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Biomedical subjects

B Melisch

Publications and source records attributed to B Melisch.

4 recordsLinked to original sources

[Neuroleptic low-dose long-term strategy and intermittent therapy strategy in chronic schizophrenia--a critical review].

Much effort has been devoted during the past decade in finding new therapeutic approaches to cope with the commonly occurring adverse side effects of long-term neuroleptic maintenance treatment of schizophrenics, such as, in particular, akathisia, parkinsonian symptoms and tardive dyskinesia. Both low-dose maintenance (e.g. long-term treatment at dosages reduced to one-fifth or even less of conventional dosage levels in remitted and stable schizophrenics) and intermittent or-target medication strategies (e.g. discontinuation of neuroleptics in remitted stable chronic schizophrenics, aimed at resuming the medication as soon as prodromal signs of a relapse or actual relapses occur) might eventually imply for many schizophrenics a substantial reduction in total long-term neuroleptic dosages. This may lead to a reduction in the incidence of side effects and to an improvement in social integration. A critical review of the results published so far arrives at the following conclusions: 1. low-dose maintenance therapy is just as effective as a standard dose regimen and even superior to intermittent (target) medication. Especially if the dosage is increased in case of exacerbations; 2. these results are representative for a very small group of patients only, since the study populations were highly selective.

Antipsychotic Agents↗

Colobronchial fistula: a rare complication of Crohn's colitis.

A 29-yr-old white woman presented with chronic pneumonia in the left lower lobe and with left pleural effusion. She was known to have inflammatory bowel disease, but she was asymptomatic under maintenance treatment with 5-ASA. She received numerous antibiotic regimens according to susceptibility testing of microorganisms cultured from sputum and bronchial lavage and on an empiric basis was also given antituberculosis treatment, but there was no clinical improvement or change in the chest radiographic findings. Sputum was repeatedly examined and yielded, among other organisms, Clostridium inocuum, Enterobacter, Klebsiella pneumoniae, Proteus mirabilis, and Staphylococcus aureus. On one microscopic examination of sputum, the presence of feculent material was suspected. A subsequent gastrografin enema revealed a cologastric and colobronchial fistula between the splenic flexture of the colon and the greater curve of the stomach and the bronchial system. Segmental resection of the colon and resection of the lower lobe of the left lung were performed. Histologic findings of the resected colon were consistent with Crohn's disease. After a long period of postoperative recovery, the patient returned to good general health and well-being. To our knowledge, a colobronchial fistula caused by Crohn's colitis has not been previously reported.

Adult↗