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Biomedical subjects

U Hartmann

Publications and source records attributed to U Hartmann.

At least 19 recordsLinked to original sources
PubMed2006

Once versus twice daily formoterol via Novolizer for patients with moderate to severe COPD--a double-blind, randomised, controlled trial.

STUDY OBJECTIVES: To evaluate in patients with moderate to severe COPD whether a single morning dose of 24 microg formoterol from the Novolizer is not inferior to two divided doses of 12 microg formoterol inhaled in the morning and in the evening. DESIGN: Randomised, double blind, active-controlled, parallel-group, multi-centre study with a 2-week run-in period and a 12-week treatment phase. SETTING: Forty-seven outpatient centres in Germany, including private practices. PARTICIPANTS: N=321 symptomatic patients with moderate to severe COPD aged 40-70 years with an FEV1 of 30-80% predicted and the requirement of 3-12 actuations of salbutamol per day on 5 days during the run-in period. TREATMENT: Eligible patients were randomised to inhale formoterol either (a) as a single 24 microg dose in the morning (OD) or (b) in two divided 12 microg doses in the morning and in the evening (b.i.d.). MEASUREMENTS AND RESULTS: The mean age was 60.3 (SD 7.3) years, and mean baseline pre-dose FEV1 was 1.5l (0.5l) or 50% (12%) of predicted, respectively. After 12 weeks of treatment, pre-dose FEV(1) improved in both groups (mean: OD, +104 ml, b.i.d., +135 ml, mean difference between groups: 31 ml). The 95% CI exceeded the pre-determined margin of 100ml by 2 ml, so that the statistical hypothesis of non-inferiority of once daily dosing was not confirmed. No statistically significant differences were seen for improvements in PEF, MEF75, MEF50, and MEF25. COPD symptoms, percentage of symptom-free days and quality of life (SGRQ) improved in both groups to a similar degree. There were no relevant differences in the incidence of adverse events. CONCLUSIONS: Based on a comparable efficacy and tolerability, the dosing schedule with formoterol via Novolizer as once daily in the morning seems to be an alternative compared to twice daily treatment. The primary endpoint suggests the equivalence of both treatment schedules from a clinical perspective. This regimen can be considered as an alternative therapeutic approach for a subgroup of COPD patients and may help to improve patient compliance.

Adult↗
PubMed2006

Randomised trial comparing as-needed versus regular treatment with formoterol in patients with persistent asthma.

PURPOSE: The aim of this study was to demonstrate the equivalent efficacy of inhaled formoterol in asthmatic patients, either given as-needed or on a regular twice-daily schedule. METHODS: Randomised, open 12-week study in patients with mild to moderate asthma not adequately controlled with inhaled glucocorticosteroids alone. Patients received inhaled formoterol as needed or on a regular schedule (2x2 puffs/day with 6 microg formoterol per puff). Patients in the twice-daily formoterol group could use salbutamol as a rescue medication. The primary endpoint was the number of patients with asthma exacerbations in each group. RESULTS: Thirty-nine centres randomised 359 patients. The number of patients with asthma exacerbations showed neither a clinically relevant nor a statistically significant difference between groups: formoterol as-needed: 3.95% (7 of 177); twice daily: 3.45% (6 of 174). Patients in the formoterol as-needed group used significantly less formoterol (-1.5 puffs per day; P<0.0001). Including the saved rescue medication (up to one puff per day), total beta-2 agonist use in the formoterol as-needed group decreased by approximately 2-2.5 puffs per day. Both formoterol treatment schedules were well tolerated. Musculoskeletal pain and tremor were less frequent in the formoterol as-needed group: headaches were slightly more frequent. CONCLUSION: Formoterol given as needed and without additional beta-2 agonist, and formoterol given on a regular basis twice daily, supplemented by salbutamol as a rescue medication, appeared equally effective in this clinical study. Drug consumption was markedly lower in the former group.

Administration, Inhalation↗
PubMed2006

[Strategies for talking to the patient with sexual dysfunction in the doctor's office].

The use of a questionnaire for initiating talks about the topic of sexual disorders and the efficacy and acceptance by the physician and patient of various communication strategies, were investigated. Each of a total of 1191 general practitioners distributed a health questionnaire which contained questions on sexuality to 150 men aged 30 and above. In a total of 10,622 first talks on sexual health, the questionnaire met with a high level of acceptance, and was the trigger for talks in 54% of the cases. More than two-thirds of the patients reacted positively to such talks, speaking freely and readily, and relieved that this aspect of their lives was being addressed. In 75% of the patients an erectile dysfunction was diagnosed, in 27% further diagnostic measures were prescribed, and in 60% treatment was initiated. In the exes of the physician, the clearly signaled readiness to talk and the discussion of treatment options were the most favorable communication strategies.

Communication↗
PubMed2006

Using a quantum dot as a high-frequency shot noise detector.

We present the experimental realization of a quantum dot (QD) operating as a high-frequency noise detector. Current fluctuations produced in a nearby quantum point contact (QPC) ionize the QD and induce transport through excited states. The resulting transient current through the QD represents our detector signal. We investigate its dependence on the QPC transmission and voltage bias. We observe and explain a quantum threshold feature and a saturation in the detector signal. This experimental and theoretical study is relevant in understanding the backaction of a QPC used as a charge detector.

Journal Article↗
PubMed2006

[Improvement of anxiety and depression in women with breast cancer during inpatient oncological rehabilitation-- results of a prospective study].

PURPOSE: Investigation of the influence of an oncological inpatient rehabilitation programme on anxiety and depression in women with breast cancer. PATIENTS AND METHOD: 198 women with breast cancer, aged 25 to 75 years, filled in the Hospital Anxiety and Depression Scale (HADS) German version at the beginning and end of inpatient rehabilitation. Focus was set on the frequency of anxiety and depression. Therefore proportions with 95 % confidence intervals (CI) were built. The before-after comparison of HADS-scores was made using the signed rank test with two-sided level of significance of alpha = 5 %. In addition effect sizes were calculated. Possible relations between the scores at the beginning of rehabilitation and the patients' age or the interval since diagnosis were analysed by calculating correlation coefficients. RESULTS: At the beginning of rehabilitation a state of anxiety was probable in 23.2 % (CI [17.3 %; 29.1 %] of the women and one of depression in 9.1 % (CI [5.8 %; 13.9 %]). In other words, they reached a level of >or= 11 score points on each scale. No correlation was found with the age of the patients or the time interval since diagnosis (|r| <or= 0.192). At the end of rehabilitation 67.5 % (CI [61.0 %; 74.0 %]) and 60.9 % (CI [54.1 %; 67.7 %]), respectively, of the women showed an improvement of anxiety and depression. The before-after difference was a median + 2 points (anxiety) and + 1 point (depression), resp., with a positive value representing an improvement. The changes after rehabilitation were statistically significant with p < 0.0001. The effect sizes ranged from 0.37 to 0.50. CONCLUSIONS: After the end of primary therapy, women with breast cancer frequently suffer from anxiety or depressive disorders, with no correlation to the patients' age or time since diagnosis. By an inpatient oncological rehabilitation programme both anxiety and depression can be improved very successfully. Whether these results represent a long-term effect is currently being evaluated in a randomised prospective study.

Adult↗
PubMed2005

Presence of 14Hz spindle oscillations in the human EEG during deep anesthesia.

OBJECTIVE: To report on presence of human EEG spindle oscillations on the cortical level within flat periods of the burst-suppression pattern during propofol-induced anesthesia; to search for corresponding oscillations and possible functional connections. METHODS: Artefact-free epochs of spindle activation were selected from the electroencephalograms of opiate-dependent patients undergoing rapid opiate detoxification. Power spectral analysis and source localization using low-resolution-brain-electromagnetic-tomography (LORETA(Key)) were performed. RESULTS: Sinusoidal rhythms with waxing and waning amplitudes appeared after propofol-induced narcosis but no direct correlations could be determined between individual dosage and characteristic spindle attributes. The power maximum stood midline over the cortical areas, especially around C(z). We calculated a peak frequency of 14(+/-1.2) Hz. Motor fields, particularly in the frontal, parietal, and various cingulate areas, were found to be the primary sources of spindle oscillations in the cortex. CONCLUSIONS: The frequent occurrence of these localized spindle sources demonstrates the preference for motor fields. Spindle oscillations observed during propofol-induced narcosis were similar in frequency and shape to those observed in natural sleep. SIGNIFICANCE: The results lend support to models that postulate a close link between the motor system and the organization of behavior. In addition, spindle rhythms under propofol bore some resemblance to spindle types which occur during sleep.

Adult↗
PubMed2005

A population survey of sexual activity, sexual dysfunction and associated help-seeking behavior in middle-aged and older adults in Germany.

The Global Study of Sexual Attitudes and Behaviors was a survey of 27,500 men and women aged 40 to 80 years in 29 countries. Here we report the sexual activity, the prevalence of sexual problems and related help-seeking behaviour among subjects in Germany. A telephone survey was conducted in 2001 and 2002, using a standardised questionnaire covering demographics, general health, relationships, and sexual behaviours, attitudes and beliefs. A total of 1,500 individuals in Germany (750 men and 750 women) completed the survey. Eighty-six percent of men and 66% of women had engaged in sexual intercourse during the year preceding the interview. The most common male sexual problems were early ejaculation (15%), a lack of sexual interest, erectile dysfunction and non-pleasurable sex (each 8%). The most common female sexual problems were a lack of sexual interest (18%), non-pleasurable sex (14%) and lubrication difficulties (13%). Most sexual problems were less common among men and women in Germany than in other European regions. Increasing age was a significant predictor of a lack of sexual interest and erectile difficulties in men. Only 18% of men and 15% of women had talked to a doctor about their sexual problem(s). In conclusion, many middle-aged and older German adults reported continued sexual interest and activity. Overall, sexual problems were less prevalent in Germany compared with other European regions. Of those who experienced sexual problems, however, few had sought medical help. This was often due to a lack of perception of a problem.

Adult↗
PubMed2005

Cognitive and partner-related factors in rapid ejaculation: differences between dysfunctional and functional men.

Despite the high prevalence of rapid ejaculation in community samples, there is still a paucity of data on cognitive and other relevant aspects of the subjective experience of premature ejaculation (PE) patients and their functional counterparts. Therefore, the main aim of this study was to expand our understanding of the complex nature of rapid ejaculation disorders by providing a detailed characterization of ejaculatory patterns, behavioral aspects, cognitive, and partner-related factors in a sample of unselected PE patients compared to a group of functional men. To explore the areas that might differentiate PE men from their sexually functional counterparts, a multidimensional self-administered questionnaire, the PEQuest, was created. This 36-item instrument addresses a number of domains relevant to ejaculatory function and dysfunction such as ejaculatory latencies and ejaculatory control, cognitions and feelings during sexual intercourse, factors interfering with ejaculatory control, techniques to delay ejaculation, and partnership factors. A total of 45 PE patients (mean age: 41.8 years) and 72 non-patients (mean age: 37.1 years) were included. The results show significant group differences in the majority of PEQuest domains. In the functional group, an average intravaginal latency time of 12.8 min (median: 10 min) was reported compared to 3.7 min (median: 2 min) in the patient group with 87% of PE patients ejaculating within 2 min and 100% within 5 min after penetration. In their subjective experience in sexual situations, PE patients were totally preoccupied with thoughts about controlling their orgasm, with the anxious anticipation of a possible failure, and thoughts about keeping their erection while the inner experience of functional men is focused on sexual arousal and sexual satisfaction. The factors that maximally impede the control of ejaculation are similar for both groups, but functional men normally succeed in adapting their sexual behavior to these factors whereas PE men fail in their efforts. Regarding partner-related factors, PE patients felt less secure and experienced with respect to female sexuality than their functional counterparts, and more often reported a discrepancy between their own limited experience and the more extensive sexual experience of their partner. In conclusion, a number of salient differences in ejaculatory behavior, cognitive-affective patterns, and partner-related factors between PE patients and functional men could be delineated in this study, indicating that chronic rapid ejaculation is a serious disorder with a profound impact on the man's life and his partnership.

Adult↗
PubMed2005

On the psychopathology of unilateral temporal lobe epilepsy.

Personality adjustment of patients with unilateral temporal lobe epilepsy (TLE) was investigated in the light of special characteristics of the epilepsy process, psychosocial stressors, and the cognitive status of the patients. Thirty-seven patients with medically intractable unilateral temporal lobe epilepsy (16-55 years of age; 20 right temporal and 17 left temporal foci) were examined with standardized personality inventories (FPI, STAI, IPC, TSK) supplemented by a rating scale evaluated by the neuropsychologist (GEWLE). Patients with left temporal lobe epilepsy were characterized by increased emotional dependency, less externally judged composedness, increased depressive drive and mood, increased nervousness, increased search for information and exchange of disease experience, and greater tendency to persevere (P < 0.05). Cognitive status and psychosocial status did not significantly differ. The evaluation of personality adjustment contributes to the lateralization of the epileptogenic focus and reveals interesting patterns in the preoperative diagnostic puzzle, and in addition provides a strategy to individualize psychotherapeutic strategies.

Adult↗
PubMed2004

[The prevalence of sexual problems in female medical students].

Female sexual dysfunction and even female sexual function are widely unknown. We therefore evaluated the sexual behaviour of younger and older women using a questionnaire. A total of 998 young women entered the study at Hannover Medical school. They were between 19 and 43 years old (median 24 years), and 64% answered the questionnaire. A total of 97.1% of the female students were heterosexual, 1.6% were lesbians and 1.3% were bisexual. Lack of sexual intercourse in the previous month was recorded by 21.1%, while 21.3% recorded intercourse 1-3 times a month, 46.8% 1-3 times a week and 5.5% daily. Adverse reactions to sexual situations were reported by 25% of the women, 20.5% had a negative perception for special partners or circumstances. Some 55% of the evaluated women were satisfied with their sexual life in the last month, 20% were fairly satisfied and 21% were un-satisfied. This study of a selected population of medical students shows a wide variety of sexual problems with a high prevalence of different disorders.

Adult↗
PubMed2004

Biofeedback as a supportive method in weaning long-term ventilated critically ill patients.

Weaning a patient from mechanical ventilation is occasionally a difficult process complicated by the patient's emotional state. Anxiety, agitation, depression and other emotional disturbances can start a vicious circle between fear of losing breath and dyspnea that impairs the process of withdrawing ventilatory support. A biocybernetic loop model is suggested that integrates psychological variables (e.g., capacity of self-control, self-confidence, sense of self-efficacy) as important factors for a successful weaning. The paradigm of biofeedback is regarded as a suited approach to strengthen these psychological factors. It means the externalization of physiological functions especially of those from the autonomous nervous system so that a patient becomes aware of them. In the case of the ventilated patient, it is assumed that the transformation of the respiratory activities into perceptible (acoustic and visual) signals supports the patient's self-controlling behaviour during the weaning process. He gets positive reinforcement for his efforts to influence his breathing intentionally and, by continuous and immediate information, he regains self-confidence to control his somatic functions effectively. The application of biofeedback is mainly described in single case studies. They all report a decrease in the respiratory rate and an increase in the tidal volume. The need for a controlled study is suggested that would answer the question of whether biofeedback is an appropriate psychological tool to facilitate the weaning process in mechanically ventilated patients.

Biofeedback, Psychology↗
PubMed2004

Nanoscale analysis of biofunctional molecules and components.

In basic medical research, as well as in concrete clinical applications, the nanoscale analysis of biofunctional units is of strongly increasing relevance. Dedicated investigations on molecules, molecular composites or functional units can efficiently be performed ex or in situ by scanning probe methods and, namely, by scanning force microscopy. In the following investigations, the folding behavior of DNA is presented as an example of basic research in medicine. In contrast, the investigation of bioadsorption phenomena in systems on which apheresis therapies are based provides a real contribution to applied medicine.

Absorbable Implants↗
PubMed2003

Atomic force microscopy and scanning near-field optical microscopy studies on the characterization of human metaphase chromosomes.

A better knowledge of biochemical and structural properties of human chromosomes is important for cytogenetic investigations and diagnostics. Fluorescence in situ hybridization (FISH) is a commonly used technique for the visualization of chromosomal details. Localizing specific gene probes by FISH combined with conventional fluorescence microscopy has reached its limit. Also, microdissecting DNA from G-banded human metaphase chromosomes by either a glass tip or by laser capture needs further improvement. By both atomic force microscopy (AFM) and scanning near-field optical microscopy (SNOM), local information from G-bands and chromosomal probes can be obtained. The final resolution allows a more precise localization compared to standard techniques, and the extraction of very small amounts of chromosomal DNA by the scanning probe is possible. Besides new strategies towards a better G-band and fluorescent probe detection, this study is focused on the combination of biochemical and nanomanipulation techniques which enable both nanodissection and nanoextraction of chromosomal DNA.

Cell Separation↗
PubMed2003

Specificity of the neuroendocrine response to orgasm during sexual arousal in men.

We have demonstrated that sexual activity produces transient sympathoadrenal activation and a pronounced, long-lasting increase in prolactin in men and women. However, by analyzing endocrine alterations at 10-min intervals, a precise assignment of these changes to the pre-, peri- and postorgasmic periods was not possible. Thus, the current study aimed to accurately differentiate the endocrine response to sexual arousal and orgasm in men using an automatic blood collection technique with 2-min sampling intervals. Blood was drawn continuously before, during and after orgasm over a total period of 40 min in 10 healthy subjects and were compared with samples obtained under a control condition. Sexual activity induced transient increases of plasma epinephrine and norepinephrine levels during orgasm with a rapid decline thereafter. In contrast, prolactin levels increased immediately after orgasm and remained elevated throughout the experiment. Although oxytocin was acutely increased after orgasm, these changes were not consistent and did not reach statistical significance. Vasopressin, LH, FSH and testosterone plasma concentrations remained unaltered during sexual arousal and orgasm. These data confirm that prolactin is secreted after orgasm and, compared with oxytocin, seems to represent a more reliable and sustained marker for orgasm in man. The results further reinforce a role for prolactin either as a neuroendocrine reproductive reflex or as a feedback mechanism modulating dopaminergic systems in the central nervous system that are responsible for appetitive behavior.

Adolescent↗
PubMed2003

Effects of acute prolactin manipulation on sexual drive and function in males.

The neuroendocrine response to sexual activity in humans is characterized by a pronounced orgasm-dependent increase of plasma levels of prolactin. In contrast to the well-known inhibitory effects of chronic hyperprolactinemia on sexual drive and function, the impact of acute prolactin alterations on human sexual physiology is unknown. Therefore, this study was designed to investigate the effects of acute manipulation of plasma prolactin on sexual behavior. Ten healthy males participated in a single-blind, placebo-controlled, balanced cross-over design. Prolactin levels were pharmacologically increased to high levels (protirelin, 50 micro g i.v.) or reduced to low physiological concentrations (cabergoline, 0.5 mg p.o.). Sexual arousal and orgasm were then induced by an erotic film and masturbation. In addition to continuous neuroendocrine and cardiovascular recordings, the quality and intensity of the acute sexual drive, arousal, orgasm and refractory period were assessed by extensive psychometric measures. Administration of cabergoline decreased prolactin levels and significantly enhanced all parameters of sexual drive (P<0.05), function (P<0.01) and positive perception of the refractory period (P<0.01). Administration of protirelin increased prolactin concentrations and produced small, but not significant reductions of sexual parameters. The sexual effects observed from cabergoline were completely abrogated by coadministration of protirelin. Although different pharmacological sites of action of prolactin-altering drugs have to be considered, these data demonstrate that acute changes in prolactin plasma levels may be one factor modulating sexual drive and function. Therefore, besides a neuroendocrine reproductive reflex, a post-orgasmic prolactin increase may represent one factor modulating central nervous system centers controlling sexual drive and behavior. These findings may offer a new pharmacological approach for the treatment of sexual disorders.

Adult↗
PubMed2002

[Sexuality in the elderly].

Disturbance of sexual function and sexual perceptions in the aging often have a significant negative impact on overall quality of life. Epidemiological data on this phenomenon are sparse. Recently, however, more investigations have been undertaken to improve diagnostic and therapeutic approaches. First scientific concepts are now emerging that will allow better patients care in the future.

Adult↗