Search PubMed⌕ Search

Biomedical subjects

M Soyka

Publications and source records attributed to M Soyka.

At least 109 records · Page 6Linked to original sources
PubMed1998

[Social psychiatry aspects of alcoholism: epidemiology, treatment structures and recent results of therapy research].

In Germany the per capita consumption of alcohol has tripled since World War II with a slight decrease in recent years. The number of alcoholics has been estimated between 2.5 mill. and 10 mill. Epidemiological studies suggest a 6-month prevalence rate of 3.1% (USA 2.9%): 10.4% in males, 0.8% in females; Life-time prevalence estimates range up to 13%. More recent findings also suggest that alcoholism in adolescents is an increasing problem. The resources for treatment of alcoholism are limited: Only 1% of all alcoholics are treated in special addiction rehabilitation programmes, whereas the majority of patients are treated by their physician, in a general hospital or not at all. Approximately 30,000 patients are treated in special clinical rehabilitation programmes per year. Socioeconomic consequences of alcoholism have not been evaluated in detail; some cast models are discussed. In recent years both day-hospital and outpatient rehabilitation programmes for alcoholics have been established but few catamnestic studies have been conducted so far. The possible benefit of new antidipsotropic agents (so-called anticraving drugs) must also be examined in greater detail. Catamnestic findings and the outcome of treatment studies are discussed.

Adolescent↗
PubMed1998

[The "Qualified Detoxification Treatment of Drug Dependent Patients" Federal Model Project in a general hospital: concept, investments and clinical results].

For 150,000 drug addicts 5,200 therapy slots are available in Germany. Until the late 80's detoxification treatment was only given a subordinate role in treating drug addicts. Due to the threat of the infectious disease AIDS and the increasing number of drug deaths new concepts were explored: In 1991 the first qualified detoxification ward for drug addicts was opened in a general hospital under the auspices of the Federal German model project "compact therapy for comprehensive drug treatment". Subsequently more than ten detoxification wards specifically for drug addicts were established in Bavaria alone, primarily in psychiatric county hospitals. Drug addicts are accepted into these qualified detoxification wards without preparation and precondition. Data of 1656 drug addicts were analysed who were treated between 1991 and 1996 at the ward described below: More than 70% come directly from the scene and 33% were accepted for the first time to inpatient detoxification treatment. Most of them are diagnosed with addictions to at least two substances (three substances 44%, two substances 24%). Many suffer from additional diseases: In 1079 out of 1656 a positive hepatitis-C serology was found, 22% had previously tried to commit suicide, 37% had to be treated in intensive-care because of life-threatening intoxication. Nevertheless, 58% of the drug addicts are transferred into continuing therapy after detoxification treatment or they continue to work in permanent employment. During detoxification treatment no patient died. Acceptance, additional diseases which can be diagnosed and treated best in a general hospital, and the high prevalence of addicted persons (at least 17-24%) in internal medical or surgical wards suggest that establishing qualified wards with special settings for addicts in general hospital is useful.

Adult↗
PubMed1997

Construction work and low back disorder. Preliminary findings of the Hamburg Construction Worker Study.

STUDY DESIGN: Cross-sectional part of a longitudinal study in 571 male construction workers. OBJECTIVES: The Hamburg construction worker study is being conducted to assess the extent of musculoskeletal disorders in construction workers and factors predisposing for or leading to musculoskeletal disorders. The purpose of this analysis is to report findings about the association between job history and low back disorder. SUMMARY OF BACKGROUND DATA: Repetitive strain in forced positions during long periods of time has been reported as a risk factor for low back disorder. Of all construction workers, bricklayers predominantly are exposed to these conditions. METHODS: Subjects were recruited mainly from a routine health check-up. A structured interview with complete job history, job related activities, and symptoms was administered, and a detailed standardized physical examination was performed. Age-adjusted prevalences of low back pain were calculated, and logistic regression models were used to estimate odds ratios and their confidence intervals for different durations of working in a specific job category and physical signs of low back disorder, adjusting for a variety of possible confounders. RESULTS: The 12 month prevalence of low back pain was highest in painters (57%), intermediate in concrete builders and bricklayers (41%), and lowest in carpenters and unskilled workers (38%). The age-adjusted odds ratio (95% confidence interval) of low back disorder for having worked longer than 10 years as a bricklayer was 2.3 (1.2-4.5). CONCLUSIONS: Working longer than 10 years as a bricklayer was associated with signs of low back disorder. No comparable associations were found for house painters, carpenters, nor concrete builders. If replicated, these findings could be used to focus preventive measures on bricklayers with a long job history.

Adult↗
PubMed1997

Zolpidem dependence in a patient with former polysubstance abuse.

Zolpidem is a non-benzodiazepine hypnotic whose actions are mediated at the central GABA-A receptor complex. It has been assumed that zolpidem has a lower potential for abuse than benzodiazepines. However, there is growing evidence form clinical and animal pharmacology that the potential for dependence on zolpidem should not be underestimated (1). In human laboratory studies, abuse liability seemed to be similar to triazolam (2). Animal models suggest that the drug even had higher reinforcing properties than any benzodiazepine tested (3). In the following, a case of zolpidem abuse and dependence is described. The patient had a history of substance abuse. The observed tolerance-related events and withdrawal symptoms were comparable to those maintained by benzodiazepines.

Drug Tolerance↗
PubMed1997

[New possibilities in therapy and rehabilitation of alcohol dependent patients. Catamnestic study of the efficacy of ambulatory withdrawal therapy exemplified by a model facility].

We report on catamnestic and clinical results of a 18-24 month follow-up study of 65 alcohol-dependent patients who in 1992-1994 took part in an 8-month outpatient treatment programme. The psychotherapeutic concept of this treatment facility is described. 51 of the 65 patients who had participated in the programme could be subsequently personally interviewed, 7 patients refused to take part, 6 could not be reached and 1 had died. 40 of the 51 patients had properly completed the outpatient treatment. Assuming that all patients who could not be interviewed or refused, were relapsers the abstinence rate was found to be 48% (n = 31). Although selective factors may contribute to this result, the clinical findings so far seem to indicate that outpatient treatment for alcoholics is a promising new therapeutic approach in the treatment of alcoholism. Further studies are needed to assess the possible benefits and the indications for this outpatient treatment in greater detail.

Adult↗
PubMed1997

[Wernicke-Korsakow syndrome: clinical aspects, pathophysiology and therapeutic approaches].

In ICD-10 or DSM IV, the Wernicke-Korsakow Syndrome (WKS) is mentioned among the criteria for the alcohol amnestic disorder. Rarely seen in clinical practice, the Wernicke-Korsakow Syndrome is important in differential diagnosis of amnestic syndromes, because life-threatening conditions can occur. A specific treatment is available for the acute form of Wernicke encephalopathy, in many cases a Wernicke encephalopathy shows a progression to the Korsakow-Syndrome, which is the chronic form of this disease. The aim of this article is to review recent developments in clinical, etiological and pathophysiological research of WKS. The role of thiamin-dependent enzymes like transketolase and the importance of the NMDA (N-Methyl-D-Aspartate) System is discussed. New trends in diagnostics are shown, as are differential diagnosis and epidemiology. Finally, the rarely investigated drug therapy of the Korsakow syndrome with clonidine and fluvoxamine is reviewed.

Alcohol Amnestic Disorder↗
PubMed1996

ERP changes in alcoholics with and without alcohol psychosis.

The present study compared alterations of event-related brain potentials (ERPs) in subgroups of chronic alcoholics with different complications during alcohol withdrawal. Twenty alcoholics with only mild to moderate alcohol withdrawal symptoms, two groups of alcoholics with histories of either delirium tremens (n = 9) or alcohol hallucinosis (n = 13), and a control group of 38 nonalcoholics were examined. Patients were tested in unmedicated state and not earlier than 14 days after drinking cessation. An auditory Oddball paradigm and a visual Letter Matching paradigm were used as cognitive tasks. In the auditory task, all alcoholic groups exhibited delayed N200 and P300 latencies and a reduced P300 amplitude as compared to nonalcoholics. In the visual task, only P300 amplitude was significantly diminished. Patients having suffered from delirium tremens or alcohol hallucinosis showed greater Oddball P300 amplitudes than alcoholics with uncomplicated withdrawal syndrome. Furthermore, delirium and hallucinosis patients differed in their ERPs, with hallucinosis patients showing an earlier P300 peak in both the auditory Oddball and the Letter Matching task. It is concluded that changes in ERPs during abstinence might reflect specific neurophysiological dysfunctions in alcoholics prone to different alcohol-related psychoses.

Adult↗
PubMed1996

Relapse prevention by acamprosate. Results from a placebo-controlled study on alcohol dependence.

BACKGROUND: The effectiveness of acamprosate (calcium bisacetylhomotaurinate) as a treatment to maintain abstinence in alcohol-dependent patients was assessed for 1 year. METHODS: After short-term detoxification, 272 patients participated in a randomized, double-blind, placebo-controlled study. Patients received routine counseling and either the study medication or placebo for 48 weeks; they were followed up for another 48 weeks without medication. Statistical analysis was performed according to the intention-to-treat principle. RESULTS: Patients who were receiving acamprosate showed a significantly higher continuous abstinence rate within the first 60 days of treatment compared with patients who were assigned to placebo treatment (67% vs 50%) until completion of the treatment period (43% vs 21%, log rank P = .005), and they had a significantly longer mean abstinence duration of 224 vs 163 days, or 62% vs 45% days abstinent (P < .001); however, there was no difference in psychiatric symptoms. Of the patients who were receiving acamprosate, 41% had dropped out, whereas 60% of the placebo-treated patients dropped out of the study. Few side effects (mainly diarrhea and headache) were recorded. At the end of a further 48 weeks without receiving study medication, 39% and 17% of the acamprosate- and placebo-treated patients, respectively, had remained abstinent (P = .003). CONCLUSION: Acamprosate proved to be a safe and effective aid in treating alcohol-dependent patients and in maintaining the abstinence of patients during 2 years.

Acamprosate↗
PubMed1996

[Alcohol-induced hallucinosis. Clinical aspects, pathophysiology and therapy].

In recent years, little research has been focused on alcohol hallucinosis. The psychopathology of alcohol hallucinosis (vivid acoustic hallucinations, paranoid symptoms and fear) resembles paranoid schizophrenia, but other organic mental disorders have to be excluded too. Prognosis is usually good, but in 10-20% of cases alcohol hallucinosis tends to become chronic. Possible pathophysiological mechanisms involved in the development of the syndrome are changes in dopaminergic transmission or other neurotransmitter systems and neuronal membranes, elevated levels of betacarbolines and an impaired auditory system. For treatment, highly potent neuroleptics (haloperidol) are the drugs of first choice. In the case of alcohol abstinence the prognosis is good, but otherwise the risk of a recurrence is high.

Alcoholism↗
PubMed1996

[Alcohol dependence and depression. Classification, comorbidity, genetic and neurobiological aspects].

The frequent comorbidity of psychiatric disorders and alcohol dependence has raised increasing interest in the scientific literature over the last few years. Special attention has been given to the coincidence of depressive syndromes and alcohol dependence. Depressive syndromes can both precede and follow the onset of alcohol dependence. Their diagnostic classification can cause considerable problems. In clinical studies, very different prevalence rates of depressive syndromes in alcohol-dependent persons were found. The frequency of primary depressive syndromes appeared to be substantially smaller than the frequency of secondary depressive syndromes. Epidemiological studies did not point at the exceedingly high comorbidity of affective disorders and alcohol dependence. In this review article, scientific results about possible causes of depressive syndromes in alcohol-dependent persons are demonstrated; genetic and neurobiological links between depression, alcohol dependence and the possible importance of changes in serotoninergic transmission are discussed; methodological problems are described, and implications of the comorbidity problem for treatment planning are presented.

Alcoholism↗