Biomedical subjects
Publications and source records attributed to H Ott.
A case of Group G streptococcal arthritis in a previously healthy man is reported. The 2nd and 3rd metatarso-phalangeal joints of the left foot were simultaneously affected. Unusual erosive joint destruction occurred in spite of early therapy and clinical improvement. Circulating immune complexes were raised and were not completely normal at 1 year.
Articular involvement is described in a 58-year-old female patient with scleroderma. Radiological findings included intra-articular calcification, destructive osteoarthritis and selective involvement of the first metacarpal base. The discussion attempts to explain the way in which intra-articular calcification and osteolytic lesions may appear, citing various hypotheses put forward concerning such involvement in scleroderma.
Sixteen healthy volunteers of a mean age of means = 26.4 years took part in a driving simulator test in an eightfold crossover study under double-blind conditions. The additional influence of alcohol was tested acutely after a single administration of 2 mg lormetazepam, a new, highly effective derivative from the benzodiazepine class, 10 mg mepindolol sulphate, a new betablocker without sedating properties, and 10 mg diazepam. All drugs were compared with placebo and the test was performed 1, 2 and 3 hours after oral intake. The aim was to investigate particularly the risks relevant in road traffic caused by simultaneous intake of these substances with alcohol. For this purpose, besides the driving simulator, an accurate reaction test ( WDG ) and self-rating scales were used, the latter in order to assess subjective stress and anxiety levels. Lormetazepam, due to its strong sedating property, showed a reduction in driving performance and an increase in reaction time and pulse rate as compared with placebo, and these effects were highly potentiated by alcohol. Mepindolol sulphate expectedly reduced pulse rate when compared with placebo, otherwise there were no significant differences. Diazepam, when compared with placebo, like lormetazepam caused a reduction in driving performance and reaction capacity and an increase in pulse rate, but intensity and duration of this effect were less than with lormetazepam and did not reach statistical significance. No significant potentiating effects were observed after the additional application of alcohol.
Nine significant concepts and definitions of vigilance and activation from the fields of psychology and neurophysiology are introduced. The term "vigilance" stands out as a neurophysiological, and especially as an electrophysiological construct which is designated a mediating role (disposition) in the optimal preparation and adaptation of behaviour to the environment. In accordance with this central idea, the term vigilance should be operationalised and parametrised primarily with neurophysiological methods. The various forms of the electroencephalogram are held to be the most accurate indicators of the state of vigilance. For the sake of semantic clarity, the term vigilance should be avoided in psychological research, and instead the terms attentiveness, concentration etc. should be used. On the basis of the tests selected for the paper, it becomes apparent that "vigilant" = attentive behaviour designates a working construct with wide applicability. The term serves to describe a preparatory state for optimal adaptation to and performance in the environment, which must be precisely defined from one experimental situation to another. These considerations apply particularly to human pharmacological experiments in which pharmacopsychological and psychopharmacological questions come into contact. The term vigilance fits into the concept of activation.
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Polydermatomyositis is a chronic, non-suppurative disease of the striated muscle. In practice, the diagnostic criteria are often associated with other factors--alcoholism, corticotherapy--which, by themselves, may induce myopathy. In adults, the possible association of dermatomyositis with cancer rises the problem of scanning for neoplasia at regular intervals. In addition to corticotherapy, physical therapy helps the patient to maintain maximal autonomy.
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We describe the clinical features of algodystrophy of the hip in 3 brothers, probably the first familial presentation of this disease to be reported. The symptoms and evolution of the disease are as usually described. The familial presentation suggests a genetic predisposition. HLA typing showed an identity of antigenic formula in the 3 brothers, a rare coincidence.
Lormetazepam significantly reduced anxiety during local anaesthesia when compared with a placebo control group. There were significantly fewer accompanying symptoms of spinal anaesthesia under lormetazepam than under placebo. This number fell in relation to the decrease in the patients' anxiety. Lormetazepam also proved to be significantly superior to placebo according to the physician's assessment of anxiety. There were no differences between the two groups with respect to side-effects. The results of the Erlanger Anxiety Scale--Situative (EAS-S) revealed: 1. Oral treatment with lormetazepam led to markedly lower anxiety values than treatment with placebo (p less than 0.1; t test, one-sided). - 2. Following additional, intravenous administration of lormetazepam an even greater difference between the two treatment groups became evident. - 3. The situative anxiety was lower under treatment with lormetazepam than with placebo, independent of the variables "sex", "trait anxiety" or "anxiety control mechanism" (dimension of sensitization-repression). - 4. Women attained higher actual anxiety values than did men. - 5. Patients with high basic anxiety expectedly attained higher situative anxiety scores than those with lower basic anxiety.
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The effect of a single dose of beta-blocker (5 or 10 mg mepindolol) during a written examination was investigated in two double-blind studies (N : 49 and 55 students, respectively). The question was whether the beta-blocker would in comparison to placebo diminish examination anxiety and improve the performance of highly complex tasks, while leaving the performance of less complex tasks unchanged. A reduction in examination anxiety after beta-blocker intake could not be demonstrated with a multi-level test model (which included the parameters self-rated anxiety, motor behaviour, task performance and physiology), although pulse rates were lowered significantly. An improvement in performance could not be observed, while - by the same token - the performance was not impaired by the beta-blocker. A hypothesis according to which a beta-blocker has an anxiolytic effect and improves performance, dependent on the level of habitual examination anxiety, was tested post hoc, but could not be confirmed. Ten of the subjects treated with 10 mg mepindolol, complained of different side effects, including dizziness, fatigue and headache.
Clinical experience with benzodiazepines shows that observable effects like sedation do not persist as long as predicted by pharmacokinetic data. As a pharmacodynamic parameter closely related to effects of tranquillizers we used the quantitative pharmaco-EEG to compare time courses of these parameters with plasma level time courses. The subjects received single oral doses (1, 2 and 3 mg) of the benzodiazepine lormetazepam. Plasma levels were detected by radioimmunoassay. After fast absorption dose-dependent plasma level peaks could be determined 2 hours after administration. Applying an open two-compartment body model the drug was excreted with an elimination half-life of 10.3 hours. EEG power reached maximum changes after 1 hour in the delta, theta, alpha 2 and beta 1 frequency bands, as well as in the dominant alpha-frequency, and declined after that with different speeds to previous levels. Three to five hours after drug administration no significant changes could be detected. Vigilance sensitive EEG changes (delta, alpha 2) diminished earlier than indicated by plasma level half-lives. In contrast the decline of relative beta-power parallels plasma level time courses more closely under the 3 mg dose. In the present investigation, the computerized EEG appears to be a suitable indicator of monitoring time courses of sedative effects after single oral doses of benzodiazepines.
The effect of thymopoietin pentapeptide (TP-5) was evaluated in patients with rheumatoid arthritis (RA). Ninety-two patients were divided into 3 groups, namely, placebo, TP-5 intramuscularly (IM) 1 mg, TP-5 intravenously (IV) 50 mg, and were evaluated for 6 measures of disease activity at the beginning of the study and at 3 and 6 months. No difference was observed between the placebo group and the group treated with TP-5 IM 1 mg. However, in the group treated with TP-5 IV 50 mg a statistically significant improvement of all parameters except the ESR was observed.
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