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Biomedical subjects

J Klug

Publications and source records attributed to J Klug.

34 records · Page 2Linked to original sources
PubMed1982

The impact of an expanding community mental health service on patterns of bed usage: evaluation of a four-year period of implementation.

In the city of Mannheim the introduction of an extensive community mental health service has been shown, by means of case-register data over 41/2 years, to have led to a considerable increase in utilization, mainly at the out-patient level of care. The rates of admission to hospital increased very little. Due to the simultaneous decline in long-term bed occupancy, the overall need for psychiatric beds remained stable at a rate of about 1.2/1000, a rate which is very low by international standards. The sharp decline in the "old' long-stay population was followed by a smaller increase in "new' long-stay patients which it has not been possible to prevent. These patients are, however, admitted for a long-term stay significantly later than formerly, and their diagnostic composition has changed significantly. The increase in the bed requirements for short- and medium-term stay patients resulted from different sources: an increasing morbidity in some groups of disorders, the rising utilization in case of emergencies and severe crises, and the transfer of long-stay patients to alternative care services. The level of these needs was very similar in Mannheim, Salford, Samsø and Camberwell, whereas the rates for long-term beds still show clear national differences.

Adult↗
PubMed1978

[Requirement and need of treatment - deliberations on psychiatric care (author's transl)].

The article defines the terms "requirement", "need" and "need of treatment", and explains their significance in the field of psychiatric care. The fundamentals of assessing the requirement are discussed, as well as the associated problems: recording and registration of patients in need of treatment, their readiness to undergo such treatment, and possible alternatives of hospitalisation. For establishing criteria required to determine the need treatment symptoms from two semi-standardised psychiatric interviews are examined for suitability (Present State Examination and Goldberg Interview); likewise, the severity of the disease, the stress from which the patient suffers, and the impairment of social relations, are also examined for suitability. It is suggested to take these criteria as basis and to operationalise the need of treatment on these lines. Relevant studies to assess the usefulness of these criteria are under way in two research projects of the Special Research Division 166 "Psychiatric Epidemiology".

Humans↗
PubMedDate not supplied

Steroid hormone receptors: an update.

Steroid hormones (SHs) are lipophilic molecules derived from cholesterol and synthesized in the adrenal cortex (glucocorticoids, mineralocorticoids, and adrenal androgens), the testes (testicular androgens, oestrogen), and the ovary and placenta (oestrogens and progestagens or progestins). SHs reach their target cells via the blood, where they are bound to carrier proteins, and because of their lipophilic nature pass the cell membrane by simple diffusion. Within the target cells SHs bind to steroid hormone receptors (SHRs), the key mediators of SH action, which are complexed to chaperones, e.g. heat shock protein 90 (Hsp90), that help other proteins to fold and prevent aggregation. SHRs are intracellular transcription factors that can be activated, among other possibilities, by the specific and high affinity binding of ligand to exert positive or negative effects on the expression of target genes. Binding of agonistic or antagonistic ligands leads to different allosteric changes of SHRs making them competent to exert positive or negative effects on the expression of target genes by different mechanisms. (i) After dissociation of chaperones the liganded SHR-complexes can bind to chromatin organized DNA sequences in the vicinity of target genes, termed hormone response elements (HREs). The HRE-recruited hormone-receptor-complexes are then able to initiate chromatin remodelling and to relay activating or repressing signals to the target genes transcription machinery; (ii) through protein-protein interactions with other sequence-specific transcription factors, SHRs can also regulate the activity of many genes that are switched on, for instance, during stress or an inflammatory response; (iii) the SH response can also be integrated in the intracellular signalling network via cross-talk of SHRs with signal transduction pathways that transmit extracellular signals via membrane receptors and activation of protein kinase cascades to nuclear transcription factors that activate various target genes. By all these different mechanisms SHRs modulate numerous and specific responses in a large variety of cells, whereby their particular effect depends on the physiological, cellular and genetic context.

Binding Sites↗