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Biomedical subjects

R Faber

Publications and source records attributed to R Faber.

At least 73 records · Page 4Linked to original sources

[Effect of pregnancy and perinatal parameters--including mode of delivery--on survival rate of "low birth weight premature infants" (less than 1,500 g)].

A retrospective analysis of 225 very low birth weight infants (less than 1500 g) was made, to assess the influence of the mode of delivery on the survival rate. In 186 preterm deliveries which could not be prevented by therapeutic measures, we included additionally certain gestational and perinatological parameters. Generally, an average survival rate of 72% was found in this study. In addition to the well-known negative influence of birth weight less than 1000 g and gestational age of less than 28 weeks, such parameters as antenatal pre-pathological CTG findings, haemorrhages at the time of hospitalisation, and ineffectuousness of tocolytic drugs, were associated with a reduced survival rate. In contrast, the presence of anamnestic risk factors of preterm delivery and prolongation of gestation by one day and more improved the survival rate. Additional consideration of foetal presentation showed, that abdominal delivery was fundamentally safer in cases with breech and transverse presentation. Whether a higher survival rate can be achieved by vaginal delivery in cases of breech presentation with premature rupture of membranes or a gestational age greater or equal to 28 weeks, remains to be proved. A gestational age of less than 28 weeks or antenatal prepathological cardiotocographic findings will facilitate in future the decision to perform Cesarean section in cases of inevitable premature deliveries with cephalic presentation.

Cesarean Section↗

Doppler sonographic examinations of uteroplacental, fetoplacental, and fetal hemodynamics and their prognostic value in preterm labor.

Doppler examinations of different uteroplacental vessels (uterine arteries, arcuate arteries), umbilical artery, fetal thoracic aorta, and median cerebral artery were performed on 55 patients with idiopathic preterm labor (24.5 to 32.5 weeks). Thirty normal pregnancies of corresponding gestational age served as a control group. Significant differences of median values between the preterm labor and control group were found only for the resistance index (RI) in the central arcuate artery and for the pulsatility index (PI) in the fetal thoracic aorta. In about twenty percent of pregnancies in preterm labor, pathological values of RI and PI in uteroplacental and fetal vessels account for the presence of an impaired perfusion. Elevated PI in the uterine artery placental site and normal RI in the fetal thoracic aorta, correlate significantly to a shorter prolongation of pregnancy, lower gestational age on birth, and lower birth weight. The combination of these two blood flow indices (maternal PI greater than 0.90 and fetal RI less than 0.90) allow us to predict a preterm birth in a high percentage of cases (sensitivity 87.5%, specificity 100%, positive predictive value 100%, negative predictive value 93%).

Aorta, Thoracic↗

[Reproducibility of the Doppler ultrasound blood flow profile of the umbilical artery with special reference to threatened premature labor].

The reproducibility of Doppler blood velocity profiles of the umbilical arteries within the umbilical cord is a special problem because of the difficult separation and extreme torsion of both vessels. Resistance-(RI) and pulsatility index (PI) have been assessed on two different locations immediately one after the other in 90 pregnancies with signs for premature labor, including 16 cases with premature rupture of membrane. For comparison the same measurements have been performed in 33 normal pregnancies. There was a significant correlation between the first and second assessment. However, the correlation coefficients of cases with premature labor are lower than in normal pregnancy. This underlines the necessity of at least two repeated measurements for these patients with signs of premature labor.

Blood Flow Velocity↗

Subjective utility ratings of neuroleptics in treating schizophrenia.

This study developed a method for measuring subjective costs and benefits of psychiatric treatments. Forty-one patients rates the relative bothersomeness of symptoms of schizophrenia and side effects of neuroleptics. Thirty-four psychiatrists made parallel ratings from the perspective of the average patient (individual utility) and of the patient's family and society (institutional utility). Psychiatrists predicted patients' ratings moderately well, but misjudged the bothersomeness to patients of 24% of side effects and 20% of symptoms. When considering the patient's perspective, both schizophrenic patients and psychiatrists rated symptoms as no more bothersome than side effects. However, psychiatrists saw side effects as significantly less bothersome than symptoms when considering costs to society. The subjective utility of neuroleptic medications for schizophrenia is most justifiable from an institutional perspective.

Antipsychotic Agents↗

[Relation of uteroplacental hemodynamics and fetal respiratory behavior in pregnancy with threatened premature labor or intrauterine retardation].

The results of uteroplacental hemodynamics obtained by nuclear medicine were correlated with the corresponding antepartal and intrapartal cardiotocographic findings in 52 patients with preterm labor and in 53 patients with intrauterine-growth-retarded fetuses. With the existence of continued disturbance in pregnancy the relationship between primary maternal hemodynamic disorders and decreased fetal respiratory performance is already evident antepartum and unambiguously intrapartum. The dependence of the antepartal cardiotocographic findings on therapeutical improvements in perfusion is of clinical relevance.

Cardiotocography↗

Neuroleptic radioreceptor activity and clinical outcome in schizophrenia.

The relationship between serum haloperidol concentration and clinical response was examined in 27 schizophrenic inpatients between the ages of 18 and 56 years. All patients were treated with haloperidol, 20 mg/day for the first 2 weeks. Dosage adjustment after 2 weeks of treatment was made in seven subjects based on poor clinical response or side effects. Haloperidol activity was determined by the radioreceptor assay for neuroleptics on weeks 2 and 4 serum samples. The results indicated that higher radioreceptor activity levels, particularly above 22 ng/ml, were associated with poorer clinical response. The data suggest that radioreceptor activity levels are not at a steady state after 2 weeks drug treatment. Additionally, problems secondary to low sensitivity of the radioreceptor assay may limit its utility at low serum concentrations.

Adolescent↗

[Hemodynamic placental insufficiency and its therapeutic modification in threatened premature labor].

The authors are involved in a study in the field of nuclear medicine aimed at further clarifying the connection between premature delivery and placental insufficiency. They are particularly concerned with uteroplacental perfusion at the time when a trend is emerging toward premature birth, and with ways of treating this by exclusive therapy using betamimetics and/or additional maternal oxygen inhalation/additional maternal transcutaneous dorsal nerve stimulation (TNS). The significantly longer half-life periods of activity increase found at the time of hospitalization similar to pregnancies with intra-uterine fetal retardation, as compared with a normal control group, are interpreted as expressing a hemodynamic placental insufficiency and a risk of premature delivery. In contrast to exclusive betamimetic therapy, additional O2 inhalation/additional TNS significantly shorten the half-life period both in short-time and long-time tests. The better therapeutic effect on uteroplacental perfusion in cases of imminent premature delivery which is thus demonstrated can be seen also in an improved respiratory condition of the fetus as shown in a cardiotocogram. From a clinical point of view, the authors call attention to the clearly prolonged pregnancy periods regardless of the duration of gestation, at the time when a trend is emerging toward premature birth, as compared with exclusive betamimetic therapy, the duration of tocolysis/amount of betamimetic applied being the same.

Combined Modality Therapy↗

[Therapeutic efforts and prenatal modification of selected disordered fetomaternal relations].

Based on the current view about disturbances of the feto-materno-placental unit we examined 37 women with suspected intrauterine fetal growth retardation and 12 women with threatened premature labor and looked for possibilities of antenatal therapeutic influence of nutritive, respiratory, endocrine and hemodynamic insufficiency. In a randomized study we can prove a normal increase of the distance between symphysis pubis and fundus as well, as the biparietal diameter not only following bedrest but also following bedrest with additional intravenous infusion of glucose respectively oral application of galactose. The high rate of hypotrophic babies is no argument against a positive influence on nutritive insufficiency, but the acquired retardation can not be compensated totally. Neither a positive influence on the endocrine insufficiency nor the moderate respiratory one could be found. As well by maternal transcutaneous nerval stimulation as by maternal oxygen inhalation an oral long-term tocolysis we can demonstrate a considerable improvement of the uteroplacental perfusion measured with isotopes. These positive aspects are basis for further investigations. An important supposition to a successful therapy remains an early diagnosis.

Bed Rest↗

Thirty-four hour dexamethasone suppression test in depression.

The utility of extending the dexamethasone suppression test past its usual 24 hr period to include a cortisol determination at 34 hr was investigated in 18 depressed patients. Conventional suppressors and non-suppressors differed significantly on their 34 hr cortisol values. However, this difference was small. Furthermore, 34 hr values generally returned close to baseline values, so that the 34 hr DST cannot now be recommended in the assessment of depressed patients without further study.

Adult↗

Comparison of schizophrenic patients with formal thought disorder and neurologically impaired patients with aphasia.

This study compares the speech and language of 14 schizophrenic patients having a formal thought disorder with 13 neurologically impaired patients with aphasia. Transcribed interviews with these patients were blindly assessed by five specialists for classification as schizophrenic or aphasic. Three of the five specialists performed better than chance but only one achieved high discriminating ability. Interrater reliability was poor. Five of 14 language abnormalities assessed differentiated the diagnostic groups. These findings suggest that schizophrenic patients share many language abnormalities with aphasic patients but do not exhibit a classic aphasic syndrome.

Aphasia↗

Bilateral versus unilateral electroconvulsive therapy: efficacy in melancholia.

The authors compared the therapeutic efficacy of bilateral and unilateral electroconvulsive therapy (ECT) in 51 patients with endogenous depression who were randomly assigned to bilateral (N = 24) or unilateral (N = 27) ECT. Seizures were monitored by oscilloscope. After 6 treatments blind assessment on a modified Hamilton depression scale showed an 81.1% improvement in the bilateral group compared with a 55.5% improvement in the unilateral group. Additional treatments were prescribed ad libitum by a hospital psychiatrist who was unaware of each patient's electrode placement. The unilateral group received more total treatments and were more frequently switched to bilateral ECT. These results were independent of age, severity of illness, or sedative drug administration.

Depressive Disorder↗

Ventricular arrhythmias induced by doxepin and amitriptyline: case report.

A case is described of ventricular arrhythmias associated with doxepin and amitriptyline treatment in a patient with preexisting heart disease. A significant correlation was found between the occurrence of premature ventricular depolarizations and serum levels of both antidepressants.

Amitriptyline↗