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Biomedical subjects

H Stierlin

Publications and source records attributed to H Stierlin.

At least 19 recordsLinked to original sources
PubMed1991

A followup study of manic-depressive and schizoaffective psychoses after systemic family therapy.

The authors report the results of a followup study of manic-depressive and schizoaffective psychoses after systemic family therapy. They describe the development of inpatient relapse rates, familial interactional patterns, and prescriptions of medication in a sample of 30 cases treated with family therapy and followed up after a mean interval of 3 years. Finally, they assess the effectiveness of systemic family therapy with manic-depressive and schizoaffective psychoses.

Adolescent↗
PubMed1988

Therapy for families manifesting manic-depressive behavior.

This is a companion piece to the article "Some Features of Families with Major Affective Disorders," published in Family Process (25: 325-336, 1986). In addition to the family features mentioned in the first article, the authors report on other features that have come to the fore since then. Subsequently, they deal with the therapeutic problems that derive from all of these features. In particular, they elaborate on how the therapists must (and can) maintain their neutrality in the face of the massive polarizations and extremes of the either/or thinking found in these families. There follows a description of typical phases in the therapeutic process. Finally, therapy with one family is described in detail.

Adult↗
PubMed1988

Systemic optimism--systemic pessimism: two perspectives on change.

Therapists have a mandate to bring about change, and family therapists appear to have unusual leverage to fullfill such a mandate, that is, to facilitate changes rapidly and effectively. Because and in spite of this mandate, the very notion of change deserves critical reflection. The history of ideas and our clinical experience teach us that changes may be problematic. They may come too fast or too slowly, may endure or fade away, may turn out to be desirable or undesirable, equitable or inequitable, and may, when further consequences and larger systems levels are taken into account, be beneficial or disastrous. This essay examines some of the problematical and contradictory aspects of change and delineates two perspectives on change--systemic optimism and systemic pessimism.

Attitude↗
PubMed1988

A new metabolite of diclofenac sodium in human plasma.

1. Among the phenolic metabolites of diclofenac in human plasma, an unknown compound (metabolite VI) was detected by h.p.l.c. and g.c. methods. This was also found in baboon plasma. 2. Metabolite VI was identified as 3'-hydroxy-4'-methoxy diclofenac by mass and n.m.r. spectroscopic analysis. Comparison with synthetic reference compound confirmed its structure. 3. In plasma, metabolite VI persists much longer than do unchanged diclofenac and the other phenolic metabolites. In urine, metabolite VI and its conjugates are excreted in trace amounts only. 4. A synthetic sample of metabolite VI was shown to be virtually inactive in animal models of inflammation and pain.

Adult↗
PubMed1986

Features of families with major affective disorders.

This article reports the authors' observations on 22 families in which a young adult member has been diagnosed as manic-depressive, and on 11 families in which a member has been diagnosed as suffering from major schizoaffective disorder. All families could be described as extremely rigid and bound-up systems. Many of them were characterized by a "restrictive parental complementarity" and reciprocal delegation, and they shared certain cognitive features and assumptions. "Manic-depressive" families showed similarities as well as differences when compared with families in which there were schizophrenic and serious psychosomatic disorders.

Bipolar Disorder↗
PubMed1986

[A systemic approach in psychotherapy].

The principle of the systemic disposition of psychotherapy is presented by the example of schizophrenic family systems. There is need of counteracting the "psychotic plays" with a communication of therapeutic strategies. The Heidelberg model works with five perspectives: the referred individuation, the delegation, the several-generations-dynamics of guilt and merit, and the status of mutuality. In schizophrenia family therapy seems to be very helpful also in the realm of a "family psychosomatics". The aim would be the introduction of a family medicine.

Combined Modality Therapy↗
PubMed1985

Isolation and stereospecific determination of the enantiomers of oxindazac by direct liquid chromatographic resolution on triacetylcellulose.

The preparation of the optically pure enantiomers of the antiphlogistic trial drug oxindazac via liquid chromatographic resolution of the corresponding tert.-butyl or benzyl ester on triacetylcellulose is described. Cleavage of the optically pure enantiomeric esters to the acids proceeds without significant racemization. The methyl ester of oxindazac is also completely resolved on the same chiral phase. Whereas oxindazac racemizes easily upon derivatization to diastereomers, no racemization is observed upon methylation to the corresponding methyl ester with diazomethane. An inverse isotope dilution method has been developed to determine both enantiomers of the drug in biological fluids after administration of 14C-labelled oxindazac. The enantiomers are converted into their methyl esters and separated on triacetylcellulose. Quantitation is performed by on-line UV detection at 290 nm and off-line radiometry. In the analysis of plasma samples, endogenous compounds do not interfere. The recoveries of [14C]oxindazac from water, rat and human plasma were 99.6 +/- 1.8% for the (+/- and 96.0 +/- 1.4% for the (-)-enantiomer. The plasma concentrations and urinary excretion of the two enantiomers were determined in a human volunteer who had received 200 mg of racemic 14C-labelled oxindazac.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1985

Indoxyl derivatives of drug metabolites.

Indoxyl derivatives were detected as minor products among the urinary metabolites of two trial drugs, a benzodiazepine (GP 55 129) and a benzophenone (CGP 11 952). Their structures were elucidated by NMR and mass spectroscopy. Presumably, metabolites containing potential aldehyde functions react spontaneously with endogenous indoxyl. Such derivatives have not hitherto been encountered in drug metabolism.

Animals↗
PubMed1985

Prebioptic psychological characteristics of breast cancer patients.

63 women were examined the day before breast biopsy using psychological ratings, speech analysis and questionnaire testings. Ratings revealed differences (benign vs. malignant, a = 5%) in 8 of 10 scales, cancer patients being inaccessible, altruistic, suppressing feelings, rationalizing and harmonizing. The biopsy's result was predicted in 75% of all cases. Questionnaire testing showed differences in 7 of 16 scales. It proved cancer patients to be more dependent, anxious, aggressive, health-conscious, family-bound and antisexual. A discriminant analysis correctly identified 77% of cancer and 87% of benign patients. Speech analysis (Gottschalk-Gleser) revealed only minor differences: fewer aggressive and more anxious utterances from cancer patients. Conclusions are drawn for the care and treatment of breast cancer patients.

Adaptation, Psychological↗
PubMed1983

Family therapy--a science or an art?

Family therapy can be viewed as science and as art. Following leads provided by Gregory Bateson, this paper reflects on problems and promises inherent in both views.

Art↗
PubMed1982

Psychological identification of breast cancer patients before biopsy.

Fifty-six women admitted consecutively for a breast biopsy were interviewed on the day prior to the operation. Interviewer ratings and blind ratings (audiotapes) allowed a [statistically significant (alpha = 5%)] differentiation of women in whom the biopsy revealed a cancer from those whose tumor was benign. The ratings took into account characteristics assumed to be typical of the women with cancer: (1) being inaccessible or overwhelmed when interviewed; (2) emotional suppression with sudden outbursts; (3) rationalization; (4) little or no anxiety before the operation; (5) demonstration of optimism; (6) superautonomous self-sufficiency; (7) altruistic behaviour; (8) harmonization and avoidance of conflicts. On the basis of the interviews the interviewer and a blind rater predicted the correct diagnosis in 83% and 94% of all cancer patients and in 71% and 68% of all benign cases. This result is also significant (alpha = 5%). The identified psychological syndrome was found in all breast cancer patients but also in a quarter to a third of the patients with benign nodes. We interpret it as a long-standing defensive pattern adopted in the face of extreme emotional stress. A possible etiological significance for the cancerous disease cannot be derived from this study.

Adult↗
PubMed1979

Family dynamics and family psychotherapy of psychosomatic.

Family therapy of psychosomatic disorders is oftern difficult and comparable to the therapy of psychotic patients. Nonetheless, the results published today by authors such as Minuchin and Selvini and our own experiences are promising indeed. We have found that what seemed to be a deep-rooted psychic structure changed rapidly and enduringly if the relationship field changed. Amelioration of symptoms is in many cases easily attained if they are understood in their function within a relational system. Also, we regard the system or family approach as a chance for medical practice. The general practioner who usually deals with family systems has, in our view, an ideal position to bring about change if he uses his authority and trust properly. He has to obtain a positive, not pathology-oriented view and should use family and social resources in spite of engaging in an often fruitless and endless contact with the designated patient, which only serves to maintain and even to increase the homeostatic lock of the family system.

Adolescent↗
PubMed1979

Biotransformation of diclofenac sodium (Voltaren) in animals and in man. I. Isolation and identification of principal metabolites.

1. The anti-inflammatory agent diclofenac sodium (o-[(2,6-dichlorophenyl)amino]phenylacetic acid sodium salt) is extensively metabolized by rat, dog, baboon and man. The main metabolites were isolated from the urine of all species and from the bile of rat and dog and identified by spectroscopy. 2. Metabolism involves direct conjugation of the unchanged drug, or oxidation of the aromatic rings usually followed by conjugation. Sites of oxidation are either position 3' or 4' of the dichlorophenyl ring or, alternatively, position 5 of the phenyl ring attached to the acetic acid moiety. 3. In the urine of rat, baboon and man conjugates of the hydroxylated metabolites predominate, but the major metabolite in dog urine is the taurine conjugate of unchanged diclofenac. 4. In the bile of rat and dog, the main metabolite is the ester glucuroniade of unchanged diclofenac.

Animals↗
PubMed1979

Biotransformation of diclofenac sodium (Voltaren) in animals and in man. II. Quantitative determination of the unchanged drug and principal phenolic metabolites, in urine and bile.

1. Quantitative determinations of unchanged diclofenac and two of its major phenolic metabolites were made by reverse isotope dilution analysis on urine of rat, dog, rhesus monkey, baboon and man and on bile of rat, dog and man. Isotope dilution analysis was performed before and after various methods of enzymic and chemical hydrolysis. 2. The same samples were also analysed by two-dimensional t.l.c. and subsequent autoradiography, to estimate the remaining phenolic metabolites. 3. In contrast to rat, rhesus monkey, baboon and man, which excrete mainly hydroxylated metabolites, the dog does not oxidize diclofenac. Dog urine contained a relatively stable taurine conjugate of diclofenac, and in the bile an ester glucuronide was excreted, which decomposed even in weakly alkaline soln. 4. The unstable ester glucuronide found in dog bile was also demonstrable in rat bile. It presumably hydrolyses in the duodenum, releasing diclofenac which undergoes enterohepatic circulation.

Animals↗