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Biomedical subjects

G Wiedemann

Publications and source records attributed to G Wiedemann.

At least 37 records · Page 2Linked to original sources
PubMed1994

Deliverability of psychoeducational family management.

As part of an open clinical trial currently underway at the Max Planck Institute of Psychiatry in Munich, the feasibility of behavioral family management (Falloon et al. 1984) for schizophrenia in combination with two different neuroleptic medication strategies was investigated. The treatment approaches were psychoeducational family management with a standard dose or with targeted medication. In this article the following questions were addressed: (1) What proportion of the total schizophrenia population admitted as inpatients might be eligible for psychoeducational family treatment (assessment based on n = 411 over a 33-month period)? (2) How representative of this population are the patients who were randomized to the experimental groups? (3) How many patients dropped out of treatment after entering the trial? The results show that about 60 percent (247) of the patients were eligible for a psychoeducational treatment approach. Of these, 34 percent (85) participated in the trial and were randomized to the treatments. Only 4 percent of the relatives but 20 percent of the patients refused to take part in the study. The 85 trial patients did not differ from the total eligible on the numerous socioeconomic and symptom variables assessed. The treatment dropout rate was 11 percent. Those patients who accepted treatment did not differ from those patients who dropped out on socioeconomic or illness variables. The results indicate that early identification of dropouts is not possible at least with the methods used in this study.

Adolescent↗
PubMed1994

Correlates of cognitive impairment and depressive mood disorder in multiple sclerosis.

The psychopathological status of 25 inpatients suffering from clinically definite multiple sclerosis (MS) according to Poser criteria was assessed by using standardized methods (Structured Clinical Interview for DSM-III-R, Inpatient Multidimensional Psychiatric Scale, Hamilton and Montgomery-Asberg Depression Rating Scales and the Structured Interview for the Diagnosis of Alzheimer Dementia and Dementias of other Aetiology (SIDAM). Magnetic resonance (MRT) (0.5 T; T2-weighted sequence) of the brain was analysed by measuring the ventricular brain ration (VBR), the area of the corpus callosum (CC) and the extension of hyperintense lesions of the brainstem, the temporal lobes and the brain at all. Six of 25 (24%) of these moderately disabled patients (mean Extended Disability Score (EDSS) 3.3) were diagnosed to suffer from depressive mood disorder (major depression or dysthymia); 2 were demented. In correlation analysis, depression was unrelated to age, gender, duration of illness, status of disability (EDSS) or the results of cognitive assessment. No relationship between the depression scores and the different MRT measures could be identified. The presence or absence of gadolinium enhancement was also uncorrelated to depressive symptoms. Fatigue as measured by the Fatigue Severity Scale was unrelated to depression or subcortical brain atrophy (increased VBR) but significantly correlated to the area of hyperintense MRT changes in brainstem and midbrain. Cognitive impairment (decreased SIDAM scores) was correlated to the total area of hyperintense MRT changes of the brain parenchyma. The type of clinical course (relapsing-remitting vs chronic progredient) was not found to influence the affective or cognitive state in our MS patient's sample.

Adult↗
PubMed1994

[Detection of early warning signs in schizophrenic patients. Possible applications in prevention of recurrence].

In the treatment of schizophrenia, two new strategies have been developed with the aim of adequate relapse prevention accompanied by lowest possible risk of side-effects. One strategy is to have the patient continue to take medication at a highly reduced dosage (10-20% of the standard dose). The other is to gradually stop neuroleptic medication after remission and to reinstitute medication only in the case of prodromal symptoms (termed targeted or intermittent treatment). According to Herz and Melville [13] many schizophrenic patients show signs of relapse well before recurrence of overt psychotic features. Monitoring to detect prodromal symptoms is especially important in targeted treatment because, otherwise, neuroleptic medication often cannot be initiated in time. In the present study of 51 schizophrenic patients we were able to replicate the results of Herz & Melville in the German-speaking countries. Prior to acute exacerbation of psychosis, most patients experience alterations of feelings and behaviour. These alterations may also be recognized by family members. Such early warning signs of relapse mainly consist of non-specific, non-psychotic symptoms: tenseness and nervousness, eating less, trouble concentrating and sleeping, depressive mood and seeing friends less. Furthermore, the regular monitoring and use of early warning signs specific to each patient in the aftercare of schizophrenic patients seems to be practicable, especially in psychoeducative family therapy.

Adult↗
PubMed1993

[Sepsis and spondylodiscitis caused by Salmonella enteritidis].

Four weeks after an attack of bronchopneumonia a 59-year-old veterinary surgeon developed backache. The chest radiograph showed an impression fracture of the 11th thoracic vertebra. Persisting fever led to hospitalization. Several blood cultures grew Salmonella enteritidis. Computed tomography demonstrated a fracture of the 11th thoracic vertebra with osteolytic infiltration and paravertebral soft-tissue infiltration. Bone scan showed band-like contrast enhancement in the same area. Treatment at first consisted of Ciprofloxacin, 200 mg twice daily intravenously for 5 days, then 750 mg orally twice daily for 3 months. The fever regressed within a few days. Sclerosis of the affected vertebral area became radiologically evident after 6 weeks. After this the patient was allowed to move around again, without any further problems.

Ciprofloxacin↗
PubMed1993

Diagnosis of renal transplant failure by real-time and duplex Doppler sonography.

A total of 419 real-time and duplex Doppler ultrasound examinations of renal allografts were carried out in 61 patients. Results were related to the clinical diagnoses based on histomorphological, clinical, and laboratory findings. The results of all sonographic examinations in terms of the diagnostic parameters of normal function, acute tubular necrosis, and interstitial and vascular rejection did not yield reliable criteria for distinguishing between the different forms of transplant dysfunction. The maximum difference was calculated for each ultrasound parameter between a time of normal transplant function and at a time of dysfunction. By means of this 'maximum parenchyma-pyelon index difference' it was possible to discriminate between acute tubular necrosis and vascular rejection (P < 0.05). Acute tubular necrosis could be distinguished from interstitial rejection using the maximum longitudinal renal diameter difference and the maximum parenchyma-pyelon index difference (P < 0.05). To discriminate between interstitial and vascular rejection the maximum pulsatility index difference was very useful (P < 0.05). Combined real-time and duplex Doppler sonography is most valuable in the diagnosis of transplant failure when it is performed not only in the case of dysfunction but also when transplant function appears to be normal.

Female↗
PubMed1993

Reference ranges for thyrotropin in the serum of full-term neonates--compared with the ranges for full-term neonates with various post-partal adaptation disorders, and premature neonates.

The "IMx hTSH ultrasensitive test" from Abbott Laboratories is a new method for the determination of thyrotropin. Its introduction for the purpose of hypothyreosis screening led to the present investigation of the reference ranges in full-term and premature neonates. In a total of 1712 healthy neonates, the reference range for serum thyrotropin on the 5th day post partum was 0.4-9.05 mU/l (median value 1.90 mU/l). In contrast, 64 full-term neonates with various post-partal adaptation disorders showed a significantly lower serum thyrotropin concentration on the 5th day post partum (0.14-6.39 mU/l; median value 1.60 mU/l). Serum thyrotropin was also determined on the 7th and 14th day post partum in 131 premature neonates with birth-weights below 2500 g. In the birth-weight range 1500- < 2500 g, the median values for serum thyrotropin were 2.35 and 2.12 mU/l, respectively. A negative correlation (r = -0.3019) was found between the birth-weight and the serum thyrotropin concentration on the 14th day post partum. In two premature neonates with birth-weights less than 800 g, the serum thyrotropin concentrations were conspicuously high (18.6 and 28.0 mU/l) on the 14th day post partum.

Birth Weight↗
PubMed1993

Establishment of reference ranges for thyrotropin, triiodothyronine, thyroxine and free thyroxine in neonates, infants, children and adolescents.

Thyrotropin, triiodothyronine, thyroxine and free thyroxine were determined in the sera of 714 euthyreotic neonates, infants, children and adolescents (age range 5 days to 18 years), using the IMx from Abbott Laboratories. Thyrotropin, triiodothyronine and free thyroxine were determined with microparticle enzyme immunoassays (MEIA). Thyroxine was determined with a fluorescence polarization immunoassay (FPIA). The proband collective was divided into 9 age groups, and each age group into males and females. In accordance with the recommendations of the International Federation of Clinical Chemistry, the 95% scatter range was taken as the reference range. In the different age groups, the ranges of some hormones showed significant differences between males and females. When no significant difference existed between the sexes, the results for males and females were evaluated statistically as a single group. Only a few reference groups showed normal Gaussian distributions. Therefore, in addition to the 50th percentile, the 2.5th and 97.5th percentiles were also calculated for all reference groups. Minimal and maximal values were also determined. The U-test of Mann & Whitney was used to test for significant differences between individual reference groups, and groups showing no significant differences were combined. The corresponding references ranges were then calculated.

Adolescent↗
PubMed1993

Establishment of reference ranges for cortisol in neonates, infants, children and adolescents.

Cortisol was determined in the sera of 687 normal, healthy probands between the ages of 5 days and 18 years (neonates, infants, children and adolescents), using a fluorescence polarization immunoassay (FPIA) on the TDx from Abbott Laboratories. The proband collective was divided into 9 age groups and each group into males and females. In accordance with the recommendations of the International Federation of Clinical Chemistry, the 95% scatter range was taken as the reference range. Only a few reference groups showed a normal Gaussian distribution. In addition to the 50th percentile, the 2.5th and 97.5th percentiles were determined for all reference groups. Minimal and maximal values were also determined. The U-test of Mann & Whitney was used to test for significant differences between the individual reference groups. Groups showing no significant differences were combined, and reference ranges were finally calculated for cortisol in the serum of normal, healthy neonates, infants, children and adolescents. The serum cortisol concentration showed a significant increase with age. In the 14-15 years age group, there was also a significant difference between males and females.

Adolescent↗
PubMed1993

Establishment of reference ranges for follitropin and lutropin in neonates, infants, children and adolescents.

Follitropin was determined in the sera of 645 probands, and lutropin in the sera of 649 probands between the ages of 5 days and 18 years (neonates, infants, children and adolescents), using microparticle-enzyme-immunoassays (MEIA) on the IMx from Abbott Laboratories. The proband collective was divided into 9 age groups and each group into males and females. In accordance with the recommendations of the International Federation of Clinical Chemistry, the 95% scatter range was taken as the reference range. In some age groups, the ranges for individual hormones showed a significant sex difference. Age groups without significant sex differences were combined and evaluated statistically as a single group. Only a few reference groups showed a normal Gaussian distribution. In addition to the 50th percentile, the 2.5th and 97.5th, or the zero and 95th percentiles were determined for all reference groups. Minimal and maximal values were also determined. The U-test of Mann & Whitney was used to test for significant differences between the individual reference groups. Groups showing no significant differences were combined, and reference ranges were finally calculated for follitropin and lutropin in the serum of healthy neonates, infants, children and adolescents.

Adolescent↗
PubMed1993

Establishment of reference ranges for prolactin in neonates, infants, children and adolescents.

Prolactin was determined in the sera of 686 healthy neonates, infants, children and adolescents (age range 5 days to 18 years), using the IMx from Abbott Laboratories. The applied test was a microparticle enzyme immunoassay (MEIA). The proband collective was divided into 9 age groups, and each age group into males and females. In accordance with the recommendations of the International Federation of Clinical Chemistry, the 95% scatter range was taken as the reference range. Only a few reference groups showed a normal Gaussian distribution. In addition to the 50th percentile, the 2.5th and 97.5th percentile were calculated for all reference groups, and the minimal and maximal values were also reported. From the age of 12 years onwards, significant differences were found between males and females. The U-test of Mann & Whitney was used to test for significant differences between individual reference groups. Groups showing no significant differences were combined, and the corresponding reference ranges for serum prolactin were then calculated.

Adolescent↗
PubMed1993

Establishment of reference ranges for ferritin in neonates, infants, children and adolescents.

Ferritin was determined in the sera of 631 healthy neonates, infants, children and adolescents (age range 5 days to 18 years), using the IMx from Abbott Laboratories. The applied test was a microparticle enzyme immunoassay (MEIA). The proband collective was divided into 9 age groups, and each group into males and females. In accordance with the recommendations of the International Federation of Clinical Chemistry, the 95% scatter range was taken as the reference range. Only a few reference groups showed a normal Gaussian distribution. In addition to the 50th percentile, the 2.5th and 97.5th percentile were calculated for all reference groups, and the minimal and maximal values were also reported. Significantly different reference ranges were found for males and females in the age group 16-18 years. The U-test of Mann & Whitney was used to test for significant differences between individual reference groups. Groups showing no significant differences were combined, and the corresponding reference ranges for serum ferritin were then calculated.

Adolescent↗
PubMed1992

Beta2-microglobulinuria as an early sign of cytomegalovirus infection following renal transplantation.

The frequency of cytomegalovirus infection was studied in a prospective study of 106 kidney recipients. The detection of cytomegalovirus-immediate-early-antigen and cytomegalovirus-immunoglobulin (IgM) antibodies in serum was used as the reference method and showed that 23.6% (25/106) of all patients were infected. In addition, four urinary proteins (IgG and transferrin as glomerular markers and alpha1-microglobulin and beta2-microglobulin as tubular markers) were quantitatively measured in 24-h urine samples from all of the patients using an immunoluminometric assay (ILMA). In all cytomegalovirus infection cases a pronounced but isolated increase of urinary beta2-microglobulin excretion was observed. In 20 of 25 infected patients, the beta2-microglobulinuria occurred 1-21 days (median 5.0) earlier than the appearance of the cytomegalovirus-immediate-early-antigen in blood. Thus, it can be seen that the quantitative measurement of beta2-microglobulin in urine is useful for the early detection of cytomegalovirus infection following renal transplantation.

Biomarkers↗
PubMed1992

Local hyperthermia enhances cyclophosphamide, ifosfamide and cis-diamminedichloroplatinum cytotoxicity on human-derived breast carcinoma and sarcoma xenografts in nude mice.

Antitumour response and toxicity of locally applied hyperthermia with or without cyclophosphamide, ifosfamide, and cis-diamminedichloroplatinum (cisplatin) have been compared. The model systems were human breast carcinoma (MX1/3) and human sarcoma (S117) grown in nude mice. In order to detect changes of tumour oxygenation intratumoral PO2 and pH were measured before, during and following hyperthermia. In both human tumour lines a monotherapy with one of the cytotoxic drugs or with hyperthermia caused a transient growth delay, while the combination of the same dose of the drugs with hyperthermia (at 43 degrees C for 1 h) resulted in complete tumour remissions. During hyperthermia, in both tumour types oxygenation was improved. Intratumoral pH remained practically unchanged.

Animals↗
PubMed1992

Hyperthermia enhances mitoxantrone cytotoxicity on human breast carcinoma and sarcoma xenografts in nude mice.

In this preclinical in vivo study, we measured antitumor response, local side effects and systemic toxicity of locally applied water-bath hyperthermia given alone or simultaneously with mitoxantrone (3 mg/kg b.w. i.v.; LD 10) on a human derived breast carcinoma (MX 1) or a human sarcoma (S 117) transplanted to female athymic (nude) mice. A single hyperthermia treatment at a tumor temperature up to 43 degrees C for 1 hr caused in both tumor lines only minor tumor regressions and transient tumor growth delay. However, the antitumor effect of mitoxantrone was significantly enhanced by local hyperthermia at 42 degrees C and particularly at 43 degrees C. In both tumor lines complete tumor regressions were achieved only if mitoxantrone was combined with hyperthermia. Undesired side effects and drug toxicity were not enhanced by hyperthermia. According to in vitro data and the results of the present in vivo study mitoxantrone seems to be a good candidate for clinical trials in combination with locoregional hyperthermia.

Animals↗
PubMed1992

Metabolic response of AH13r rat tumours to cyclophosphamide as monitored by pO2 and pH semi-microelectrodes.

The composition of the microenvironment has an important influence on the cellular response to cytotoxic agents. Using pH and pO2 semi-microelectrodes, we have monitored metabolic changes in AH13r rat tumours as a function of time after subcurative chemotherapy. Prior to therapy, tumours contained large areas considered hypoxic (mean pO2 approximately 4 mmHg) and are characterised by a marked accumulation of acidic metabolites (mean pH 6.65). Administration of cyclophosphamide (40 mg/kg body weight) resulted in tumour regression to 15% of pretreatment volumes and a growth delay of 12 days. Concomitant with volume reduction, tumours became reoxygenated (mean pO2 approximately 7 mmHg), with maximum values being reached within 2-4 days, paralleled by a shift of pH to more alkaline values (0.17 U on average). These changes coincided with the development of subtotal necrosis. During early tumour regrowth, the pH and pO2 histograms returned to control values. These data corroborate and extend the results of previous studies in which noninvasive techniques had been applied for the monitoring of treatment-induced metabolic changes in malignant tumours in vivo. In addition, these results support the notion that the effectiveness of anticancer therapy might be improved by selecting and scheduling therapeutic agents in consideration of physiological changes caused by preceding courses of treatment.

Animals↗
PubMed1992

[Establishment of reference values for fructosamine and HbA1c in childhood].

Reference values for fructosamine and glycated haemoglobin in children are still lacking. Using samples from 522 children (age range 1 day to 9 years), plasma electrophoresis was performed, fructosamine and total protein were determined in EDTA-plasma, and glucose and the fraction of glycated haemoglobin (HbA1c) were determined in EDTA blood. The results were grouped according to age (1, 3 and 5 days, 6-28 days, 2-12 months, 2-3 years, 4-6 years, and 7-9 years). Differences between the age groups were determined using the Mann-Whitney-U-test, and the values in each group were summarized where possible. The 95%-interval was calculated for fructosamine, protein-corrected fructosamine, and HbA1c.

Child↗