Search PubMed⌕ Search

Biomedical subjects

J Fritze

Publications and source records attributed to J Fritze.

At least 37 records · Page 2Linked to original sources
PubMed2002

[Benzodiazepines and benzodiazepine-like anxiolytics and hypnotics. The implausible contraindication of closed angle glaucoma].

Official drug information materials mention angle-closure glaucoma as an absolute or relative contraindication for benzodiazepines, albeit with some unexplained variability. A systematic review of the literature reveals that this contraindication seems to be based on only one published case while 22 other investigations, some of them controlled, tend to favor that benzodiazepines reduce intraocular pressure. The common 1990-2001 database of the Drug Commission of the German Medical Profession and the Federal Institute for Drugs and Medical Devices contained one spontaneous report of glaucoma related to a benzodiazepine-like hypnotic.

Anti-Anxiety Agents↗
PubMed2002

Bias in computerized neuropsychological assessment of depressive disorders caused by computer attitude.

OBJECTIVE: Psychiatric patients are increasingly confronted to computerized psychological and psychopathological assessment. Patients' attitude to computers was reported to affect acceptance of computerized assessment. METHOD: In 78 psychiatric in-patients neuropsychological impairment was examined following admission on an open ward by conventional as well as computerized memory and attention tasks. Besides psychopathological assessment, self ratings of computer attitude and acceptance of the computerized assessment were completed. RESULTS: A more negative attitude to computers was found to be significantly correlated to higher nervousness in patients' self report (R=0.38, P=0.0005) as well as to poorer results of computerized attention tasks (R=0.39, P=0.0007). Particularly in patients with depressive disorders computer attitude could be shown to explain 39% of the variance of attention performance. CONCLUSION: Results indicate a significant effect of negative computer attitude on acceptance and thus reliability of computerized examination, resulting in a bias in computerized attention-related assessment in patients with depressive disorders.

Adolescent↗
PubMed2001

A genome screen for genes predisposing to bipolar affective disorder detects a new susceptibility locus on 8q.

Bipolar affective disorder (BPAD), also known as manic depressive illness, is a severe psychiatric disorder characterized by episodes of mania and depression. It has a lifetime prevalence of approximately 1% in all human populations. In order to identify chromosomal regions containing genes that play a role in determining susceptibility to this psychiatric condition, we have conducted a complete genome screen with 382 markers (average marker spacing of 9.3 cM) in a sample of 75 BPAD families which were recruited through an explicit ascertainment scheme. Pedigrees were of German, Israeli and Italian origin, respectively. Parametric and non-parametric linkage analysis was performed. The highest two-point LOD score was obtained on 8q24 (D8S514; LOD score = 3.62), in a region that has not attracted much attention in previous linkage studies of BPAD. The second best finding was seen on 10q25-q26 (D10S217; LOD score = 2.86) and has been reported in independent studies of BPAD. Other regions showing 'suggestive' evidence for linkage localized to 1p33-p36, 2q21-q33, 3p14, 3q26-q27, 6q21-q22, 8p21, 13q11 and 14q12-q13. In addition, we aimed at detecting possible susceptibility loci underlying genomic imprinting by analyzing the autosomal genotype data with the recently developed extension of the GENEHUNTER program, GENEHUNTER-IMPRINTING. Putative paternally imprinted loci were identified in chromosomal regions 2p24-p21 and 2q31-q32. Maternally imprinted susceptibility genes may be located on 14q32 and 16q21-q23.

Bipolar Disorder↗
PubMed2001

[Stroke management in Germany].

Stroke is a leading cause of morbidity and mortality (rank 3) and thus a mass disease. Therefore, immediate access for everybody to stroke treatment services is indispensible. Therapeutic efficacy has been shown for lysis therapy and early rehabilitation in stroke units, respectively. The British-Scandinavian stroke unit concept focusses on immediately starting rehabilitation over 4-6 weeks by a specifically trained and motivated team. Since 1995, so-called stroke units are established in Germany adhering to a specific concept of the German Society for Neurology (DGN). Although referring to the British-Scandinavian concept in terms of efficacy the German concept differs fundamentally by focussing on monitoring as well as lysis therapy and neuroprotection in a short (3-5 days) stay. This is an intensive care unit approach for which scientific evidence is lacking. More essential are reasonable doubts that this concept can ever expand sufficiently to ensure comprehensive care. At least presently, stroke care is provided unevenly, thus contravening legislation (section 70 Social Security Act Vol. V). Acknowledging the restrictions the DGN adapted its concept, now advocating a two-step model comprising intensive care stroke units plus rehabilitative stroke units.

Combined Modality Therapy↗
PubMed2001

[G-DRG: the for Germany modified AR-DRG system as a complete case-associated hospital reimbursement system according to section 17bKHG. Must it apply to psychiatry?].

The introduction of a German ("German") DRG system (G-DRG) by 01.01.2003 is to improve efficiency and transparency of hospital performance and to terminate the presently implausible variability of costs. For the first time world wide the attempt is undertaken to finance by a DRG-system--supplemented by certain additional charges and rebates--hospital costs completely. Institutions submitted to the psychiatry personnel regulation (PsychPV) are excluded. As the basis for the G-DRG-system self-administration authorities have selected the Australian AR-DRG system. The adjustment to German conditions is an extraordinary challenge: Compatibility must be achieved between the German classification of diagnoses (CGD-10) and procedures (OPS-301) and pertinent coding standards and the Australian classification systems. In the hospitals a unit cost accounting must be established, which at least approximately allows a strictly case-related calculation of actual costs. The relative cost weights of the DRGS and thus in the long run, their prices will be calculated on the basis the costs of a complete sample of cases of a representative subset of hospitals. The full-scale DRG system will confront with new risks. One is the transfer of treatment components and thus costs to Institutions not covered by the DRG system (e.g. rehabilitation hospitals, psychiatry). Thus, psychiatry will be at least indirectly involved. In addition, psychiatric patients will be directly affected if they are treated--possibly due to misallocation--in non-psychiatric institutions (e.g. internal medicine, neurology) or in psychosomatic departments not covered by the PsychPV.

Diagnosis-Related Groups↗
PubMed2001

Psychiatric reform in Germany.

OBJECTIVE: To describe the ongoing process of German psychiatric reform and the structure and functioning of mental health services. METHOD: Information sources used include official reports describing mental health services, relevant publications related to organization and functioning of services. RESULTS: There has been far-reaching change in mental health care since the late 1960s: psychiatric hospitals have lost about 50% of their beds and one psychiatric hospital has been closed. One hundred and sixty-five general hospital psychiatric units have been built up. Out-patient, community and residential services have been developed. There is a lack of diversified residential and rehabilitation services, particularly for the most severely ill. Co-ordination of care is not always ensured, transfer of patients to remote nursing homes has occurred in some places. Carers and service users articulate their views to an increasing degree. CONCLUSION: Political and professional enthusiasm have been important in implementation of the German reform. Evolving it further will require major efforts.

Germany↗
PubMed2001

A possible susceptibility locus for bipolar affective disorder in chromosomal region 10q25--q26.

In an attempt to identify susceptibility loci for bipolar affective disorder, we are currently conducting a systematic genome screen with highly polymorphic microsatellite markers at an average marker spacing of 10 cM in a series of 75 families, comprising 66 families from Germany, eight families from Israel, and one family from Italy. The families were ascertained through index cases with bipolar affective disorder. The distribution of diagnoses is as follows: 126 individuals with bipolar I disorder, 40 with bipolar II disorder, 14 with schizoaffective disorder of the bipolar type, 40 individuals with recurrent unipolar depression, 51 with a minor psychiatric diagnosis, and two individuals with a diagnosis of schizophrenia. One hundred and seventy-one individuals are unaffected. Here, we present results from chromosome 10. Linkage analyses using a total of 33 microsatellite markers with parametric and non-parametric methods provided evidence for linkage at chromosomal region 10q25--q26. The highest two-point LOD score (2.86, theta = 0.05) was obtained for D10S217 using a dominant genetic model and a broad definition of affection status. The GENEHUNTER program localized the putative susceptibility locus within a ca 15-cM interval between markers D10S1483 and D10S217 with a maximum NPL(all) score of 3.12 (P = 0.0013). Positive linkage findings that have been reported by two independent studies further support the hypothesis of a susceptibility gene for bipolar affective disorder on 10q25-q26.

Bipolar Disorder↗
PubMed2001

Design of clinical trials of antidepressants: should a placebo control arm be included?

There is no doubt that available antidepressants are efficacious and effective. Nevertheless, more effective drugs with improved tolerability are needed. With this need in mind, some protagonists claim that future antidepressants should be proved superior to, or at least as effective as, established antidepressants, making placebo control methodologically dispensable in clinical trials. Moreover, the use of placebo control is criticised as unethical because it might result in effective treatment being withheld. There are, however, a number of methodological reasons why placebo control is indispensable for the proof of efficacy of antidepressants. Comparing investigational antidepressants only with standard antidepressants and not placebo yields ambiguous results that are difficult to interpret, be it in superiority or equivalence testing, and this method of assessment requires larger sample sizes than those required with the use of placebo control. Experimental methodology not adhering to the optimal study design is ethically questionable. Restricting the testing of investigational antidepressants only to superiority over standard antidepressants is an obstacle to therapeutic progress in terms of tolerability and the detection of innovative mechanisms of action from which certain subgroups of future patients might benefit. The use of a methodology that requires larger samples for testing of superiority or equivalence is also ethically questionable. In view of the high placebo response rates in trials of antidepressants, placebo treatment does not mean withholding effective treatment. Accepting the necessity of the clinical evaluation of new, potentially ineffective antidepressants implicitly means accepting placebo control as ethically justified. Three- or multi-arm comparisons including placebo and an active reference represent the optimal study design.

Animals↗