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W Maier

Publications and source records attributed to W Maier.

At least 343 records · Page 19Linked to original sources
PubMed1992

Neuropsychological indicators of the vulnerability to schizophrenia.

Schizophrenia is associated with enduring deficits in neuropsychological functioning. It is widely undecided if the various aspects of neuropsychological impairment are a consequence of the disorder or if they are also present premorbidly and in populations at increased risk for schizophrenia (vulnerability markers). Neuropsychological deficits in healthy relatives of schizophrenic patients who are at an elevated risk for schizophrenia and who did not yet pass the period of risk would indicate that these deficits are vulnerability markers. This hypothesis was tested for three neuropsychological paradigms which have been proven to distinguish schizophrenic patients from controls. 33 siblings of drug-free schizophrenic probands revealed deficits has compared to 33 matched healthy controls in a blurred single target version of the Continuous Performance Test and in a multiple item version of the Span of Apprehension Test but not so in less difficult versions of both tests or in the time needed to react to stimuli with shifting modality.

Adult↗
PubMed1992

Wisconsin Card Sorting Test: an indicator of vulnerability to schizophrenia?

The Wisconsin Card Sorting Test (WCST) is a neuropsychological test, hypothesized to be an indicator of dorsolateral prefrontal cortex (DLPFC) functioning. The performance of schizophrenic patients in our sample (off medication) was worse than the performance of healthy controls in all variables of the WCST, including perseverative responses (PR) as well as non-perseverative responses (NPR). The rate of perseverative and non-perseverative responses was neither a function of the severity of the illness (measured by SANS/SAPS scales) nor the duration of the disease. Healthy siblings of schizophrenic probands revealed more perseverative responses than healthy controls, but did not show any difference with respect to the non-perseverative responses. This finding suggests that the difficulty to shift a cognitive set, reflected by the frequency of perseverative responses, is in favor of the WCST as a vulnerability marker for schizophrenia, whereas non-perseverative responses presumably indicate a state, but not a trait marker of the disease. However, the usefulness of this indicator may be limited by its association with age, which is worthy of being studied in closer detail.

Adult↗
PubMed1992

Eustachian tube function in sudden hearing loss and in healthy subjects.

The relationship between sudden hearing loss and an ipsilateral patulous tube was tested in our Eustachian tube laboratory. Fifty patients suffering from sudden hearing loss were examined by the pressure chamber impedance method, giving objective data on Eustachian tube function. Results were compared to those obtained from 56 healthy volunteers in a preceding investigation. Our investigation did not show any associations between patulous tube syndrome and sudden hearing loss, as had been claimed by several authors previously. There was even indication of a decreased patency of Eustachian tube in our patients in active and passive tubal tests. We could demonstrate a high reproducibility of values obtained by our method, indicating that results are representative in healthy persons as well as in patients. In a case report the importance of objective diagnostic methods in differential diagnostics of Eustachian tube pathology is emphasized.

Ear, Middle↗
PubMed1992

Risperidone in the treatment of disorders with a combined psychotic and depressive syndrome--a functional approach.

In vitro receptor-binding profiles and in vivo pharmacological studies have shown risperidone to be a potent mixed serotonin-S2 dopamine-D2-like receptor antagonist. While anti-D2 activity may relate to the antipsychotic potency of neuroleptic drugs, an antidepressive efficacy of substances with anti-S2 activity has been suggested. In an open pilot-study, ten patients with schizodepressive disorders or a DSM-III-R diagnosis of psychotic major depressive episodes were treated with risperidone (2-10 mg/d) for six weeks. Weekly psychopathological evaluation was performed, including BPRS, SANS, SAPS, VAS scales, and AIMS and UKU for the assessment of side-effects. Generally, the psychotic syndrome (BPRS, SANS and SAPS) decreased markedly in all patients; seven patients also showed a clinically significant improvement of depressive symptoms (BPRS). Except for two patients who needed biperiden because of extrapyramidal side-effects, the tolerance of risperidone was good. The antipsychotic and antidepressive properties of risperidone shown in our pilot study are promising enough to merit full double-blind controlled trials for further evaluation of its therapeutic value in this broad spectrum of psychiatric disorders.

Adult↗
PubMed1992

[Laryngeal cancer following gunshot injury and paraffin injection].

Subcutaneous and submucosal injections of paraffin were a wide-spread technique in plastic and reconstructive surgery during the early decades of this century. Intralaryngeal injections were applied to patients suffering from paralysis of one vocal cord or a defect resulting from perforating trauma, intending improvement of the voice. This method was widely abandoned within the fifties when severe complications like foreign-body granuloma and carcinoma developed in patients undergoing paraffin injections. The development of cancer after a trauma is a common question in expert reports. We report the case of a patient who developed carcinoma of the vocal cord 49 years after perforation of the larynx by a shot with consecutive injection of paraffin. The relationship between trauma, injections of paraffin and cancer is discussed and consequences on diagnostics and treatment of risk patients are outlined.

Aged↗
PubMed1992

[Perioperative single dose prevention with cephalosporins in the ENT area. A prospective randomized study].

Perioperative systemic antibiotic cover is usually recommended in major head and neck surgery with the aim of preventing postoperative wound infection. The surgeon must administer the drug most suitable for the particular operation and patient at an adequate dosage and over an adequate period. On the other hand, he has an obligation to minimize costs and find ways of avoiding the development of bacterial resistance to the antibiotic. This means that prophylactic antibiotics may not have too broad an antibacterial spectrum and may only be used over the short term. In an attempt to improve antibiotic prophylactic in head and neck surgery, we tested the effectiveness of a perioperative single-dose antibiotic cover with cefuroxim (Zinacef) in patients undergoing parotidectomy, sinus surgery or neck dissection with no transcutaneous exploration of the pharynx. This single-shot prophylaxis was compared with a three-shot, 24-hour regimen using the same antibiotic. The two regimens were equally effective in preventing wound infection and no case of infection was observed among the 106 patients involved. Preoperative concentrations of cefuroxim were measured in serum and tissue, and the large majority of specimens showed effective concentrations against the typical wound infection bacteria. In conclusion, a perioperative single-dose administration of cefuroxim proved to be suitable prophylaxis against postoperative wound infection in head and neck surgery.

Cefuroxime↗
PubMed1992

Schizoaffective disorder and affective disorders with mood-incongruent psychotic features: keep separate or combine? Evidence from a family study.

OBJECTIVE: This study investigated whether the distinction between schizoaffective disorder and affective disorders with mood-incongruent psychotic features as described in DSM-III-R is reflected by aggregation of schizophrenia in the families of probands with the former disorder and aggregation of affective disorders mainly among the relatives of probands with the latter type of disorders. METHOD: The probands were 118 inpatients with definite lifetime diagnoses of DSM-III-R schizoaffective disorder or a major mood disorder with incongruent psychotic features according to structured clinical interviews. Diagnostic information on 475 of the probands' first-degree relatives was gathered through direct interviews (with 80% of the living first-degree relatives) or the family history approach. The rates of affective and psychotic disorders among these relatives were then compared with those among the relatives of a comparison group of 109 interviewed individuals from the general population who were matched on sociodemographic factors to the inpatient probands. RESULTS: With regard to the familial aggregation of schizophrenia, the DSM-III-R distinction emerged as valid. However, the risk of unipolar affective disorders was enhanced in the families of all of the subgroups of patients studied. The unipolar/bipolar distinction in both DSM-III-R diagnostic groups was reflected by distinct patterns of bipolar disorders in the relatives. CONCLUSIONS: The results partly support the DSM-III-R dichotomy of schizoaffective disorder and affective disorders with mood-incongruent psychotic features. Although the differences between these two diagnostic groups were significant, the magnitude of the differences remained relatively modest.

Adult↗
PubMed1992

The Hamilton scales and the Hopkins Symptom Checklist (SCL-90). A cross-national validity study in patients with panic disorders.

The HRSD, HRSA, SCL-90 scales were psychometrically investigated in a cross-national sample of patients with varieties of non-psychotic symptoms of anxiety and depression. Across the cultural backgrounds the scores obtained from the original versions of these scales are not sufficient statistics. However, latent structure analysis has identified homogeneous subscales for depression (the HRSD) and for discomfort (an SCL subscale). High concurrent validity was found between the subscales of depression, anxiety and discomfort. In international research, inhomogeneity among scale items can be confounded with group differences which are usually ascribed to drug differences.

Adult↗
PubMed1992

[Radiation exposure during defecography].

The introduction of a new radiological method requires the assessment of the advantage-risk ratio. On measuring the radiation doses during defecography, skin entrance and gonadal exposure values were found to be lower than during well-known and well-established examinations of the small pelvis, such as colon enema and CT of the lower abdomen. Defecography, as a radiological tool for diagnosing the anorectal function is, therefore, also suitable for young persons.

Defecation↗
PubMed1991

Studies on the lethal effect of ultraviolet light on Trichomonas vaginalis.

Following cultivation in Asami medium, centrifugation and resuspension in saline or in water from a medicinal spring, Trichomonas vaginalis trophozoites were exposed to well-defined doses of ultraviolet (UV) light (254 nm). We used 24- and 48-h-old trichomonads at concentrations of 1 x 10(5) and 5 x 10(4) trophozoites/ml in a total volume of 20 ml for these studies. The apparatus for UV irradiation was especially constructed for batch experiments. After irradiation at doses ranging from 80 to 160 mJ/cm2, the mobility of the parasites was reduced and morphological alterations appeared: rounding of the cells, vacuolization of the cytoplasm and even cytolysis. A dose of 401.7 mJ/cm2 killed 99.8% of the 48-h-old trichomonads when irradiation occurred in saline at a cell density of 1 x 10(5) trichomonads/ml and 98.9% when irradiation was done at a cell density of 5 x 10(4) trichomonads/ml. A dose of 362.1 mJ/cm2 killed only the more sensitive 24-h-old trichomonads. In mineral water, 241 mJ/cm2 was sufficient to kill up to 99.5% of the 48-h-old trichomonads. When 48-h-old trichomonads that had been exposed to a radiation dose of 160-240 mJ/cm2 were subcultured, they lost their ability to propagate. At a dose of 80 mJ/cm2, both the trichomonads that had been harvested during the log phase and the 48-h-old organisms suspended in mineral water lost their ability to propagate on subculture. These results indicate that 24-h-old trichomonads were more sensitive than 48-h-old organisms. Furthermore, the experiments demonstrated that a higher dose of UV radiation must be applied to T. vaginalis trophozoites than to the more sensitive bacterial strain Escherichia coli ATCC 11229 so as to achieve comparable killing results.

Animals↗
PubMed1991

The concept of major depression. I. Descriptive comparison of six competing operational definitions including ICD-10 and DSM-III-R.

All operationalized diagnostic systems contain a diagnostic category, which corresponds to the concept of major depression. Yet, these corresponding definitions are not identical. Up to now, no comprehensive comparisons of the competing diagnoses have been published. We will therefore present a series of studies, describing six different operational definitions of major depression according to their content and construction and empirically comparing them in large inpatient and outpatient samples. This first paper presents a descriptive comparison of the definitions given in the Feighner Diagnostic Criteria, the Research Diagnostic Criteria, the Diagnostic and Statistical Manual of Mental Disorders, third edition and third edition, revised, and in two developmental drafts of the ICD-10 diagnostic criteria for research (draft April 1987-I87; draft April 1989-I89). The descriptive comparison will demonstrate that there are many similarities, especially concerning the symptom-criteria of major depression. Classificatory relevance could only be assumed for those differences found for cut-offs, for time criteria and especially for exclusion criteria. Whether these differences are negligible and whether patients classified by different diagnostic systems are really comparable will be examined in subsequent publications.

Depressive Disorder↗
PubMed1991

The concept of major depression. II. Agreement between six competing operational definitions in 600 psychiatric inpatients.

Six operational definitions of the concept of major depression were submitted to empirical evaluation in 600 psychiatric inpatients. Special attention was given to the comparison of major depression in DSM-III-R and ICD-10. The data base created by a polydiagnostic interview revealed relevant classificatory differences between the six definitions under study. Sources of different diagnostic base rates were: inclusion or omission of anhedonia as an obligatory mood criterion; minimal number of syndrome criteria required for the syndrome diagnosis; different width and reference points of time criteria; exclusion rules for co-existing schizophrenic symptoms and for previous nonaffective and manic episodes. The empirically evaluated overlap between pairs of diagnostic definitions was less than excellent in most of the diagnostic definitions under study; only the DSM-III and DSM-III-R definitions agreed with each other to a highly comparable degree. The relatively good agreement of the 1989 draft definition of ICD-10 for major depression ("mild depression") with the other five operational definitions (kappa = 0.69) led us to expect that this definition should receive sufficient international acceptance.

Depressive Disorder↗
PubMed1991

The concept of major depression. III. Concurrent validity of six competing operational definitions for the clinical ICD-9 diagnosis.

The comparative validity of six operational diagnoses of major depression was evaluated in 600 psychiatric inpatients using the independently assessed clinical ICD-9 diagnoses as a yardstick. Agreement with, and positive predictive value for the ICD-9 categories of pure (endogenous and psychogenic) depression served as validation criteria; sensitivity of major depression diagnoses for detecting ICD-9 bipolar depressions was additionally used for examining the adequacy of width, time and exclusion criteria of the competing operational definitions. Three essential results were found. First, the "old" diagnostic definitions of RDC and FDC are superior to all newer definitions because they define the time criteria and the schizophrenic exclusion criteria more adequately than, for example, both DSM-III and DSM-III-R definition. Secondly, the current ICD-10 definition of 1989 ("mild", "moderate" or "severe" depression) comes closer to the concurrent validity of RDC and FDC than DSM-III, DSM-III-R and the previous ICD-10 definition of 1987. Thirdly, using the criterion of identifying a high proportion of ICD-9 bipolar depressions, all six competing diagnostic systems are too restrictive. Evaluations of predictive and criterion-related validity will be needed to substantiate these findings.

Affective Disorders, Psychotic↗
PubMed1991

Chronology of panic and avoidance, age of onset in panic disorder, and prediction of treatment response. A report from the Cross-National Collaborative Panic Study.

The relevance of the chronology between panic disorder and avoidance behavior and of an early, medium or late onset of panic disorder was tested. Groups from the sample of the cross-national collaborative panic study (CNCPS) were compared for differences in basic characteristics and for the ability to predict treatment response. Patients who developed avoidance behavior before the full syndrome of panic disorder had less often a full agoraphobia but were not different in their response to treatment. Patients with an early onset of panic disorder suffered more often from agoraphobia. The treatment response was similar in the groups with early, medium or late onset of panic disorder. Neither the chronology between panic disorder and avoidance behavior nor the age of onset of panic disorder predicted outcome in short-term treatment with alprazolam or imipramine.

Adult↗
PubMed1991

Subtyping panic disorder by major depression and avoidance behaviour and the response to active treatment.

In order to establish the clinical validity of currently used ways of subtyping panic disorder the predictive power of associated current avoidance behaviour and (secondary) major depression for the response to active treatment (alprazolam, imipramine) was tested. The analysis was based on the data from the Cross-National-Collaborative-Panic-Study. Limited support for validity evidenced by predicting drug response was found for grading panic disorder by the severity of avoidance behaviour; patients with panic attacks and agoraphobia are more responsive to imipramine (compared with alprazolam) when using the reduction of the total number of panic attacks (or of spontaneous panic attacks) as the outcome criterion; patients without any avoidance behaviour did better with alprazolam (compared with imipramine).

Adult↗