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At least 1,657 records · Page 92Linked to original sources
PubMed2004

[Treatment of patients with personality disorders in specialized units for psychotherapy in Bavarian psychiatric hospitals].

UNLABELLED: Data about patients with personality disorders treated in specialized psychotherapy units in bavarian psychiatric hospitals during the second half-year 2001 (n = 256) were collected by a questionnaire. Diagnostic, therapeutic and social characteristics were registered. Treatment possibilities of the psychotherapeutic units und special qualifications of the staff were investigated as well. - RESULTS: The investigated population of personality disorders is mentally seriously handicapped has high rates of suicide-attempts and co-morbidity with other mental disorders. The units for psychotherapy offer a wide range of different psychotherapeutic treatments. The staff is well trained in psychotherapeutic qualifications. These results show, that bavarian psychiatric hospitals play an important role in psychotherapeutic treatment of severely ill in-patients.

Combined Modality Therapy↗
PubMed2006

[Travel medicine and vaccination as a task of infection prevention--data of the special consultation hours of the public health department Frankfurt on the Main, Germany, 2002-2004].

UNLABELLED: Infection prevention is one of the main tasks of the Public Health authorities. Because of hundreds of travel associated infections imported by travellers every year and considering increasing travel activities to tropical countries, travel medicine and consultation on the correct prevention measures including vaccination is becoming more and more important. Hence the data of the special consultation hours of the public health department of Frankfurt am Main are reported and discussed with regard to possible improvements. MATERIAL AND METHODS: The public health department of Frankfurt am Main has been offering special consultation hours for travel medicine for many years. Here, data derived from the anamneses of the clients from 2002 - 2004 are reported: personal data such as age, sex, travel destination as well as medical data such as vaccination and malaria prevention. RESULTS: 2002 - 2004, more than 14,000 persons were seen in the consultation hours, more than 66% of them asked for travel health advice, about 25% of them asked for standard vaccination (such as influenza), some others asked for attestation or certification. More than 20,000 doses of vaccines were given, the most important vaccination against hepatitis A (n = 5791), hepatitis B (n = 4064), typhoid fever (n = 2718) and yellow fever (n = 2473). 2814 were informed with regard to malaria prevention, including recipes. 7814 persons with complete data on their reason for travel were subjected to more detailed analysis: 75% of them were holiday tourists, 18% travelled as "hikers", 7% were business travellers and less than 1% of them planned a round-the-world tour. The most frequent travel destinations were: Asian or African countries about 33% each, 25% Middle or South America. Thailand, South Africa with Namibia, Brazil and India were the most important countries. The time from health consultation to the beginning of the journey was too short for full vaccine protection against typhoid fever and meningococcal disease in 10% and against rabies in 44% of the consultants. There were no significant differences between holiday tourists, business and "hikers" travellers. CONCLUSION: According to many studies, only one-third of the travellers going abroad, especially to developing countries, obtain travel health information. Hence, the clients of our consultation hours are a positive selection. Nevertheless, great need for improvement could be seen as well. In many of the clients the time from getting health information and vaccination was too short for obtaining complete vaccination protection. People travelling to countries where most hepatitis A infections are obtained and re-imported home, such as Turkey and Tunisia and other Mediterranean countries almost never came for health advice and vaccination. Therefore, public health authorities should improve and increase their publicity campaigns for travel health and vaccination in order to prevent travel-associated infections and re-importation of such diseases.

Communicable Disease Control↗
PubMed2006

[Implementation of perinatal regionalization: frequency of high-risk deliveries outside of specialized perinatal care centres].

BACKGROUND: The concentration of high-risk deliveries in specialized perinatal care centres contributes to the reduction of infant mortality and morbidity. This study investigates the frequency of high-risk deliveries in hospitals with inadequate level of perinatal care. METHODS: From the files of a German statutory health insurance we draw a random sample of 3.967 women who gave birth april to june 2002. The women received a questionnaire and were asked to send in their "maternity logbook", a document that every pregnant woman receives and where prenatal visits and births are documented by the obstetricians in standardized form. From the 1,593 responders (response rate 40.2 %) we selected 559 high-risk cases. 83 of these (14.8 %) delivered at a specialized perinatal care centre. The remaining 476 deliveries were subjected to an individual analysis of their data. Based on published guidelines for antenatal transport and on data about the perinatal care facilities of German hospitals the adequacy of the delivery hospital was rated for each case. RESULTS: 2.4 % of the whole sample (38/1,503) were classified as "inadequate hospital of delivery". 17 of these 38 cases were considered as potentially avoidable because significant antepartal risk factors were documented. 5 (25 %) of the 20 highest risk cases (twins < 36 weeks of gestational age, singletons < 32 weeks, infants < 1.500 g) were classified as avoidable referrals to inadequate hospitals. CONCLUSIONS: Regionalization of perinatal care must be enhanced by adequate appreciation of antenatal risk factors and counselling of pregnant women on the choice of place of delivery.

Adolescent↗
PubMed1997

[Special technics for angioplasty of the brachiocephalic vessels].

PURPOSE: Description of special techniques for retrograde angioplasty of cerebral arteries with protection of the brain. MATERIAL AND METHOD: During the last 3 years, 51 dilatations of cerebral vessels were carried out in 45 patients; in 8, special techniques were required. In cases with particular operative risks, angioplasty of cerebral vessels can be performed using various techniques (double catheter [8 cases], retrograde PTA [8 cases], kissing balloon technique [3 cases]). RESULTS: All stenoses were successfully dilated, using a local anaesthetic. One patient with a double stenosis of the common carotid artery developed severe headache and visual disturbances in the ipsilateral eye following dilatation of a tight stenosis with total remission of all symptoms within 24 hours. CONCLUSION: Stenoses of cerebral arteries where surgery would be difficult and associated with a high risk can be dilated by retrograde PTA using a double catheter technique with a low complication rate.

Aged↗
PubMed1994

[In vitro fertilization in male subfertility--micromanipulation and special techniques for semen preparation].

Poor semen quality is increasingly the reason for human infertility. For couples who cannot be helped by conventional in vitro fertilization (IVF) treatment, micromanipulation methods and special sperm preparation techniques in in vitro fertilization hold considerable promise to enhance fertilization of the egg. "Partial zona dissection" (PZD n = 59) or "subzonal insemination" (SUZI n = 36) were performed in 88 IVF cycles obtaining a fertilization rate between 12.2% and 34.8% depending on the micromanipulation technique applied and a pregnancy rate of 19.2% per embryo transfer. So far ten ongoing pregnancies have occurred and five healthy children have been born. In certain cases of male factor infertility micromanipulation and special sperm preparation techniques therefore represent the only possibility of conceiving.

Adult↗
PubMed1995

[Special suction tube holder for a laser handpiece in effective smoke suction evacuation. On the problem of smoke suction in external CO2 laser therapy].

Treatment with a CO2 laser causes high smoke production, which leads to reduced view to the surgical field, to bad smell and has potential health hazards. Hitherto the problem of the external smoke evacuation had not been solved sufficiently. Therefore a special sucking-tube holder for a laser handpiece is presented. The end of the sucking tube exactly follows all movements of the handpiece and can be positioned close to the source of smoke. Through a defined angle the smoke can be removed quickly out of the way of the laser beam. According to the practical experiences so far, this special equipment on a laser handpiece guarantees an effective evacuation of smoke, allows the reduction of assisting staff, reduces irritation through bad smell and additionally minimizes the potential risks of smoke caused by an external CO2 laser application.

Condylomata Acuminata↗
PubMed1996

Proof of efficacy of the ginkgo biloba special extract EGb 761 in outpatients suffering from mild to moderate primary degenerative dementia of the Alzheimer type or multi-infarct dementia.

The efficacy of the ginkgo biloba special extract EGb 761 in outpatients with presenile and senile primary degenerative dementia of the Alzheimer type (DAT) and multi-infarct dementia (MID) according to DSM-III-R was investigated in a prospective, randomized, double-blind, placebo-controlled, multi-center study. After a 4-week run-in period, 216 patients were included in the randomized 24-week treatment period. These received either a daily oral dose of 240 mg EGb 761 or placebo. In accordance with the recommended multi-dimensional evaluation approach, three primary variables were chosen: the Clinical Global Impressions (CGI Item 2) for psychopathological assessment, the Syndrom-Kurztest (SKT) for the assessment of the patient's attention and memory, and the Nürnberger Alters-Beobachtungsskala (NAB) for behavioral assessment of activities of daily life. Clinical efficacy was assessed by means of a responder analysis, with therapy response being defined as response in at least two of the three primary variables. The data from the 156 patients who completed the study in accordance with the study protocol were taken into account in the confirmatory analysis of valid cases. The frequency of therapy responders in the two treatment groups differed significantly in favor of EGb 761, with p < 0.005 in Fisher's Exact Test. The intent-to-treat analysis of 205 patients led to similar efficacy results. Thus, the clinical efficacy of the ginkgo biloba special extract EGb 761 in dementia of the Alzheimer type and multi-infarct dementia was confirmed. The investigational drug was found to be well tolerated.

Aged↗
PubMed1994

[The morphology of endonasal cavernous tissue with special reference to muscular cushion formation. A light and transmission electron microscopy study].

Nasal "cavernous" tissue is widely accepted as a key structure for the tumefactive mechanism inside the nose; still there is no common understanding of the structural composition of this special tissue. In the present paper the authors demonstrate the results of their histological and transmission electronmicroscopic findings in human nasal "cavernous" tissue, especially referring to the structural and ultra-structural pattern of the so-called muscular pads or "cushion". Serial sections revealed that these structures occur at the transition of communicating vessels; their muscular coat shows a different and irregular pattern, compared to the vascular wall structure of other parts of nasal "cavernous" tissue. Ultrastructural examination confirmed the impression of a variable and complex orientation of smooth muscle cells within the muscular "cushions". The cytoplasmic components, however, were the same as in other smooth muscle cells of nasal "cavernous" tissue. Localisation and structure of muscular "cushions" imply their functional significance for tumescence of the nasal mucosa in a variety of rhinological disorders. Therefore, the authors suggest to include these special features in therapeutic considerations on the treatment of congested nose. Evaluation of the neurovegetative regulation of this tissue could be a step in the right direction.

Humans↗
PubMed1993

[Reliability of diagnostic procedures in facial paralysis with special reference to magnetic resonance tomography].

Facial nerve palsy is commonly examined using a variety of topodiagnostic and electrophysiological tests. More recently, MRI has also been used to study lesions of the facial nerve. Due to varying time intervals between the onset of symptoms and clinical examination, however, the diagnostic value of these procedures remains limited. In the present study, 30 patients with facial nerve palsy of diverse origin were examined with MRI (1.5 Tesla magnetom) using a special surface coil and 30 degrees parasagittal slices of 3 mm thickness. These special modifications enabled us to visualize the nerve in its entire course through the temporal bone. After the application of Gd-DTPA the enhancement of the contrast medium could be verified in all cases. A moderate enhancement in the geniculate ganglion as well as in the labyrinthine segment correlated with a good prognosis in terms of complete restoration of facial nerve activity, while an increased enhancement correlated with a poor prognosis. Our results indicate that MRI is of superior diagnostic value as compared to clinical and electrodiagnostic tests, at least in the patients we examined in this study. Still, further evaluations are necessary to justify a possible routine clinical use of this procedure.

Blood-Brain Barrier↗
PubMed1989

[Introduction of an aspiration-irrigation-reflow system with a special handle for extracapsular cataract operation].

A new irrigation/aspiration system consisting of an electromechanical switch and a special handle is described. The switch mechanisms acts on a tube system connected to the handle, enabling the anterior chamber to be refilled immediately via the aspiration opening, so that collapse is impossible. A further advantage is that fluid exchange is minimized, because aspiration only occurs when the pedal switch is operated. When the pedal is released the fluid is spontaneously flushed back via the aspiration opening. This results in a significant reduction in capsular and iris complications. Thanks to the special handle the fluid flushed back is practically free of lens particles.

Cataract Extraction↗
PubMed1996

Specialized studies in pediatric dysphagia.

The evaluation and management of the pediatric patient with a feeding and swallowing disorder may require the use of specialized studies to evaluate specific aspects of swallowing function; to judge the consequences of the swallowing dysfunction; and to assess factors that may be contributing to swallowing dysfunction. Instrumental assessment of swallowing function may include upper gastrointestinal studies, videofluoroscopy or videofluoroscopic swallow studies, ultrasonography, radionuclide imaging, fiberoptic endoscopy of swallowing, and cervical auscultation. Procedures that assess the consequences and/or identify factors contributing to swallowing dysfunction may include pulse oximetry, chest x-rays, laryngoscopy and/or bronchoscopy, and pulmonary function tests. The use of such specialized procedures to evaluate children with dysphagia is the focus of this article.

Deglutition Disorders↗
PubMed2001

Enhanced magnification endoscopy: a new technique to identify specialized intestinal metaplasia in Barrett's esophagus.

BACKGROUND: Specialized intestinal metaplasia (SIM) in Barrett's esophagus (BE) is not identifiable by standard endoscopy. Acetic acid instillation enhances the ability to detect columnar epithelium at the squamocolumnar union. Enhanced magnification endoscopy involves the combined use of magnification endoscopy with acetic acid. This study assessed the value of enhanced magnification endoscopy in detecting SIM in patients with BE. METHODS: Patients undergoing endoscopic surveillance because of short segment BE without dysplasia underwent enhanced magnification endoscopy with 1.5% acetic acid instillation. Standard endoscopy was followed by magnification endoscopy and repeated after acetic acid spraying. Surface patterns were characterized prior to and after acetic acid spraying. The observed surface patterns were compared with histology results. RESULTS: Forty-nine patients, 9 women and 39 men, with a mean age of 50.5 years were studied. One was excluded because of unclear definition of the surface pattern. Enhanced magnification endoscopy detected 4 different mucosal surface patterns: I, round pits; II, reticular; III, villous; and IV, ridged. A total of 129 areas were examined. Standard endoscopy identified an endoscopic pattern in 1.5% of the areas, standard endoscopy and acetic acid in 8.5%, magnification endoscopy alone in 38%, and enhanced magnification endoscopy in all 129 endoscopic areas. The yields for detecting SIM according to endoscopic patterns were as follows: pattern I, 0%; II, 11% (odds ratio 0.5, p = 0.54); III, 87% (odds ratio 36, p = 0.001); and IV, 100% (odds ratio 14, p = 0.015). CONCLUSIONS: Enhanced magnification endoscopy is an accurate method of predicting SIM in BE. The simplicity of the technique and its ability to identify characteristic endoscopic patterns with outstanding clarity and resolution that correlate with histologic identification of specialized intestinal metaplasia make enhanced magnification endoscopy an excellent method for the evaluation of patients with BE.

Acetic Acid↗
PubMed2003

Can minilaparotomy abdominal aortic aneurysm repair be performed safely and effectively without special skills?

BACKGROUND: The purpose of this study was to determine whether a surgeon without special skills can perform minimal incision abdominal aortic aneurysm repair as safely and effectively as traditional retroperitoneal aneurysmectomy. METHODS: After informed consent, eligible patients were randomized into minilaparotomy and retroperitoneal groups. The minilaparotomy repair consisted of a short transabdominal midline incision, intraabdominal retraction of the bowel, control of back bleeding with balloon catheters, and hand-sewn anastomoses. The retroperitoneal approach was performed through a left vertical-lateral abdominal incision. RESULTS: Twenty-six patients were randomly treated by minilaparotomy approach (n = 14) or retroperitoneal approach (n = 12) from December, 1999, to May 2001. Parameters for speed of recovery were indistinguishable and of no clinical significance. In the long-term follow-up (mean period, 27 months), no patients in the minilaparatomy group complained of discomfort from the incision, whereas 4 patients in the retroperitoneal group complained of discomfort (P < 0.05). CONCLUSIONS: Minilaparotomy approach can be performed safely and effectively without specialized skill. With regard to wound discomfort, the minilaparotomy technique is excellent. The minilaparotomy approach is therefore a useful alternative to traditional repair.

Aged↗
PubMed2004

Reorganization of the auditory cortex specialized for echo-delay processing in the mustached bat.

Focal excess sensory stimulation evokes reorganization of a sensory system. It is usually an expansion of the neural representation of that stimulus resulting from the shifts of the tuning curves (receptive fields) of neurons toward those of the stimulated neurons. The auditory cortex of the mustached bat has an area that is highly specialized for the processing of target-distance information carried by echo delays. In this area, however, reorganization is due to shifts of the delay-tuning curves of neurons away from those of the stimulated cortical neurons. Elimination of inhibition in the target-distance processing area in the auditory cortex by a drug reverses the direction of the shifts in neural tuning curves. Therefore, such unique reorganization in the time domain is due to strong lateral inhibition in the highly specialized area of the auditory cortex.

Acoustic Stimulation↗
PubMed2004

Aging reduces neural specialization in ventral visual cortex.

The present study investigated whether neural structures become less functionally differentiated and specialized with age. We studied ventral visual cortex, an area of the brain that responds selectively to visual categories (faces, places, and words) in young adults, and that shows little atrophy with age. Functional MRI was used to estimate neural activity in this cortical area, while young and old adults viewed faces, houses, pseudowords, and chairs. The results demonstrated significantly less neural specialization for these stimulus categories in older adults across a range of analyses.

Adult↗
PubMed2001

Plasticity of the cochleotopic (frequency) map in specialized and nonspecialized auditory cortices.

Auditory conditioning (associative learning) causes reorganization of the cochleotopic (frequency) maps of the primary auditory cortex (AI) and the inferior colliculus. Focal electric stimulation of the AI also evokes basically the same cortical and collicular reorganization as that caused by conditioning. Therefore, part of the neural mechanism for the plasticity of the central auditory system caused by conditioning can be explored by focal electric stimulation of the AI. The reorganization is due to shifts in best frequencies (BFs) together with shifts in frequency-tuning curves of single neurons. In the AI of the Mongolian gerbil (Meriones unguiculatus) and the posterior division of the AI of the mustached bat (Pteronotus parnellii), focal electric stimulation evokes BF shifts of cortical auditory neurons located within a 0.7-mm distance along the frequency axis. The amount and direction of BF shift differ depending on the relationship in BF between stimulated and recorded neurons, and between the gerbil and mustached bat. Comparison in BF shift between different mammalian species and between different cortical areas of a single species indicates that BF shift toward the BF of electrically stimulated cortical neurons (centripetal BF shift) is common in the AI, whereas BF shift away from the BF of electrically stimulated cortical neurons (centrifugal BF shift) is special. Therefore, we propose a hypothesis that reorganization, and accordingly organization, of cortical auditory areas caused by associative learning can be quite different between specialized and nonspecialized (ordinary) areas of the auditory cortex.

Animals↗
PubMed2001

Molecular organization of the postsynaptic specialization.

A specific set of molecules including glutamate receptors is targeted to the postsynaptic specialization of excitatory synapses in the brain, gathering in a structure known as the postsynaptic density (PSD). Synaptic targeting of glutamate receptors depends on interactions between the C-terminal tails of receptor subunits and specific PDZ domain-containing scaffold proteins in the PSD. These scaffold proteins assemble a specialized protein complex around each class of glutamate receptor that functions in signal transduction, cytoskeletal anchoring, and trafficking of the receptors. Among the glutamate receptor subtypes, the N-methyl-d-aspartate receptor is relatively stably integrated in the PSD, whereas the alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor moves in and out of the postsynaptic membrane in highly dynamic fashion. The distinctive cell biological behaviors of N-methyl-d-aspartate and alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors can be explained by their differential interactions with cytoplasmic proteins.

Animals↗
PubMed2000

Plasmid-encoded MucB protein is a DNA polymerase (pol RI) specialized for lesion bypass in the presence of MucA', RecA, and SSB.

Replication through damaged sites in DNA requires in Escherichia coli the SOS stress-inducible DNA polymerase V (UmuC), which is specialized for lesion bypass. Homologs of the umuC gene were found on native conjugative plasmids, which often carry multiple antibiotic-resistant genes. MucB is a UmuC homolog present on plasmid R46, and its variant plasmid pKM101 has been introduced into Salmonella strains for use in the Ames test for mutagens. Using a translesion replication assay based on a gapped plasmid carrying a site-specific synthetic abasic site in the single-stranded DNA region, we show that MucB is a DNA polymerase, termed pol RI, which is specialized for lesion bypass. The activity of pol RI requires the plasmid-encoded MucA' protein and the E. coli RecA and single-strand DNA binding proteins. Elimination of any of the proteins from the reaction abolished lesion bypass and polymerase activity. The unprocessed MucA could not substitute for MucA' in the bypass reaction. The presence of a lesion bypass DNA polymerase on a native conjugative plasmid, which has a broad host range specificity and carries multiple antibiotic-resistant genes, raises the possibility that mutagenesis caused by pol RI plays a role in the spreading of antibiotic resistance among bacterial pathogens.

Bacterial Proteins↗