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Biomedical subjects

J Kruse

Publications and source records attributed to J Kruse.

At least 19 recordsLinked to original sources
PubMed2006

[Eating disorders and diabetes mellitus].

Adolescent and young women with type 1 diabetes mellitus demonstrate a more than random coincidence with bulimia nervosa. However, the prevalence of eating disorders that do not fulfil the criteria of bulimia nervosa is also raised in women of this age group yet without diabetes mellitus. The comorbidity of type 1 diabetes and an eating disorder poses a risk factor in the development of diabetic follow-up diseases. Patients with an eating disorder and type 1 diabetes are characterized by an insufficient metabolic control and the early development of diabetic complications such as a retinopathy. The binge eating disorder, according to research aspects initially a new eating disorder entity, may especially be observed in overweight and obesity. Even if a binge eating disorder in persons with a type 2 diabetes does not occur more frequently than in those metabolically healthy persons, it does depict a risk factor for an accelerated weight gain which as rule involves an increase of insulin resistance.

Comorbidity↗
PubMed2005

Routes towards Anderson-like localization of Bose-Einstein condensates in disordered optical lattices.

We investigate, both experimentally and theoretically, possible routes towards Anderson-like localization of Bose-Einstein condensates in disordered potentials. The dependence of this quantum interference effect on the nonlinear interactions and the shape of the disorder potential is investigated. Experiments with an optical lattice and a superimposed disordered potential reveal the lack of Anderson localization. A theoretical analysis shows that this absence is due to the large length scale of the disorder potential as well as its screening by the nonlinear interactions. Further analysis shows that incommensurable superlattices should allow for the observation of the crossover from the nonlinear screening regime to the Anderson localized case within realistic experimental parameters.

Journal Article↗
PubMed2004

Contamination of anaesthetic gases with nitric oxide and its influence on oxygenation: study in patients undergoing open heart surgery.

BACKGROUND: Nitric oxide is important in vasomotor regulation. Contamination of anaesthetic gases with nitric oxide could affect gas exchange. METHODS: We measured oxygenation and nitric oxide concentrations in the inspiratory and expiratory limb of the ventilator circuit in patients about to have cardiac surgery. Measurements were made before surgery when the circulation and respiratory conditions were stable. Fi(o(2)) was set at 0.35. The breathing circuit was supplied with a fresh gas flow greater than the minute volume so that exhaled gas was not re-used. Three gas mixtures were given in sequence to each patient: oxygen and compressed air (AIRc), oxygen and nitrous oxide, and oxygen and synthetic air (AIRs) that was free from nitric oxide. All patients were given AIRs as the second gas and the other two gas mixtures (AIRc and nitrous oxide) were given randomly as the first and third gases. RESULTS: During ventilation with oxygen-AIRc, the median nitric oxide concentration was 5.6 ppb, during ventilation with oxygen-nitrous oxide it was 5.0 ppb and using oxygen-AIRs it was 1.5 ppb. When AIRc and nitrous oxide were used, Pa(o(2)) was greater and venous admixture was less than when AIRs was used. The different gas mixtures did not affect pulmonary vascular pressures or cardiac output. CONCLUSIONS: Compressed air and nitrous oxide contain very low concentrations of nitric oxide (<10 ppb). This can affect pulmonary oxygen transfer during anaesthesia.

Adult↗
PubMed2003

A reduced model of the fluorescence from the cyanobacterial photosynthetic apparatus designed for the in situ detection of cyanobacteria.

Fluorometric determination of the chlorophyll (Chl) content of cyanobacteria is impeded by the unique structure of their photosynthetic apparatus, i.e., the phycobilisomes (PBSs) in the light-harvesting antennae. The problems are caused by the variations in the ratio of the pigment PC to Chl a resulting from adaptation to varying environmental conditions. In order to include cyanobacteria in fluorometric analysis of algae, a simplified energy distribution model describing energy pathways in the cyanobacterial photosynthetic apparatus was conceptualized. Two sets of mathematical equations were derived from this model and tested. Fluorescence of cyanobacteria was measured with a new fluorometer at seven excitation wavelength ranges and at three detection channels (650, 685 and 720 nm) in vivo. By employing a new fit procedure, we were able to correct for variations in the cyanobacterial fluorescence excitation spectra and to account for other phytoplankton signals. The effect of energy-state transitions on the PC fluorescence emission of PBSs was documented. The additional use of the PC fluorescence signal in combination with our recently developed mathematical approach for phytoplankton analysis based on Chl fluorescence spectroscopy allows a more detailed study of cyanobacteria and other phytoplankton in vivo and in situ.

Cyanobacteria↗
PubMed2003

[Personality disorders and psychopathology following trauma. Reflection on diagnostic classification].

Pervasive personality disorders have been shown to be long-term sequelae of cumulative childhood physical and sexual traumatization. This finding is not reflected in DSM-IV and ICD-10 classifications where post-traumatic stress disorder is confined to intrusions, avoidance, numbing, and hyperarousal. However, there is growing evidence that trauma etiology should be taken into account in planning treatment for personality disorders. It is not yet clear whether childhood traumatization is more strongly associated with borderline personality disorder than with other personality disorders. The finding of a substantial overlap between borderline personality disorder and dissociative identity disorder gives rise to discussions concerning the relationship of these two pathologies.

Adult↗
PubMed2002

A time-limited, problem-orientated psychotherapeutic intervention in Type 1 diabetic patients with complications: a randomized controlled trial.

AIMS: To examine the effects of a time-limited, problem-orientated psychotherapeutic intervention on self-defined psychological problems and metabolic control in Type 1 diabetic patients with microvascular complications. DESIGN: Randomized wait-list controlled trial with a follow-up of 6 months. SETTING: Out-patient clinic of a university diabetes centre. PARTICIPANTS: Forty-six Type 1 diabetic patients with intensified insulin therapy and presence of microvascular diabetic complications. Twenty-four patients were randomly allocated to the intervention group and 22 patients to the control group. INTERVENTION: Participation in a structured, problem-orientated, time-limited psychotherapeutic intervention (IG). The control group (CG) patients received routine diabetes care in a specialized diabetes university clinic. OUTCOME MEASURES: Degree of change of three self-defined main psychological and psychosocial problems (no. 1, no. 2 and no. 3) on a 1-10 graded scale and glycosylated haemoglobin HbA1c values. RESULTS: Two patients (one in each group) died during the study period. All remaining patients were followed for 6 months. Problem scores were high at baseline in both groups: IG/CG (mean values, standard deviation in parentheses): problem no. 1, 7.8 (2.0)/8.3 (1.7); problem no. 2, 7.7 (2.3)/7.6 (1.8); and problem no. 3, 7.7 (2.3)/7.4 (2.6). At follow-up, all problems were significantly lower in the intervention group (IG) when compared with the CG: IG/CG: problem no. 1, 4.3 (2.9)/6.8 (3.0), P = 0.03; problem no. 2, 3.9 (2.4)/5.8 (2.8), P = 0.03; problem no. 3, 4.7 (2.4)/6.8 (2.4), P = 0.02. Mean HbA1c decreased in the intervention group by 0.6 (1.2)% and increased in the control group by 0.1 (0.7)%, P = 0.016. In patients with suboptimal metabolic control, i.e. HbA1c > 8%, mean HbA1c decreased by 1.0 (1.2)% in the IG and increased by 0.1 (0.7)% in the CG, P = 0.011. CONCLUSION: A time-limited, structured, problem-orientated psychotherapeutic intervention decreases the severity of psychological problems and improves metabolic control in Type 1 diabetic patients with microvascular complications and self-management of intensified insulin therapy.

Adult↗
PubMed2001

Tobacco plants that lack expression of functional nitrate reductase in roots show changes in growth rates and metabolite accumulation.

When tobacco is provided with a high nitrate supply, only a small amount of the nitrate taken up by the roots is immediately assimilated inside the roots, while the majority is transported to the leaves where it is reduced to ammonium. To elucidate the importance of root nitrate assimilation, tobacco plants have been engineered that showed no detectable nitrate reductase activity in the roots. These plants expressed the nitrate reductase structural gene nia2 under control of the leaf-specific potato promoter ST-LS1 in the nitrate reductase-mutant Nia30 of Nicotiana tabacum. Homozygous T2-transformants grown in sand or hydroponics with 5.1 mM nitrate had approximately 55-70% of wild-type nitrate reductase acivity in leaves, but lacked nitrate reductase acivity in roots. These plants showed a retarded growth as compared with wild-type plants. The activation state of nitrate reductase was unchanged; however, diurnal variation of nitrate reductase acivity was not as pronounced as in wild-type plants. The transformants had higher levels of nitrate in the leaves and reduced amounts of glutamine both in leaves and roots, while roots showed higher levels of hexoses (3-fold) and sucrose (10-fold). It may be concluded that the loss of nitrate reductase acivity in the roots changes the allocation of reduced nitrogen compounds and sugars in the plant. These plants will be a useful tool for laboratories studying nitrate assimilation and its interactions with carbon metabolism.

Biological Transport↗
PubMed2000

Application of stratum-specific likelihood ratios in mental health screening.

BACKGROUND: The accuracy of a diagnostic procedure is commonly assessed by measuring sensitivity, specificity and positive and negative predictive values. Likelihood ratios provide an alternative method for describing these results, though they are typically reported only for dichotomized outcomes. However, likelihood ratios can also be applied to ordinal or continuous results. METHODS: The present paper discusses the application of stratum-specific likelihood ratios in a primary care setting using the General Health Questionnaire (GHQ-12) and the Symptom Check List 90-R (SCL-90-R). A randomly selected sample (n = 408) of adult outpatients from primary care offices in Düsseldorf was screened using the German versions of the GHQ-12 and the SCL-90-R. RESULTS: Logistic regression analysis indicated that stratum-specific or multilevel likelihood ratios preserve more information than a fixed threshold approach with a single cutoff point. For each test, five clinically useful strata with monotonically increasing stratum-specific likelihood ratios were selected. CONCLUSIONS: Stratum-specific likelihood ratios have enormous practical value, and they are becoming an important way of expressing and comparing the usefulness of different tests. Stratum-specific likelihood ratios reduce the spectrum bias that might arise if only two categories (cases and non-cases) are chosen. Additionally, multilevel likelihood ratios can be used as bedside information to obtain the post-test probability from the pre-test probability of the disorder.

Adult↗
PubMed2000

[Narcissistic regulation and metabolic control in type-II diabetics].

The influence of narcissistic regulation on metabolic control was investigated in 130 patients with Type-II-diabetes in the course of a rehabilitation programme. Two groups were studied: a) diabetics on a non-drug therapy regimen, b) diabetics treated by insulin. At the end of the rehabilitation programme 55.6% of the non-insulin patients and 60.1% of the insulin treated patients exhibited a clinically significant improvement as measured by HbA1c. On the basis of the Düsseldorf Questionnaire for Narcissistic Regulation in Chronic Disease (DNACE) predictors of metabolic control were established. Using decision analysis, a correct prediction was possible in 73.1% resp. 85.4% of the cases. In the non-drug group, low values of the "helplessness/powerlessness" scale and high values of the "mourning" scale predicted an improvement of metabolic control at the end of the rehabilitation programme. On the other hand, in the insulin treated group the more successful patients were shown to have low values in the scales "distrust", "feeling of being ashamed of disease", "feeling of inferiority" and "fighting self-image" and high values in the scales "value ideal" and "symbiotic protection of the self". The results are discussed within the theoretical framework.

Blood Glucose Self-Monitoring↗
PubMed1999

School problems and the family physician.

Children with school problems pose a challenge for the family physician. A multidisciplinary team of professionals can most appropriately assess and manage complex learning problems, which are often the cause of poor school performance. The family physician's primary role in this process is to identify or exclude medical causes of learning difficulties. An understanding of the complicated nature of school problems, the methods used to assess, diagnose and treat them, and the resources available to support the child and family are essential to successful management. Various references and resources are helpful for a more in-depth study of specific school problems.

Adolescent↗
PubMed1999

Diagnosing mental disorders in primary care: the General Health Questionnaire (GHQ) and the Symptom Check List (SCL-90-R) as screening instruments.

BACKGROUND: The treatment of mental disorders in Germany is mainly done by primary care physicians. Several studies have shown that primary care physicians have difficulty in diagnosing these disorders. Recently, several self-report questionnaires have been developed that can be used as screening instruments to identify psychopathology in primary care settings and in the community. The aim of this paper was to investigate the screening properties of the General Health Questionnaire (GHQ-12) and the Symptom Check-List (SCL-90-R) in a primary care setting in Germany. METHOD: A randomly selected sample (n = 408) of adult outpatients from 18 primary care offices in Düsseldorf was screened using the German versions of the GHQ-12 and the SCL-90-R. A structured diagnostic interview (SCID) and an impairment rating (IS) were used as a gold standard to which both questionnaires were compared. Test performance was evaluated by receiver operating characteristic (ROC) analysis. RESULTS: We found no difference in the performance of the general scores of the two questionnaires. Both instruments were able to detect cases. Complex scoring methods offered no advantages over simpler ones for the GHQ-12. ROC analysis confirmed that the SCL-90-R subscales "anxiety" and "depression" showed acceptable concurrent validity for the diagnostic groups anxiety and depression (according to DSM-III-R). CONCLUSIONS: GHQ-12 and SCL-90-R appeared to be useful tools for identifying mental disorders in primary care practice and research. The use of GHQ-12 or SCL-90-R, employed as a first step, supplemented by a second-stage interview, may enhance the detection rate of mental disorder in primary care settings.

Adult↗
PubMed1999

Indicators of dysautonomia in severe Guillain-Barré syndrome.

This study sought to establish quantitative criteria for dysautonomia in artificially ventilated patients with Guillain-Barré syndrome (GBS). Such criteria would help to identify patients at risk for cardiovascular complications. This retrospective controlled clinical study compared hourly cardiovascular monitoring data from 36 successive, artificially ventilated GBS patients with that from 11 artificially ventilated control patients with myasthenia. Tolerance limits for daily means, extremes, and variations in heart rate (HR) and blood pressure (BP) were estimated from the most abnormal subgroups of the treatment days of our control patients. These exceeded previously suggested arbitrary cutoff values for dysautonomia. The range in systolic BP was increased in 27 GBS patients, despite an upper limit of normal (85 mmHg) that was double the value suggested in previous work. All 16 patients with mean systolic BP above 165 mmHg also had persistent tachycardia (mean HR > 125 bpm), or were treated with beta-blockers. This pattern of sympathetic hyperactivity was combined with probable vagal hyperactivity (bradycardia < 48 bpm) in 6 patients. Hypotension (minimal systolic BP < 85 mmHg) and unprovoked bradycardia indicated sympathetic hypoactivity in 3 patients. Except in one patient who suffered from asystole on his first day on the ICU, all episodes of bradycardia were preceded by increased daily systolic BP variation (> 85 mmHg), which thus proved to be a sensitive and prognostically valuable indicator of dysautonomia in GBS.

Autonomic Nervous System Diseases↗
PubMed1999

Psychometric properties of the General Health Questionnaire (GHQ-12) in a German primary care sample.

OBJECTIVE: The aim of this investigation was to examine the psychometric properties of the German 12-item General Health Questionnaire (GHQ-12) in a primary care sample. METHOD: A sample (n = 421) of adult out-patients was screened using the GHQ-12. A standardized clinical interview (SCID) was conducted with all screened patients. Reliability, validity and factor analysis of the GHQ-12 were evaluated. Item characteristics were examined using item characteristics curves. Item bias analysis was performed using contingency tables. RESULTS: The German version of the GHQ-12 is a reliable instrument and performed well in detecting cases of psychological disorders. Factor analysis replicated the findings of earlier studies. Item characteristics curves and item bias analysis indicated that the individual items should be assessed carefully. One item was biased in relation to age, while another item showed a low positive response rate. CONCLUSION: The GHQ-12 as a whole is a reliable questionnaire and can be a useful screening tool in primary care.

Adult↗
PubMed1999

Neutron yields from 155 MeV/nucleon carbon and helium stopping in aluminum.

Neutron fluences have been measured from 155 MeV/nucleon 4He and 12C ions stopping in an Al target at laboratory angles between 10 and 160 deg. The resultant spectra were integrated over angle and energy above 10 MeV to produce total neutron yields. Comparison of the two systems shows that approximately two times as many neutrons are produced from 155 MeV/nucleon 4He stopping in Al and 155 MeV/nucleon 12C stopping in Al. Using an energy-dependent geometric cross-section formula to calculate the expected number of primary nuclear interactions shows that the 12C + Al system has, within uncertainties, the same number of neutrons per interaction (0.99 +/- 0.03) as does the 4He + Al system (1.02 +/- 0.04), despite the fact that 12C has three times as many neutrons as does 4He. Energy and angular distributions for both systems are also reported. No major differences can be seen between the two systems in those distributions, except for the overall magnitude. Where possible, the 4He + Al spectra are compared with previously measured spectra from 160 and 177.5 MeV/nucleon 4He interactions in a variety of stopping targets. The reported spectra are consistent with previously measured spectra. The data were acquired to provide data applicable to problems dealing with the determination of the radiation risk to humans engaged in long-term missions in space; however, the data are also of interest for issues related to the determination of the radiation environment in high-altitude flight, with shielding at high-energy heavy-ion accelerators and with doses delivered outside tumor sites treated with high-energy hadronic beams.

Altitude↗
PubMed1999

[Diagnosis and management of patients with psychogenic disorders in family practice. Results of a field study].

The majority of patients with psychological disorders are seen in primary care. The diagnosis of the general practitioner (GP) influences decisively the subsequent treatment. Our study provides an insight into GP's diagnosis and treatment. 18 GP's and a psychotherapist rated 572 patients using a global diagnostic rating scale and the impairment score (BSS). The GPs noted down their treatment. The patients filled in symptom checklists (SCL-90-R, GHQ-12). Agreement between the doctor and the researchers on mental ill health was modest. GPs identified 51.4% of the patients with psychological disorders. Adjustment disorders were often ignored by GPs. They prescribed psychotherapy for 3.3% of their patients, especially patients with somatoform disorders and with high values in the impairment score. A path analysis shows, that psychotherapists' ratings agree much more with patients' self-assessment than GP ratings.

Adult↗
PubMed1997

[The rehabilitation of chronic respiratory insufficiency].

Respiratory rehabilitation is defined as a medical practice including a multidisciplinary medical program fitting each individual. Personalized retraining by means of exercises, is the master part of it, its aim is to improve the physical fitness in specialised institution then to maintain it when he becomes an out patient. In both cases, this retraining complies with strict rules concerning the mode of exercises (imposed power--duration of sessions--weekly frequency--progressiveness of overloading ...). This codification rests mainly on the recommendations of the American College of Sports Medicine. The choice of intensity at the beginning of the stay will be determined either by the maximal reserve of cardiac frequency or by the ventilatory threshold. This training has to involve extensive muscular mass and must not neglect the upper limbs. Ventilatory physiotherapy also plays an important part. The other components of rehabilitation concern optimisation of bronchodilator treatment, cessation of smoking, health education, physical education and relaxation, appraisal of nutritional status, assessment of therapeutic programs, of the quality of life and a long-term program for reinforcement of acquisitions. The therapeutic programs improve ventilatory performance, maximal oxygen intake, maximal tolerated power and quality of life. An adaptation of the St. George's Respiratory Questionnaire to patients hosted at the TOKI EDER Medical Center points out that the quality of life of patients with chronic respiratory failure is improved very highly significantly by this rehabilitation.

Chronic Disease↗