Biomedical subjects

W Hundt

Publications and source records attributed to W Hundt.

24 records · Page 2Linked to original sources

PubMed1997

[Advantages and cost-benefit analysis of various teleradiology scenarios].

With the increasing number of users and technical improvements, there are several application scenarios of teleradiology. To perform a cost-benefit analysis, an approach is presented, which focuses on both monetary and qualitative aspects. Process-related, qualitative and quantitative evaluations are described. The prestudy compares the radiological workflow before and after the introduction of a teleradiology system. A scoring model is part of the qualitative evaluation. The quantitative study focuses on costs and savings. Amortisation and a net present value of savings versus costs can be derived using dynamic investment methods. Savings can be achieved after a short time under ideal conditions, but there is no guarantee for a reimbursement for all systems.

Computer Systems↗

PubMed1996

Acamprosate and alcohol: III. Effects on alcohol discrimination in the rat.

It has been shown that acamprosate (calcium-acetyl homotaurinate) decreases voluntary ethanol drinking in laboratory animals as well as relapse behaviour in human alcoholics. Although glutamatergic mechanisms have been implicated in several recent studies in the action of acamprosate, the basic mechanism remains unknown. In order to gain more insight into possible mechanisms underlying the ethanol intake-suppressing effects of acamprosate, we investigated this compound in an ethanol discrimination test. Male Wistar rats were trained in a two-lever operant drug discrimination paradigm to make differential responses for food following ethanol (1 g/kg i.p.; 12% v/v ethanol solution) or saline vehicle injections with a fixed ratio schedule of food reinforcement (FR 10) and a post-administration interval of 10 min. Once rats had acquired the discrimination, the criterion for stimulus control was set as at least 90% ethanol- or vehicle appropriate responding during ten consecutive sessions, an ethanol dose-response test (0.25-1.5 g/kg i.p.) was conducted. The effects of acamprosate on the discrimination were assessed in two ways: (i) Generalization test: acamprosate (25-250 mg/kg i.p.) was given either 30 or 120 min before the animals were put in the operant chambers. (ii) Antagonism test: acamprosate (25-250 mg/kg i.p.) was given 120 min before the animals were injected with ethanol, 10 min later the animals were tested. Data obtained in the dose-response test showed a dose-dependent effect with an ED50 of 0.53 g/kg ethanol. The results of generalization testing revealed that acamprosate failed to substitute for the ethanol cue, whereas, in comparison, dizocilpine (0.01-0.2 mg/kg i.p.) completely generalized for the ethanol cue (ED50 = 0.05 mg/kg). Acamprosate also had no effect when tested as an antagonist. Thus, neither the ethanol nor the saline discrimination was altered by acamprosate pretreatment. Furthermore, acamprosate had no effect on response latencies at all doses tested. In conclusion, acamprosate does not generalize for the ethanol cue, suggesting that it is not a substitution drug. Further, acamprosate does not seem to act via the dizocilpine binding site of the N-methyl-D-aspartic acid (NMDA) channel.

Acamprosate↗

PubMed1994

Evaluating the new ICD-10 categories of depressive episode and recurrent depressive disorder.

The new ICD-10 categories of 'depressive episode' (F32) and 'recurrent depressive disorder' (F33) were evaluated on the levels of diagnoses, subtypes, syndromes and symptoms. Interrater reliability was analyzed from findings of four independent diagnosticians who rated 100 written psychiatric case records with the help of criteria-related checklists. Agreement was sufficient if patients with and without the diagnosis of a depressive disorder were included (kappa = 0.82), but low in the depressed subsample (kappa = 0.40). Unclear boundaries became apparent for the classification of depressive syndromes as moderate or severe. The results suggest that the ICD-10 concept of depressive disorder is very similar to the well-known international concept of 'major depression'.

Adult↗

PubMed1994

Testing the comparability of psychiatric diagnoses in ICD-10 and DSM-III-R.

The compatibility of the classification systems ICD-10 and DSM-III-R was investigated in a sample of 100 psychiatric inpatients with severe affective and psychotic disorders. Four independent raters assessed diagnoses by means of checklists from psychopathological descriptions of case records. Congruence between ICD-10 and DSM-III-R was good for depressive disorders with agreement rates above 80% and fair for bipolar disorders with rates above 60%. Less consistent findings were obtained for schizophrenia with rates of 57.5% for ICD-10 diagnoses and 82.6% for DSM-III-R diagnoses. Agreement for schizoaffective disorder was below 40% and thus insufficient. The results indicate that even small differences in the definitions of mental disorders may result in considerable inconsistencies.

Adult↗

PubMed1993

An empirical comparison of diagnoses and reliabilities in ICD-10 and DSM-III-R.

The psychiatric classification systems ICD-10 and DSM-III-R were compared by applying both sets of diagnostic criteria to the same sample of patients suffering from affective and psychotic disorders. Four independent raters assessed diagnoses according to both systems to 100 written case records which had been prepared in a traditional, standard format. The International Diagnostic Checklists (IDCL) were employed to rate relevant psychopathological signs and symptoms and to apply diagnostic decision rules. The results showed that ICD-10 yielded a generally higher reliability for all main disorders except for bipolar disorder. Overall reliability was kappa = 0.53 for diagnoses according to DSM-III-R and 0.59 for diagnoses according to ICD-10. Agreement was best for affective disorders, moderate for schizophrenia and inacceptable for schizoaffective disorder. Insufficient boundaries were found in both systems between schizoaffective disorder on one side and schizophrenia and bipolar disorder on the other side. The different duration criteria for schizophrenia of six months in DSM-III-R and one month in ICD-10 tend to have considerable consequences for frequency rates of schizophrenia in a typical clinical setting.

Adult↗

PubMedDate not supplied

In vitro susceptibility and sterol biosynthesis of Candida albicans strains after long-term treatment with azoles in HIV-infected patients.

Over a period of 6 to 24 months a long term follow up of the in vitro antifungal susceptibility of 306 Candida albicans strains from 49 HIV-infected patients was performed. Using a microdilution test, the strains were tested against the azoles ketoconazole, itraconazole and fluconazole. The susceptibility range for fluconazole was between 1 and 128 mg/l, for itraconazole between 0.015 and 32 mg/l and for ketoconazole between 0.007 and 16 mg/l. 11.7% of the strains showed elevated IC30-values against ketoconazole, 9.1% against itraconazole and 10.1% against fluconazole. Sterol biosynthesis was examined by thin layer chromatography in 18 less sensitive strains and nine sensitive strains in the presence of ketoconazole. The proportion of ergosterol in the presence of ketoconazole at a concentration of 0.003 mg/l varied between 7.6% and 21.1% in sensitive strains and between 11.1% and 86.6% in less sensitive strains. In resistant control strains the proportion of ergosterol was 73% and 94.2%, respectively. Without ketoconazole the ergosterol proportion was > 85% in all strains. There was a significant correlation between the IC30-values and the inhibition of ergosterol biosynthesis (p = 0.05).

AIDS-Related Opportunistic Infections↗