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Biomedical subjects

N Schmitz

Publications and source records attributed to N Schmitz.

241 records · Page 14Linked to original sources

Assessment of red cell autoantibodies in autoimmune hemolytic anemia of warm type by a radioactive anti-IgG test.

To evaluate the applicability of a radioactive 125I-anti-IgG test (RIAT) for the detection of small amounts of IgG antibodies on red blood cells (RBC) of patients with autoimmune hemolytic anemia of warm type (AIHA), RBC of 125 patients were studied (AIHA, n = 53; Coombs'-negative AIHA, n = 6; chronic cold agglutinin disease, n = 7; non-immune anemias, n = 59). It was found that the RBC of all cases (33/33) with a positive direct IgG antiglobulin test (DAT-IgG), but also 13 out of 20 patients with a negative DAT-IgG, but detectable complement (C3/C4), and 4 out of 6 cases with Coombs'-negative AIHA gave positive results in the direct RIAT. RBC-associated IgG was higher in the DAT-IgG positive group (n = 33; -x = 8.1%) than in the DAT-IgG negative group (n = 26; -x3.4%). There was no correlation between hypergammaglobulinemia and RBC-associated IgG. The sensitivity of the indirect RIAT was not remarkable better as compared to the indirect antiglobulin test. The RIAT is valuable in the serology of borderline cases of AIHA.

Anemia↗

Allogeneic transplantation of peripheral blood stem cells.

Mobilized peripheral blood stem cells (PBSC) are increasingly being used instead of bone marrow for allogeneic transplantation. This chapter will briefly review important aspects of allogeneic PBSC transplantation including PBSC harvesting and donor safety, reconstitution of haematopoiesis and the immune system, graft-versus-host disease, graft-versus-leukaemia effects and graft engineering.

Animals↗

Improving screening for mental disorders in the primary care setting by combining the GHQ-12 and SCL-90-R subscales.

Most of patients with mental disorders are cared for in the primary care sector, rather than in the mental health sector. Self-report questionnaires can be used as screening instruments to identify mental disorders in primary care. The 12-item General Health Questionnaire (GHQ-12) is a widely used screening questionnaire for common mental disorders. Unfortunately, the GHQ-12 generates many false presumptive positives and forces the employer to expend resources on confirmatory testing. Therefore, the aim of the present report was to investigate a two-stage questionnaire screening design in a primary care setting. The GHQ-12 was used as an initial screening test followed by the Symptom Checklist (SCL-90-R). A randomly selected sample of adult outpatients (N = 408) from 18 primary care offices was screened using the two questionnaires. A structured diagnostic interview and an impairment rating were used as standards. Subjects were classified into true-positives and false-positives based on their GHQ-12 score and the clinical interview. Logistic regression and receiver operating characteristic analysis were performed to determine whether the SCL-90-R increased accuracy in screening for mental disorders by discriminating between true-positive and false-positive cases. The SCL-90-R subscales Depression, Obsessive-Compulsive, and Somatization were identified as factors associated with the GHQ-12 classification. Therefore, a significant improvement in screening performance of the GHQ-12 is obtained by combination of the test results. The approach may reduce artifact due to high scoring tendencies not associated with psychological disorder.

Adolescent↗

[Premature termination--a multifactoral phenomenon].

Twelve drop out cases in psychodynamic short term therapies according to the focus of cyclic maladaptive pattern by Strupp and Binder (CMP 1984) are reviewed regarding initial diagnostics, tape-recorded therapy sessions, and supervision records. Predictors of premature termination of therapy such as initially rated patients' therapy motivation, narcissistic personality traits, but also characteristics of interpersonal behavior of both patient and therapist are examined and discussed. Particularly important are the therapeutic alliance and narcissistic patients' difficulties to relate personally to their therapists instead of enacting projective dynamics of idealization and devaluation. Therapists frequently tend to respond to them by subconscious display of hostile countertransference. Four patterns of dynamics of therapy drop outs are described.

Adult↗

[Determinants of high risk illness behavior in patients with bronchial asthma].

The aim of this study was to identify factors influencing high-risk illness behaviour in patients with bronchial asthma. High-risk illness behaviour was defined as 1. non-compliance with antiasthmatic medication and 2. delaying or avoiding medical help when facing airways deterioration or severe attacks. 150 patients with bronchial asthma were investigated; 60 of them had participated in the structured Asthma Treatment and Teaching Programme (ATTP), 90 had not taken part in such a programme by then. Using structural equation models, lack of emotional support by a key figure, poor doctor-patient relationship, and a negative cortisone image were identified as predictors of high-risk illness behaviour in patients who had attended ATTP, while in patients without participation in a treatment and teaching programme, only a negative cortisone image was predictive of this criterion.

Adolescent↗