[A program for the early detection of Parkinson syndrome].
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Biomedical subjects
Publications and source records attributed to S Lehrl.
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The quality of living in homes for the elderly and health resort institutions must be assessed in accordance with subjective and objective criteria. From the medical point of view, stress factors in the living area should be avoided, and health-promoting factors introduced. In this connection, consideration must be given to the biological, psychological and sociological aspects of ageing. Both in homes for the elderly and in health resort institutions, the particularly features of variability of interior design, compactness, clarity, safety, separation of functional rooms, furnishability and domestic comfort should be taken into account. The question of comfort (homeliness) in the health resort clinics, would appear to be an important factor, since it promotes patient contentment and willingness to cooperate, and thus also patient compliance.
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All teams of investigators concerned with compliance rate have come to the conclusion that one can seldom rely on patients to take their tablets as prescribed. In case of long-term medication the problem becomes even more acute. A method for checking on compliance is, therefore, of great help in controlling medical therapy as well as in judging the effectiveness of pharmaceuticals. The results of this study imply that diachronic determination of piracetam concentration in patients' urine is an especially simple way of testing compliance without undue strain on the patient.
An overview on an follow-up study is given that concerns the drug-compliance of 990 pregeriatric rehabilitation patients. During 20 days the drug intake of every patient was controlled by riboflavine method. The compliance-rate was at 47.9 +/- 32.4%, and it was relatively constant during the course of the investigation. Other features as age, nationality, number of risk factors etc. correlated but moderately though significantly with the compliance-rate. The lowest values had foreigners, and/or patients prone to nicotine or alcohol abuse. The highest rate was found on patients being in the state after heart infarction.
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Methodological differences between techniques used to examine recovery from anesthesia prevent direct comparison of results. Also psychological tests are not validated for certain anaesthesiological considerations. The two tests presented here combine ease of use for a bedside test with the advantage that the results are expressed as absolute values of cerebral depression. Based on Wieck's concept of symptomatic or functional psychosis they were developed to document the course of neuropsychiatric illness. Their application following anaesthesia seems to be justified as anaesthesia may be regarded as being a deliberately induced functional psychosis characterized by extremely compressed dynamics. The target of a first pilot study were 60 patients following neuroleptanalgesia with and without antagonization with naloxone, or enflurane anaesthesia, respectively. Psychopathometric evaluation yielded an obvious post-operational decline in the SKT-scores which clearly remained below the pre-operative values even after three hours. All the patients revealed a severe transient syndrome after thirty minutes, a moderate syndrome after one and two hours and a mild syndrome after three hours. The only exception were patients antagonized with naloxone who initially showed an improvement but who afterwards did not behave any better. Neither duration of anaesthesia nor total dose of drugs administered showed any significant correlation to the extent of postoperative cerebral depression. Being uninfluenced by moderating variables such as age and IQ, the psychopathometric tests presented here seem to provide a sensitive and reliable method for quantification of recovery from anaesthesia.
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A 76-year-old man with bilateral temporal lobe agenesis producing clinical features resembling the Robinson syndrome is described. The malformation was discovered during a routine CT examination after the appearance of a homonymous visual field defect. The patient was examined by (neuro) psychological testing. The findings are compared with other reported cases and discussed with regard to cerebral localisation.