Biomedical subjects

M Bach

Publications and source records attributed to M Bach.

186 records · Page 11Linked to original sources

PubMedDate not supplied

120 Hz oscillations in the flash visual evoked potential are strictly phase-locked and limited to the first 100 ms.

Flash stimulation elicits a visual evoked potential (VEP) as part of the electroencephalogram (EEG). This VEP is known to contain strong oscillatory activity around 120 Hz, which ceases 100 ms after the flash. It was unclear so far whether this time limit represents an averaging artifact due to loss of intertrial phase coherence or indicates a veridical cessation. Here we present results obtained from single-trial analysis of the EEG. These show that the oscillations exhibit virtually perfect phase locking and do in fact cease around 100 ms after the stimulus. Thus, the cessation of oscillatory activity in the VEP is not due to increasing intertrial phase jitter. Comparison with simultaneous retinal recordings exclude the possibility of direct crosstalk from the retina, but suggest that the oscillations are propagated from the retina to the cortex with a time lag of 48 ms.

Cerebral Cortex↗

PubMedDate not supplied

[Quality of life and mortality following major neurosurgical interventions in advanced age].

Mortality and quality of life was studied retrospectively in a group of 109 patients over 60 years old who had undergone a major neurosurgical operation because of vascular malformation, an acute or chronic intracranial hematoma or an intracranial tumor, were compared with a group of younger patients (n = 80) submitted to surgical treatment of the same kind of lesions, and also with a group of patients (n = 40) over 60 years old submitted to lumbar disk surgery. The overall mortality (within 2 years) was significantly higher in the group of older patients undergoing neurosurgery (52% vs. 22%), while in the group of patients submitted to lumbar dis surgery, the overall mortality (10%) corresponded to the natural mortality rate. The postoperative quality of life was improved in 70% of the surviving elderly patients after neurosurgery, in 67% of the group of younger patients and in 65% of the group of patients submitted to lumbar disk surgery. These differences are not significant.

Adult↗

PubMedDate not supplied

[Diagnosis of depression in the elderly. The "Geriatric Depression Scale"].

Psychiatric diseases are very common among elderly people. Depressions rank before dementias in this age group. 2-2.5 million people aged over 65 years are suffering from symptoms of depression in Germany. Patients with Mayor Depression Disease (MDD) have a poor prognosis. MDD should therefore be recognized and treated in community dwelling elderly, in nursing homes and in hospitals. Underdiagnosis of MDD is well documented in the medical literature. Only a quarter of patients with a MDD are detected. By a short screening test for depression such as the Geriatric Depression Scale (GDS) depressed patients can be identified. With a sensitivity and specificity of about 70%. The time needed to perform the short form of the GDS is only 5-7 min. The GDS is an important part of many assessment programs in England and USA. It is also recommended in Germany by the "Geriatric Assessment" working group.

Aged↗

PubMedDate not supplied

Effectiveness of hospital-based geriatric evaluation and management and home intervention team (GEM-HIT). Rationale and design of a 5-year randomized trial.

In this ongoing randomized controlled trial the effectiveness of an interdisciplinary team implementing hospital-based comprehensive geriatric assessment (CGA) and home intervention is being studied. All patients admitted from home showing functional decline with impairment of any basic activity of daily living are randomly assigned to one of the following courses of treatment: CGA with in-hospital and post discharge management by a home intervention team (HIT), where necessary (group 1): CGA with recommendations and usual care at home (group 2); or usual hospital and home care (group 3). The HIT consists of 3 nurses, 1 geriatrician, 1 physiotherapist, 1 occupational therapist, and 1 social worker. 540 patients will be recruited for the trial, which will assess the effects of GEM-HIT on the following outcomes: health status, functional status, survival, hospital readmission, nursing home placement and costs. The purpose of the GEM-HIT trial is to answer many of the current questions concerning treatment and health care delivery for frail older persons under the specific conditions found in Germany. The large sample size and the broad range of diagnoses included in the study will allow the evaluation of effects of GEM-HIT for subgroups and may help to identify the most effective assessment tools for use within our particular context.

Activities of Daily Living↗

PubMedDate not supplied

[Social aspects in diagnosis and therapy of very elderly patients. Initial experiences with a newly developed questionnaire within the scope of geriatric assessment].

To evaluate social aspects of elderly patients which are important for diagnosis and therapy within geriatric assessment, a questionnaire was developed and validated. Raters showed a high degree of agreement on the scale, which contains social contacts and support, activities, economic situation, and housing conditions (0.92-0.97; p < 0.05). Compared to the interrater reliability the test-retest reliability was somewhat lower (0.75), but also significant at the 5% level. The internal consistency showed high values between 0.72-0.89. In order to evaluate the validity of the screening test the answers of the patients were compared with the assessment of the therapeutic team. The team had information from a home visit, patients spouse, relatives, neighbors, community nurses and/or general practitioners. There was a significant relationship (p < 0.01) between therapeutic assessment and the scale (r = 0.51). Sensitivity, specificity, and total efficiency also attained sufficiently high values at a cut-off of 16/17 for the complete scale (max. 25 points). The test is easily and quickly performed; its acceptance is high. Social data relevant for treatment and discharge planning can thus be obtained and patients can be identified, for whom a home visit seems to be useful.

Activities of Daily Living↗

PubMedDate not supplied

[Problems of geriatric patients with managing drug containers].

The purpose of the study was to measure the prevalence of difficulties in elderly inpatients in opening a range of common commercial drug packagings, in breaking a bar-scored tablet, and in reading medication instructions. Sixty-seven patients (female: 47; male: 20, mean age: 81.6 +/- 6.1) who reported that they had managed their medication independently before hospital admission, underwent a comprehensive geriatric assessment. They were also asked to remove tablets and drops from various commercial drug packagings and a "dosett", to break a tablet, and to read medication instructions enclosed in the packings. Only 21 patients (31%) were able to perform all tasks. Thirty-one patients (46.3%) failed in opening the "push and turn" bottle and 44 patients (65.7%) were unable to open the flip-top container. There were significant differences (p < 0.05) in age, cognitive capacity, handgrip, and manual dexterity between the patients who were able to perform all tasks, and those who were not able to do so. Many of the common medication packagings impede a reliable management of drugs by elderly patients.

Aged↗