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Biomedical subjects

R Pohl

Publications and source records attributed to R Pohl.

At least 127 records · Page 7Linked to original sources
PubMed1984

Changes in the drug treatment of anxiety disorders.

One of the major changes in the clinical treatment of anxiety has been the substitution of benzodiazepines for less safe sedative-hypnotic drugs. A second major change has been the finding that antidepressants suppress panic attacks. The evidence for this is reviewed in this paper. It appears that panic anxiety is qualitatively different from other kinds of anxiety; this has important implications for diagnosis and treatment. Other clinical issues presented in this symposium are a review of benzodiazepine and new, non-benzodiazepine anxiolytic drugs, the treatment of separation anxiety, and the relationship of mitral valve prolapse to anxiety. Further advances are likely to depend both on our understanding of benzodiazepine and gamma-aminobutyric acid receptors and on drug models for inducing anxiety. The fact that antidepressants suppress panic attacks, and the ability to produce panic attacks in the laboratory opens up a number of possibilities for the investigation of the physiological basis of panic attacks. All of these topics are taken up in this symposium.

Agoraphobia↗
PubMed1984

Psychophysiological factors in panic disorder.

Panic disorder patients were compared with normal subjects during intravenous infusion of sodium lactate, isoproterenol, and placebo. Panic attacks meeting the criteria of the Diagnostic and Statistical Manual, vol. 3 [American Psychiatric Association, 1980] occurred during all three conditions in patients and during the lactate and isoproterenol infusions in normals. Patients had significantly higher average levels of skin conductance, heart rate and state anxiety, and significantly lower finger temperatures compared to normal subjects. However, no measure reliably differentiated panic attacks from nonattack periods. It is concluded that the peripheral physiologic responses investigated are neither necessary nor sufficient for the occurrence of panic attacks. It is possible that reports of these attacks represent phobic responses to intense anxiety.

Anxiety Disorders↗
PubMed1984

Acetylcholine and alpha 1-adrenergic sensitivity in the separation of depression and anxiety.

Three relatively clear-cut diagnostic groups, namely primary major depressive disorder-endogenous subtype (PRI MDD-E), primary anxiety disorder with no depression (PRI ANX), and normal controls as well as two additional patient groups with mixed or coexisting anxious/depressive diagnoses were studied. Clinical assessment was made by routine psychiatric interview, Schedule of Affective Disorder and Schizophrenia (SADS) research interview, and obtaining family history of MDD. Subjects underwent both routine 'baseline' sleep EEG polygraphic arecoline, a muscarinic, cholinergic agonist infused during sleep. Cholinergic sensitivity was assessed by measuring the time to induction of REM sleep after arecoline infusion. In addition, a subgroup of MDD patients underwent pupillographic testing. Peripheral alpha-adrenergic responsivity was measured by the magnitude of pupillary mydriatic response after local ocular instillation of phenylephrine. Successful separation (83% correct classification) of the 'pure' groups (PRI MDD-E, PRI ANX, and normal) was achieved by discriminant function analysis of sleep EEG variables. Compared to PRI ANX and normal groups, patients with PRI MDD-E had supersensitive cholinergic REM-induction response, shorter REM latency, increased first REM density and REM percent. Separation of the PRI ANX and normal groups was by intermittent awake time, delta sleep percent, and total REM density. Classification of the mixed anxious/depressive groups was next attempted using the discriminant coefficients derived from the above analysis of 'pure' groups. We found that the presence of absence of family history of MDD in patients with mixed diagnosis offered the best prediction of classification into PRI MDD-E and PRI ANX groups, respectively. MDD patients with coexisting panic disorder were significantly subsensitive to phenylephrine-induced mydriasis compared to MDD patients without anxiety.

Acetylcholine↗
PubMed1984

Prognostic parameters in patients with advanced ovarian malignant tumors.

The role of a number of parameters was evaluated in 172 patients with advanced ovarian tumors. The clinical stage appears to be one of the most important of these parameters. Thus 3 years survival of patients in stage II was 40% whereas of those in stage IV only 5%. Granulosa cell tumors and mucinous cystadenocarcinomas presented the best prognosis while patients with undifferentiated and endometrioid carcinomas had a shorter survival. Patients with well differentiated tumors had a 3 year survival of 28% and those with poorly differentiated neoplasms 10%. Women under the age 50 showed a better prognosis than those over 50. The 3 year survival rate with residual tumors measuring less than 2 cm in diameter was 55% and that with residual tumors of more than 2 cm 18%. These parameters should therefore be carefully considered when therapy is being planned and when results of various therapeutic procedures are being compared.

Adenocarcinoma↗
PubMed1982

Teaching the mental status examination: comparison of three methods.

The authors compared videotape and lecture methods of teaching the mental status examination to a second-year medical school class. The results of each teaching method were evaluated by a multiple-choice examination and a feedback questionnaire and were compared with the results from teaching the mental status examination using simulated patients in a previous year's class. There was no clear difference in examination results for students exposed to different instructional methods. On the feedback questionnaire, students appeared to prefer instruction in whatever form it was given. The authors discuss the significance of these findings.

Clinical Competence↗
PubMed1982

Tricyclic antidepressants and monoamine oxidase inhibitors in the treatment of agoraphobia.

The efficacy of tricyclic antidepressants and monoamine oxidase inhibitors for the treatment of agoraphobia and other panic disorders is reviewed with an emphasis on controlled prospective studies. After methodological biases are taken into account, there is strong evidence that antidepressants suppress panic attacks. This effect is not dependent on the presence of concomitant depressive symptoms. The clinical issues of dosage, delay in response, and relapse with discontinuation of treatment are also reviewed.

Agoraphobia↗
PubMed1981

Regulation of phenol degradation in Pseudomonas putida.

In order to characterize the ability of Pseudomonas putida (TREVISAN 1889) MIGULA 1895 strain H to degrade various mono- and diphenolic aromatic compounds, respiratory activities towards phenol, catechol, and the cresol isomers were determined. The following rates of oxygen uptake (QO2) were obtained with resting phenol-grown cells: phenol -- 229, o-cresol -- 231, m-cresol -- 43, p-cresol -- 200, catechol -- 262. All these compounds were oxidized by a two-phase-kinetics, the first phase is characterized by a higher oxidation rate than the second. The oxidation of phenol as well as of p-cresol was found to be substrate-inhibited at concentrations above 0.25 mM. A Ki-value of 100 mg/l was calculated for phenol oxidation. The phenol-degrading enzyme system is induced, probably coordinately, by phenol and the cresol isomers. In strain H the degradation of phenol is carried out simultaneously with the assimilation of natural carbohydrates like glucose and sodium pyruvate. Aniline as well as sodium benzoate, though not metabolized by strain H, cause a concentration-dependent inhibition of phenol degradation in resting phenol-grown cells of that strain. The mechanism of this inhibition is discussed.

Catechol 1,2-Dioxygenase↗
PubMed1981

[A report about 311 ovarian carcinomas, treated at the "Universitäts-Frauenklinik des Klinikums Mannheim der Universität Heidelberg" from 1960--1978 (author's transl)].

In the medical histories no hints could be found, suggesting a definite risk-group for ovarian carcinoma. Symptoms and complaints are often uncharacteristic and no methods for early recognition are known. The therapy of the ovarian cancer is an operation, combined with chemotherapy, or radiation considering to the stage of the tumour. Most important for the prognosis is the degree of expansion, besides age of the patients and the histological pattern of the tumour. The three-years-survival rate of our patients with stage T1 is 71,7%, and with stage T4 only 13,5%. Above all advance in early diagnosis it is necessary to achieve higher survival rates.

Adolescent↗
PubMed1981

[The prognosis of malignant ovarian tumours in correlation to the histological findings (author's transl)].

The prognosis of malignant ovarian tumours depends upon the stage at the onset of treatment when the histology is similar and in tumours of the same stage upon the histologic type of tumour. Ovarian cancers were histologically divided into 7 groups. The diagnosis in our series allowed to consider the following groups: Germinal cell tumours (group 1), tumours arising from isolated epithelial rests (group 2), tumours of follicular cell origin (group 3), tumours of the covering epithelium (group 4), and genetically indeterminate tumours (group 6). The stage T1 at the onset of treatment was most frequently diagnosed in tumours arising from follicular cells (61%). Tumours arising from the covering epithelium or genetically indeterminate tumours showed stage T1 in 15 or 16%. Secondary tumour at the onset of therapy was found in increasing frequency from group 1 to group 6. The survival rate decreases from group 1 to group 6. The worst prognosis show patients with genetically indeterminate tumours, followed by patients with malignant tumours of the covering epithelium. The best survival chance have patients with tumours of the germinal epithelium. It is therefore important to plan the post-operative treatment not only according to the stage of tumour but also according to the microscopic findings.

Adolescent↗
PubMed1979

[The special case: rare gynecologic emergency of uterine perforation in placenta percreta].

The term placenta percreta signifies a penetration of placenta villus growing through the myometrial wall to the serosal side. The incidence has been reported to vary between 1:1000 to 1:70 000. Thus uteral rupture as a result of placenta percreta is a rare event. Signs of severe shock as leading signs predominate. Immediate laparotomy with hysterectomy is the therapy of choice. The final diagnosis is based on histology.

Adult↗