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Biomedical subjects

O M Lesch

Publications and source records attributed to O M Lesch.

At least 55 records · Page 3Linked to original sources
PubMed1988

[Does alcohol consumption promote the manifestation of strokes? Considerations on pathophysiology].

Arterial hypertension is the most important risk factor in all types of stroke. The significance of alcohol in the pathogenesis of stroke is less well defined. Chronic alcoholism leads to an elevation of blood pressure. Thus, the association between alcohol and stroke might be the blood pressure effect of alcohol. However, some studies have shown a significant influence of alcohol on the incidence of stroke--especially of intracerebral haemorrhage and subarachnoid haemorrhage--even after adjustment for blood pressure. Many possible pathomechanisms are discussed. Alcohol inhibits aggregation of thrombocytes, and chronic alcohol abuse may induce thrombocytopenia, which could lead to a haemorrhagic stroke. Alcohol withdrawal leads to rebound thrombocytosis. Acute alcohol ingestion induces a decrease in fibrinolytic activity and an increase in factor VIII activity, which enhances the thrombotic potential. Additionally, alcohol increases plasma osmolarity, erythrocyte aggregability, haematocrit and blood viscosity, and decreases deformability of erythrocytes. The effects of alcohol on cerebral blood flow are still under debate; there is a deterioration in autoregulation of cerebral blood flow anyway. In animal studies alcohol induced dose-dependent vasospasm of the cerebral blood vessels, which could be a possible pathomechanism in ischaemic, as well as in haemorrhagic stroke. Chronic alcoholism is the most common cause of secondary non-ischaemic cardiomyopathy, which can lead to cerebral embolism via rhythm disorders or intracardiac thrombus formation.(ABSTRACT TRUNCATED AT 250 WORDS)

Alcohol Drinking↗
PubMed1988

The course of alcoholism. Long-term prognosis in different types.

The disease concept of alcoholism was first introduced into the medical literature by Magnus Huss in 1984. Since that time many authors have attempted to define therapy-related sub-groups of chronic alcoholics but have been unsuccessful until now because alcoholism represents a complex development and becomes apparent in various clinical pictures. As the method of cross-sectional investigations does not seem to be able to produce reliable results, we performed a prospective long-term study of 444 alcoholics. The methodological claims in literature were taken into consideration like selection criteria, programmes and goals of therapy, follow-up rate and time, etc. Careful observation of the pertinent parts of the pathogenetic pathway leading to chronic alcoholism enabled the authors to establish 4 sub-groups of alcoholics relevant for treatment.

Alcohol Drinking↗
PubMed1988

Neurophysiological aspects of auditory hallucinations. 99mTc-(HMPAO)-SPECT investigations in patients with auditory hallucinations and normal controls--a preliminary report.

In a symptom-oriented study 17 patients suffering from chronic auditory hallucinations were investigated by means of 99mTc-HMPAO-SPECT and compared with healthy controls. The results confirm the relative frontal hypoactivity in junction with a relative hyperactivity in the basal ganglia and mesial limbic structures in both hemispheres found in a previous pilot study in auditorily hallucinating patients. Our results should fortify the symptom-oriented approach in psychiatric research.

Adult↗
PubMed1988

[Psychopathology of patients with delusions of ectoparasitic infestation].

This paper presents a literature review as well as a study in 13 patients suffering from delusion of infestation. Symptoms found in MMPI are related to clinical experience. Our results suggest the distinction of three different groups of these patients: 1. Patients with predominantly hypochondric traits, with a distinct conviction to suffer from a severe, physical illness that is often looked at as incurable (hypochondriacal delusion of parasitosis). 2. Patients with paranoid symptoms and without hypochondric apprehensions. These patients usually hopelessly fight against their parasites, that impair their sphere of existence. Physical illness is denied. ("delusion of infestation"). 3. Patients with signs of both, hypochondrical as well as paranoid delusions ("hypochondriacal delusion of infestation").

Adult↗
PubMed1987

Dysphoric states in the course of manic-depressive illness.

The purpose of the present study is to investigate the relationship between dysphoric states (episodes in which irritable mood is prominent and relatively persistent) and manic-depressive illness. A further purpose is to clarify the probable causal influence of chemotherapy and the social consequences concerning dysphoria. The observations carried out on 14 patients are illustrated by 2 case reports. A strong tie seems to exist between dysphoric state and manic-depressive illness, especially with respect to typical biorhythmic disturbances. Although the origin of such states is generally unknown, there are indications that neuroleptics and lithium may play a major role. Social consequences are on the whole minor, if the disturbances in mood and drive occur acutely and markedly. On the other hand, mild to moderate mood changes (especially when unaccompanied by drive changes) may lead to severe social impairment. The reason for this may be that the latter-mentioned states are misinterpreted by the entourage as personality traits rather than as expressions of an illness.

Affective Disorders, Psychotic↗
PubMed1986

[Circadian neuroendocrinologic profile in patients with multiple drug abuse].

13 cases of politoxicomania that had undergone stationary treatment and, at the time of observation, were in rehabilitation, comprised the case load of this study. They were compared with 10 test persons in good state of health. In order to obtain circadine hormone profiles for melatonine, cortisol, human growth hormones (HGH) and thyroid stimulating hormones (TSH), blood samples were taken every hour from 6 pm until 7 am the following morning. The test cycle commenced with obtainment of a biochemical blood profile and a drug-oriented urine analysis. The cases were assorted into three therapy groups: Group 1: complete abstinence. Group 2: no hard drug intake. Group 3: acute relapse after a prolonged period of abstinence. This categorization (i.e. abstinence, soft or hard drug intake) was clearly mirrored by significant differences in the hormone profiles: the group of "abstinents" showed remarkably higher melatonine and cortisole levels than the acute relapsive cases. HGH and TSH profiles showed partly pathological levels which appeared unrelated, however, to the incidence of abstinence, or the manner of drug intake. Compared to the healthy control group, the test cases showed an increase of liver enzymes (Gamma-GT, SGOT, SGPT and LDH) but there was no marked difference between the 3 user categories themselves. The pathological neuroendocrine findings identified in test patients after a long period of abstinence are indicative of changes possibly based on genetic disposition rather than on abusive habits. The issue of self-inflicted damage, therefore, becomes a questionable one.

Adult↗
PubMed1986

[Chronic alcoholism--alcohol sequelae--causes of death].

In this study 444 chronic alcoholic patients, hospitalized at the beginning of this study, were followed up for 4 to 7 years (31). During this time 101 patients died (23.2%), with whom severeness of disease as well as the extent of social depravation could be identified as factors influencing mortality. Beginning in January of 1982 we investigated mortality of the population of a village with a similar socio-cultural background (working situation, rural population, wine-growing area). As it was possible to cooperate with the local general practitioner, who has been living and working in this village since 1946, knowing all the troubles and sorrows, we could get data of each person having died. We collected data on each dead of this village until we had 101 definitely not alcohol addicted cases as control group. For getting this number of cases we had to investigate data of 116 dead, because 15 of them met the diagnostic criteria for chronic alcoholism. Sociodemographic data, social development, diseases and causes of death were recorded in all groups of investigation. In the group of formerly hospitalized chronic alcoholic patients we found a preponderance of men as well as a significantly shorter life-time (alcoholic group: 50 +/- 9.8 years, control group 73.9 +/- 12.5 years). Besides alcohol misuse other factors influencing mortality could be elaborated (e. g. stressing or discriminating working situation, incontinuous and/or unsatisfying partnership, additional criminal acts etc.) separating the chronic alcoholic group (with former hospitalisation) from the control group in a significant way. Concerning the disease leading to death, chronic alcoholic patients more frequently had suffered from liver damage (with break of oesophagus blood vessels) as well as from auto-destructive behaviour patterns (like suicide, masked accidents) compared to the non-alcoholic group. This control group died significantly more frequent because of cardio-vascular diseases, often accompanied by cerebral deficits.

Adult↗
PubMed1986

Effect of biologically active light and partial sleep deprivation on sleep, awakening and circadian rhythms in normals.

The effects of biologically active light (BL) on subjective and objective quality of sleep and awakening, as well as circadian rhythms in cortisol, temperature and well-being were studied in 10 hospitalized normal female volunteers as compared with partial sleep deprivation (PSD). After 2 adaption days, three 24-hour periods were recorded before (baseline), during (intervention) and after (recovery) treatment with BL (exposure between 5.00-9.00 p.m. and 6.00-9.00 a.m.; light sensitivity: 2,800 lx at eye level) and PSD (1.30-6.00 a.m.). Somnopolygraphic investigations demonstrated a significant improvement in sleep maintenance both after BL and PSD, while sleep induction improved only after PSD. Subjectively experienced sleep quality increased after both treatments. However, subjective and objective awakening quality (objectivated by means of psychometric test battery) was improved by BL only, while PSD produced no changes or even a deterioration. Cortisol levels tended to be lowered by BL, while the troughs increased after PSD; there was also an earlier rise in cortisol levels after PSD than BL. No significant differences were found in regard to temperature. Subjectively experienced well-being tended to improve after both interventions. Our findings concerning the beneficial effect of BL on objective and subjective quality of sleep and awakening in normals encourages us to initiate a single-dose study with BL in depressed patients.

Adult↗
PubMed1986

Light treatment in depressive illness. Polysomnographic, psychometric and neuroendocrinological findings.

Objective and subjective quality of sleep and awakening as well as circadian rhythms in cortisol, temperature and well-being were investigated in 10 female hospitalized depressed patients diagnosed as major depressive disorders according to RDC criteria before (baseline), during (intervention) and after (recovery) treatment with biologically active or bright light (BL) and were compared with the findings in 10 normals. Polysomnographic evaluation demonstrated in depressed patients an increased sleep latency, decreased total sleep time, attenuated S4 and augmented REM sleep, as well as a shortened REM latency and a statistically significant increased average REM length as compared with normals. BL tended to shorten sleep onset, decrease number of awakenings, increase REM latency and significantly attenuated the average REM length. Subjective sleep quality tended to improve as did the subjective awakening quality after the recovery night. There was, however, a statistically significant improvement of the objectively evaluated quality of awakening and early morning behavior characterized by an improved attention, reaction time and performance in the reaction time task, while concentration and psychomotor activity tended to improve as as well. BL effects were also seen in hormonal secretion patterns: circadian cortisol secretion maxima occurred earlier in depressed patients than in normals before and after BL treatment, while during BL intervention this difference disappeared. Circadian temperature rhythms did not exhibit any significant findings with the exception of an earlier occurring minimum in depressed patients than in normals after treatment. Finally, subjective well-being as rated by means of an analogue scale was significantly worse in depressed patients than normals before but not during and after light treatment. The findings are discussed.

Adult↗
PubMed1986

Cognitive disturbances in chronic schizophrenia: formal thought disorder and basic symptoms.

We investigated 37 chronic schizophrenic patients with two objective rating scales (AMDP and Brief Psychiatric Rating Scale; BPRS) and compared the questioned symptoms with the Frankfurter Beschwerde Fragebogen (FBF), a questionnaire for subjective complaints which are close to the uncharacteristic 'basic' symptoms of schizophrenic patients. It was pointed out that the questions in the FBF relate mainly to uncharacteristic symptoms like disturbances of perception, concentration, attention, perceiving, and memory. These subjective symptoms of the FBF show a few correlations with the AMDP/BPRS rating. The total score of the FBF gave no further information about social functioning of patients with cognitive disturbances.

Brief Psychiatric Rating Scale↗
PubMed1986

Alcohol and depression.

The relationship of alcohol and depression has always been a subject of clinical and scientific interest. Though many studies have been carried out to clarify the mode of this relationship it still remains in its complexity an area for further research. The two basic ideas of a possible connection are on one hand symptomatic alcoholism with a preexisting depression and on the other hand alcoholism leading to a symptomatic depression. There is in literature a great variability of results with regard to this problem which will be discussed in view of the results of an own study on 444 chronic alcoholic patients.

Alcoholism↗
PubMed1985

[Therapy of organic psychosyndromes of cerebrovascular origin with a vasoactive drug combination].

Concrete cross-sectional studies of the organic brain syndrome, carried out periodically, attempt to establish for the parameters evaluation of substrate damage--and different noopsychopathological rating-scales for the measurement of brain capacity impairment. Beyond the level of the purely correlative-statistical point of view of the relationship between parameter and score changes, demanding for a quantitative model which could provide not only a description, but also an explanation for such a relationship. The fact that there can only be a question here of a "quantitative causality" embracing non-specificity of toxic substances and relative to acute and chronic diffuse organic brain syndromes. It results, that quantitative causality meets the requirements of an exponential function model and that one can validate such models through correlative-statistical methods. This has already been carried out by Ball and Taylor.

Adult↗
PubMed1985

[Social integration of long-term paraphrenic patients with low-dose depot neuroleptic medication].

All long-term patients with the diagnosis "paraphrenia systematica" out of one region were included in this study. 53 patients were treated in an in-patient psychiatric unit between 1979 and 1981 and were available in this study. Parenteral Fluphenacin-Decanoate (25-75 mg monthly) was given. Before, during and after Fluphenacin (each schedule lasting for at least 20 weeks) psychopathological and social evaluations were done. We used quantitative scales: NGI (Nurses Global Impressions) and BPRS (Brief psychiatric Rating Scale). Good Socialization showed a striking correlation to parenteral Fluphenacin-treatment. Differences in the present state psychopathology were not able to explain the social difference. During parenteral treatment 49 patients switched from badly socialized (NGI: more than 12 points) to well socialized (NGI less than 7 points). 18 patients stopped parenteral neuroleptic treatment for various reasons. 13 Patients out of this group had to be readmitted to the psychiatric hospital, while those staying on their parenteral neuroleptic drug-treatment stayed well socialized.

Adult↗
PubMed1983

[MAO-(monoamine oxidase-)inhibitor plus lithium. 1. Choice in psychopathologic rapidly changing bipolar manic-depressive patients (rapid cyclers)].

Patients resistant to therapy with lithium or lithium plus tricyclic antidepressants were included in our study. They had shown no curtailment of depression, no lessening of the depth of depression nor any improvement in the manic symptoms. Therapeutic medication with lithium, lithium plus tricyclics, neuroleptics and/or tranquilizer had been tried out for at last three years and the episodes of the manic-depressive illness were documented over this period. The diagnosis in the case of these patients was manic-depressive illness, type bipolar I or II. We report one case covering three years of treatment showing the following trend: Psychopathology did not change after quitting anciliary medication and tricyclic antidepressants while lithium intake was continued. A low-dose MAO inhibitor (tranylcypromine 13.7 mg/die) in addition to lithium led to shortened and less pronounced depressive and manic episodes and more prolonged normorhythmic periods. This trend emerged with even greater clarity during the course of the study.

Bipolar Disorder↗
PubMed1980

[Problems in the rehabilitation of mental patients in rural districts (author's transl)].

We report on the establishment and organization of a residential home, located in a small, fairly industrialized community without institutional background (nearest psychiatric treatment facilities more than 100 km away). Following a description of the structure of the populace, a report on the difficulties encountered in the attempt to integrate the inmates of the communal house into the local social frame, is provided. It is shown that a two year period was needed, before adequate communication between local population and home residents could be established and a satisfactory relationship realized. After a detailed account covering the rehabilitation methods employed, the special problems connected with legal and social re-integration are discussed (i.e.: transportation facilities to and from the communal home and the pace of employment). We conclude our review by a report on the results obtained and attempt to provide a number of suitable suggestions on possible improvements, for discussion and comment.

Alcoholism↗