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Biomedical subjects

W Feuerlein

Publications and source records attributed to W Feuerlein.

At least 37 records · Page 2Linked to original sources
PubMed1986

Parameters affecting the course and results of delirium tremens treatment.

The histories of 778 patients were analysed in respect of the course, type of treatment and lethality of delirium tremens. The lethality was highest in patients in the higher age range, those who were overweight and in spirit drinkers. The lowest mortality was in the patients treated with chlormethiazole (other drugs used included haloperidol and phenothiazines).

Adult↗
PubMed1986

[A hospital unit for psychiatric crisis intervention 5 years later].

On 7 January 1981 a special ward for crisis intervention and emergency psychiatric cases went on stream at the Max Planck Institute of Psychiatry in Munich. The article reports on the development of this ward between 1981 and 1985. First of all, a brief outline of the structure of the ward is given explaining indications and contraindications for acceptance and the treatment concept. This is followed by statistical evaluation of 1981 to 1985 data in respect of number of admissions and readmissions, duration of stay, percentage distribution of the referring institutions, age distribution, distribution of diagnosis, rates of attempted and committed suicides and onward referral to other institutions for further treatment. Finally, the article reviews changes in the basis concept of therapy and in the style of communication and behaviour within the therapeutic team, besides commenting on unfavourable conditions.

Combined Modality Therapy↗
PubMed1984

[Tolerance of nitrefazole in alcoholics with liver disease. A 4-week placebo-controlled double-blind study].

Liver damage is one of the most common organ manifestations of chronic alcoholism. The recovery process following abstinence should not be impaired by therapy with alcohol sensitizing drugs. In a double-blind multicentre-study (controlled against placebo) the liver tolerance of Nitrefazole which is indicated as an alcohol sensitizing agent for therapy of alcoholics, was tested during the first four weeks of a planned longterm therapy. A total of 62 patients with alcoholic liver disease--demonstrated clinically and in the laboratory--were tested. The patients received 800 mg of Nitrefazole (4 capsules a 200 mg), respectively 4 placebo capsules of identical appearance, once a week in the presence of the doctor. In both treatment groups there was a significant (p less than or equal to 0.01) decline of the previously pathologically altered laboratory values, especially concerning gamma-GT, GPT, GOT. The physical and mental condition which was additionally evaluated by the doctor improved within both treatment groups. The improvement of the liver functions due to abstinence is not delayed or impaired by Nitrefazole .

Adult↗
PubMed1984

Detection and exclusion of alcoholism in men on the basis of clinical laboratory findings.

Alcoholism is a common disease; it is found in 10% to 15% of all patients admitted to general hospitals. There is no single characteristic finding, but on the other hand, changes as compared with normal values have been reported in the literature for more than 30 frequently assayed clinical chemical and haematological parameters. In the project reported here all 24 clinical chemical parameters and all 8 haematological parameters frequently assayed were studied in each of 82 hospitalized men with a confirmed diagnosis of alcoholism. The diagnosis of alcoholism was made on the basis of the Munich Alcoholism Test (MALT) together with the following standardized assessments and examinations: past history, an alcohol questionnaire, general physical examination and neurological examination. All forms were filled in completely. All steps in the clinical laboratory investigations were standardized, and all were subject to ongoing reliability control. The clinical problem is usually not to differentiate alcohol abusers or alcoholics from healthy persons but rather to identify the alcoholics among a population of patients with a variety of illnesses. For this reason 70 patients from two hospitals who were clearly neither alcohol abusers nor alcoholics were studied in exactly the same manner as the alcoholics. In this combined group of 152 hospitalized patients significant differences were found in the distribution of the values for the alcoholics and the non-alcoholics for the following clinical chemical and haematological parameters: at the 0.1% level gamma-glutamyltransferase, aspartate aminotransferase, urea, creatinine and mean corpuscular volume (MCV), and at the 1% level glutamate dehydrogenase, alanine aminotransferase and alkaline phosphatase. From these eight parameters those combinations of between two and six parameters were selected that discriminated best between the alcoholics and the non-alcoholics. Using conventional decision limits the following was found: For the alcoholics two or more of the results for the following five parameters were outside the decision limits given in parentheses: gamma-glutamyltransferase (greater than or equal to 28 U/l), aspartate aminotransferase (greater than or equal to 18 U/l), alanine aminotransferase (greater than or equal to 22 U/l), MCV (greater than or equal to 96 fl), creatinine (less than or equal to 66.3 mumol/l). The diagnostic sensitivity (alcoholics) is 85%, the diagnostic specificity (non-alcoholics) is 64%.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1984

Excessive consumption of alcohol in men as a biological influence factor in clinical laboratory investigations.

It is known that excessive alcohol consumption leads to changes in clinical chemical and haematological parameters that are reversed to a greater or lesser degree after alcohol consumption ceases. Such factors that lead to changes in vivo in the parameters studied are termed biological influence factors. In the study reported here the biological influence factor "excessive alcohol consumption" was assessed in its most severe form, namely alcoholism. To this end 24 clinical chemical parameters and 8 haematological parameters were studied in 82 male alcoholics. The diagnoses of alcohol abuse and alcoholism were made on the basis of the Munich Alcoholism Test (MALT) and the information obtained in the following standardized interviews and examinations: past history, an alcohol questionnaire, general physical examination and neurological examination. All forms were filled in completely. All steps in the clinical laboratory investigations were standardized, and all were subject to ongoing reliability control. In the comparison of the analytical results for the alcoholics with reference intervals for healthy persons (normal ranges) the following alterations were found, the percentage of the alcoholics being given in parentheses. (Table: see text) Furthermore, the result was below the location parameter of the reference sample group for: Urea (80%) Thus excessive alcohol consumption is clearly a biological influence factor that must be taken into consideration in the medical assessment of analytical results for numerous clinical chemical and haematological parameters. In determining reference values and reference intervals for the transverse assessment of analytical results for these parameters it is therefore absolutely essential that subjects with excessive alcohol consumption be excluded from the reference sample group. According to the present data, alcoholism can be neither detected nor excluded by evaluating a single parameter, i.e. on the basis of only one clinical chemical finding.

Adult↗
PubMed1983

[Crisis intervention technics and organization of crisis intervention. A unit for emergency psychiatry and crisis intervention-concept, structure and initial results].

Using the psychiatric admission unit of the Max-Planck- Institute for Psychiatry as an example, the principles of inpatient treatment of psychiatric emergency patients respectively inpatient crisis intervention are presented. It can be demonstrated, that small units with short treatment duration and a multidisciplinary team with psycho-therapeutic orientation are most useful. Supportive psychotherapy with emotional support, cognitive support and support by direct intervention in the environment of the patient are used. The therapeutic endeavours are done in single and group sessions. A regular supervision is necessary. Most of the patients are referred after the completion of the inpatient stay for further treatment on an in- or outpatient basis.

Adolescent↗
PubMed1983

[A unit for emergency psychiatry and crisis intervention--concepts, structure and initial experiences].

The article reports on a ward with 12 beds which has been set up for emergency cases in psychiatry or for immediate intervention in case of a crisis experienced by a patient. In the theoretical part of this article, it is explained that crisis situations are present in most of the psychiatric emergency patients. The article then goes briefly into the fundamentals of therapeutic strategy in such patients: A therapy which helps to uncover hidden conflicts, the pros and cons of therapy focussed on conflict and on supportive measures; as well as a therapy which supports and promotes the ego. This is followed by a comparison of the ward with corresponding facilities in Germany and abroad and a description of their structure, their patients and their function within a psychiatric care system. The concluding part of the article is devoted to a description of the authors' initial experiences and impressions gained during their work with the ward patients, quoting several examples.

Adolescent↗
PubMed1979

[A six-year follow-up study of 100 patients who attempted suicide (author's transl)].

This follow-up study assesses further suicidal risk and discusses the characteristics of patients who have repeatedly attempted suicide. Depth of coma alone due to overdose of medication does not seem to be a sufficient criterion for the assessment of further suicidal risk. Better predictors seem to be: age, family status, degree of loneliness and social disintegration, presence of existential anxiety, and lack of self-assertiveness. Patients who made repeated suicide attempts had a higher neuroticism score, were more often alcohol- and drug-dependent, and came more often from a broken home. Finally, the characteristics of various patient groups are delineated.

Adolescent↗
PubMed1979

[Early recognition and diagnosis of alcoholism].

The starting point is a discussion of the definition of alcoholism in its various aspects: somatic, psychic and social sequelae, loss of control, amount of alcohol consumption. The clinical approach is oriented on target symptoms ("Leitsymptome") followed by a search for details of symptoms of alcoholism. Diagnostic tests for alcoholism and their problems are discussed. Examples of these tests are described, especially the Munich Alcoholism-Test (MALT).

Alcohol Drinking↗
PubMed1979

Diagnosis of alcoholism: the Munich Alcoholism Test (MALT).

The purpose of our project was to develop and empirically test a diagnostic instrument which would permit sufficiently reliable differentiation between alcoholics and healthy as well as sick persons and which would also be easy and economical to administer. For this purpose, roughly 250 diagnostically relevant items were selected from the extensive literature on alcoholism and, with a total of 1335 patients (661 of these were alcoholics), were evaluated in three separate phases for their ability to differentiate. The best items were selected on the basis of various statistical criteria and then cross-validated. The result is the Munich Alcoholism Test (MAT) which consists of two complementary parts: a 7-item physician's assessment part and a 24-item self-assessment part. In a cross-validation study on 675 unselected in- and outpatients a validity of r = 0.94 was obtained. The reliability of the self-assessment part was r = 0.84.

Adolescent↗