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Biomedical subjects

B Hamann

Publications and source records attributed to B Hamann.

At least 19 recordsLinked to original sources

No major effect of orciprenaline and propranolol upon ACTH-induced cortisol secretion.

Preclinical research suggests adrenal beta-adrenergic receptors to be involved in the regulation of steroid synthesis. In a group of healthy male volunteers, we compared ACTH-induced cortisol and dehydroepiandrosterone (DHEA) secretion after pre-treatment with orciprenaline, propranolol or placebo. Neither baseline nor ACTH-induced steroid secretion differed between these conditions. Our data do not support the hypothesis that the adrenal beta-receptor plays a major role in steroid secretion in humans.

Adrenergic beta-Agonists↗

Impaired declarative memory in depressed patients is slow to recover: clinical experience.

INTRODUCTION: The temporal course of recovery of depressed patients' cognitive impairment is not fully understood. METHODS: We used the California Verbal Learning Test (CVLT) to test declarative memory in 24 depressed patients before and after 35 days of antidepressive treatment as well as after long-term follow-up (> 12 months) in order to relate improvement of depression to recovery of cognitive impairment. RESULTS: Patients with complete remission after 35 days had generally been less impaired at baseline. The disturbance of declarative memory in treatment responders as well as in non-responders did not change from baseline to end of treatment (day 35). However, our results revealed normal values in the CVLT sum score as well as in measures of short- and long-delay free-recall measures in both groups after long-term full remission. DISCUSSION: We conclude that clinical response to antidepressive treatment precedes improvement of declarative memory. A low degree of impairment of declarative memory is associated with early complete remission of depression.

Amitriptyline↗

Open-label non-randomized versus double-blind randomized antidepressive treatment: what are the advantages of clinical decision over randomization?

OBJECTIVE: To study, whether and how the results from open and double-blind randomized trials on antidepressants differ. METHODS: Seventy-one patients were included in a study comparing open, non-randomized, standardized treatment with paroxetine (PAROX) and amitriptyline (AMI) after a minimum of six drug-free days (OPEN). A second group of 56 patients received the same treatment under blind-randomized conditions (BLIND-RANDOM). The course of psychopathology as assessed by the Hamilton Depression Rating Scale was compared using repeated measurements ANOVA-(rm). RESULTS: While the rate of adverse events was higher in the BLIND-RANDOM compared to the OPEN condition, completer-analyses revealed no differences in psychopathological outcome. CONCLUSIONS: With similar clinical outcome BLIND-RANDOM trials of antidepressants may expose depressed patients to an increased risk of adverse events, when compared to OPEN conditions. However, the clinical outcome in study completers did not differ between the BLIND-RANDOM and the OPEN condition. Thus, the psychiatrist's choice may have impact on adverse events rather than on clinical outcome of antidepressant treatment.

Adult↗

Increased platelet aggregability in major depression?

There is compelling evidence that depression constitutes an independent risk factor for cardiovascular morbidity and mortality. As exaggerated platelet reactivity is associated with an increased risk of intra-arterial thrombus formation, we studied platelet aggregability in patients with major depression both before and after 5 weeks of anti-depressant therapy as well as in healthy control subjects. Twenty-two depressed patients and 24 healthy control subjects participated in the study. Washed and rediluted platelets were stimulated with the agonists collagen and thrombin in three concentration steps. Depression was associated with a higher aggregability after stimulation with thrombin in the intermediate concentration and with collagen at the low concentration, with ceiling effects for the other concentrations. After 5 weeks of anti-depressant therapy, aggregability was somewhat less exaggerated, although this effect did not reach statistical significance. We thus conclude that major depression is associated with increased platelet aggregability, which seems to persist even under a marked improvement in depressive symptomatology. This effect may contribute to the increased cardiovascular morbidity in depressed patients.

Adult↗

[Sleep-related respiratory disorders and coronary heart disease].

A review of the literature shows that more than 50% of examined patients suffering from coronary heart disease were also suffering from sleep-related apnea. We were able to diagnose a pathological sleep apnea in 9 out of 25 patients (36%) suffering from an angiographically confirmed coronary 2-vessel and 3-vessel disorder. Patients with this combination--this is the hypothesis derived from our study--are at risk due to nocturnal apnea-induced myocardial ischaemia and rhythmic disorders. In 15 patients with sleep apnea and coronary heart disease or small vessel disease, nocturnal polysomnography was conducted, in parallel a 6-channel ECG was recorded. The apnea index (second night) was on the average 33 phases/h, the maximal duration of an apnea phases being 120 seconds. The minimal blood gas saturation recorded during sleep was between 46 and 89% (median 76.0%). In 4 of the 15 patients it was possible to confirm myocardial ischaemia (correlated via REM and also via NREM) with a maximum duration of 60 seconds, mainly during the phases of maximal apnea activity and blood gas desaturation. On comparing the ventricular arrhythmias waking/sleep, the Lown class did not change in 12 patients; there was deterioration in 2 patients and in one patient a qualitative improvement during the sleep phase. Patients suffering from sleep-related respiratory disorders and coronary heart disease are at cardiac risk, the more so since long-lasting apneas can lead to conditions of hypoxia at the heart in pre-existing changes in the coronary arteries, restricted coronary reserves and reduced tolerance to hypoxia. Such hypoxia can in turn induce enhanced electrical instability and a disturbance of the contractile function.

Arrhythmias, Cardiac↗

[Changes in the vaginal flora caused by supporting pessary treatment in pregnancy].

200 pregnant women with supporting pessary treatment because of cervical insufficiency were compared with one of normal pregnancies concerning microbiological findings and puerperal morbidity. -- 5,5% of the women in the supporting pessary group had pathogenic organisms in their cervix before first amnioscopy, compared to 2% in the control group. The different results of cultural microbiologic examinations in both groups depend on type and duration of birth as well as time of amnion rupture. Women with premature rupture of the membranes (31,0%) had more pathogenic organisms than women with rupture (2,5%) in time. There was no higher infection morbidity compared to the control group.

Female↗

[A cubical support pessary within the scope of complex therapy of threatening prematurity].

Report about experience with a cubic supperting pessary for the prophylaxis and therapy in cervixinsufficiency or inpending premature delivery. The indication, selection, evaluation of riscfactors and the application of a complex therapy are discussed.--Information on therapeutic results and a first conclusion concerning the longtime incorporation of pessaries during pregnancy and the questions related to this. For the period under review, in which intensive prophylactic measures were carried out, a considerable decrease in premature deliveries could be achieved in the territory of pregnancy care center attached to our hospital.

Abortion, Threatened↗

[Clinical experiences with percutaneous digitoxin therapy in pregnant women with varicose veins].

It is reported on the clinical recommendations in a cutaneous treatment with "Digitoxinpasta" in varicose veins of pregnant women. The patients' arrangement in groups and the valuation of the result of the treatment was done after clinical aspects. The rate of failures (12%) ranges in tolerable limits. Neither a "Digitoxinbradycardy" or signs of overdosage were found in the electrocardiogram.

Administration, Topical↗

[A gradual method for a more physiological hormonal contraception].

The multiple physiologie stages of method by oral hormonal anticonception was reported, which have been in use in combination. Since 1969 about 362 women at the average age of 27,5 years received 10281 cycles, that means in an average cycles from 28,4 days, the stage method from 11/10 days or 7-7-7 days rhythmus.

Adult↗

[Results of preventive mycological examination in pregnant women].

From accidential patients fifteen per cent of 2328 pregnant women showed in a cultural method (malt-extract-agar) a vaginal mycosis in the seventh month of pregnancy. In most of the cases it was Candida albicans, but there were also other cases of Candida and Toruplopsis glabrata. The therapy of vaginal mycosis during pregnancy should be done generally, to prevent infections of infants and infections is gynecological and neonatological departments.

Antifungal Agents↗

[1st results with a new suction curettage system].

The point is a self-developed Suction-curette-system, consisting of a suction-curette of diametres of 3, 4, 5, 6, 7 und 8 mm, a cervicometer and a filter. Effectivity and histological evidence of 1. Suction-curettage after hysterectomy 2. Suction-curettage before hysterectomy in full-narcosis 3. Suction-curettage without full-narcosis were examined. Advantages of this method are discussed.

Adult↗