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Biomedical subjects

D Klingler

Publications and source records attributed to D Klingler.

At least 19 recordsLinked to original sources
PubMed2003

One-year prevalence of migraine in Austria: a nation-wide survey.

This study presents the first nation-wide survey of migraine in Austria. A sample of 997 Austrian > or = 15 years old were interviewed personally (face-to-face) in a random sample in the whole country. Diagnosis of migraine was based on the International Headache Society (IHS) classification. Of the Austrian adult population 10.2% were identified to suffer from IHS migraine, 5.6% from migraine without aura, 2.3% from migraine with aura and 2.3% from borderline migraine. Another 8.5% have possible migraine. Other primary headaches were reported in 30.7%. Sex, age, working status and region were found to be the main demographic influencing factors. Further influences were stress, spinal column problems or weather changes. The most used acute medications were over-the-counter drugs, doctor attendance rate was very low. Working people with migraine dropped out of work 14 days per year, which adds up to 6.8 million working days per year. This remains a substantial economic factor. The findings indicate that migraine sufferers in Austria need to be more informed about their illness and what to do against it, especially encouraging doctor visits.

Adolescent↗
PubMed2001

[Incidence and cost estimation of diseases of the nervous system and the psyche. An evaluation of non-profit hospitals].

There were 273,722 hospitalizations due to neurological disorders reported in Austria's nonprofit hospitals in 1997, including the related operated cases (14.12% of all 1.9 million hospitalizations). The individual disease groups, e.g., cerebrovascular disorders (59,269 admissions or 3.06%), multiple sclerosis (3,920 admissions or 0.2%) are detailed and the cost resulting from these diseases were estimated according to the Austrian Diagnosis Related Groups. The number of hospitalizations due to psychiatric disorders was 99,346 (5.13%). According to our results, we were able to estimate that 6,492 beds (at the moment 2,053 beds) were required for inpatient treatment in the area of neurology and psychiatry, which means one bed per 1,260 inhabitants.

Adolescent↗
PubMed2001

Hospitalization of patients with neurological disorders and estimation of the need of beds and of the related costs in Austria's non-profit hospitals.

In 1997, 273 722 hospitalizations as a result of neurological disorders, including the related operated cases, were reported in Austria's non-profit hospitals (80% of all hospitals). They represent 14.12% of all 1.9 million in-patient treatments. The individual disease groups, e.g. cerebrovascular disorders (59 269 admissions or 3.06%), multiple sclerosis (3920 admissions or 0.2%) and all other groups are detailed. We estimated the cost resulting from these diseases which amounted to 11.88% of all hospital costs. We were also able to estimate that 5549 beds are required for in-patient treatment in the area of neurology, assuming an average duration of treatment of 8 days (Austrian mean value for neurological disorders). This is equivalent to one bed per 1367 inhabitants or 11.31% of all beds for in-patient treatment in non-profit hospitals in Austria. Obviously at present the majority of neurological patients are treated in non-neurological departments. A major increase in resources to neurology is necessary if patients are to receive the benefit of specialized diagnosis and treatment. These further resources not only cover the increase of neurological beds in hospitals but also financial, personal resources and in consequence increased capacity for neurological education, training and research.

Austria↗
PubMed2001

A 28-week, double-blind, placebo-controlled study with Cerebrolysin in patients with mild to moderate Alzheimer's disease.

Cerebrolysin (Cere) is a compound with neurotrophic activity which has been shown to be effective in the treatment of Alzheimer's disease (AD) in earlier trials. The efficacy and safety of repeated treatments with Cere were investigated in this randomized, double-blind, placebo-controlled, parallel-group study. One hundred and forty-nine patients were enrolled (76 Cere; 73 placebo). Patients received i.v. infusions of 30 ml Cere or placebo 5 days per week for 4 weeks. This treatment was repeated after a 2-month therapy-free interval. Effects on cognition and clinical global impressions were evaluated 4, 12, 16, and 28 weeks after the beginning of the infusions using the Clinical Global Impression (CGI) and the Alzheimer's Disease Assessment Scale-cognitive subpart (ADAS-cog). All assessments, including the 28-week follow-up visit were performed under double-blind conditions. At week 16, the responder rate of the Cere group was 63.5% on the CGI, compared to 41.4% in the placebo group (P < 0.004). In the ADAS-cog, an efficacy difference of 3.2 points in favour of Cere was observed (P < 0.0001). Notably, improvements were largely maintained in the Cere group until week 28, 3 months after the end of treatment. Adverse events were recorded in 43% of Cere and 38% of placebo patients. Cere treatment was well tolerated and led to significant improvement in cognition and global clinical impression. A sustained benefit was still evident 3 months after drug withdrawal.

Aged↗
PubMed2000

Migraine-like headache in bacterial meningitis.

The effect of sumatriptan has not been previously described in the treatment of the headache of meningitis, although this headache has similarities to migraine. This study presents the clinical features of two patients who had fulminant bacterial meningitis with migraine-like headache and who experienced no improvement in headache intensity after administration of sumatriptan 6 mg s.c. On these grounds the lack of response of this type of headache to sumatriptan is discussed.

Adult↗
PubMed1998

Transcutaneous electrical nerve stimulation in the treatment of chronic pain: predictive factors and evaluation of the method.

OBJECTIVE: Transcutaneous electrical nerve stimulation (TENS) is a widely used therapeutic approach in acute and chronic pain syndromes. The aim of this study was to investigate the influence of patient management as well as other factors on the outcome of TENS treatment. DESIGN: The study was carried out as a retrospective analysis of the course of treatment and the therapeutic results of transcutaneous electric nerve stimulation (TENS) in 482 patients with chronic pain of various origins. The follow-up period was up to 48 months. Two groups with differing patient management were compared. RESULTS: Competent patient evaluation and education (i.e., a long testing and learning phase as well as regular comprehensive after-care) was found to be important. Our analysis of the reasons for the discontinuation of long-term TENS therapy showed that the most important feature was the discrepancy between effort and therapeutic result. Other causes were intermittent depressive states and progression of the underlying disease followed by an aggravation of pain. In addition, numerous factors were identified that adversely affected the outcome of TENS treatment. These factors were listed in order of importance and were included in a prognostic score. CONCLUSIONS: The prognostic score permits an efficient selection of patients. Moreover, a comprehensive documentation of pain syndromes and their organic, psychogenic, and social features is presented. On the basis of this documentation, an appropriate therapeutic concept may be established. The prognostic score was validated in a subsequent study including 99 patients with chronic pain treated with TENS.

Adult↗
PubMed1995

Clinical case report: opiate antagonist and event-related desynchronization in 2 autistic boys.

Event-related desynchronization and visual orientational behavior were examined in 2 autistic boys to determine if blockade of endogenous opioid activity facilitates cognitive processing at a cortical level. Before naltrexone, the boys showed no selective alpha blocking during exposure to either mother's pictures or white light. Unlike normals, they exhibited strong alpha band enhancement at temporocentral recording sites. Two hours after administering 0.5 mg/kg naltrexone, mother-as well as light-related alpha blocking appeared at occipital, occipitotemporal, and prefrontal sites. These effects were gone 24 h after dosing in one child, but persisted in the other. A parallel increase in visual pursuit in a social context was observed. These results affirm that autistic gaze aversion can be caused by excessive opioid activity interfering with corticothalamocortical processing of visual stimuli.

Alpha Rhythm↗
PubMed1994

[Migraine--summary of diagnostic and therapeutic strategies].

The International Headache Society 1988 has boosted the research on and therapy of migraine by classifying the headache and operationalizing the diagnostic criteria in the recent years. The prevalence of migraine (12% in the western industrial countries) and its genetic causes are now undoubted. Numerous short-term or long-term triggers, like for instance the female hormone constellation from puberty to menopause, or prolonged stress, contribute considerably to the severity and frequency of the illness. Due to the central role of serotonin in the pathomechanism of the migraine headache and intensive research on the part of the pharmaceutical industry it was possible to develop a new, efficient drug for the treatment of migraine attacks: sumatriptan, a 5HT1-agonist. The efficiency of prophylactics has been defined and covered. For about one third of the migraine patients a long-term therapy, which is continuously adapted, is necessary, because they suffer simultaneously from a tension-type headache and a continual headache due to an abuse of pain-killers or ergotamin (analgesic or ergotamin headache), and from accompanying anxiety syndromes, depression and cervical syndromes. Only in this way can the abuse of pain-killers or ergotamin be prevented or cut back, the fear of the next attack reduced, and the ability to work maintained as well as the quality of life improved. The strategies of the therapy of migraine attacks and their prophylaxis are summed up.

Humans↗
PubMed1992

Naltrexone open trial with a 5-year-old-boy. A social rebound reaction.

The neurobiological rationale for an opiate antagonist pharmacotherapy of autism is presented. Naltrexone efficacy in decreasing autistic behaviour and in increasing social-affiliative behaviour was explored in a 5-year-old autistic boy. Naltrexone (0.5 mg/kg 3 times peer week) was effective in immediately decreasing gross motor activity and stereotyped behaviour and caused a delayed increase of crying, smiling and rough-and-tumble play. This single case presents preliminary evidence that a therapeutically valuable rebound reaction is possible and that the human opioid system modulates social-affective processes. The possibility of psychological factors being instrumental in achieving this effect is discussed as being suitable for future clinical trials.

Attention Deficit Disorder with Hyperactivity↗
PubMed1986

[Social problems and rehabilitation of the Parkinson patient].

The rehabilitation of parkinson patients is being discussed with the legal situation in mind. Summing up we can say: Drug therapy as the most important part of medical rehabilitation has achieved a high standard. Further information and education may help in keeping and advancing the standard. It could be a task not only for the Austrian Parkinson Society and self-help groups yet to be founded, and one well worth supporting, to establish programs and recommendations for adequate physio- and physico-therapy, in general and especially with regard to sanatoriums. This should also include in patient rehabilitation in special institutions or special departments within existing rehabilitation centers and clinics as well as promoting follow-up treatment. Patient clubs and self-help groups could considerably contribute to vocational and social rehabilitation.

Antiparkinson Agents↗
PubMed1986

A comparison of laser acupuncture versus placebo in radicular and pseudoradicular pain syndromes as recorded by subjective responses of patients.

In a prospective randomized single blind cross over study the analgesic effects of laser irradiation on acupuncture points and a mock laser treatment (placebo) were compared in a sample of 21 patients suffering from radicular and pseudoradicular pain syndromes. Subjective pain levels were recorded on a visual verbal analogue pain rating scale before and after laser treatment and placebo along with the duration of any effects on pain observed. Mean pain levels after laser treatment were statistically significantly lower than after placebo (p less than 0.001, t-test). In the cross over section laser treatment was more effective than placebo in 20 out of 21 patients and pain relief lasted longer after laser treatment in 18 out of 21 patients.

Acupuncture Therapy↗
PubMed1985

[Phenomenology of Huntington chorea, analysis of a large family].

The marked variability of psychiatric and neurological features of Huntington's chorea is described in a large family consisting of 31 members of two filial generations and the parenteral generation, of which 13 members showed manifest signs of the disease, while two further members died probably in a preliminary stage of the disease. It is of interest that a few members of the family had a large number of children, while the majority remained without offspring. Analysis of the psychiatric symptoms and signs shows that the course of the disease may take either a quiet demential, or a turbulent form. In the latter the features of manic-depressive psychosis or of schizophrenia occur, as well as a syndrome resembling psychopathic states with explosive-violent features comparable to the pseudo-psychopathia syndrome of U. H. Peters. The quiet demential course is correlated to progressive cerebral atrophy. The different forms of the turbulent course may be due to additional, genetically determined radicals of both groups of psychoses, to localized differences in the progression of the cerebral atrophy or to unspecific noxious influences from the external or internal milieu. With regard to neurological features, apart from the signs of chorea, akinesic rigidity and tic-like hyperkinesias with transition into stereotypes and primitive motor patterns were observed, as well as an apallic syndrome in the terminal phase. As a rare psychiatric variant, a syndrome characterized by compulsive pedantry combined with tic-like hyperkinesias was observed. The possibility of a striatal lesion causing motor and psychiatric impulsive features is pointed out.

Adolescent↗
PubMed1984

Epileptic seizures in alcoholism and diagnostic value of EEG after sleep deprivation.

Alcoholism and epileptic seizures frequently coincide. Two groups can be distinguished clinically and by EEG. In one group (group I), seizures occur only during a period of alcohol withdrawal or partial withdrawal and can only be explained because of alcoholism in the history of the patient. In the other group (group II), seizures occur spontaneously, as well as during alcohol withdrawal, and epileptogenic factors (residual brain damage, former epileptic seizures, and a family history of seizures) probably play an important role in the manifestation of the seizures. Paroxysms or focal abnormalities are rarely seen in group I; in group II, EEG abnormalities are seen approximately as frequently as in other epileptic conditions. Both groups were examined to determine the extent of their EEG abnormalities after 24 h of sleep deprivation. Before and after sleep deprivation, only 4% of 52 chronic alcoholic patients without epileptogenic risk factors had EEG foci. Of the 52, 2% before sleep deprivation and 8% after sleep deprivation had generalized paroxysms. Of 128 chronic alcoholic patients with additional epileptogenic factors, 19% before sleep deprivation and 24% after sleep deprivation had EEG foci, and 17% before and 28% after sleep deprivation had generalized paroxysms. The pathogenesis of epileptic seizures in both groups and the therapeutic consequences are discussed.

Adult↗
PubMed1982

[The value of EEG after sleep deprivation for the diagnosis of epileptic seizures, epilepsy and other cerebral disorders].

114 electroencephalographic and 49 clinical criteria of 1010 patients, including 64 healthy volunteers, were evaluated by means of a computer. In 549 patients with epileptic seizures spike wave (sw) paroxysms were seen in 13.3%. Following a 24-hour period of sleep deprivation sw paroxysms were present in 24.2% cases which represents an increase of 82.0%. The number of cases with focal discharges increased in this group from 21.3% initially to 27.5% after sleep deprivation, representing an increase of only 29.1%. The percentage increase in sw paroxysms and focal discharges following sleep deprivation was approximately as marked also in patients without epileptic seizures, so that sleep deprivation was found to be equally useful in patients with non-epileptic cerebral disorders. The rate of activation is higher in children and juveniles than in adults. Similarly, it is higher in patients with awaking epilepsy than in patients with sleep epilepsy. The influence of sleep deprivation and that of sleep, respectively, upon the provocation of EEG changes was not sharply differentiated. By counting sw paroxysms in the EEG before sleep deprivation, in the waking EEG following sleep deprivation, as well as in the subsequent sleeping EEG further evidence was obtained, however, supporting the suggestion that special significance may be attributed to sleep deprivation as a provocation method. If the activation of sw paroxysms and focal changes is related to sleep and sleep stages it can be shown that their frequency decreases from stage 1 to stage 4. In particular, the short fluctuations in vigilance, the waking reactions frequently occurring under routine laboratory conditions and the transitions between sleep stages were seen to assume trigger functions.

Adolescent↗
PubMed1982

[Sleep deprivation as activating procedure in EEG of patients with and without epileptic seizures. I. Generalized paroxysmal discharges ].

The EEGs of 459 patients with and 442 patients without epileptic seizures showed generalized spike wave (s/w) paroxysms in 126 cases and generalized slow wave paroxysms in 63 cases before and/or after sleep deprivation. In patients with epileptic seizures s/w paroxysms appeared in 23%, whereas in patients without epileptic seizures. S/w paroxysms were present in only 5%. The difference is statistically highly significant. The frequency of generalized slow wave paroxysms showed with 6% and 8% respectively no statistical significance. In 91% of patients with s/w paroxysms the latter appeared already in the waking phases of the EEG following sleep deprivation. All s/w paroxysms which appeared in the sleep EEG were demonstrable already in stage I according to Rechtschaffen and Kales. The rate of activation of s/w paroxysms following sleep deprivation was 42% in patients with epileptic seizures, that of slow wave paroxysms was 38%. Although the number of patients with s/w paroxysms increases by approximately 100% following sleep deprivation they comprise still only 9.6% of all 459 patients with epileptic seizures. Combined with EEGs which show slow wave paroxysms or focal disturbances the incidence increases to 17%. Sleep deprivation as an activating procedure therefore provides a significant contribution to the confirmation of the diagnosis of epilepsy as well as control of therapy of epileptic patients whose routine EEG does not show typical pathological signs.

Electroencephalography↗