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Biomedical subjects

W Poser

Publications and source records attributed to W Poser.

At least 37 records · Page 2Linked to original sources

Prognostic indicators in multiple sclerosis.

The influence of sex, age at onset, course of the disease and initial symptomatology on the mortality of patients with multiple sclerosis is analysed. A sample of 1926 patients was followed up prospectively over 4.9 years. Both, the mortality ratio (number of observed to expected deaths) and the excess death rate are calculated. Whereas the mortality ratio as a parameter of overall mortality is influenced by a variety of factors, such as age and sex; the excess death rate represents the number of extra deaths per 1000 exposed to risk in an indicated year and is, therefore, a parameter of the mortality which is attributed to MS. The excess death rate was comparable for the sexes, it was slightly higher for patients with a higher age at onset and it was clearly higher for the progressive course. Patients with initial diplopia and sensory signs and symptoms had the lowest excess death rate, whereas patients with pareses, cerebral and sphincter disturbances at onset showed the highest excess death rate.

Adult↗

Mortality of patients dependent on benzodiazepines.

For patients dependent on benzodiazepines alone, or in combination with alcohol and/or other legal and illegal drugs, observed mortality rates were compared with the average population, and, in cases of isolated benzodiazepine dependence, also with a control group of non-dependent patients chosen to match each dependent not only in sex and date of birth, but also in pre-existing psychiatric illness besides dependence. For patients with an isolated benzodiazepine dependence, the mortality rate was increased, when compared with the average population, by a ratio of observed to expected numbers of deaths of about 3. However, this mortality rate did not differ from that of the control group (non-dependent patients with comparable psychiatric illnesses). For patients combining benzodiazepines with alcohol among other addictive drugs, and for patients combining benzodiazepines with illegal drugs among other addictive substances, the ratio of observed to excepted numbers of deaths was 6.2 resp. 21, thus corresponding well with other studies on mortality rates associated with alcoholism and dependence on illegal drugs. We conclude that our study does not give evidence of higher risk of early death correlated with dependence on benzodiazepines alone. However, it confirms the well-known fact of increased mortality rates in patients with psychiatric illnesses, especially with dependence on alcohol or illegal drugs.

Adult↗

Chronic enteral poisoning caused by potassium permanganate: a case report.

To our knowledge, this is the first case report of a multiple, low dosage ingestion of manganese. A 66-year-old male patient is presented, who ingested 125 ml of a 8% solution of potassium permanganate (10 g) within 4 weeks. As early as 2 weeks after the beginning of poisoning, psychological alterations were noted. Neurological examination revealed disturbances of many subsystems of the CNS. Visually evoked potentials showed prolongation of the P2-latency, not reported in earlier publications. Levels for manganese were elevated in peripheral blood as well as in hair samples. Treatment with calcium trisodium pentetate decreased serum levels and increased urine excretion of manganese. Nine months after poisoning, the first signs of progressive Parkinson disease became evident. The time-course of neurological symptoms seems to depend on a critical dose of manganese.

Aged↗

Adverse drug reactions. An epidemiological study at psychiatric hospitals.

A drug monitoring system has been established at psychiatric university hospitals in Berlin, Goettingen, and Munich since 1979 in order to investigate adverse reactions to psychotropic drugs. This report describes the system and presents results obtained over 3 years. 504 randomly selected patients were observed by Intensive Drug Monitoring; 75% of them had an adverse drug reaction (ADR) during hospitalization that was assessed as possible, probable, or definite including all grades (I-III) of severity. 5,096 other patients were monitored by Organized Spontaneous Reporting during treatment with psychotropic drugs: ADRs were responsible for drug withdrawal (severity grade III) in about 10% of them. Parkinsonism, psychomotor disturbance, akathisia, delirium, oversedation and increased transaminases were the most frequent ADRs of this kind. The relative frequency of ADRs was calculated, and ADR-profiles established for drugs most frequently withdrawn. The impact of ADRs on ongoing therapy of patients was assessed. Reliable data obtained by drug monitoring systems can be expected to aid in therapeutic decisions in patients with special risks of side effects to psychotropic drugs.

Adult↗

Multiple sclerosis and gestation.

The gestational history of 512 women with multiple sclerosis revealed that the risk of MS-onset, exacerbation, or progression was two to three times as high during the 6 months after childbirth as during pregnancy. Using a progression-index as a measure of prognosis (disability divided by duration), the speed of deterioration was comparable for women who became pregnant and those who did not. An apparent but insignificant trend toward better prognosis for women with pregnancies after MS-onset was most likely due to their younger age at onset. The natural course of pregnancy and childbirth was comparable among women pregnant before and during the disease. There was no evidence of an increased frequency of congenital malformations in the offsprings.

Adult↗

Prognosis of multiple sclerosis. Results from an epidemiological area in Germany.

Clinical data and the prognosis are presented for an epidemiological group of multiple sclerosis (MS) patients. Symptoms and signs of MS, with the exception of optic nerve involvement, were less frequent in the group of 221 patients from the epidemiological area of Southern Lower Saxony than in the hospital series (n = 1837), although the mean duration of the disease was somewhat longer in the epidemiological group. Fifty-two percent of the latter were unrestricted or minimally restricted upon examination compared to 26% of the hospital group. Taking a progression index as a measure for prognosis (disability grade divided by the duration of the disease) 36% of the epidemiological group belonged to a benign category compared to 16% in the hospital group. The progress of these patients was not more than 1 grade of disability within a 5-year-period (progression index 0.2 or less). A malignant course was defined as a progression of at least 7 grades during a 5-year period (progression index 1.4 or more). Ten percent of the hospital series belonged to this category compared to 2% of the epidemiological group. Thus data from a representative group of patients show that the overall prognosis of MS is considerably better than generally suspected.

Adult↗

[Endocrinological findings in patients with multiple sclerosis (author's transl)].

In 15 patients with multiple sclerosis about half of the patients showed decreased gonadotropin and estrogen values in the urine. A control examination of these findings in 19 additional patients showed normal plasma FSH and LH values. Except for one slightly elevated value the prolactin levels were normal in this group.

17-Ketosteroids↗