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N Müller

Publications and source records attributed to N Müller.

At least 109 records · Page 6Linked to original sources
PubMed1999

Disability and quality of life in pure and comorbid social phobia--findings from a controlled study.

Social phobia is increasingly recognized as a prevalent and socially impairing mental disorder. However, little data is available regarding the general and disease-specific impairments and disabilities associated with social phobia. Furthermore, most studies have not controlled for the confounding effects of comorbid conditions. This study investigates: (a) the generic quality of life; (b) work productivity; and, (c) various other disorder-specific social impairments in current cases with pure (n = 65), comorbid (n = 51) and subthreshold (n = 34) DSM-IV social phobia as compared to controls with no social phobia (subjects with a history of herpes infections). Social phobia cases reported a mean illness duration of 22.9 years with onset in childhood or adolescence. Current quality of life, as assessed by the SF-36, was significantly reduced in all social phobia groups, particularly in the scales measuring vitality, general health, mental health, role limitations due to emotional health, and social functioning. Comorbid cases revealed more severe reductions than pure and subthreshold social phobics. Findings from the Liebowitz self-rated disability scale indicated that: (a) social phobia affects most areas of life, but in particular education, career, and romantic relationship; (b) the presence of past and current comorbid conditions increases the frequency of disease-specific impairments; and, (c) subthreshold social phobia revealed slightly lower overall impairments than comorbid social phobics. Past week work productivity of social phobics was significantly diminished as indicated by: (a) a three-fold higher rate of unemployed cases; (b) elevated rates of work hours missed due to social phobia problems; and, (c) a reduced work performance. Overall, these findings underline that social phobia in our sample of adults, whether comorbid, subthreshold, or pure was a persisting and impairing condition, resulting in considerable subjective suffering and negative impact on work performance and social relationships. The current disabilities and impairments were usually less pronounced than in the past, presumably due to adaptive behaviors in life style of the respondents. Data also confirmed that social phobia is poorly recognized and rarely treated by the mental health system.

Adult↗
PubMed1999

Cost effectiveness of quality assurance in plateletpheresis.

BACKGROUND AND OBJECTIVES: A quality assurance system (QAS) is part of modern blood banking facilities. Quality control of single donor platelet (SDP) concentrates includes the determination of the platelet (PLT) yield and the white blood cell (WBC) contamination. Improvements in modern apheresis technology allow the collection of high PLT yields and leukoreduced products. Double dose SDPs can be split and WBC-reduced products may be labelled as leukodepleted thereby reducing costs. MATERIAL AND METHODS: 3309 SDPs obtained with the Amicus, AS 104, AS.TEC 204 and MCS + blood cell separators were retrospectively analysed for their PLT yield. SDPs with > or = 4.0 x 10(11) PLTs were considered as double dose SDPs and split. WBCs were determined microscopically in 170 SDPs. SDPs with a leukocyte content < 1.0 x 10(6) were labelled as leukodepleted and no further WBC filtration was recommended. RESULTS: PLT yield was statistically higher in SDPs from the Amicus device, 84.8% of these products could be split. Double dose concentrates were collected in 22.7% with the MCS + machine and in 4.8% with the AS 104/AS.TEC 204 blood cell separators. The savings for disposables was $150,041 and for infectious disease testing $75,766. After the subtraction of the costs for PLT determinations in all SDPs $215,880 could be saved. WBC contamination was statistically lowest in in-line filtered SDPs from the MCS + device (median 0.29 x 10(5), range 0.22-9.96 x 10(5)) and all of these products were considered as fulfilling the criterion of leukodepeletion so that we were able to save $17,135 for bedside filters. Median WBC content was 0.75 x 10(5) (range 0.35-22.5 x 10(5)) in SDPs from the Amicus and 0.9 x 10(5) (range 0.27-99.8 x 10(5)) in SDPs from the AS 104/AS.TEC 204 devices, respectively. CONCLUSION: Blood cell separators of the newest generation allow the collection of leukodepleted double dose SDPs. An intensified QAS in plateletpheresis allows the decision whether a product can be split and/or released as leukodepleted. By this means we were able to save a total of $233,015 per year.

Cost-Benefit Analysis↗
PubMed1999

T-cell subsets and expression of integrins in peripheral blood of patients with migraine.

Neurogenic inflammation is considered as an animal model of human migraine attacks. Using flow cytometry, we examined T-cell subsets and their integrin expression in the peripheral blood of 32 migraine patients in order to evaluate a possible inflammatory process in humans, as postulated in the migraine animal model. Our results show that migraine patients have a significant increased proportion of T-helper (47.4 +/- 6.3% vs 43.2 +/- 5.8%; p < 0.01) and T-helper memory cells (23.6 +/- 5.9 vs 20.3 +/- 6.5%; p < 0.01). Moreover, the 22 migraine patients without aura also exhibited an increase of LFA-1 expression of T-helper cells (34.7 +/- 11.5%) compared to the 35 controls (27.5 +/- 12.0%; p < 0.01). These preliminary results support the hypothesis that immunological mechanisms (such as an enhanced lymphocyte endothelium interaction) could be part of the migraine pathophysiology in humans.

Adult↗
PubMed1999

White cell reduction during plateletpheresis: a comparison of three blood cell separators.

BACKGROUND: White cell (WBC)-reduced single-donor platelet concentrates (SDPs) can be collected by the newest generation of blood cell separators. Three WBC-reduction techniques during plateletpheresis were investigated in the present study with respect to WBC content and platelet yield. STUDY DESIGN AND METHODS: The Amicus device used the elutriation principle for WBC reduction, and separations with periodically alternating interface position (PAIP) were employed in the AS.TEC 204. WBC reduction by in-line filtration was performed in the MCS+. Platelets were measured electronically and WBCs were determined manually (Nageotte chamber). RESULTS: In-line filtered SDPs showed significantly lower WBC content (0.088+/-0.178 x 10(6)) than SDPs that were WBC reduced by elutriation (0.31+/-0.48 x 106) or PAIP technique (0.89+/-1.57 x 10(6), p = 0.0001). Platelet yield (5.0+/-0.46 x 10(11)) was significantly higher in components obtained with the Amicus device (p = 0.0001). The AS.TEC 204 and MCS+ gave similar results for platelet yields: 3.15+/-0.63 and 3.28+/-0.71 x 10(11), respectively. CONCLUSIONS: The plateletpheresis systems studied allow the collection of WBC-reduced SDPs. In-line filtration resulted in the best WBC reduction. Some SDPs collected with the devices studied had a WBC content >1 x 10(6) per unit. Platelet yield was significantly higher in SDPs from the Amicus device.

Blood Cells↗
PubMed1999

Complete glycan structure of the S-layer glycoprotein of Aneurinibacillus thermoaerophilus GS4-97.

Isolate GS4-97 was purified from an extraction juice sample of an Austrian beet sugar factory and affiliated to the newly described species Aneurinibacillus thermoaerophilus. It is closely related to the type strain of this species, A.thermoaerophilus L420-91(T), and possesses a square surface layer (S-layer) array composed of identical glycoprotein monomers as its outermost cell envelope component. By sodium dodecyl sulfate-polyacrylamide gel electrophoresis, the purified S-layer showed an apparent molecular mass of approximately 109,000. After thorough proteolytic degradation of this material by pronase E and purification of the reaction mixture by gel permeation, chromatofocusing, and reversed-phase chromatography, a homogeneous glycopeptide fraction was obtained which was subjected to one- and two-dimensional nuclear magnetic resonance spectroscopy. The combined chemical and spectroscopic evidence, together with N-terminal sequencing, suggest the following structure of the O-glycosidically linked S-layer glycan chain of the glycopeptide: This is the first description of a beta-d-GalNAc-Thr linkage in glycoproteins.

Bacterial Proteins↗
PubMed1999

Harvesting of peripheral blood progenitor cells with different programmes of discontinuous flow systems.

BACKGROUND AND OBJECTIVES: From a technical point of view two problems arise during the collection of peripheral blood progenitor cells (PBPC): first, the volume of the apheresis product is often large, requiring volume reduction prior to cryopreservation. Second, the platelet (PLT) loss due to the harvesting of the buffy coat is an unwanted side effect. With respect to these problems, the present study was designed to compare programs for PBPC collection with discontinous-flow cell separators. MATERIALS AND METHODS: Three different protocols for PBPC harvesting were investigated in 32 patients with malignancies. In the first protocol, the blood cell separator Haemonetics MCS 3p was used. In the second protocol using the same machine, the opening and closure of the stem cell valve was modified in combination with a centri surge to reduce the PLT loss. The MCS+ device with another configuration of the valves was used in the third protocol. PBPC were mobilised by chemotherapy plus cytokine administration or application of growth factor alone. Blood counts and CD34 antigen-expressing cells were determined before apheresis and in the PBPC product. Colony-forming unit granulocyte/macrophage (CFU-GM) were determined in the apheresis product. RESULTS: 55 PBPC collections were carried out with a median end product volume of 105 ml. The median counts for CD34+ antigen-expressing cells and CFU-GM were 1.5x10(6 )and 2.5x10(4)/kg body weight, respectively. PLT loss was significantly lower in protocol III. CONCLUSION: The study reported here revealed that PBPC could be easily collected in a reduced product volume by the intermittent-flow cell separators. No additional centrifugation prior to cryopreservation was necessary to remove the plasma from the apheresis product. Patient's PLT loss was reduced by the centri surge technique but this still has to be improved.

Anticoagulants↗
PubMed1999

Antibodies to heat shock proteins in schizophrenic patients: implications for the mechanism of the disease.

OBJECTIVE: The involvement of heat shock proteins has been determined in the pathophysiology of several disorders of the central nervous system, including multiple sclerosis. To elucidate their role in schizophrenia, the authors investigated antibody titers to heat shock proteins in unmedicated and medicated patients with schizophrenia. METHOD: Using the enzyme-linked immunosorbent assay technique, the authors measured titers of antibodies to 60 kilodaltons (kD) heat shock proteins (HSP60) and 70 kD heat shock proteins (HSP70) in 30 patients with schizophrenia before and during neuroleptic treatment and compared the titers with those of 31 healthy individuals. RESULTS: Ten (33%) of 30 patients with schizophrenia but only one (3%) of 31 healthy individuals showed immunoreactivity to HSP60 or HSP70. The authors found especially high anti-HSP70 titers in never-medicated patients. High anti-HSP60 titers were mainly found in patients who were being treated with neuroleptics. CONCLUSIONS: Since heat shock proteins are involved in diverse neuroprotective mechanisms, antibodies against heat shock proteins may inhibit neuroprotection. The authors discuss the implications of these findings for schizophrenia.

Adult↗
PubMed1999

Worldwide ethnic distribution of the G protein beta3 subunit 825T allele and its association with obesity in Caucasian, Chinese, and Black African individuals.

Recently, it was demonstrated that one allele (825T) of the gene encoding the G protein beta3 subunit (GNB3) is associated with hypertension in Germans. This study investigates a possible association with obesity in young male Germans, Chinese, and black South Africans with low, intermediate, and high 825T allele frequencies, respectively. In each of these three distinct cohorts, the 825T allele frequency was increased significantly in overweight (body mass index [BMI] > or =25 kg/m2) and obese individuals (BMI >27 kg/m2) compared to those with normal weight. The 825T allele frequencies in these three BMI groups were, respectively, 29.5, 39.3, and 47.7% in Germans, 46.8, 53.9, and 58.6% in Chinese, and 83.1, 87.7, and 90.9% in South Africans. In each of these three distinct groups, the 825T allele was significantly associated with obesity with odds ratios between 2 and 3. More urban than rural black Africans were overweight despite similar 825T allele frequencies in both populations, which underscores the role of both genetic and environmental factors. BP values in young male whites increased significantly with increasing BMI values but were independent of the C825T polymorphism, suggesting that hypertension associated with the 825T allele could be a consequence of obesity. Genotyping of 5254 individuals from 55 native population samples from Africa, the Americas, Europe, Asia, Australia, and New Guinea demonstrated highest 825T allele frequencies in black Africans (82%) and intermediate values in east Asians (47%). It is anticipated that high frequencies of the 825T allele in Africans and Asians may contribute to an obesity and hypertension epidemic if Westernization of lifestyles continues.

Adolescent↗
PubMed1999

[Molecular and immunodiagnostic studies of bovine neosporosis in Switzerland].

Cyst-forming coccidia may cause significant losses in livestock, primarily due to abortion, loss of young animals and neuromuscular diseases. Rather recently, Neospora caninum has been recognized as one of the major protozoal abortion-inducing parasites in cattle. The present study addressed the performance of different diagnostic tools (in vitro-cultivation; histology; immunohistochemistry; serology; PCR) suitable for the direct or indirect detection of N. caninum. By PCR, Neospora-DNA was detected in 24 brains (29%) from 83 bovine abortion, many of these brains were simultaneously characterized by histopathological findings typical for a protozoal, cerebral parasitosis. The diagnostic methods were furthermore assessed using samples of different tissues and body fluids from three experimentally Neospora-infected pregnant cows and their foetuses. The diaplacental passage of N. caninum to the foetus was successful in two of the three cases. In these two cases, PCR was positive for different foetal organs and, additionally, for the abomasal and amniotic fluid. The successfully infected cows developed anti-Neospora serum antibodies between 10 and 17 days post infection, foetuses remained serologically negative in all cases. The results obtained in the present study demonstrated the usefulness of PCR, complemented by serology, for the specific diagnosis of bovine neosporosis. Such tests may prove suitable to perform epidemiological investigations. Taken together, our data indicated that prenatal neosporosis may be an important cause of infectious bovine abortion in Switzerland.

Abortion, Veterinary↗
PubMed1999

Increase in expression of adhesion molecule receptors on T helper cells during antipsychotic treatment and relationship to blood-brain barrier permeability in schizophrenia.

OBJECTIVE: The authors estimated the expression of adhesion molecule receptors (VLA-4 and LFA-1) on T helper (CD4+) and T suppressor/cytotoxic (CD8+) lymphocytes in schizophrenic patients before and during antipsychotic treatment and studied the relationship of these subpopulations to CSF measures and blood-brain barrier permeability. METHOD: Blood was drawn from hospitalized patients with schizophrenia before (N = 45) and after (N = 22) neuroleptic treatment and from an age-matched comparison group (N = 41). Lumbar punctures were performed on 32 of the schizophrenic patients. RESULTS: During antipsychotic treatment there were significant increases in the percentage of VLA-4+/CD4+ and VLA-4+/CD8+ cells. VLA-4+/CD4+ and LFA-1+/CD4+ cells were both closely related to disturbance of the blood-brain barrier. Higher values for VLA-4+/CD4+ and LFA-1+/CD4+ cells were found in patients with a disturbed blood-brain barrier. CONCLUSIONS: The findings suggest that adhesion molecules are involved in immunoregulation between the central nervous system and the peripheral immune system in schizophrenia.

Adult↗
PubMed1999

Inappropriate calls to an emergency medical despatch centre via cellular telephones--no impact of a once-only multimedia coverage.

Due to fusions of emergency despatch centres, implementation of computer-aided localization and medical regulation, the despatcher's workload is increasing. We report about one more phenomenon which is needlessly disorganizing alarm centres. Moreover, the unintentional activation of the '100' ('112') alarm centre continued to increase even after a once-only media campaign.

Advertising↗
PubMed1999

'Primum non nocere'.

Explore the source record for details and available documents.

Cardiopulmonary Resuscitation↗
PubMed1999

[Affective, somatoform and anxiety disorders in Germany--initial results of an additional federal survey of "psychiatric disorders"].

BACKGROUND AND AIMS: The paper informs about methods and field survey procedures used in the German National Health Interview and Examination Survey--Mental Health Supplement (GHS-MHS)--and provides 12-month prevalence estimates of affective, anxiety and somatoform disorders in the general population. Such data have previously not been available for Germany on a nationwide level. METHODS: Findings are based on a two-stage design: In the first stage all the 7124 participants of the German National Health Interview and Examination Survey (core survey) completed the Composite International Diagnostic-Screener (CIDS) for mental disorders. In the second stage 4181 probands (all screen-positive and a random sample of 50% of the screen-negative subjects) were interviewed with the full Composite International Diagnostic Interview (DIA-X-M-CIDI) by clinical interviewers. The overall response rate was 87.6%. RESULTS: Affective (12-months prevalence estimate: 6.3%), anxiety (9%) and somatoform disorders (7.5%) are widespread in all age groups (18 to 65 years) of the German population; women are significantly more often affected than men. The prevalence rates of somatoform and affective disorders were found to be significantly lower in the former East German Länder as compared to the former West, whereas no such difference was found with regard to anxiety disorders. All disorders resulted in considerable reduction of work productivity during the past month; affective disorders reported on average 1.3 days/month total impairment and 7.2 days/month partial impairment, indicated significantly higher reduction in work productivity than anxiety and somatoform disorders. CONCLUSIONS: Affective, somatoform and anxiety disorders are highly prevalent mental disorders (total: 17.3%) in the German population. The result of a lower morbidity of affective and somatoform disorders in former East Germany was unexpected and requires further clarification. The findings on impairment of work productivity emphasize the economic impact of psychiatric disorders on society.

Adolescent↗
PubMed1998

Blood-cerebrospinal fluid barrier impairment as indicator for an immune process in schizophrenia.

An impairment of the blood-cerebrospinal fluid barrier (BCB) has repeatedly been described in schizophrenic patients. A BCB impairment can be due to vascular leakage during an inflammatory process, or to neuroleptic treatment. The soluble intercellular adhesion molecule-1 (sICAM-1) has been demonstrated to be a reliable marker for an inflammatory process causing an BCB impairment. To clarify the basis of a BCB impairment in schizophrenic patients, we measured the sICAM-1 levels in CSF of 40 schizophrenic patients. High concentrations of sICAM-1 were found to be related to high concentrations of albumin, IgG and total protein in CSF. A BCB impairment was associated with high levels of sICAM-1. Our data indicate an inflammatory mechanism of BCB impairment in schizophrenics and should enrich the discussion on an expanded immunological diagnosis in schizophrenia.

Adult↗