2,3,5,6-tetrachlorophenol, tetrachloro-1,4- and -1,3-benzenediol (except for the 1,3-isomer against Streptomyces spp.), tetrachloro-1,3-dimethoxybenzene, and tetrachloro-1,3-benzenediol diacetate. Two chlorophenols, five dichlorophenols, four trichlorophenols, two tetrachlorophenols, and tetrachloro-1,2-benzenediol were more active than pentachlorophenol against some, but not all, of the strains tested.

Bacteria↗