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Biomedical subjects

R Harlacher

Publications and source records attributed to R Harlacher.

11 recordsLinked to original sources
PubMed2000

Geriatric assessment in the elderly cancer patient.

Lost and remaining functions are of special importance in geriatric medicine. The level of functional deficits ultimately determines the remaining quality of life and the patient's ability to continue independently. In contrast, the actual severity of a disease measured by common standards becomes less important. Geriatric assessment is increasingly used to describe the impact of disease and to focus on the functional losses and problems that are particularly relevant to the individual elderly patient. When developing a treatment plan for older cancer patients, it is essential to consider the functional deficits caused by age-related changes or comorbidity, the remaining compensation mechanisms and the patient's expectations. Cancer treatment has to be adapted to the individual needs of elderly patients. As the number of cancer patients is rising in all areas of medical practice, a close collaboration between oncologists and geriatricians will become increasingly important.

Affect↗
PubMed1999

[Geriatric assessment--description of functional deficits and follow-up assessment of elderly stroke patients].

The aim of the present study was to describe the course and outcome of rehabilitation using a national recommended assessment program (AGAST). In our study 162 patients with stroke were included. Nearly all patients had improvement of activities of daily living (Barthel Index) and mobility (Tinetti Gait and Balance Score, Frenchay Arm Test). A similar trend was observed in patients with cognitive impairment and depression on admission. Of the different tests, the Barthel Index and mobility scores were shown to be important predictors of length of hospital stay. Further evaluation of the assessment instruments is needed to assess different aspects of quality of life (self-rated well-being, satisfaction). To assess the efficiency of geriatric rehabilitation in patients with stroke, it will be important to measure resource consumption and to evaluate the long-term results.

Aged↗
PubMed1999

[The elderly stroke patient - observations 18 months after the event].

The further development of 162 stroke patients (average age 77 years), who were geriatrically assessed during hospitalization, was evaluated ca. 18 months after stroke. Questionnaires were mailed to patients. 53% of the patients (n = 86) returned the questionnaire duly filled in; 20% (n = 32) had died; in the remaining 27% of cases (n = 44) no information was obtained on further development. 80% of those patients who responded lived at home despite numerous medical problems. Family members assumed most of the care required. Follow-up treatment and pain therapy proved to be particularly problematic. The Barthel Index according to data collected was significantly lower compared to figures noted upon release from the hospital. Hardly anyone among those patients received follow-up treatment. 74% of patients complained of pain although the majority has regular contacts with the family doctor. For those patients who died in the 18 months interval, significantly lower values for the activities of daily living (ADL) has already been recorded upon hospitalization. They had a less favorable view of their state of health and were less satisfied with life in general.

Activities of Daily Living↗
PubMed1994

Distribution of radiocaesium activities in the waters of a Bavarian chain of lakes.

The procedure to extract caesium from seawater developed by Mann and Casso (1984) has been slightly modified and applied to the determination of radiocaesium originating from the Chernobyl accident in the waters of a Bavarian chain of lakes. Activity concentrations and estimated water inventories are given for 15 lakes 5 years after the accident, and depth profiles of the 137Cs activity concentration in the water column of three selected lakes are presented. The activity concentrations in water of the different lakes show a high variability from 1.2 to 93 mBq l-1. The calculated inventory of dissolved radiocaesium has decreased over the 5 years to 0.03% and 2% of the deposited activity, respectively.

Cesium Radioisotopes↗
PubMed1990

Comparison of the effects of bacterial lipopolysaccharide and muramyl dipeptide on food intake.

For further characterization of the mechanism involved in the anorexia during bacterial infection, we investigated whether muramyl dipeptide (MDP), the minimal immunologically active structure of gram-positive bacterial cell walls, affects rats' food intake in the same way as lipopolysaccharide (LPS) from E. coli. MDP (1.6 mg/kg body weight = b.wt.) injected intraperitoneally (IP) reduced food intake by decreasing meal frequency without affecting meal size. Indomethacin (2.5 mg/kg b.wt., IP) but not verapamil (5 mg/kg b.wt., IP) attenuated the hypophagic effect of MDP. In further experiments, MDP and LPS (100 micrograms/kg b.wt., IP) both inhibited gastric emptying and indomethacin failed to block this effect of LPS. Hepatic vagotomy did not attenuate the hypophagic effects of MDP or LPS. LPS reduced water intake only when food was available, but reduced food intake also during water deprivation. MDP did not affect water intake. MDP and LPS both had an aversive effect, but LiCl, which was also aversive, failed to reduce feeding under the conditions tested. This questions the role of a conditioned taste aversion in the hypophagia induced by MDP or LPS. The results suggest that a stimulation of eicosanoid synthesis contributes to MDP-induced hypophagia and may therefore also contribute to the anorexia during infection. In contrast, an inhibition of gastric emptying, an activation of hepatic satiety signals or a reduction of water intake, does not seem to be crucial for the hypophagic effects of MDP or LPS.

Acetylmuramyl-Alanyl-Isoglutamine↗
PubMed1989

Verapamil and indomethacin attenuate endotoxin-induced anorexia.

To characterize the mechanism of the anorexia during infection, we investigated the effect of E. coli lipopolysaccharide (LPS) on feeding in rats under various conditions: LPS (125, 100, 75, and 50 micrograms/kg body weight = b. wt.) injected intraperitoneally (IP) reduced food intake by decreasing meal frequency without affecting meal size. The Ca++-channel blocker verapamil (5 mg/kg b. wt., IP) or the antipyretic and antiphlogistic drug indomethacin (2.5 mg/kg b. wt., IP), but not combined alpha- and beta-adrenergic receptor blockade by IP phentolamine plus propranolol (500 micrograms/kg b. wt., each) attenuated the anorectic effect of LPS (125 or 100 micrograms/kg b. wt.). The results suggest that a phospholipase A2-sensitive mechanism contributes to the anorexia during injection.

Animals↗