Search PubMed⌕ Search

Biomedical subjects

P Berner

Publications and source records attributed to P Berner.

At least 19 recordsLinked to original sources
PubMed1998

Dose variation due to differences in applicator placement used for intracavitary brachytherapy of cervical cancer.

The prognosis for women with early stage cancers of the cervix is excellent. The cervix and proximal vagina are relatively radioresistant structures; dose limiting critical structures for radiation treatment in this area are tissues such as the bladder and rectum. The high dose rate gradient of brachytherapy allows high doses to the tumor volume, while doses to the neighboring structures are lower. Intracavitary treatment of cervical cancer is performed by insertion of tandem and ovoid applicators. Correct tandem and ovoid placement is verified and documented with orthogonal radiographs. If placement of the tandem and ovoid is not acceptable, the packing is removed, and the tandem or ovoid is repositioned or exchanged as necessary. To examine the difference in dose to specific reference points when tandem or ovoid placement was changed by the physician, three patients' initial insertion radiographs were compared to those that were accepted to treat. Points of comparison selected for the patients on each of the insertions were: point A (L and R), external iliac nodes (L and R), bladder, and rectum. Each of the placement changes for the three patients resulted in differences in distance, and therefore, differences in dose. Changes as high as 823 cGy resulted from the adjustment of only one component. In the cases examined, repositioning improved dose distribution to the cervix, and lowered the dose to adjacent critical structures.

Brachytherapy↗
PubMed1997

Conceptualization of schizophrenia: the symptom-oriented approach.

E. Bleuler proposed to establish the diagnosis of schizophrenia on the basis of fundamental symptoms which he presumed to be particularly linked with the primary deficiency. K. Schneider, on the other hand, based his diagnosis on the presence of symptoms recognizable without difficulty. Modern classifications include both Bleuler's fundamental and Schneider's first-rank symptoms in their diagnostic criteria. This may lead to erroneous attributions in view of the possibility that most first-rank and some of the symptoms Bleuler suspected to be fundamental may be unspecific reactions to different basic disturbances. It can therefore be expected that research on symptoms is better suited for aetiopathogenetic investigations than research based on diagnoses. Strategies to select those symptoms on which research should focus are described and recent findings of symptom-oriented studies are discussed.

Humans↗
PubMed1995

[Suggestion and hypnosis in hysteria].

Suggestive influences allow to resolve ambiguities. Normally they are only accepted if they correspond with the knowledge and believes of the subject. Under hypnosis or under the impact of serious psychic perturbations one may take up reality constructions which are not in conformity with these criteria. The restriction of consciousness and the ignoring of certain functions permitting this are the common basis of hypnosis and hysteria. But suggestions do not cause the later; they may only shape the symptomatology. Hypnosis can create a terrain facilitating the resolution of the problems underlying hysteria but it does not represent the treatment of hysteria.

Humans↗
PubMed1992

Dysphoric mood.

Explore the source record for details and available documents.

Affect↗
PubMed1992

A multicenter double-blind study of three different doses of the new cAMP-phosphodiesterase inhibitor rolipram in patients with major depressive disorder.

A multicenter randomized 4-week interindividual double-blind study was carried out in 58 hospitalized patients with major depressive disorder (DSM III 296.23, 296.22, 296.33, 296.32, 296.53 and 296.52) to test the dose-effect relationship of three different doses of the new cAMP-phosphodiesterase inhibitor rolipram: 3 x 0.25 mg, 3 x 0.50 mg and 3 x 1.00 mg rolipram/day. With respect to the desired effect, the 3 x 0.50 mg dosage stood out from the others in almost all relevant parameters. With respect to the response rate, the efficacy of the 3 x 0.25 mg dosage was about the same as that reported in the literature for placebo. The inferior performance of the 3 x 1.00 mg dosage compared to the 3 x 0.50 mg dosage might indicate a reverse U-shaped dose-effect relationship. There was good tolerance to all three dosages. There were no findings that might cast doubt on the safety of the dosages tested.

Antidepressive Agents↗
PubMed1992

[Development of the manic-depressive concept in German language psychiatry].

German language psychiatry has had and still has much difficulty in getting rid of the dichotomy of endogenous psychosis as set by Kraepelin. The concept which makes a distinction between schizophrenic psychosis and manic-depressive psychosis grants the former a predominant position by applying Jasper's hierarchic rule: the presence of symptoms regarded as schizophrenic indubitably attributes the disorder to schizophrenia. Such classification, however, does not necessarily imply that schizophrenia and cyclothymia (word proposed by K. Schneider for manic-depressive psychosis) represent separate nosological entities. It is admitted that it is possible for each group to include diseases whose hereditary transmission is not necessarily due to the same genetic predisposition. Thus, German language psychiatry has well accepted the possibility that bipolar manic-depressive psychosis and unipolar depressions represent separate etiologies. For most German-speaking psychiatrists, however, the distinction between endogenous and psychogenic depressions still remains a current assumption. The distinction between these two types of depression is generally made with reference to an "endogenous item profile" or to a depressive endogenomorphous axial syndrome. Only a few authors have accepted the model of continuity between these two types of depression proposed by the London school. The Hamburg school gave a new dimension to the conceptualization of manic-depressive psychosis by drawing attention on the existence of "rapidly alternating mixed states" which are much more common than the stable mixed conditions described by Kraepelin. On the basis of this concept and by questioning the validity of Jaspers' hierarchic rule, the Vienna school has considerably extended the limits of affectives psychosis to the detriment of the wide concept of schizophrenia described by K. Schneider.(ABSTRACT TRUNCATED AT 250 WORDS)

Affective Disorders, Psychotic↗
PubMed1991

Wittgenstein.

Explore the source record for details and available documents.

Humans↗
PubMed1991

Clinical and epidemiological aspects of dementia in the elderly.

Dementia of the Alzheimer's type (DAT) is the most significant disease of the aging brain. Descriptive epidemiology of DAT found a constant doubling of prevalence rates every 5 years. Analytic epidemiology so far failed to reliably detect risk factors for DAT other than age. This might depend on the difficulties encountered in the clinical diagnosis and differential diagnosis of dementia in the elderly, which are discussed with special reference to 1) the definition of dementia, to 2) the grading of severity of dementia, to 3) the differentiation between dementia and depression, and to 4) the differentiation between multi-infarct dementia and DAT.

Aged↗
PubMed1991

Predicting course and outcome in delusional psychoses.

Eighty-four of 90 patients with delusional syndromes of different nosological attribution underwent a 7-year follow-up. From 179 items covering the whole spectrum of psychiatric description of index examination, 20 were found to be statistically significant in predicting different aspects of course and outcome by stepwise discriminant analysis. Course and outcome were defined by 6 criteria (course of illness, course of delusion, development of deficiency, length of inpatient care, adequate activity and social adjustment) encompassing separate (but only partly independent) aspects of a disorder. In contrast to the literature, clinical and psychopathological variables have major prognostic weight for different psychopathological as well as psychosocial aspects of outcome. Ten of the 20 significant items cover psychopathology, 4 pre-index course, 3 precipating events, 2 data from childhood, and 1 premorbid personality. Our results stress the importance of sensitive data collection and a clear separation of different outcome variables.

Adolescent↗
PubMed1991

Methodological aspects of follow-up studies on psychotic patients in a polydiagnostic perspective.

Polydiagnostic follow-up studies should explore whether certain definitions of a given disorder permit better prediction of the illness course than others and whether this good predictive validity is related to specific etiopathogenetic conditions. In order to carry out such studies successfully they should be based on broadly defined samples and comprise provisions for additional validation such as genetic data, neuropsychological testing etc. After an assessment at baseline and at discharge from hospital, the follow-up assessments should comprise five steps: (1) Identification of successful and unsuccessful diagnostic systems; (2) identification of features determining successful attribution; (3) analysis of successful systems; (4) analysis of unsuccessful systems, and (5) analysis of cases which have changed diagnostic attribution. The conclusions drawn from these analyses are intended to refine classification in psychiatry.

Chronic Disease↗
PubMed1991

Temporal stability of diagnostic criteria for functional psychoses. Results from the Vienna follow-up study.

200 first admissions with functional psychoses were interviewed with PSE and rated simultaneously according to different diagnostic criteria (ICD-9, RDC, DSM-III, St. Louis, Taylor, Vienna Research Criteria). At follow-up 7 years later 186 patients could be traced and a course diagnosis was applied to each patient. Temporal stability of diagnostic criteria was calculated for ICD-9, RDC and DSM-III by stability coefficient and kappa values and was used as a criterion for validity. Schizophrenia and affective disorder display considerable stability over time, no matter whether one uses ICD-9, RDC or DSM-III. The data for schizoaffective disorder are less impressive, the stability coefficient is much higher for schizoaffective bipolar than for schizoaffective depressive patients.

Family↗
PubMed1990

Neurotic, stress-related and somatoform disorders (section F4) and physiological dysfunction associated with mental or behavioural factors (section F5): results of the ICD-10 field trial.

The results of the ICD-10 field trial in German-speaking countries relevant to sections F4 (neurotic, stress-related and somatoform disorders) and F5 (physiological dysfunction associated with mental or behavioural factors) show a comparatively low level of acceptance. Interrater-reliability in various diagnostic categories is not always adequate. In particular the allocation of some of the "old" diagnostic entities of ICD-9 to various sections of ICD-10, and in part unsatisfactory classificatory distinctions gave rise to certain problems.

Behavior↗
PubMed1989

Delusional theme, sex and age.

In a retrospective study of 865 delusional syndromes, connections were investigated between delusional themes and the sex of patients, and the ages in which these themes extensively occurred. According to previous reports, the results of this investigation indicated that differences exist between the ages of manifestation regarding the themes of hypochondria, persecution, love and jealously. Furthermore, differences could be observed between males and females in relation to the frequency of choice of particular themes, as well as the age of occurrence. Based on psychological studies concerned with the content's dependence on motives we conclude that the age distribution of delusional themes corresponds to the main existential concerns in different life periods.

Adolescent↗
PubMed1988

Emotion, affect and mood: a terminological introduction.

It is difficult to establish clear distinctions between emotion, affect and mood, because they belong to the same physiological dimension which may be conceived as 'background' activity'; for the purposes of research definitions should be as precise as possible. After a review of the most commonly used and sometimes contradictory definitions of these and related terms, a modified version of Janzarik's model of the 'structural-dynamic coherency' is proposed as a frame of reference for improvement in defining different 'dynamic states'. The clear distinction between emotional resonance, mood and drive for the description of pathological modifications of the background activity is discussed.

Affect↗
PubMed1987

Psychopathological concepts of dysphoria.

Dysphoric conditions are increasingly postulated as representing independent mood disorders. However, despite much effort at clarification, their psychopathological definitions remain unclear and variable. This paper reviews some examples of these divergent definitions, most of which are based on quality of mood, as well as responsiveness to external stimuli. The paper then introduces a strategy in possible solution of the above-mentioned definition problems. Setting out from restriction of the term dysphoria to conditions of a morose, tense and irritated mood, as suggested by Snaith and Taylor, we support the opinion that dysphoria should be accepted as a third possibility of mood swing, as a psychopathological disturbance which can be well distinguished from stable and unstable mixed states.

Depressive Disorder↗
PubMed1986

Approaches to the assessment of schizophrenia in Europe.

All definitions of schizophrenia rely more or less on Kraepelin's hypothesis, Bleuler's theory or Schneider's pragmatic criteria. After a discussion on how these assumptions are referred to in classical and operational diagnostic systems in Europe, the results of a survey of 1983 literature are presented to show what kinds of assessments European workers currently employ. Lastly, guidelines are presented to enable psychopharmacological research to make the best use of the diagnostic systems to suit its purposes: essentially, which system or systems (the polydiagnostic approach for example) one should choose depends upon the symptoms the medication to be tested is supposed to treat, keeping in mind that patient sampling varies according to the system in question.

Europe↗