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Biomedical subjects

J Fritze

Publications and source records attributed to J Fritze.

At least 55 records · Page 3Linked to original sources
PubMed2000

Exonic variants of the GABA(B) receptor gene and panic disorder.

The enhancement of GABAergic neurotransmission has been closely linked to antipanic drug efficacy. This is the first study to investigate a putative association of exonic sequence variants of the human GABA(B) receptor 1 (GABA(B)R1) gene and susceptibility to panic disorder. Three DNA sequence variants in exons 1a1, 7 and 11 were assessed by polymerase chain reaction-based restriction fragment length polymorphism in a case-control study among patients with panic disorder with and without agoraphobia (DSM III-R criteria) and blood donors. There was no indication of an increased vulnerability to panic disorder or agoraphobia with respect to the allelic variants under study.

Agoraphobia↗
PubMed2000

Polymorphic MAO-A and 5-HT-transporter genes: analysis of interactions in panic disorder.

Recurrent panic attacks, anticipatory anxiety and phobic avoidance characterise panic disorder. The influence of genetic factors on liability to the disease has been the object of several linkage and association studies and appears to relate to an oligo- or polygenic rather than a monogenic mode of inheritance. Recently, an excess of high activity monoamine oxidase A (MAO-A) gene promoter alleles was found in female patients with panic disorder. An analysis of possible synergistic effects of the MAO-A gene promoter variant and the short serotonin transporter (5-HTT) gene promoter variant in panic disorder was performed in a German and an Italian sample (combined panic disorder n = 144, combined controls n = 175). There was no significant difference in odds ratios, suggesting that the observed increase of genetic liability by the long MAO-A gene promoter allele is not modified by the 5-HTT gene promoter polymorphism.

Adult↗
PubMed1999

[Is orlistat medically essential for the treatment of obesity?].

Obesity is a major health problem in western societies. The mainstay of therapy is behavioral modification. By inhibiting intestinal lipases orlistat modifies food composition. Thus, orlistat is a dietetic compound. Therefore, orlistat does not represent a medically necessary treatment option in terms of the conditions of private health insurances. However, adjunctive treatment with orlistat may make sense in single high risk patients.

Anti-Obesity Agents↗
PubMed1999

Evaluation of linkage of bipolar affective disorder to chromosome 18 in a sample of 57 German families.

Previously reported linkage of bipolar affective disorder to DNA markers on chromosome 18 was reexamined in a large sample of German bipolar families. Twenty-three short tandem repeat markers were investigated in 57 families containing 103 individuals with bipolar I disorder (BPI), 26 with bipolar II disorder (BPII), nine with schizoaffective disorder of the bipolar type (SA/BP), and 38 individuals with recurrent unipolar depression (UPR). Evidence for linkage was tested with parametric and non-parametric methods under two definitions of the affected phenotype. Analysis of all 57 families revealed no robust evidence for linkage. Following previous reports we performed separate analyses after subdividing the families with respect to the sex of the transmitting parent. Fourteen families were classified as paternal and 12 families as maternal. In 31 families the parental lineage of transmission of the disease could not be determined ('either' families). Evidence for linkage was obtained for chromosomal region 18p11.2 in the paternal families and for 18q22-23 in the 'either' families. The findings on 18p11.2 and 18q22-23 support prior evidence for susceptibility loci in these regions. The parent-of-origin effect on 18p11.2 is confirmed in our sample. The delineation of characteristics of 'either' families requires further study.

Bipolar Disorder↗
PubMed1999

Competence to give informed consent to clinical studies. Statement by the taskforce on "ethical and legal questions" of the Association for Neuropsychopharmacology and Pharmacopsychiatry ("Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie [AGNP]").

Over the last 50 years, patient autonomy has become an increasingly important part of the principles of medical ethics, or rather of the ethics of the doctor-patient relationship. While the principle of charity and the associated paternalism became less important, the patient's active consent became more and more relevant (Sass, 1989; Bayer, 1998; Nedopil, 1998). This development was inevitably also accompanied by a demand for more detailed information prior to medical interventions (Appelbaum and Grisso, 1988; Weisstub, 1990; Kreussler, 1997; Ulsenheimer, 1995; Laufs, 1997; Sommer, 1997) and for complete information on medical procedures subsequent to interventions (e. g. Bender, 1997). Determination of a person's competence to give informed consent is a central problem in the assessment of his expression of consent to a medical intervention. The capacity to adequately express consent can be impaired at certain stages of life and during some illnesses. Patients in borderline situations, children, mentally ill patients and old people with dementia may either be limited in their capacity to give informed consent, or be completely unable to do so. This results in special ethical problems when such groups are included in research projects.

Clinical Trials as Topic↗
PubMed1999

Excess of high activity monoamine oxidase A gene promoter alleles in female patients with panic disorder.

A genetic contribution to the pathogenesis of panic disorder has been demonstrated by clinical genetic studies. Molecular genetic studies have focused on candidate genes suggested by the molecular mechanisms implied in the action of drugs utilized for therapy or in challenge tests. One class of drugs effective in the treatment of panic disorder is represented by monoamine oxidase A inhibitors. Therefore, the monoamine oxidase A gene on chromosome X is a prime candidate gene. In the present study we investigated a novel repeat polymorphism in the promoter of the monoamine oxidase A gene for association with panic disorder in two independent samples (German sample, n = 80; Italian sample, n = 129). Two alleles (3 and 4 repeats) were most common and constituted >97% of the observed alleles. Functional characterization in a luciferase assay demonstrated that the longer alleles (3a, 4 and 5) were more active than allele 3. Among females of both the German and the Italian samples of panic disorder patients (combined, n = 209) the longer alleles (3a, 4 and 5) were significantly more frequent than among females of the corresponding control samples (combined, n = 190, chi2 = 10.27, df = 1, P = 0.001). Together with the observation that inhibition of monoamine oxidase A is clinically effective in the treatment of panic disorder these findings suggest that increased monoamine oxidase A activity is a risk factor for panic disorder in female patients.

Alleles↗
PubMed1998

[Extracorporeal shockwave therapy (ESWT) in orthopedic indications: a selective review].

A search of Medline concerning the efficacy of shock wave therapy for pseudarthritis (nonunion), calcifying tendinitis of the shoulder, lateral epicondylitis and painful heel identified 25 publications describing 31 investigations. These investigations cannot be accepted as confirmative. The effects in pseudarthritis appear most promising but the cases reported need a reanalysis and thorough description before efficacy can be accepted as granted. Moreover, the indication as well as the stimulus parameters have to be specified and standardized. Published data on the other indications justify prospective, randomized, double-blind, placebo-controlled (sham treatment) trials to confirm efficacy where again the procedure and dosing of shock wave therapy need data-based, rational standardization.

Humans↗
PubMed1998

Increase of optical illusion in demented patients.

Assuming a particular psychological function of optical gestalt perception, its impairment would lead to a decreasing extent of gestalt related optical illusion. An increase of optical illusion would be expected in the case of a loss of adaptability and cognitive compensation, usually revising the phenomenon of optical illusion. 16 demented out-patients were compared to 16 hospitalized schizophrenics by a 'Computerized Assessment of Change in Optical Illusion' (CACOI), measuring the extent of optical illusion by patient's assessment of 12 variations of the figure of Mueller-Lyer, differing in baseline length. The results showed a significant increase of optical illusion in demented patients compared to the schizophrenic controls (p = 0.019). Taking into account that the extent of optical illusion by the figure of Mueller-Lyer usually is decreasing with age and was found to be increased in schizophrenics, our results support the hypothesis of an early loss of adaptability and cognitive compensation in dementia.

Aged↗
PubMed1998

[Psychopharmacotherapy during pregnancy and lactation. 1: Pregnancy].

Approximately one-third of all pregnant women take psychotropic drugs at least once during pregnancy. At the same time, there are no preparations on the market that can be considered entirely appropriate for expectant mothers. The effects of psychopharmacological therapies have exclusively been discussed in the context of their risk during the first trimester. However, treatment after this phase is not absolutely without risk, and it is striking that there are grave differences between various substances. There are currently controversial discussions going on in literature as far as the teratogenicity of lithium is concerned, especially during the formation of the heart. It is suggested that the risk for congenital malformations is increased after intrauterine lithium exposure, whereas such a risk cannot be proved for most of the antidepressants and neuroleptics. Still, it should be noted that psychopharmacology is not harmless even after the organogenesis, as intrauterine exposure during the 2nd and 3rd trimester can lead to postnatal complications. For example, floppy-infant syndrome after taking benzodiazepines, and the extrapyramidal-motor effects on the newborn after neuroleptic therapy during pregnancy should be mentioned.

Abnormalities, Drug-Induced↗
PubMed1998

[Psychopharmacotherapy in pregnancy and lactation. 2: Lactation].

Whilst the incidence of psychiatric disorders decreases during pregnancy, the risk during the postpartum period increases significantly, often leading to the necessity of psychopharmacological intervention during the puerperium, and subsequently during lactation and breast-feeding. The necessity for lithium prophylaxis in manic-depressive women after childbirth has been identified, and it is recommended that weaning rather than omission of psychopharmacological treatment is preferable during the puerperium.

Female↗
PubMed1998

[Self-assessment and follow-up of delusional dysfunctional cognitions in inpatient treatment of depressed patients].

Even today psychotic depression is connected to a lot of unanswered questions. A self-questionnaire (BFD) was developed in order to evaluate cognitions corresponding to mood congruent depressive delusions. They were assumed to indicate psychotic depression and to be related to severity of the depressive syndrome. 42 depressed inpatients were examined by the BFD, the Hamilton Depression Scale (HAMD) and the Beck Depression Inventory (BDI). BFD scores were found increased in psychotic depression (p = 0.009) and correlated to BDI scores (p = 0.002). 19 re-examined patients showed a significant improvement in HAMD and BDI scores but not concerning the delusion indicating cognitions (BFD), which were significantly correlated to suicidality items of BDI and HAMD (p = 0.005). The results prove the delusion indicating nature of cognitions measured by the BFD and their correlation to severe depression. Differences in treatment response are indicated and persisting or increasing BFD scores seem to be accompanied by more severe suicidal tendency.

Adult↗
PubMed1998

Systematic mutation screening and association study of the A1 and A2a adenosine receptor genes in panic disorder suggest a contribution of the A2a gene to the development of disease.

Several lines of evidence suggest a contribution of adenosinergic neurotransmission to the development of panic disorder. We therefore hypothesized that variation in the A1 and A2a adenosine receptor (AR) genes modifies genetic susceptibility to panic disorder. To test this hypothesis, we screened 38 patients with panic disorder for mutations in the coding sequence of the A1AR and A2aAR genes. An association study between the identified DNA sequence variants and panic disorder was performed in an extended sample of 89 patients and matched controls. One silent mutation (716T/G) in the A1AR gene and two silent mutations (432C/T and 1083C/T) in the A2aAR gene were detected. The association sample shows a significant association between the 1083T allele (P=0.01) and 1083T/T genotype (P=0.024) of the A2AR gene and panic disorder. Our findings thus lend further support to the hypothesis that the A2aAR gene, or a locus in linkage disequilibrium with it, confers susceptibility to panic disorder. Replication studies in independent samples with nuclear families applying the transmission disequilibrium test (TDT) are warranted.

DNA Primers↗
PubMed1998

Computerized self-assessment in psychiatric in-patients: acceptability, feasibility and influence of computer attitude.

In recent years various approaches using computerized assessments and tests in psychiatry have been published. In our study, the acceptability and feasibility of computerized self-assessments and attitude to computers were examined in psychiatric in-patients, using an improved interactive schedule, the Interactive Self-Assessment Scale (ISAS), based on the Windows operating system. In general we found a good level of acceptability and feasibility of the computerized self-assessment. Our results confirm the influence of attitude to computers on acceptability, and indicate a lack of self-confidence in interacting with computers, accompanied by a less positive attitude to computers than reported by healthy subjects and psychiatric out-patients. Computerized self-assessment is suitable for psychiatric in-patients. Nevertheless, further research is necessary in order to improve attitude to computers and the patient-computer interaction.

Adult↗
PubMed1997

Tolerability of low dose neuroleptics: a case control study of flupenthixol.

There are no data available on the risk of extrapyramidal symptoms when using long-term flupenthixol in low dosage in patients suffering from anxiety and depressive disorders. In a case control study 106 patients essentially treated with the neuroleptic flupenthixol in a so-called low, non-antipsychotic dosage were compared to n=37 otherwise comparable patients who never had been treated with neuroleptics. The investigator was blind to the previous treatment conditions. Extrapyramidal symptoms were found although with a low prevalence and mild degree: 6.7% tardive dyskinesia, none in controls; pseudoparkinsonism 26%, 16% in controls. Extrapyramidal side-effects, especially tardive dyskinesia, have to be considered in the individual weighing of therapeutic benefits and risks even when prescribing flupenthixol in low dosages.

Adult↗