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Biomedical subjects

H Bickel

Publications and source records attributed to H Bickel.

At least 19 recordsLinked to original sources
PubMed1992

[Dementia diseases and minor cognitive impairments in elderly patients in general practice. Results of a cross-sectional study].

General practitioners in 24 Mannheim practices kept a record of all over-65-year-old patients seen during four weeks (n = 3,737), and made ratings of their cognitive functioning with the help of simple guidelines. For a sub-sample of patients (n = 407), these ratings could be compared with assessments made by the research team, on the basis of a standardized interview and test procedure (Hierarchic Dementia Scale). The research data indicate that 8% of the patients manifested clinical dementia, a further 8% so-called 'mild dementia' and 17% milder, non-disabling degrees of cognitive impairment. The proportion of affected persons in each of the groups rises steeply with increasing age above 65 yr. The ability of the practitioners to detect dementia--including the milder degrees--among their elderly patients exceeded expectation (sensitivity 92%; specificity 76%). The test-score profiles of the patients, grouped according to their own doctors' ratings, conformed to clinical concepts of the progressive course ('staging') of dementing illness, while the degree of disability in everyday life, and dependency on others, also increased steeply across the groups. These findings emphasize the importance of general medical practice for the early detection of dementia in the elderly population, and potentially also for case management.

Activities of Daily Living↗
PubMed1991

Mental illness in a cross-national perspective. Results from a Brazilian and a German community survey among the elderly.

Findings for unselected samples for the elderly in two urban populations - one in Mannheim, Germany (n = 418) and the other in Sao Paulo, Brazil (n = 111) - are compared and contrasted. Each study was restricted to persons aged over 65 years living in private households, and each employed a single-stage method of psychiatric case-identification, based on the Clinical Interview Schedule (CIS). Apart from marked differences in educational standards and proportions living alone the two samples were broadly similar in their recorded socio-demographic characteristics. Comparison revealed no significant difference in total prevalence, though there was a trend towards a higher case-frequency in Sao Paulo (29.7%) than in Mannheim (23.3%). The clinical-item profiles for the two samples indicated a higher rate of symptom reporting in Sao Paulo, whereas the Mannheim sample had higher mean scores for a number of psychiatric abnormalities observed at interview. Separate cluster analyses carried out on the two data sets divided the samples into four pairs of sub-groups with similar clinical profiles, which were designated respectively as 'organic', 'depressive', 'neurotic' and 'normal'. While a more careful standardization of method would probably reduce the observed disparities between the samples, some of these are thought to be real and to relate to sociocultural differences, as well as to the greater stresses of daily life in Sao Paulo.

Aged↗
PubMed1979

[Sulfites in infusion solutions].

9 commercially available high-calorie carbohydrate solutions were investigated for their sulfite content. It became evident that 6 manufacturers of infusion solutions add varying amounts of sulfite to their solutions. We consider such an addition to be unnecessary and risky from the toxicological point of view.

Carbohydrates↗
PubMed1978

Maple syrup urine disease: treatment of the acutely ill newborn.

Three patients with maple syrup urine disease were treated during the acute neonatal stage. Multiple exchange transfusions proved to be a satisfactory means of achieving rapid clinical and biochemical improvement during this phase. On the other hand, evidence is provided suggesting that in addition to exchange transfusions, a high calorie intake above 150 Cal/kg body weight/day is necessary to lower the plasma concentration of the branched chain amino acids to near-normal levels. As long as this calorie intake was not provided, further exchange transfusions failed to lower the plasma leucine concentration to below 17 mg/100 ml in one patient. It is assumed that this high calorie intake is necessary to prevent the breakdown of endogenous protein. Treatment of acute episodes in maple syrup urine disease should therefore not only eliminate the elevated alpha-keto acids and branched chain amino acids quickly (i.e. by multiple exchange transfusions or peritoneal dialysis), but in addition should provide a high calorie intake.

Energy Intake↗
PubMed1978

Effect of stopping low-phenylalanine diet on intellectual progress of children with phenylketonuria.

Forty-seven patients at the Hospital for Sick Children, London, who had phenylketonuria and were on a low-phenylalanine diet (21 early-treated--that is, treatment started before the age of 4 months--and 26 late-treated) were placed on a normal diet between the ages of 5 and 15 years. They showed significant falls in mean IQ of about six points after the diet was withdrawn. Twenty-two similar patients (five early-treated and 17 late-treated) at the Universitäts-Kinderklinik, Heidelberg, who were placed on a relaxed low-phenylalanine rather than a normal diet, showed smaller and non-significant falls in mean IQ. During the period of strict diet none of the patients in London or Heidelberg showed any consistent falls in IQ. These results suggest that complete withdrawal of the low-phenylalanine diet during childhood leads to a fall in intellectual progress in many patients.

Adolescent↗
PubMed1978

[Study of a carrier solution for the lidocaine infusion therapy in myocardial infarct].

Corafusin, an infusion solution containing lidocaine, electrolytes and sorbitol, was tested during 4-day continuous infusion of patients with myocardial infarction. The serum sodium level remained constant within the normal range whereas initially reduced serum potassium and magnesium concentration increased to normal within 24 hours. Both sodium and water balance were generally equilibrated during the entire test period. Testing of lactate and non-esterified fatty acids revealed a significant decrease within the first 24 hours. On the basis of these findings it can be concluded that the infusion solution tested is suited for lidocaine infusion therapy of patients with myocardial infarction.

Electrolytes↗
PubMed1977

Acid-base status in dietary treatment of phenylketonuria.

Blood acid-base status, serum electrolytes, and urine pH were examined in 64 infants and children with phenylketonuria (PKU) treated with three different low phenylalanine protein hydrolyzates (Aponti, Cymogran, AlbumaidXP) and two synthetic amino acid mixtures (Aminogran, PAM). The formulas caused significant differences in acid-base status, serum potassium, and chloride, and in urine pH. In acid-base balance studies in two patients with PKU, Aponti, PAM, and two modifications of PAM (P2 + P3) were given. We observed a change from mild alkalosis to increasing metabolic acidosis from Aponti (serum bicarbonate 25,8 mval/liter) to P3 (24,0Y, P2 (19, 3) and PAM (17,0). Urine pH decreased and renal net acid excretion increased. In the formulas PAM, P2 and P3 differences in renal net acid excretion correlated with differences in chloride and sulfur contents of the diets and of the urines. New modifications of AlbumaidXP and of PAM, prepared according to our recommendations, showed normal renal net acid excretion (1 mEq/kg/24 hr) in a balance study performed in one patient with PKU and normal acid base status in 20 further patients.

Acid-Base Equilibrium↗
PubMed1976

Comparative study of the balance and metabolic effect of post-operatively infused carbohydrates.

If glucose, fructose, and xylitol are infused in the immediate post-operative period at rates necessary for parenteral nutrition, all three substrates produce specific undersired effects. These effects can be reduced significantly when the three substrates are infused in the form of a mixture. The composition and the rate of intake of such a mixed solution are of importance.

Acid-Base Equilibrium↗