PubMed Health⌕ Search

Biomedical subjects

A Pauls

Publications and source records attributed to A Pauls.

18 recordsLinked to original sources
PubMed1996

St John's wort for depression--an overview and meta-analysis of randomised clinical trials.

OBJECTIVE: To investigate if extracts of Hypericum perforatum (St John's wort) are more effective than placebo in the treatment of depression, are as effective as standard antidepressive treatment, and have fewer side effects than standard antidepressant drugs. DESIGN: Systematic review and meta-analysis of trials revealed by searches. TRIALS: 23 randomised trials including a total of 1757 outpatients with mainly mild or moderately severe depressive disorders: 15 (14 testing single preparations and one a combination with other plant extracts) were placebo controlled, and eight (six testing single preparations and two combinations) compared hypericum with another drug treatment. MAIN OUTCOME MEASURES: A pooled estimate of the responder rate ratio (responder rate in treatment group/responder rate in control group), and numbers of patients reporting and dropping out for side effects. RESULTS: Hypericum extracts were significantly superior to placebo (ratio = 2.67; 95% confidence interval 1.78 to 4.01) and similarly effective as standard antidepressants (single preparations 1.10; 0.93 to 1.31, combinations 1.52; 0.78 to 2.94). There were two (0.8%) drop outs for side effects with hypericum and seven (3.0%) with standard antidepressant drugs. Side effects occurred in 50 (19.8%) patients on hypericum and 84 (52.8%) patients on standard antidepressants. CONCLUSION: There is evidence that extracts of hypericum are more effective than placebo for the treatment of mild to moderately severe depressive disorders. Further studies comparing extracts with standard antidepressants in well defined groups of patients and comparing different extracts and doses are needed.

Antidepressive Agents↗
PubMed1991

SIDAM--A structured interview for the diagnosis of dementia of the Alzheimer type, multi-infarct dementia and dementias of other aetiology according to ICD-10 and DSM-III-R.

The SIDAM--a new instrument for the symptomatic diagnosis and measurement of dementia according to DSM-III-R and ICD-10--is described. It comprises a brief structured clinical interview, a range of cognitive tests (e.g. including the Mini-Mental State (Folstein et al. 1975)) which constitute a short neuropsychological battery and a section for clinical judgement and third party information. All items rely on DSM-III-R and ICD-10 algorithms. The SIDAM has a high overall test-retest reliability which equally holds true on the diagnostic, criterion and item level. It is a brief (average of 28 min), practical and easily scored diagnostic instrument, which reliably separates subjects with DSM-III-R and ICD-10 dementia from those without such a disorder. Good congruence was found between SIDAM diagnoses and corresponding ICD-9 expert diagnoses. Furthermore, the SIDAM-Score (SISCO) allows a detailed measurement of even low levels of cognitive impairment and provides quantification of severity grading of cognitive dysfunction.

Aged↗
PubMed1986

Hypercalcemia and elevated serum 1,25-dihydroxyvitamin D3 in a patient with Hodgkin's lymphoma.

A 74-year-old woman was hospitalized because of decreased appetite, fatigue, and weight loss. The laboratory examination revealed hypercalcemia, a slightly increased serum creatinine level, and a markedly elevated serum level of 1,25-dihydroxyvitamin D3. The most important finding the physical examination revealed was enlarged inguinal lymph nodes. A biopsy disclosed lymphocyte-depleted Hodgkin's disease. After steroids, but not after calcitonin, both the elevated calcitriol concentration and serum calcium normalized. In spite of intensive chemotherapy, a further episode with hypercalcemia occurred and increased 1,25-dihydroxyvitamin D3 serum levels were observed. According to the available evidence it seems probable that the humoral hypercalcemia in this patient resulted from production of 1,25-dihydroxyvitamin D3 in the tumor.

Aged↗
PubMed1986

Renal osteodystrophy in asymptomatic hemodialysis patients: evidence of a sex-dependent distribution and predictive value of serum aluminum measurements.

Bone histologies and serum concentrations of calcium, phosphate, alkaline phosphatase, iPTH, 25 OHD, 1,25(OH)2D3, and aluminum were obtained from 113 chronically hemodialyzed patients free of symptoms and signs of renal osteodystrophy. All patients had a pathologic bone histology; in 69.0%, a mixed form with predominant osteitis fibrosa and concomitant osteoidosis. In 30.1%, we found pure hyperosteoidosis, nearly half of these cases showing osseous aluminum deposits. Hyperosteoidosis was much more frequent in women (35.7%) than in men (20.9%), although the prescribed intake of aluminum-containing phosphate binders was the same. It is possible that female hemodialysis patients were more prone to aluminum accumulation or that they had a better compliance in taking the aluminum hydroxide. Serum parameters alone were not very helpful in predicting the underlying bone disease. Mean iPTH concentrations tended to be lower in the patients with hyperosteoidosis than in those with the mixed lesion, but there was wide variation. Serum aluminum was only predictive for aluminum deposits in the bone when concentrations exceeded 100 micrograms/L.

Adult↗
PubMed1986

Effect of long-term administration of 1,25-dihydroxyvitamin D3 and 1 alpha-hydroxyvitamin D3 on the calcium content of the aorta, heart and kidney of normal and uremic rats.

Studies in uremic rats were performed to see whether or not the long-term administration of therapeutical doses of 1,25-Dihydroxyvitamin D3 or 1 alpha-hydroxyvitamin D3 would induce histological changes in the aorta or increase the calcium content of the aorta or the heart. In contrast to observations of others, no effect of both vitamin D sterols could be observed on both investigated tissues. However, the remnant kidneys of the rats treated with both vitamin D compounds showed a significantly increased calcium content. According to these results one cannot exclude that the chronic application of active vitamin D metabolites has induced a calcium deposition in the remnant kidney. This finding deserves special attention, although we found, on the other hand, no evidence that an underlying arterial disease is aggravated by this therapy.

Animals↗
PubMed1986

The occurrence of fever during hemodialysis and hemofiltration. A comparative study.

The occurrence of fever during various blood purification methods was evaluated in a retrospective study. It could be demonstrated, that patients treated chronically by conventional hemodialysis experience six times more febrile episodes than patients on chronic hemofiltration (4.84% versus 0.81%). Since many of the increased temperatures could not be explained by conventional means, it has to be assumed that the treatment itself caused the fever, possibly activating the monocyte hormone interleukin 1. It is of further note that there was no difference in the magnitude of the temperature due to septicaemia or to no obvious cause. This finding necessitates in our opinion an early antibiotic therapy in those cases where fever develops without clear explanation.

Acute Kidney Injury↗
PubMed1985

Effect of an acute protein load on the creatinine clearance in healthy vegetarians.

In normal man an acute protein load increases the glomerular filtration rate (GFR) significantly, which seems to represent a renal functional reserve. Healthy vegetarians are known to have a statistically reduced baseline GFR. We performed three creatinine clearance studies (24-h study design) on each of nine healthy vegetarian subjects. The first clearance was measured as baseline, the second one was done on day 2 after an oral protein load of 100 g vegetarian protein (1.2-2.0 g/kg body wt.), respectively, ingested within half an hour. The third clearance, serving as a control, was done on day 14. All subjects had their normal vegetarian meals during the study. All vegetarians had at all times a normal serum creatinine level. The mean baseline creatinine clearance was 65.4 +/- 33.3 ml/min. 1.73 m2. In five of nine vegetarians we found a significant increase of the creatinine clearance after the protein load of 66.0% (mean) and a decrease to the baseline values, respectively, when the control clearance was measured. The remaining four vegetarians did not increase their creatinine clearance immediately after the protein challenge and their control clearances were found to be significantly reduced (-40.2%) compared to the individual baseline.

Adult↗
PubMed1985

Organ distribution of aluminium in uremic rats: influence of parathyroid hormone and 1,25-dihydroxyvitamin D3.

Investigations were performed in order to see whether or not the application of parathyroid hormone or 1,25-dihydroxyvitamin D3, or both might influence the organ distribution of orally and parentally administered aluminium in control and uremic rats. The data show that 1,25-dihydroxyvitamin D3, affects the organ uptake in a different way than parathyroid hormone. Whereas parathyroid hormone increased the aluminium concentration in the liver, 1,25-dihydroxyvitamin D3 enhanced the aluminium uptake in the heart and the muscle, on the other hand, simultaneous application of 1,25-dihydroxyvitamin D3 and parathyroid hormone decreased the aluminium content of the bone, liver and brain.

Aluminum↗
PubMed1985

Optimum dialysis treatment for patients over 60 years with primary renal disease. Survival data and clinical results from 242 patients treated either by haemodialysis or haemofiltration.

An analysis of the data of 180 haemodialysis patients and 62 haemofiltration patients over 60 years of age when commencing treatment, clearly shows that this age group of patients (when suffering from primary renal disease) has a very good chance of surviving many years when treated with either haemodialysis or haemofiltration. This refers also to patients being older than 75 or 80 years, who have survival rates of 50 per cent after five years and three years respectively. The presented data further indicate that chronic haemofiltration seems to be the superior treatment when compared with acetate haemodialysis for the treatment of elderly renal patients, as the survival rates are at any chosen time interval higher with haemofiltration than with haemodialysis.

Age Factors↗
PubMed1982

Successful hemodialysis for acute renal failure in late pregnancy.

The occurrence of an acute renal failure during pregnancy does not necessarily imply the termination of the gestation. A 21-year-old pregnant woman was successfully dialyzed because of an acute azotemia developing in the 27th week of pregnancy. After repeated hemodialysis treatments the renal function recovered and the patient gave birth to a healthy child at full term. It is suggested that hemodialysis should be performed as often as possible (twice daily) in order to avoid any dramatic changes of the serum chemistry and the fluid content of the body. Furthermore, such a regimen allows the regular intake of calories, which is considered as especially important in such an event.

Acute Kidney Injury↗
PubMedDate not supplied

[Description and validity of Enedam test-retest. A structured interview for the diagnosis of Alzheimer's, multi-infarction dementias and dementias of other etiologies based on the CIE-10 and DSM-III-R].

The SIDAM, a new clinical structured interview for the diagnosis and measure of dementia according to DSM-III-R and ICD-10, is described. This instrument comprises a clinical overview, several cognitive tests, including the Mini-Mental State, and a section for clinical judgement and information coming from others. Every item relies on DSM-11-R and ICD-10 algorithms. The SIDAM has a hight test-retest reliability on the clinical diagnosis and the different diagnostic criteria. It is a brief (28 minutes), practical screening instrument. Good congruence is found between SIDEM, DSM-III-R and ICD-10, and the corresponding ICD-9 expert diagnosis. Furthermore the SIDAM Total Score (SISCO), allows a good measurement of low level of cognitive impairments and provides quantification of severity of cognitive disorders. The SIDAM has been translated and adapted into Spanish.

Aged↗