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Biomedical subjects

W Maier

Publications and source records attributed to W Maier.

540 records · Page 30Linked to original sources
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The relationship between alcoholism and unipolar depression--a controlled family study.

This family study explores the controversial relationship between unipolar major depression and alcoholism. Thirty-nine families of patients with non-psychotic unipolar depression and alcoholism, 160 families of patients with non-psychotic unipolar depression without alcoholism, and 64 families of patients with alcoholism without psychotic or major affective disorders were compared with 109 families of unscreened probands recruited in the general population. Both disorders were familial. They were transmitted independently in families; a sharing of substantial genetic or of other familial components between the two disorders was unlikely to occur in the sample under study, particularly among male subjects. Comorbidity between the two disorders was more common than expected by chance, but excess comorbidity was preferentially mediated by non-familial factors. Reasons for discrepancies among the conclusions of different family studies on these issues are discussed.

Adolescent↗
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The familial relationship between panic disorder and unipolar depression.

This controlled family study explores (1) whether panic disorder and unipolar depression share familial factors, and (2) whether the co-occurrence of lifetime diagnoses of panic disorder and unipolar depression in individuals defines a distinct diagnostic subtype in terms of familial aggregation. To be most informative, the familial lifetime prevalence rates for panic disorder and unipolar depression have to be determined in a set of four proband groups: 78 patients with unipolar depression and panic disorder. 121 patients with unipolar depression alone (no panic disorder), 81 patients with panic disorder alone (no unipolar depression), and 109 control probands sampled in the general population were compared by lifetime prevalence rates for panic disorder and unipolar depression in their first-degree relatives. Altogether 1046 relatives were interviewed directly; family history information was available on another 346 subjects. Both disorders were aggregating in families. We found modest overlap of familial components; the relative risk of panic disorder only in relatives of patients with unipolar depression only was 2.3, and the relative risk of unipolar depression only in relatives of patients with panic disorder only was 1.8. The comorbid condition did not represent a distinct subtype in terms of familial aggregation. Excess comorbidity was observed in affected relatives independent of the diagnostic status of the index case. Thus, a sharing of familial factors of aetiological relevance between panic disorder and unipolar depression might explain a limited proportion of comorbid cases. However, the major proportion of comorbidity between panic disorder and unipolar depression may still be due to non-familial factors.

Adult↗
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Research diagnosis of current depressive disorder: a comparison of methods using current symptoms and lifetime history.

Data from the WHO international study of Psychological Problems in General Health Care were used to compare two alternative algorithms for diagnosing current major depression using the Composite International Diagnostic Interview: the traditional method based on lifetime diagnosis and an alternative method based on number of current symptoms. Using DSM-IV criteria for current major depression, 6.2% of 5394 primary care patients were diagnosed by both methods, 2.0% by the lifetime-based method only, and 1.9% by the current symptom method only. Measures of severity (current symptoms, lifetime symptoms, disability, and comorbid anxiety) indicated that those diagnosed by only one method were only slightly less ill than those diagnosed by both. While the symptom-based method identifies a slightly more ill group, use of either method alone may exclude many who differ little from those classified as cases.

Adult↗
PubMedDate not supplied

Selection biases during recruitment of patients and relatives for a family study in the elderly.

The aim of the present study was to examine selection effects during recruitment of patients, controls and relatives for a family study in the elderly. The primary sample consisted of 368 in-patients (aged above 60 years) admitted in the years 1992 and 1993. One-hundred and eighty-four subjects (50%) suffering from dementia of Alzheimer type or major depression fulfilled the diagnostic inclusion criteria. Finally, 100 subjects participated in the family study. Demographic data of participants, ineligible subjects, uncooperative candidates, and control subjects from the general population was examined. Demographic parameters, reasons for refusal of personal interviews, and family history information were compared in first-degree relatives of participants and of 40 control subjects. According to demographic data, participants were representative for the whole sample of demented or depressed patients, and were comparable with the control sample. Demographic parameters of relatives were also equivalent in both groups. Rates of psychiatric disorders were equal in interviewed and unavailable relatives of patients (18.0% and 18.8%, respectively). However, interviewed relatives of controls had significantly fewer psychiatric disorders than unavailable relatives (7.8% vs 20%). This selection effect indicates the need for family history information on unavailable relatives in family studies on geriatric patients. Equivalence of demographic data alone was not a sufficient indicator of sample comparability. A second hospitalized comparison group might serve to increase the validity of conclusions resulting from comparative family studies.

Aged↗
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Clinical subtypes in panic disorder: their descriptive and prospective validity.

In a sample of 97 patients with panic attacks, presence of agoraphobia was associated with a more severe syndrome of panic anxiety both at index assessment and during one-year follow-up but was not associated with increased incidence of major depression. Groups with a history of depression--primary or secondary to the onset of panic--did not differ from the group without depression when severity of anxiety was concerned but were more severely impaired and had a higher incidence of further depressive episodes during follow-up. For future classification of panic disorder, subtypes defined according to associated syndromes of agoraphobia or depression are proposed, since these conditions appear constant through follow-up.

Adult↗
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Sources of disagreement between clinical (ICD-9) and operational (RDC, DSM-III) diagnosis of endogenous depression (melancholia).

In a sample of 173 depressed in-patients, the sources of disagreement between the clinical ICD-9 diagnosis of endogenous depression (ED) and the corresponding operational definitions of RDC and DSM-III were analyzed. The RDC definition of ED gave a significantly higher degree of concordance with the ICD-9 diagnosis of ED, than that of DSM-III. This difference was mainly due to the algorithm used in DSM-III. When empirically derived algorithms were applied to the diagnostic criteria of DSM-III and RDC, both criteria lists reached a higher degree of concordance with the ICD-9 diagnosis of ED. When the criteria lists of RDC and DSM-III were supplemented with cross-sectional criteria (psychotic features, incapacitation) and by course-related criteria (recurrence, bipolarity, primary episode, adequate personality, no precipitating stress), this did not result in significant enhancement of the degree of concordance.

Adjustment Disorders↗
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The Hamilton Anxiety Scale: reliability, validity and sensitivity to change in anxiety and depressive disorders.

The Hamilton Anxiety Scale (HAM-A) was tested for reliability and validity in two different samples, one sample (n = 97) defined by anxiety disorders, the other sample (n = 101) defined by depressive disorders. The reliability and the concurrent validity of the HAM-A and its subscales proved to be sufficient. Internal validity tested by latent structure analysis was insufficient. The major problems with the HAM-A are that (1) anxiolytic and antidepressant effects cannot be clearly distinguished; (2) the subscale of somatic anxiety is strongly related to somatic side effects. The applicability of the HAM-A in anxiolytic treatment studies is therefore limited. More specific anxiety scales are needed.

Agoraphobia↗
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Specificity of lactate response in panic disorder, panic with concurrent depression and major depression.

Lactate infusions with 0.5 molar sodium lactate in a dose of 10 ml/kg within 20 min were given to patients with panic disorder (n = 6), panic attacks with concurrent major depression (n = 7) and major depression without panic (n = 5). Lactate-induced anxiety and symptom attacks without panic were seen more often in the groups with panic attacks, but a full-blown panic attack was provoked in only four subjects, all belonging to the groups with a history of panic attacks. The low incidence of lactate-induced panic attacks can be explained by differences in the procedure that aimed at reducing expectancy biases and baseline anxiety.

Adolescent↗
PubMedDate not supplied

Echographic patterns of just evolving acute pancreatitis: an experimental study.

The earliest echographic manifestations of just evolving acute pancreatitis were studied in five dogs. Fifteen minutes after induction of acute pancreatitis, the pancreas was excised. Serial echographic and microscopic cuts were performed in exactly corresponding levels of each pancreas. In all slices containing a pancreatic necrosis of 50% or more, the echographic pattern was abnormal. In extended pancreatic necrosis (i.e., 75-100% necrosis), a characteristic sonographic pattern could be observed, allowing differentiation from interstitial acute pancreatitis and minor necroses.

Acute Disease↗
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Age and cognitive impairment influence the performance of the General Health Questionnaire.

The General Health Questionnaire (GHQ) is a screening instrument designed to detect nonpsychotic psychiatric disorders. Its discriminating ability can be influenced by factors such as the presence of physical illness, comorbidity with other psychiatric disorders, and the presence of cognitive impairment, which are more frequent in the elderly. The present study examines the influence of age and cognitive impairment on the performance of the GHQ-12, and was performed in the course of a family study designed to evaluate the risks for dementia, depression, and geriatric depression in the relatives of elderly subjects with dementia of Alzheimer type or major depression. Four hundred subjects who had completed the GHQ-12 were included. Test performance was evaluated by receiver-operating characteristic (ROC) analysis. Our results indicate that (1) the GHQ-12 is applicable to elderly subjects (>65 years), (2) its performance is comparable in different age groups, (3) the cutoff value for case identification is higher in the elderly (3/4) compared with younger individuals (1/2) and (4) mild cognitive impairment does not influence the good performance of the GHQ-12 in elderly subjects. In conclusion, our study verifies the usefulness of the GHQ-12 as an instrument to identify states of depression; this applies also to subjects with mild intellectual impairment. To optimize the discriminative ability of the questionnaire, we propose the use of different cutoff values for the GHQ-12 score for case identification depending on the age of each individual.

Adult↗
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Working under pressure: the vascular endothelium in arterial hypertension.

The vascular endothelium synthesizes and releases a spectrum of vasoactive substances like nitric oxide (NO) and endothelin (ET). In hypertension, the delicate balance of endothelium-derived factors is disturbed. ET acts as the natural counterpart to endothelium-derived NO, which exerts vasodilating, antithrombotic, and antiproliferative effects, and inhibits leukocyte-adhesion to the vascular wall. Besides its blood pressure rising effect also in man, ET induces vascular and myocardial hypertrophy, which are independent risk factors for cardiovascular morbidity and mortality. The derangement of endothelial function in hypertension is likely to be caused in part by genetic factors, but also due to elevated blood pressure itself. Due to its position between blood pressure and smooth muscle cells responsible for peripheral resistance, the endothelium is thought to be both target and mediator of arterial hypertension. Oxidative stress plays an important role in the pathogenesis of hypertension. Superoxide anions, ie, oxygen radicals produced in part by angiotensin II-activated NAD(P)H oxidase, can scavenge NO to form peroxynitrite, which can nitrosylate membrane proteins and oxidize lipids. Another source of superoxide is cyclooxygenase. Paradoxically, dysfunctional endothelial NO synthase may also be a source of superoxide anions. Surprisingly and in contrast to animal experiments, not all antihypertensive treatments consistently restore endothelium-dependent vasodilation in patients with arterial hypertension. Endothelial dysfunction in hypertension is crucial both for the development of the disease process in the vasculature and an important therapeutic target.

Angiotensin-Converting Enzyme Inhibitors↗
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CYP2D6 polymorphism and tardive dyskinesia in schizophrenic patients.

Antipsychotic drug-induced tardive dyskinesia (TD) is a serious problem during psychopharmacologic treatment of schizophrenic patients. In search of genetic factors contributing to TD, there is a lack of consensus regarding the role of the polymorphic isozyme cytochrome P450 CYP2D6, which is involved in the oxidative metabolism of antipsychotic drugs. In the present case-control study, we tested the putative influence of the CYP2D6 genotype on the development of TD. Out of 157 patients, 109 were retrospectively selected meeting DSM IV criteria for schizophrenia or schizoaffective disorder, and 50 of them persistently presenting with TD. Genotyping detected the functional allele CYP2D6 *1, the known major defective alleles CYP2D6 *3, *4, *5, *6, and gene duplication. According to their number of functional CYP2D6 alleles, subjects were divided into carriers of none, one, or at least two functional CYP2D6 alleles. The proportions of these categories did not differ between patients and an ethnically homogenous control population (n = 195, p = 0.99) or between patients with and without TD (p = 0.818). Schizophrenic patients were carriers of gene duplication more often than healthy probands, without revealing statistical significance (p = 0.10). Out of seven patients with gene duplication, three developed persistent TD. Furthermore, patients with and without TD were comparable according to age, age of onset, gender, and duration of illness, but subjects with TD had taken more lifetime chlorpromazine equivalents (CPZ) than had patients without TD (chi 2-test, Student's t-test). Forward as well as backward logistic regression analyses confirmed that the presence of TD was influenced by lifetime CPZ but not by age, age of onset, gender, duration of illness, or CYP2D6 genotype. In contrast to the relevance of lifetime CPZ, the lifetime dose of antipsychotic drugs known to be metabolized by CYP2D6 did not significantly influence the presence of TD. In conclusion, our results provide no evidence for the contribution of CYP2D6 genotype to the development of TD in schizophrenic patients receiving long-term antipsychotic medication.

Adult↗
PubMedDate not supplied

Alpha-1-antichymotrypsin gene polymorphism and risk for sporadic Alzheimer's disease in a German population.

The A allele of a common A-T polymorphism in the signal peptide of alpha(1)-antichymotrypsin gene (ACT) has been reported to contribute a two- to threefold increased risk to Alzheimer's disease (AD) patients who carry the apolipoprotein E epsilon4 (APOE epsilon4) genotype. Since the ACT expression in AD brains is enhanced in particular in areas that develop amyloid plaques, the ACT polymorphism is considered to be a good candidate gene. We have analyzed this polymorphism in 102 AD patients and 191 matched controls, all originating from Western Germany. No statistically significant differences in allele frequencies and in genotype distribution of ACT could be shown between AD patients and controls. When we analyzed the polymorphism in APOE epsilon4 carriers, no overrepresentation in our AD group could be shown for the ACT*AA genotype carriers. Copyrightz1999S.KargerAG,Basel

Aged↗
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Investigation of complement C4B deficiency in schizophrenia.

Several lines of evidence suggest that autoimmune mechanisms might contribute to the development of schizophrenia. Important factors involved in immune responses in man include the human leukocyte antigens and components of the complement system. In the present study we attempted to confirm a positive association between a homozygous deficiency in complement factor C4B and schizophrenia as previously reported. We also determined parental genotypes in a subset of our schizophrenic patients to test the hypothesis of a genetic mechanism depending on the mother's genotype. C4B deficiency was found in similar frequency among patients (n = 176) and controls (n = 145). There was also no increased frequency of C4B deficiency in the mothers of schizophrenic patients. Our study does not support a widespread or consistent association between a deficiency in complement component C4B and schizophrenia.

Alleles↗
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Concentration of cephalosporins in tissues of the head and neck after parenteral infusion.

Cephalosporins are successfully used in the therapy of acute sinusitis, purulent parotitis, and lymphadenitis. Anti-infectious prophylaxis in major head and neck surgery may be performed with cephalosporins as first choice. For sufficient prophylaxis or therapy, an effective level of the antibiotic drug in the serum and tissue of the target organs is necessary. In a comparative investigation, we measured serum and tissue levels of three regions of the head and neck (parotid glands, paranasal sinuses, soft tissue of the neck) of the second-generation cephalosporins, cefuroxime and cefotiam, after a single parenteral infusion. Both antibiotics reach levels which are effective against bacteria typically causing spontaneous or postoperative infection of head and neck tissue. Effective levels of cefuroxime both at the investigated tissue sites and in serum are greater than those of cefotiam, and cefuroxime is eliminated from serum less rapidly. The pharmacologic data show that both drugs are suitable for therapy and perioperative prophylaxis of purulent head and neck infections, but various data indicate that there is an advantage in favor of cefuroxime.

Adult↗
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Purification and properties of acridone synthase from cell suspension cultures of Ruta graveolens L.

Acridone synthase has been purified from cell suspension cultures of Ruta graveolens using a combination of gel filtration and ion exchange chromatography. The purified enzyme has an apparent molecular weight of 69 kDa on gel filtration and a subunit structure on SDS-PAGE of 40 kDa. The apparent Km-values are 10.64 microM and 32.8 microM for N-methylanthraniloyl-CoA and malonyl-CoA, respectively. Tryptic digestion of the homogeneous acridone synthase was performed. Seven of the peptides were chosen for microsequencing. The homology of the amino acid sequences from this particular polypeptide and corresponding peptides from chalcone synthase 3 from garden pea amounted to 76%.

Acyltransferases↗