Biomedical subjects

C Dickmann

Publications and source records attributed to C Dickmann.

5 recordsLinked to original sources

PubMed2002

[Injuries of the alar ligaments in children and adolescents].

Cervical spine trauma most commonly involves the lower parts in adults. In children lesions of the cervical spine can predominantly be found in the region of C1/C2 including ligament injuries at this level. However such injuries are difficult to detect and only few data are available concerning therapy and prognosis of atlantoxial ligament lesions. We report on two children suffering from isolated rupture of the alar ligaments. Both injuries were proven by magnetic resonance imaging which is recommended as the resource of choice for the evaluation of the cervical spine soft tissues in children. Although the biomechanic properties of the alar ligaments remain unclear non-operative treatment for the rupture of these ligaments seems to be adequate. In order to avoid neurologic symptoms or long term complications an immediate diagnosis is indispensable.

Adolescent↗

PubMed2000

WWW-based continuing medical education: how do general practitioners use it?

WWW-based Continuing Medical Education (CME) is assumed to have the potential to make up for shortcomings in traditional lifelong learning of General Practitioners (GPs). This is obvious for CME systems with accreditation and control of the individual GP's CME activities but seems less clear for non-controlled CME systems like in several European countries, e.g. Germany. This paper reports results from the evaluation of a German CME website by 59 GPs (internet experience of 20 months on average) during a 4-months period. GPs mainly learned at home after work, with 46% of the GPs visiting the website at least once per month. Self-study and information seeking accounted for 58% of the activities, while communication and interaction were used infrequently. 77% of the GPs judged less but detailed information on selected topics more important than being able to access many but broad contents. GPs mostly prefer established means of learning and communication. It is concluded that the GPs' self-directed individual learning mainly needs high-quality information and well-structured collections of existing relevant WWW resources. Communication, virtual community building and sophisticated interactivity are of little importance at present. WWW-based CME complements existing CME activities, especially regarding individual information seeking on focused problems.

Computer Literacy↗

PubMed1999

Post-Doc: satisfying the information needs of general practitioners in continuing medical education and daily practice.

The learning needs of General Practitioners (GPs) are not optimally covered by traditional ways of Continuing Medical Education (CME). The European-funded Post-Doc project sets up a model for a European internet-based infra-structure and learning environment to support GPs' individual CME activities, focusing on problems of daily work. It integrates education, information and communication for both daily work and learning at home. Based upon a user requirements analysis, the service includes multimedia training applications, selections of relevant information sources, a calendar of events, and communication facilities. The service is intended to fit in existing health care structures and accreditation systems. Because of different languages and user requirements in Post-Doc's regions each region builds an own website. The regional prototypes are built and evaluated in cooperation with small core user groups. This regional approach proved feasible and also influenced the network structure with regional demonstrator websites and one master website including central functionality.

Computer-Assisted Instruction↗

PubMed1997

Regional cerebral blood flow and negative/positive symptoms in 24 drug-naive schizophrenics.

UNLABELLED: SPECT/PET studies in schizophrenia revealed inconsistent changes of regional cerebral blood flow (rCBF). Frontal hyperperfusion as well as hypoperfusion are described. This study was undertaken to investigate the relations between rCBF, psychopathology according to PANSS and effects of neuroleptic therapy. METHODS: Twenty-four drug-naive acute patients with a first manifestation of schizophrenia were examined with 99mTc-HMPAO brain SPECT and assessed according to PANSS. Of these, 22 were controlled again after neuroleptic treatment. Following attenuation correction, region-to-cerebellar count ratios were obtained from 98 irregular regions of interest drawn in all slices (6.25 mm). The ratios were compared to 20 control subjects, and changes lying outside of 2 s.d. were considered abnormal. RESULTS: In different drug-naive patients, hyperperfusion as well as hypoperfused patterns were found. In drug-naive patients, the seven subscores of positive symptoms (pos 1-7) in PANSS showed different correlations to rCBF: Formal thought disorders (pos 2) and grandiosity (pos 5) were positively correlated to bifrontal and bitemporal rCBF (r = +0.59 to +0.70). Delusional ideas (pos 1), hallucinatory behavior (pos 3) and suspiciousness (pos 6) demonstrated a negative correlation to bifrontal, cingulate, left temporal and left thalamic rCBF (r = -0.59 to -0.66). Stereotyped ideas (neg 7) as a negative symptom showed a negative correlation to left frontal, left temporal and left parietal rCBF (r = -0.59 to -0.65). No correlations were found between residual positive symptoms and rCBF after neuroleptic treatment and clinical improvement, but all negative symptoms (neg 1-7) had a negative correlation to bifrontal, bitemporal, cingulate, basal ganglia and thalamic rCBF (r = -0.59 to -0.74). CONCLUSION: Our results illustrate that different positive symptoms are accompanied by different rCBF values: some induce hyperperfusion, others hypoperfusion. After therapy (and reduction of positive symptoms), only negative symptoms correlate exclusively to hypoperfusion. This may be the crucial factor in explaining inconsistencies of past results in perfusion pattern in drug-naive schizophrenic patients.

Adult↗

PubMed1997

Altered relationships between rCBF in different brain regions of never-treated schizophrenics.

AIM: of this study was to investigate the relations between regional cerebral blood flow (rCBF) of different brain regions in acute schizophrenia and following neuroleptic treatment. METHODS: Twenty-two never-treated, acute schizophrenic patients were examined with HMPAO brain SPECT and assessed psychopathologically, and reexamined following neuroleptic treatment (over 96.8 days) and psychopathological remission, rCBF was determined by region/cerebellar count quotients obtained from 98 irregular regions of interest (ROIs), summed up to 11 ROIs on each hemisphere. In acute schizophrenics, interregional rCBF correlations of each ROI to every other ROI were compared to the interregional correlations following neuroleptic treatment and to those of controls. RESULTS: All significant correlations of rCBF ratios of different brain regions were exclusively positive in controls and patients. In controls, all ROIs of one hemisphere except the mesial temporal ROI correlated significantly to its contralateral ROI. Each hemisphere showed significant frontal-temporal correlations, as well as cortical-subcortical and some cortico-limbic. In contrast, in acute schizophrenics nearly every ROI correlated significantly with every other ROI, without a grouping or relation of the rCBF of certain ROIs as in controls. After neuroleptic treatment and clinical improvement, this diffuse pattern of correlations remained. CONCLUSIONS: These results indicate differences in the neuronal interplay between regions in schizophrenic and healthy subjects. In never-treated schizophrenics, diffuse interregional rCBF correlations can be seen as a sign of change and dysfunction of the systems regulating specificity and diversity of the neuronal functions. Neuroleptic therapy and psychopathologic remission showed no normalizing effect on interregional correlations.

Adult↗