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P Werner

Publications and source records attributed to P Werner.

At least 73 records · Page 4Linked to original sources
PubMed1998

Pain in participants of adult day care centers: assessment by different raters.

The aim of this study is to compare the assessment of pain in 200 elderly persons participating in five senior day care programs, as rated by family caregivers, day care staff members, and the participants themselves. Staff members and participants provided information in a face-to-face interview. Family members provided information about the participants and their demographic characteristics via a mailed questionnaire. Agreement rates among informants ranged between 63% and 69%, showing moderate agreement rates. Health status (as reflected in number of medications taken and the presence of a diagnosis of musculoskeletal disease) and depression were associated with ratings of pain by all the informants. The assessment of pain in the elderly population is very difficult and there is a need for reliable and valid pain assessments to be used by different raters. The relationship between pain, depression and other variables should be further explored.

Aged↗
PubMed1998

RXRA and HSPA5 map to the telomeric end of dog chromosome 9.

Previous results showed that loci from human chromosome 17q (HSA17q) map to the centromeric two-thirds of dog chromosome 9 (CFA9). In these studies fluorescence in situ hybridization (FISH) using a human total chromosome 17 painting probe, indicated that the telomeric one-third of CFA9 must have homology to one or more human chromosomes other than HSA17. Here we report that this distal part of CFA9 contains a segment syntenic to the telomeric end of HSA9q and mouse chromosome 2 (MMU2). The gene loci encoding retinoid X receptor, alpha (RXRA) and heat shock protein 5 (HSPA5 or GRP78), which are found on HSA9q34 and MMU2, occupy a region on CFA9 distal to NF1 and CRYBA1. FISH of a canine specific genomic cosmid clone for RXRA demonstrated the more telomeric localization of this locus to NF1 on CFA9. A linkage map developed for the distal region of CFA9 included: NF1-(2.7 CM)-CRYBA1-(6.5 CM)-RXRA-(22CM)-HSPA5. The next best order, RXRA-NF1-CRYBA1-HSPA5 with a difference in the log odds of 1.43 does not correspond to our findings with FISH. The most probable map order places HSPA5 distal to RXRA on CFA9 whereas in humans it lies centromeric of RXRA on HSA9q34.

Animals↗
PubMed1998

Longitudinal changes in behavioral problems in old age: a study in an adult day care population.

BACKGROUND: Four types of agitation have been identified: physically aggressive behaviors, physically nonaggressive behaviors, verbally aggressive behaviors, and verbally nonaggressive behaviors. These pose a major challenge to caregivers and are sometimes indicators of the emotional state of the older person. Longitudinal changes in these four subtypes of agitated behaviors were examined. METHODS: One hundred and four community-dwelling participants of five senior day care centers (mean age = 79) were followed up for 2 years. Their agitation was assessed, as was their cognitive functioning, affect, and medical functioning. RESULTS: Although physically nonaggressive, physically aggressive, and verbally aggressive behaviors increased significantly over 2 years, verbally nonaggressive behaviors did not show significant changes over time. These patterns can be partially explained by the relationship between the different types of agitation and cognitive functioning. Increases in physically nonaggressive behaviors from start to end of the 2 years were predicted by greater cognitive impairment at baseline and by receiving a smaller number of medications at baseline. Increases in verbally aggressive behaviors and in physically aggressive behaviors during the study period correlated significantly with a greater decline in cognitive functioning and increased depression at baseline. In addition, increases in physical aggression were correlated with greater cognitive impairment at baseline. CONCLUSIONS: The course of change for each type of agitation was unique. The relationships between inappropriate behaviors, cognitive functioning, physical health, and depression over time are complex and vary by type of agitation.

Affect↗
PubMed1998

Predictors of aggressive behaviors: a longitudinal study in senior day care centers.

Aggressive behaviors place elderly persons and their caregivers at risk. This study examines longitudinally the predictors of aggressive behaviors based on staff and family members' ratings of 200 community-dwelling participants from senior day care centers. The main difference between physically and verbally aggressive behaviors was found to be the role of physical and mental health. Cognitive impairment and poor quality of relationship were the main predictors of physically aggressive behaviors. Verbally aggressive behaviors were predicted mainly by depressed affect, low quality of relationships, and poor physical health. These results validate and expand prior cross-sectional research on the correlates of aggression in other populations, and guide in the development of interventions.

Aged↗
PubMed1998

The effects of an enhanced environment on nursing home residents who pace.

This study sought to enhance the well-being of older nursing home residents who pace and wander by enriching their nursing home environment. Visual, auditory, and olfactory stimuli were added to the nursing home unit environment to simulate two types of environments: a home environment and an outdoor nature environment. Participants seemed to prefer the enhanced environments by choosing to spend more time in them, and by sitting on benches in those environments. There was a trend toward less trespassing, exit-seeking, and other agitated behaviors being exhibited in the enhanced environment, and residents were observed to manifest more pleasure in it. Staff members and family members definitely expressed a preference for the enhanced environment over the regular one. Although effects on residents were limited, this approach offers a low-cost method for making the nursing home environment a better place for those residents.

Aged↗
PubMed1998

Treatment of hypertension in patients with pre-eclampsia: a prospective parallel-group study comparing dihydralazine with urapidil.

BACKGROUND: The primary objective of treatment in women with severe hypertension and pre-eclampsia is to prevent complications such as encephalopathy and haemorrhage. In many countries dihydralazine is considered the drug of choice for treating hypertension in pregnancy, because it now has been used safely for about 30 years, and the introduction of a new drug in pregnancy is a difficult task with partially unknown hazards. In some other countries combined alpha- and beta-blockers are also used. Taking into account that some patients with pre-eclampsia do not respond to dihydralazine and the drug has serious side-effects like headache and reflex tachycardia, there is some need for developing alternative treatment strategies using drugs that are more adequate for pregnancy than dihydralazine. METHODS: Urapidil is a post-synaptic alpha 1 adrenoceptor antagonist, which is widely used to control hypertensive crises unrelated to pregnancy. Since it is known that pre-eclampsia is associated with increased sympathetic activity, administration of an alpha 1 adrenoceptor antagonist provides a reasonable therapeutic basis. So far there is only one report describing the i.v. use of urapidil in the treatment of hypertension in pregnancy unresponsive to dihydralazine and one report which describes the oral use of urapidil. In an earlier pilot study we examined the dose range for i.v. application of urapidil necessary for adequate blood pressure control in patients with pre-eclampsia. In the present randomized controlled study 26 white women with pre-eclampsia and hypertension in pregnancy were included. Treatment was not blinded. During the initial period of intensive intravenous treatment all subjects were under constant surveillance by a physician and a nurse. RESULTS: Effective prolonged control of blood pressure (values below 150/100 mmHg) was achieved in all patients of the two groups. In one patient of the dihydralazine group signs of lightheadedness and near syncope were noted. After this side-effect of dihydralazine the patient was treated with urapidil. At the end of the observation period the maternal heart rate in the dihydralazine group was higher than in the urapidil group. CONCLUSIONS: Since urapidil decreased the high blood pressure in patients with pre-eclampsia without serious side-effects urapidil appears preferable superior to dihydralazine. The haemodynamic effects of urapidil were more predictable than those of dihydralazine. The reduction of intracerebral pressure could be an additional advantage of urapidil in the treatment of patients with pre-eclampsia.

Adult↗
PubMed1998

Protein nitration in Parkinson's disease.

Oxidative stress has been proposed as a pathogenetic mechanism in Parkinson's disease (PD). One mechanism of oxidative cellular injury is the nitration of protein tyrosine residues, mediated by peroxynitrite, a reaction product of nitric oxide and superoxide radicals. We demonstrate here the presence of nitrotyrosine immunoreactivity in Lewy bodies within melanized neurons and in amorphous deposits associated with intact and degenerating neurons. The core of the Lewy body was frequently intensely immunolabeled, while the rim was lightly labeled or unlabeled. This likely reflects the fact that tyrosine residues of neurofilament proteins are primarily localized to Lewy body cores, and suggests that nitrotyrosine is present in neurofilament protein itself. Although these observations are as yet unable to provide a definitive link between oxidative stress and neuronal dysfunction, they demonstrate that oxidative stress has occurred within the vulnerable neurons of PD, leaving a permanent marker of oxidative modification of neuronal proteins within the target cells of neurodegeneration. In addition, these observations provide a potential link between excitotoxicity and oxidative stress within the vulnerable neurons of PD and represent a pathogenetic mechanism in common with the 2 other major age-related neurodegenerative diseases, Alzheimer disease and amyotrophic lateral sclerosis.

Adult↗
PubMed1998

Blood flow of the middle cerebral artery with sleep-disordered breathing: correlation with obstructive hypopneas.

BACKGROUND AND PURPOSE: Epidemiological data link heavy snoring to an increased risk for stroke, an association often ascribed to hypertension and/or sleep apnea. The aim of this study was to determine whether obstructive hypopneas, central apneas, or obstructive apneas during sleep alter blood flow of the middle cerebral artery (MCA). METHODS: Doppler sonography of the MCA was performed in conjunction with nightly polysomnography in 11 men and one woman. RESULTS: A significant decline in blood flow occurred in 76% (169/223) of obstructive hypopneas and in 80% (98/123) of obstructive apneas, compared with only 14% (13/96) of central apneas (P<.0001). While duration of events was not significantly different, MCA blood flow reductions were associated only with the duration of the obstructive hypopneas (P< or =.01) and not with the duration of central (P=.17) or obstructive (P=.07) apneas. The magnitude of fall in arterial oxygen saturation from baseline correlated with a reduced blood flow with obstructive hypopneas but not with obstructive or central apneas. CONCLUSIONS: With obstructive hypopneas and obstructive apneas, MCA blood flow is more often decreased in comparison to central apneas. MCA blood flow reductions occur with longer obstructive hypopneas and with those hypopneas with greater falls in oxygen saturation. These observations indicate pathophysiology relevant to an increased risk for stroke in heavy snorers and patients with obstructive hypopneas and apneas.

Adult↗
PubMed1998

A rapid assay for tyrosine hydroxylase activity, an indicator of chronic stress in laboratory and domestic animals.

Tyrosine hydroxylase (TH) (EC 1.14.16.2) activity has been frequently employed as a marker of adrenomedullar catecholamine-synthesizing capacity and, thus, as an indicator of chronic stress exposure in various animal species. We have developed a thin layer chromatography (TLC) procedure for its assay in adrenal glands of rats and large animals that reduces some of the drawbacks of currently employed methods, thereby facilitating routine use. Preparation of tissue samples was adapted for rats and pigs. The activity of the enzyme is expressed as the rate of the TH-catalysed tyrosine hydroxylation to 3,4-dihydroxyphenyl-alanine (DOPA) using tritium-labeled tyrosine, in the presence of cofactors and a DOPA decarboxylase inhibitor. The subsequent separation of the radioactive product (DOPA) from the substrate (tyrosine) is accomplished by TLC on silicagel plates, in a n-butanol/acetic acid/water solvent system (4:1:1). Radioactivity in the scraped zones, in which DOPA has been detected by means of an internal standard, is measured by beta-counting. An advantage of this procedure is its simplicity, reliability, and convenience for routine assays. Levels of endogenous adrenal tyrosine (HPLC assay) are considerably higher in pig (2.5-5 nmol/mg protein) than in rat (0.15 nmol/mg protein); their effects upon assay results being, in both cases, negligible. Michaelis constants estimated by this procedure amounted to 0.9 mmol l(-1) (at 0.7 mM DMPH4) for pig, and 1.1 mmol l(-1) (at 1.5 mM DMPH4) for rat.

Adrenal Medulla↗
PubMed1998

[Not Available].

The significance of Warburg's work for the transformation of concepts in the investigation of vitamins is stressed, and the different investigative approaches of the competing groups are made clear. The grounds for the controversy carried out in their scientific publications, between Paul Karrer and Warburg on the one side, and Richard Kuhn on the other side, are fully examined, using the example of vitamin B2. A second level of discussion that remained hidden from behind the public scienfific debate is analysed; the priority dispute between the savants was connected with the interests of the chemical industry.

Economics, Pharmaceutical↗
PubMed1998

Deprenyl and desmethylselegiline protect mesencephalic neurons from toxicity induced by glutathione depletion.

Oxidative stress is thought to play an important role in the pathogenesis of Parkinson's disease (PD). Glutathione (GSH), a major cellular antioxidant, is decreased in the substantia nigra pars compacta of PD patients. The aim of the present study was to investigate whether deprenyl and its desmethyl metabolite, putative neuroprotective agents in the treatment of PD, could protect cultured rat mesencephalic neurons from cell death caused by GSH depletion due to treatment with L-buthionine-(S,R)-sulfoximine (BSO). BSO (10 microM) caused extensive cell death after 48 hr, as demonstrated by disruption of cellular integrity and release of lactate dehydrogenase into the culture medium. Both deprenyl and desmethylselegiline, at concentrations of 5 and 50 microM, significantly protected dopaminergic neurons from toxicity without preventing the BSO-induced loss in GSH. Protection was not associated with monoamine oxidase type B inhibition in that pargyline, a potent MAO inhibitor, was ineffective and pretreatment with pargyline did not prevent the protective effects of deprenyl. Protection was not associated with inhibition of dopamine uptake by deprenyl because the dopamine uptake inhibitor mazindol did not diminish BSO toxicity. The antioxidant ascorbic acid (200 microM) also protected against BSO-induced cell death, suggesting that oxidative events were involved. This study demonstrates that deprenyl and its desmethyl metabolite can diminish cell death associated with GSH depletion.

Amphetamines↗
PubMed1998

Delusions and hallucinations in an adult day care population. A longitudinal study.

The frequency of the manifestation of delusions and hallucinations (d/h) among participants of adult day care centers was examined, as was the relationship of d/h to demographic and medical variables, agitation, depressed affect, and dementia. Changes in d/h were also assessed over a 1-year period, and those changes were compared with changes in agitation, depressed affect, and dementia. Depressed affect and agitation were related both to delusions and to hallucinations. Dementia was also related to d/h, although a substantial percentage of individuals who were not diagnosed with dementia also experienced some type of d/h. Finally, delusions were more prevalent and generally tended to relate more strongly to agitation, depressed affect, and dementia than did hallucinations.

Aged↗
PubMed1998

[Pregnancy in corrected transposition of great arteries and therapy with ACE inhibitors].

A pregnancy after Mustard repair for transposition of the great arteries and ventricular septal defect with pulmonary stenosis is reported. The 23-year-old gravida 1 was treated with ACE inhibitors up to 26 weeks of gestation until cardiac medication was changed to dihydralazine. At 28 weeks of gestation the patient developed cardiac decompensation leading to caesarean section for maternal indication at 29 weeks of gestation. The neonate did not show any congenital malformation nor anuria. The patient was moved to a normal ward six days after delivery. A cardiac follow-up examination showed no difference to the condition before pregnancy.

Adult↗
PubMed1997

Physical and linkage mapping of human chromosome 17 loci to dog chromosomes 9 and 5.

Genome mapping in the dog is in its early stages. Here we illustrate an approach to combined physical and linkage mapping of type 1 anchor (gene) loci in the dog using information on syntenic homology from human and mouse, an interbreed cross/backcross, and a strategy for isolation of dog genomic clones containing both gene-specific sequences and simple sequence repeat polymorphisms. Eleven gene loci from human chromosome 17q (HSA17q) were mapped to the centromeric two-thirds of dog chromosome 9 (CFA9), an acrocentric chromosome of medium size: P4HB, GALK1, TK1, GH1, MYL4, BRCA1, RARA, THRA1, MPO, NF1, and CRYBA1. Eight of these were also positioned on a linkage map spanning 38.6 cM. Based on combined fluorescence in situ hybridization and linkage mapping, the gene order on CFA9 is similar to that of the homologous genes on HSA17q and mouse chromosome 11 (MMU11), but in the dog the gene order is inverted with respect to the centromere. Canine loci, GALK1, TK1, GH1, MYL4, THRA1, and RARA constitute a closely linked group near the centromeric end of CFA9, spanning a genetic distance of only 4.7 cM. Canine NF1 and CRYBA1 lie distally, near the lower border of the Giemsa band adjacent to the distal one-third of CFA9. NF1 and CRYBA1 are loosely linked to the more centromeric group (31.2 cM). No HSA17 genes were found on the telomeric one-third of CFA9. Painting of dog chromosomes with a human whole chromosome 17 probe showed hybridization with only the proximal two-thirds of CFA9, consistent with the conclusion that the distal one-third corresponds to a segment or segments of other human chromosomes. Two loci, GLUT4 and PMP22, located on HSA17p, were mapped by FISH to dog chromosome 5 in a region also identified by the whole human chromosome 17 paint, indicating disruption of HSA17 syntenic homology at the centromere.

Animals↗
PubMed1997

Typology of disruptive vocalizations in older persons suffering from dementia.

Verbal and vocal disruptive behaviors (VDB) are important clinical features in dementia because they frequently signal discomfort experienced by an elderly person and because they are disturbing to caregivers, thereby affecting the care of elderly persons manifesting them. This article describes a typology of VDB, the Typology of Vocalizations-TOV. The conceptual framework underlying the development of this typology includes the assumptions that VDB consist of more than one type of behavior and that interventions should be matched to the etiology of the specific type of VDB. The article reports interrater reliability of the typology and validates it against Ryan's classification of verbal and vocal disruptive behaviors. Critical dimensions of the typology are examined and used for its refinement. Finally, use of the TOV for matching individuals to the most effective intervention is demonstrated.

Aged↗
PubMed1997

Morphological aspects of necrosis as a guideline for treatment of necrotizing pancreatitis. A brief report about 50 patients.

In a retrospective study, 50 patients with obvious necrotizing pancreatitis (NP) were allocated in four groups according to the morphological aspects of the necrosis. Appearance of ascite (N1), extrapancreatic spread of necrosis towards neighboring organs (N2), a large amount of necrosis (N3), and infected necrosis (N4), appears to be an easy and useful guideline for the management of NP patients. Organ failures (72%) and mortality rate (36%) are higher when the process is infected. In the other groups, organic dysfunctions were frequent, but all the patients except one survived. The majority (80%) of patients were operated on. Only 20% of patients had successful nonsurgical treatment and they were in N3 group. This percentage may increase through a morphological approach to treating necrosis, with the use of endoscopic treatment for the disruption of pancreatic duct, and better accuracy in the management of patients with noninfected necrosis, whenever organ failures are present.

Adult↗
PubMed1997

L-deprenyl protects mesencephalic dopamine neurons from glutamate receptor-mediated toxicity in vitro.

L-Deprenyl is a relatively selective inhibitor of monoamine oxidase (MAO)-B that delays the emergence of disability and the progression of signs and symptoms of Parkinson's disease. Experimentally, deprenyl has also been shown to prevent neuronal cell death in various models through a mechanism that is independent of MAO-B inhibition. We examined the effect of deprenyl on cultured mesencephalic dopamine neurons subjected to daily changes of feeding medium, an experimental paradigm that causes neuronal death associated with activation of the NMDA subtype of glutamate receptors. Both deprenyl (0.5-50 microM) and the NMDA receptor blocker MK-801 (10 microM) protected dopamine neurons from damage caused by medium changes. The nonselective MAO inhibitor pargyline (0.5-50 microM) was not protective, indicating that protection by deprenyl was not due to MAO inhibition. Deprenyl (50 microM) also protected dopamine neurons from delayed neurotoxicity caused by exposure to NMDA. Because deprenyl had no inhibitory effect on NMDA receptor binding, it is likely that deprenyl protects from events occurring downstream from activation of glutamate receptors. As excitotoxic injury has been implicated in neurodegeneration, it is possible that deprenyl exerts its beneficial effects in Parkinson's disease by suppressing excitotoxic damage.

2-Amino-5-phosphonovalerate↗