Biomedical subjects

Elisabeth Geiger

Publications and source records attributed to Elisabeth Geiger.

8 recordsLinked to original sources

PubMed2006

Antidepressants and driving ability: results from a clinical study.

OBJECTIVE: Psychomotor disturbances can frequently be found in depressed patients and may have an important influence on the ability to drive. Additionally, effects of sedation, as seen with some antidepressants, probably impair driving performance. The present study was designed to evaluate the effects of antidepressant monotherapy on psychomotor functions related to car-driving skills in depressive patients in a routine clinical setting. METHOD: Inpatients (N = 100) who met the ICD-10 and DSM-IV criteria for major depressive disorder were tested under steady-state plasma level conditions prior to being discharged to out-patient treatment. The study ran from January 2004 through March 2005. All patients participated voluntarily and gave informed consent. According to the German guidelines for road and traffic safety, data were collected with the computerized Act & React Testsystem ART-90 and the Wiener Testsystem, measuring visual perception, reaction time, selective attention, vigilance, and stress tolerance. Psychopathologic symptoms were rated with the Hamilton Rating Scale for Depression. RESULTS: Before discharge to outpatient treatment, 24% of the patients tested were without clinically relevant psychomotor disturbances. In 60% of the cases, mild to moderate impairments could be seen, and about 16% of the patients were considered as severely impaired in psychomotor functions related to car-driving abilities. Data show that patients treated with selective serotonin reuptake inhibitors (SSRIs) or the noradrenergic and specific serotonergic antidepressant (NaSSA) mirtazapine had an altogether better test performance in comparison with patients receiving tricyclic antidepressants (TCAs). Differences were most pronounced in measures of reactivity, stress tolerance, and selective attention. Statistically significant differences between patients treated with TCAs or the serotonin-norepinephrine reuptake inhibitor (SNRI) venlafaxine could not be found. Among the newer antidepressants there is an advantage for patients treated with mirtazapine, especially in tasks with high multi-channel perception and output demands. CONCLUSION: About 16% of depressive patients discharged from hospital to outpatient treatment must be considered unfit to drive. In 60% of the cases, patients performed at a questionable level of fitness for driving, and it seems justified to counsel patients individually, taking into account compensational factors. Data point to an advantage for patients treated with SSRIs or mirtazapine when compared with TCAs or venlafaxine. However, causal relationships cannot be drawn from our data.

Adult↗

PubMed2004

[Antipsychotics and memory functions in schizophrenic patients].

OBJECTIVE: The aim of this study was to evaluate the effects of antipsychotics on memory functions in schizophrenic patients under clinical routine conditions. METHOD: Schizophrenic patients (n = 111) before discharge to outpatient treatment were evaluated on verbal memory function. Data were analyzed according to pharmacological treatment controlling for age. RESULTS: We observed that treatment with atypical antipsychotics (n = 80) compared with conventional neuroleptics (n = 31) was significantly associated with a more favorable effect on memory function. In short-term- and working-memory and retention a clear advantage of atypical antipsychotics could be seen. CONCLUSIONS: Results from this study suggest that even under clinical routine conditions atypical antipsychotics have an advantage on memory function when compared with conventional antipsychotics.

Adult↗

PubMed2004

The impact of antipsychotics on psychomotor performance with regards to car driving skills.

Cognitive and psychomotor impairments are a core feature of most patients with schizophrenia and may have an important influence on driving ability. The present study investigated the effects of neuroleptic monotherapy on psychomotor functions related to car driving skills in schizophrenic patients. Consecutively admitted schizophrenic inpatients (n = 120) were tested under steady state plasma level conditions before discharge to outpatient treatment. Patients met the International Classification of Diseases, Tenth Revision criteria for schizophrenia. The study followed a naturalistic nonrandomized design. Data were collected with the computerized Act & React Testsystem and were analyzed according to medication, severity of illness, and age. Only 32.5% of the schizophrenic inpatients passed the tests without major impairments. Patients treated with atypical neuroleptics or clozapine showed a better test performance on skills related to driving ability when compared with patients on typical neuroleptics. Differences were most pronounced in measures of divided attention, stress tolerance, and attention. Data also suggest that treatment with clozapine had an overall positive impact on measures of reactivity and stress tolerance. These results show that even under steady state pharmacologic conditions psychomotor functions of most schizophrenic patients partly remitted must be considered as impaired. To evaluate these effects, a systematic neuropsychologic examination is recommended.

Adolescent↗

PubMed2003

[Neuroleptics and Cognition]

OBJECTIVE: The aim of this study was to evaluate the effects of atypical antipsychotics on cognitive function in schizophrenic patients under clinical routine conditions. METHOD: Schizophrenic patients (n = 78) were evaluated on neuropsychological tests of attention, short-term- and working memory, learning, long-term memory (retention) and executive function. Data were analyzed according to medication, severity of illness and age. RESULTS: We observed that treatment with atypical antipsychotics compared to conventional neuroleptics was significantly associated with a more favorable effect on cognitive function. Especially in short-term memory and retention a clear advantage of atypical antipsychotics could be seen. CONCLUSION: Results from this study suggest that even under clinical routine conditions atypical antipsychotics have an advantage on cognitive function when compared with conventional neuroleptics.

Journal Article↗

PubMed2003

Characterization of dendritic cells from human oral mucosa: a new Langerhans' cell type with high constitutive FcepsilonRI expression.

BACKGROUND: The oral mucosa represents a unique immunologic unit with a high frequency of native allergen contact within the gastrointestinal tract in which immune tolerance is the natural outcome of allergen contact. Although Langerhans' cells (LC), known to play a crucial role in initiating allergen-dependent immune responses in the skin, have also been detected in the oral mucosa, little is known about their phenotype and exact physiologic role. OBJECTIVE: To elucidate whether LC from oral mucosa (oLC) differ from skin LC (sLC), these cells were subjected to detailed comparative analysis. METHODS: Crude epidermal and oral mucosa cell suspensions were prepared by trypsinization. oLC and sLC were compared phenotypically by flow cytometry techniques and functionally in T-cell proliferation assays. RESULTS: In contrast to sLC, freshly isolated oLC expressed significantly higher amounts of MHC class I and II, as well as costimulatory molecules CD40, CD80/B7.1, and CD86/B7.2. oLC displayed FcgammaRIII/CD16 and FcgammaRI/CD64. Most surprisingly, oLC constitutively expressed the high affinity receptor for IgE (FcepsilonRI) even in nonatopic donors. FcepsilonRI expression on oLC was further increased and correlated with the serum IgE levels in atopic individuals. oLC showed a higher allogeneic stimulatory activity than sLC, whereas the activation of autologous T cells correlated to the FcepsilonRI expression. CONCLUSION: Taken together, our results strongly indicate that oLC profoundly differ from their skin counterparts. The constitutive high expression of FcepsilonRI on oLC could point to particular skills of these cells within the regional immune system of the oral mucosa.

Antigens, CD↗

PubMed2003

[Neuroleptics and cognition].

Adult↗

PubMed2002

A reducing microenvironment leads to the generation of FcepsilonRIhigh inflammatory dendritic epidermal cells (IDEC).

Inflammatory dendritic epidermal cells present in skin lesions of the atopic eczema/dermatitis syndrome display the highest expression of the high-affinity receptor for IgE (FcepsilonRI), ever detected on human antigen-presenting cells. Owing to the instability of the FcepsilonRI (alphagammagamma) complex and fast cleavage from the cell surface during the interleukin-4/granulocyte-macrophage colony-stimulating factor driven in vitro differentiation of monocytes, a method to generate inflammatory dendritic epidermal cells was not at our disposal in the past and the amount of ex vivo isolated inflammatory dendritic epidermal cells available for functional assays was limited. Therefore, information about the role of inflammatory dendritic epidermal cells and FcepsilonRI on this dendritic cell subtype in atopic and inflammatory skin diseases is completely missing. In this study, we were able to: (i) increase the expression of a functional FcepsilonRI complex on the cell surface of immature monocyte-derived dendritic cells from atopic donors by creating a reducing microenvironment; (ii) enhance significantly the intracellular pool of the FcepsilonRIgamma chains, which is the limiting parameter for the FcepsilonRI surface expression; and (iii) generate monocyte-derived dendritic cells displaying the phenotypical characteristics of inflammatory dendritic epidermal cells, producing high amounts of proinflammatory cytokines and chemokines similar to the cytokines found in lesional skin of the atopic eczema/dermatitis syndrome. Altogether the high expression of functional FcepsilonRI on these cells enables us for the first time to study inflammatory dendritic epidermal cells and FcepsilonRI-mediated mechanisms of inflammatory dendritic epidermal cells in vitro, in order to shed light on the putative role of this important cell type in the atopic eczema/dermatitis syndrome.

Cells, Cultured↗

PubMed2002

Dichotomic nature of atopic dermatitis reflected by combined analysis of monocyte immunophenotyping and single nucleotide polymorphisms of the interleukin-4/interleukin-13 receptor gene: the dichotomy of extrinsic and intrinsic atopic dermatitis.

Patients with atopic dermatitis display substantial immunologic abnormalities, among which elevated total IgE is considered as a hallmark; however, a subgroup of atopic dermatitis patients exhibits normal IgE levels, but mechanisms contributing to the so-called "intrinsic" or "nonallergic" form of atopic dermatitis are obscure. In order to unravel similarities and differences of both atopic dermatitis subtypes, the phenotype of monocytes, total serum IgE levels, and serum levels of cytokines regulating the IgE production from nonatopic individuals and patients with allergic rhinitis, and extrinsic and intrinsic atopic dermatitis were measured. Concomitantly, genomic DNA probes of all subjects were analyzed for single nucleotide polymorphisms of candidate genes of structures involved in the regulation of the IgE synthesis, such as interleukin-4 and the interleukin-4R/interleukin-13R. Our data show that the surface expression of the high- and low-affinity receptor for IgE (FcepsilonRI and FcepsilonRII/CD23) and the interleukin-4Ralpha chain were significantly elevated in monocytes from patients with extrinsic atopic dermatitis. Furthermore, serum levels of interleukin-13 were significantly increased in patients with intrinsic atopic dermatitis. In addition, the frequency of the interleukin-4Ralpha polymorphism C3223T and the interleukin-4 polymorphism C590T tended to be higher in extrinsic atopic dermatitis than in intrinsic atopic dermatitis. Altogether our findings indicate that intrinsic atopic dermatitis patients exhibit phenotypic and immunologic features, which differ from those of patients with extrinsic atopic dermatitis or other atopic disorders.

Adolescent↗