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Biomedical subjects

M H Schmidt

Publications and source records attributed to M H Schmidt.

At least 91 records · Page 5Linked to original sources
PubMed1998

[An inventory for assessing the quality of life of children and adolescents--a pilot study].

Up to now, the quality of life of children and adolescents with psychiatric disorders has rarely been investigated. Not many suitable instruments are available. A new one is the "Inventory for the Assessment of the Quality of Live in Children and Adolescents" presented here. Objectives and underlying conceptual assumptions are discussed, followed by an explanation of the instrument itself (questionnaires, rating scales, etc.). Finally, experiences with the application of the instrument are reported together with initial empirical results from a clinical sample and a sample of high school students. These indicate that the instrument usefully assesses clinically relevant information about the quality of life of the patients. A broader empirical analysis of this method is being prepared.

Adaptation, Psychological↗
PubMed1997

[Urogenital atrophy and recurrent urinary tract infection in elderly patients].

Postmenopausal lower urinary tract atrophy and its relations to recurrent urinary infections in elderly women are studied. Clinical aspects, functional and histological aspects and hypothetic mechanisms of atrophy are reported, epidemiologic data, mechanisms of urinary infections and of estrogen effects are reviewed and reports on the results of local or systemic use of drugs from the literature are presented. Local administration of estrogen seems to be efficient on the urinary tract. Local treatment is less dangerous and cheaper than systemic treatment. Hormonal treatment is one of the preventive measures against recurrent urinary infections in elderly women.

Aged↗
PubMed1997

The intellectual functioning of adolescents with anorexia nervosa and bulimia nervosa.

The aim of this study was to investigate the intellectual functioning of a large group of eating disordered adolescents in order to test two hypotheses, viz, that the intellectual functioning of eating disordered adolescents conforms to the normal distribution, and that eating disordered adolescents do not perform better in verbal abilities than in nonverbal abilities. Standard intelligence tests were applied to 190 consecutive out- and inpatients with eating disorder diagnoses. The results were compared with those of a group of patients with other disorders, similar in age, sex, SES, and year of admission. The IQ of the eating disordered patients was significantly higher than that of patients in the comparison group. Patients in the comparison group and bulimic patients, but not anorexic patients, showed better nonverbal than verbal intellectual performance.

Adolescent↗
PubMed1997

Pelvic ultrasound scanning of the ovaries in adolescent anorectic patients at low weight and after weight recovery.

In sixteen adolescent anorectic inpatients with secondary amenorrhea pelvic ultrasound examination of the ovaries was performed at lowest weight and after weight recovery. The outcome was assessed six months later at follow-up, assigning the patients to the categories of good, intermediate and poor outcome according to the modified Morgan and Russell criteria. At lowest weight all patients' ovaries were smaller than expected for age. After weight recovery the good outcome group had mature and fully developed ovaries whereas the ovarian morphology of patients with poor outcome remained prepubertal. The ovarian volume in the good outcome group was significantly higher than in the poor outcome group. From a threshold BMI of 17.8 upwards we observed a positive linear correlation between BMI and ovarian volume. At BMI 18 the probability for recovered ovaries was 53% rising to 82% at BMI 19.8, which was the highest noting in our study. Nevertheless, we could not find a clear cut-off BMI for definite prediction of recovered ovaries. Therefore, in patients with anorexia nervosa pelvic ultrasound is a very suitable method for determining the target weight required for recovery of ovarian function and resumption of menses. Normalized ovaries indicate favourable outcome and physical recovery.

Adolescent↗
PubMed1997

Does oligoantigenic diet influence hyperactive/conduct-disordered children--a controlled trial.

A crossover 'placebo'-controlled, double-blind design was used to examine the effectiveness of an oligoantigenic diet in 49 children with hyperactive/disruptive behavior disorder. Effects of diet were compared with those yielded by stimulant medication (methylphenidate). The study was conducted in an inpatient unit at the Department of Child and Adolescent Psychiatry, Central Institute of Mental Health, Mannheim. Change in behavior was measured in standardized situations by trained raters, including behavior assessment when testing with CPT and PAT, during a free play situation, and at school. Twelve children (24%) showed significant behavioral improvement in two behavior ratings during diet relative to control diet conditions. Methylphenidate used in 36 children yielded more responders (44%) than diet. The amount of positive changes in behavior in those who received both treatments was about the same. Although only effective in a minority of children, dietary treatment cannot be neglected as a possible access to treating hyperactive/disruptive children and merits further investigation.

Attention Deficit Disorder with Hyperactivity↗
PubMed1997

Course of adolescent psychotic disorder with schizoaffective episodes.

This study examines educational/occupational outcome and social functioning of adolescents treated for psychosis (mean onset age 16.1 yrs +/- 1.3). In a sample of 157 subjects, 26 patients with schizoaffective episodes (defined as any episode meeting ICD-9 criteria for schizoaffective psychosis, occurring at any time during the course of illness) were compared to 101 patients with schizophrenia, and to 30 affective disordered patients, all without schizoaffective episodes. Follow-up information (mean interval 7.3 yrs +/- 4.3) was obtained on 130 subjects. The three groups did not differ concerning sex, duration of first inpatient treatment, symptoms and social competence at discharge, nor at follow-up. At the time of outcome subjects with schizoaffective episodes showed greater similarities to schizophrenic than to severe affective disorder. Educational and occupational impairment was found in 72% of the schizoaffective group (schizophrenic group 79%, affective group 40%), obvious or more severe social disability in 86% of the schizoaffective group (schizophrenic 79%, affective 40%). Disabilities regarding performance of specific social roles and specific downward educational and occupational drifts were found to be more marked in schizoaffective than in affective disorder. Implications for further research and clinical practice are discussed.

Adolescent↗
PubMed1997

Serotonin transporter gene-linked polymorphic region: allele distributions in relationship to body weight and in anorexia nervosa.

Several lines of evidence implicate a role for the serotonergic system in body weight regulation and eating disorders. The magnitude and duration of postsynaptic responses to serotonin (5-HT) is directed by the transport into and release from the presynaptic neuron. Recently, a common polymorphism of a repetitive element in the region of the serotonin transporter (5-HTT) gene-linked polymorphic region (5-HTTLPR) was identified that results in a system of two common alleles. The activity of the 5-HTT, as measured in in vitro assays and in human lymphoblastoid cell lines, is dependent on the respective genotype. We thus hypothesized that this polymorphism is relevant for weight regulation in general and is possibly involved in the etiology of anorexia nervosa (AN). Allele frequencies and genotypes were determined in a total of 385 unrelated obese children, adolescents and adults, 112 underweight subjects and 96 patients with AN. Furthermore, both parents of 98 obese children and adolescents and of 55 patients with AN, respectively, were genotyped, thus allowing to test for both association and linkage. The comparison of allele frequencies between obese and underweight probands provided no evidence for a major role of the 5-HTTLPR in weight regulation. Patients with AN had allele frequencies not significantly different to those observed for obese and underweight individuals.

Adolescent↗
PubMed1997

Beta 3-adrenergic-receptor allele distributions in children, adolescents and young adults with obesity, underweight or anorexia nervosa.

OBJECTIVE: The missense mutation (64Trp to 64Arg) in the beta 3-adrenergic-receptor has previously been described to confer a genetic predisposition to the development of obesity. DESIGN: To test the hypothesis we evaluated allele frequencies in children, adolescents and young adults who belonged to different weight groups that were delineated with percentiles for the body mass index (BMI; kg/m2). SUBJECTS: 99 underweight probands (BMI < or = 15th percentile). 80 normal weight probands (BMI: 5th-85th percentile). 238 obese children and adolescents (BMI > or = 97th percentile). 84 patients with anorexia nervosa (AN). MEASUREMENTS: The cohorts were screened by polymerase chain reaction with subsequent restriction fragment length polymorphism (PCR-RFLP) analysis. Data were statistically analysed for association. In addition to these case control studies, the transmission disequilibrium test (TDT) was applied to 80 families of obese probands and to 52 families of patients with AN. RESULTS: Both the tests for association and linkage were negative. The Trp64Arg allele frequencies in the three weight groups (obesity: 0.071; normal weight: 0.081; underweight: 0.056) and the AN patients (0.054) were similar. Extremely obese individuals showed no excess of the Trp64Arg allele. No homozygotes for the Trp64Arg allele were detected. CONCLUSION: Heterozygosity for the Trp64Arg allele is not of major importance in regulation of body weight in individuals younger than 35 y. Additionally, the extreme obese subgroup is not enriched for the polymorphism.

Adolescent↗
PubMed1997

Developmental outcome of infants born with biological and psychosocial risks.

The significance of prenatal and perinatal complications (biological risk) and of family adversity (psychosocial risk) on early child development was examined in a prospective study. Developmental outcome of 350 infants was assessed by measures of motor, cognitive, and social-emotional functioning at 3, 24, and 54 months. Results indicated a differential impact of risk factors on specific outcomes. Whereas psychosocial risks became more prominent with growing age and were related to poorer child outcome in all areas of functioning, biological risks decreased in influence and predominantly resulted in poorer motor development. The contributions of biological and psychosocial risks on outcomes were additive. A number of individual risk factors emerged as significant predictors of later maladaptation.

Affective Symptoms↗
PubMed1997

Bilateral anterior ischemic optic neuropathy as a presentation of Takayasu's disease.

Takayasu's disease is an arteritis with a predilection for the proximal branches of the aortic arch. Chronic retinal hypoxic changes and ischemic ocular inflammation, resulting from cervical vascular occlusion, have been described extensively. Anterior ischemic optic neuropathy has rarely been reported in this condition, and only in conjunction with other ophthalmic findings. Here we present the case of a patient who developed bilateral anterior ischemic optic neuropathy in the absence of other eye findings, and was subsequently found to have an aortic arch syndrome compatible with Takayasu's disease.

Anti-Inflammatory Agents↗
PubMed1997

[Does cognitive performance of adolescents with anorexia nervosa change with treatment?].

In the present pilot study 52 inpatients with anorexia nervosa were examined with regard to cognitive impairments. A psychological assessment was made on admission (T1) and shortly before discharge (T2), the focus being on fluency aspects of cognitive functioning. The results showed high test scores at T1 on all cognitive measures and improvement in cognitive functioning in the course of inpatient treatment. However, the level of cognitive functioning was not correlated with weight loss or duration of illness. Patients who were discharged with a BMI below 17.5 kg/m2 scored even higher at T1 (reaction time, concentration task) than those with a BMI above 17.5 kg/m2, pointing to a negative association between cognitive performance and outcome (target weight). Psychopathological variables that may play a role and that should therefore be considered in future research are discussed.

Adolescent↗
PubMed1997

[Determination of body feat in treatment of anorexia nervosa].

Bioimpedance analysis was used for weekly assessments of body fat content in 20 adolescents with anorexia nervosa (mean BMI 15.6 kg/m2; mean age, 14 years 5 months) until the desired weight had been achieved, but for a minimum of 12 weeks. As expected, body fat content increased with BMI. Total body fat increased faster than fat-free body mass, the relative increase being 66%, vs 11% for fat-free body mass. However, an expected association between an increase in the percentage of body fat and resumption of menstruation did not occur. As a noninvasive, repeatable procedure including the assessment intraabdominal fatty tissue, determination of total body fat by bioimpedance analysis is suitable for use in longitudinal studies of anorexia nervosa.

Adipose Tissue↗
PubMed1997

[Cognitive deficits in animals fed a hypocaloric diet: analogies to neuropsychological deficits in anorexia nervosa?].

Improvement in cognitive functions with weight gain in patients with anorexia nervosa leads to the assumption of cognitive functions decrease during long-lasting self-starvation. In the present study the effects of chronic undernutrition on learning abilities, in rodents were investigated in an open-field test and a passive avoidance paradigm. The findings suggest that cognitive deficits after a weight loss of 32% of normal weight may be caused by undernutrition. Further research is necessary to clarify other influencing conditions and identify the underlying biochemical mechanisms.

Animals↗
PubMed1997

[The fractal dimension as an imaging parameter in CT scans of patients with anorexia nervosa before and after therapy].

Brain development is a self-organizing process and hence the brain structures correspond to a highly recursive system consisting of a multitude of parts. Quantitative analysis of recursive, self-similar structures is possible in CT scans as what is termed synergistic diagnostic using the fractal dimension. In 10 patients with anorexia nervosa (ICD-10, F50.0) we determined the fractal dimension of the cerebral cortex contour in a CT image using the "boxcounting method" after filtering of the data and separation with a defined cut-off. There was a significant difference between the results from CTs obtained before and after therapy. There was a high correlation between the fractal dimension and body weight, brain volume and sulcal cerebrospinal fluid volume, but only a low correlation with ventricular volume. The findings suggest that the qualification of the fractal dimension may be useful as one of postprocessing methods on CT scans. Further studies will be necessary to assess its importance for diagnosis.

Adolescent↗
PubMed1997

[Mannheim Rating Scales for the analysis of mother-child interaction in toddlers].

As part of a prospective study on child development from birth to age 11 the Mannheim Rating Scales for the Analysis of Mother-Child Interaction in Toddlers was constructed. Ten-minute interactions of 352 mothers and their toddlers were videotaped in the laboratory and evaluated with micro- and macroanalytic techniques. The instrument consists of a combination of second-by-second codings and dimensional ratings of 5-second to 1 minute periods. Interrater reliability, assessed by having two raters analyze 16 mother-child dyads, proved satisfactory. Psychosocial risk showed different patterns from those at low risk. Interactions of mothers and daughters seemed to be more harmonious than interactions of mothers and sons.

Aggression↗
PubMed1996

Feasibility of retroperitoneal pelvic lymph node exploration in cervical carcinoma. Assessment of morbidity in 33 cases treated by combined radio-surgery or definitive radiotherapy.

BACKGROUND AND PURPOSE: Laparoscopic modalities by selective biopsies permit a better assessment of the pelvic lymph nodes status than imaging procedures in cervix carcinoma. They could enable the radiation oncologist to adapt the target volume of external irradiation, provided the feasibility of such procedures is good and the toxicity reduced as much as possible. MATERIAL AND METHODS: From June 1980 to May 1993, 52 women with a mean age of 49, underwent a retroperitoneal pelvic lymph node laparoscopic procedure for cervix carcinoma classified according to FIGO as stages IA2 (14), IB (12), IIA (6), IIB (14), IIIB (3) and IVA (3). Two techniques were used: retroperitoneoscopy (RPS) in 16 cases, and a panoramic retroperitoneal pelviscopy (PRPP) in 36 cases. RESULTS: Intra-operative and post-surgical morbidity were equivalent in the two procedures. Among the 33 patients who had external irradiation, one Grade 3 urinary late morbidity (3%) due to an overtreatment was observed; no Grade 3/4 morbidity of the gastro-intestinal tract, no lymphoedema of the lower extremities, no parietal tumor cells implantation were noticed. CONCLUSIONS: These procedures can be used safely to better know the prognosis and to define the pelvic lymph node planning target volume and its radiation management with accuracy.

Adult↗