Biomedical subjects
Publications and source records attributed to M Soyka.
Confusion is a frequent syndrome in alcoholism caused by a large number of neuropsychiatric and somatic disorders with severe alcohol intoxication, pathological intoxication, alcohol dementia and hepatic encephalopathy among them. Possible pathophysiologic mechanisms involved and therapeutic strategies are discussed.
Alcohol dependent patients with a family history of alcoholism and with antisocial personality traits were supposed to have frontal brain dysfunction. Late evoked potentials may be useful to discriminate these patients from patients without family history or antisocial behavior. We investigated 56 abstinent patients hypothesizing that four subgroups of abstinent alcoholics with regard to family history (FHP: family history positive, FHN: family history negative) and antisocial behavior (ASP: antisocial traits present, ASN: antisocial traits not present) would exhibit differences in P300, particularly when recorded by frontal electrodes. FHP/ASP patients were expected to show the lowest P300 amplitudes in frontal electrode sites. Beside single electrode recordings, a new method in analyzing P300 scalp data by dipole source analysis (BESA: Brain electric signal analysis) was used. No difference in the P300 values was observed between the FHP/FHN and ASP/ASN groups. Similar results were found by analyzing ASP/ASN and FHP/FHN groups separately. The findings of single electrode recordings were consistent with BESA-dipole results. In conclusion, auditory P300 had a low discriminative power with regards to subgroups of inpatient alcoholics defined by family history and antisocial personality traits. Reasons for the negative findings in this study are discussed.
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The Internet is a fast growing medium, which is about to alter our all day life. Most impact is given to advantages of telemedicine to psychiatrists and psychotherapists as well as patients. After introduction of the essential features of the Internet practical aspects of medicine in Cyberspace for psychotherapists, psychiatrists and their patients are shown. Then, the general prohibition of advertisement for physicians is discussed on the bases of actual laws related to Internet activities. Relevant resources of medical information are shown with regard to the detailed facilities of using search engines. Highlighting opportunities and possible resources of medicine in cyberspace, it is made clear, that the rising interest in telemedicine on Internet is more than justified. Finally, some risks of virtual communication are visible. Important and mentioned Web-sites are listed at the end.
The aim of our experimental study was to gain informations and data on the driving ability of patients undergoing a methadone substitution programme as well as to explore the influence of an HIV infection. 28 patients, five of them HIV-positive, were compared to a control group equal in age, sex and education. For the traffic relevant tests the methadone patients showed significantly reduced performance. Six of the methadone patients passed the tests in a way regarded to have sufficient driving skills. We were unable to prove an influence of HIV infection on driving skills when lacking relevant somatic and neuropsychiatric symptoms. There was no significant correlation between the test results and patients age or dose of medication. We conclude that in general methadone substitution does not implicate driving inability although the majority of our patients showed some reduction of their psychomotoric skills.
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First of all, an introduction to worldwide communication networks is given. Some relevant basic features are explained. Actual and future aspects of the Internet for psychiatry, psychotherapy, and psychosomatic medicine are highlighted. There is a variety of possible advantages in World Wide Web telemedicine for patients, clients, consultants, clinicians and scientists. Useful tools and established opportunities are discussed and listed as Web-sites. The systematic review gives access to the most important fields of mental health on the Internet. Finally, some of the risks of this kind of communication for therapy and society are visible.
Acute and chronic exposure to ethanol influences intracellular calcium homeostasis via NMDA receptors, direct regulation of calcium channels or the phosphoinositide pathway. To explore the influence of alcohol withdrawal on calcium metabolism, we have investigated the resting and phytohemagglutinin (PHA) stimulated [Ca2+]i in lymphocytes of 10 alcoholics before, during and after withdrawal. Our findings suggest that both compartments of the PHA-stimulated signal are affected in alcoholics, with flattening of the initial peak and sustained calcium influx, as long as severe vegetative signs are present. MANOVA results showed significant interaction effects for both measurement points, for the initial peak, 40 s after stimulation (P = 0.05), and especially for the sustained influx at the end of the observation period (P = 0.001). The detailed mechanisms of this disturbed calcium homeostasis need further investigation.
In this report we consider the development of the Internet, from its origins as a military invention in the times of the cold war to its present day role, together with the World Wide Web, as a means of global communication which plays a key role in medical research and particularly in medical genetics. A few of the major genetics related research projects and gene research centers are introduced and their aims are briefly discussed. Detailed information about chromosome and gene mapping, together with sequence and structure databases, can be easily and rapidly accessed through the Internet. A variety of web-sites are briefly described and then listed at the end of the report, which will serve as a useful starting point from which the interested reader can access an almost endless source of genetics related information on the Internet. Finally, some of the ethical, legal and social implications of the links between gene therapy and the Intemet are considered.
The driving ability of patients under therapy with antidepressives is seen less restrictive than some years ago. The inhibition of psychomotor performance is of special interest. Some empirical studies point at antidepressives increasing the risk for accidents at least in elderly patients. Different groups of antidepressants apparently show different effects. Tricyclic antidepressants were shown to worsen cognitive and psychomotor performance in some patients while serotonin reuptake inhibitors and some other new antidepressants may cause less behavioral toxicity. Methodological problems in assessing driving ability and some recent findings are discussed.
Recently the concept of dissociative identity disorder (formerly known as multiple personality disorder) has attracted increasing public and scientific interest. However, it is rarely diagnosed in the clinical setting. the reported case of a 47-year-old woman with a history of child abuse demonstrates the problems of differential diagnosis. A number of psychopathologic symptoms pointed to a multiple personality disorder, but in the follow-up psychotic symptoms such as delusions, possible hallucinations and bizarre behavior clearly emerged. The differential diagnosis of dissociative identity disorder includes paranoid schizophrenia, as in the case described, borderline personality disorder, hysteria, simulation and the false memory syndrome. Finally, social and cultural factors have to be considered.
The possible effects of acute and long-term treatment of the antidipsotropic agent acamprosate on psychomotor performance and driving ability were studied in a prospective open clinical trial involving 5 alcoholic patients without any clinical evidence for cognitive impairement. Acamprosate 1995 mg/day was given for 6 months for relapse prevention with all patients being abstinent throughout the study. No side effects were reported during treatment. Psychomotor performance and driving ability were assessed using the ART 90, a standardized and computerized neuropsychological test battery. A number of relevant subtests measuring peripheral vision, split attention, sensomotoric function, reaction time, stress resistance and the capacity to integrate information was used at study entry, 6 weeks and 6 months after onset of treatment. While in two subtests a moderate improvement in psychomotor performance was found, in most subtests no differences compared to baseline could be shown. The results of this pilot study do not indicate any impairment of psychomotor performance by acamprosate.
The article is preceded by an introduction to world-wide communication networks. Some important basic features are explained. The major impact is on temporary and future aspects of the Internet for psychiatry. A variety of advantages in World Wide Web telemedicine for patients, clients, psychotherapists, clinicians and scientists are extensively demonstrated. Useful and established possibilities are discussed. Finally, the risks of this kind of communication are shown and listed.