Biomedical subjects

G Wiedemann

Publications and source records attributed to G Wiedemann.

At least 19 recordsLinked to original sources

PubMed2003

[Psychotherapy of positive symptoms in the treatment of patients with schizophrenia psychosis].

While the treatment of positive symptoms of patients with schizophrenic psychosis appeared until recently to be solely pharmacotherapeutic, new research findings show the efficacy of cognitive-behavioural psychotherapy (CBT) on positive symptoms in chronic psychotic patients. In addition, the effectiveness even in acute and recent-onset psychosis could be shown in some studies. The effects of CBT and standard care in psychosis compared to standard care alone and to other psychosocial interventions plus standard care are reviewed. The results of several studies and one meta-analysis show that CBT in schizophrenia patients has a direct effect on psychotic symptoms such as hallucinations as well as on relapse prevention. In routine settings,however,CBT has until now only rarely been delivered to these patients. In so-called large pragmatic trials, which might be subsumed as phase IIIb studies, the effects are tested. The therapeutic approach with the components of CBT for psychosis are described: building a therapeutic relationship, cognitive-behavioural coping strategies, developing an understanding of the experience of psychosis,working on hallucinations and delusions, addressing negative self-evaluations, anxiety, and depression,managing risk of relapse and social disability. Further clinical implications are described (capability of learning the therapeutic strategies, deliverability in broader clinical settings, acceptability by patients, combination with atypical neuroleptic drugs,and treatment of choice in risk populations).

Adult↗

PubMed2001

Effectiveness of targeted intervention and maintenance pharmacotherapy in conjunction with family intervention in schizophrenia.

A sample of 85 patients with schizophrenia, of whom 34 later dropped out, received randomised treatment. There were no significant differences between treatment-takers and drop-outs in the variables assessed. Patients received either standard-dose maintenance neuroleptic treatment or targeted maintenance pharmacotherapy and all patients received behavioural family therapy. Measures of psychopathology, social adjustment, side-effects, family burden, and expressed emotion were assessed at baseline and then periodically over an 18-month period. The study was designed to compare the two alternative pharmacological maintenance approaches, each of them supported by psychosocial intervention. Any evaluation of the impact of behavioural family treatment on relapse rates and other outcome criteria is exclusively descriptive. A significantly higher rate of relapse was observed at 18 months in patients randomised to targeted treatment compared to those randomised to standard-dose treatment (35% vs 4%). Although patients assigned to the targeted maintenance group received significantly lower mean doses of neuroleptics, there were no significant differences between the two groups with regard to side-effects, global measures of social function, and overall psychopathology. Family burden was higher in the targeted-treatment group at six months, but did not differ at the one-year and eighteen-month time points. However, both groups improved significantly from baseline to 12 or 18 months in almost all variables assessed. Thus, the behavioural family approach did not compensate for the problems associated with the targeted medication strategy.

Adolescent↗

PubMed2001

A priori expectancy bias and its relation to shock experience and anxiety: a naturalistic study in patients with an automatic implantable cardioverter defibrillator.

Patients with an automatic implantable cardioverter defibrillator (AICD) may offer an unique naturalistic opportunity to study whether expectancy biases develop because of precipitating aversive or traumatic experiences and/or because of elevated anxiety. An expectancy bias and its associations with AICD discharge and anxiety was examined in 24 AICD patients with a thought experiment. While patients without AICD discharge exhibited no expectancy bias, patients with discharge experiences were found to expect that stimuli depicting medical emergency situations will be followed by an aversive consequence. The magnitude of their expectancy bias was positively correlated with their anxiety level. In the group with AICD discharge, patients with low anxiety levels exhibited no bias, while patients with high anxiety levels exhibited a rather strong bias. It seems that the experience of an aversive or traumatic event, here an AICD discharge, is a necessary (but not sufficient) precipitating event for the development of an expectancy bias. If such an event happens, trait anxiety level presumably determines if and how strong the expectancy bias will be.

Adult↗

PubMed2000

Determination of urinary protein fractions. A comparison with different electrophoretic methods and quantitatively determined protein concentrations.

The second morning urine of 207 patients with various renal diseases was examined. After testing the urine with the Combur-9-RL((R)) dip strip, the concentrations of total protein, creatinine, albumin, alpha-1-microglobulin, immunoglobulin G and transferrin were determined. The urinary protein fractions were measured in parallel with the electrophoresis kits: Hydragel-Proteinuria (sebia GmbH, Fulda); Protur-HiSi (Beckman Coulter GmbH, Krefeld); SPE-II (Beckman Coulter) and the protein concentrations were calculated. The method comparison was based on the agreement of the ascertained types of proteinuria, and on comparison of the electrophoretically obtained albumin protein concentrations with the automated concentration results. It could be shown that urine electrophoresis is a reliable analytic method for the diagnosis of proteinurias. A good agreement and significant correlations were found between single protein determination and urinary electrophoresis. A diagnostic strategy that combines electrophoresis, single protein determination and immunofixation is useful for the diagnosis and differentiation of proteinuria.

Albuminuria↗

PubMed1999

Frontal brain asymmetry as a biological substrate of emotions in patients with panic disorders.

BACKGROUND: Right frontal hemisphere activation, as indicated by reduced frontal alpha amplitude, seems to represent activation of an avoidance-withdrawal system and seems to be associated with negative emotions. Since patients with panic disorder are characterized by both negative emotions and avoidance-withdrawal behavior, we expected them to show greater right than left frontal hemisphere activation. METHODS: Spontaneous electroencephalography was recorded from the left and right frontal and parietal scalp regions of 23 patients with panic disorder patients without a diagnosis of depression and from 25 healthy control participants during the following conditions: rest, confrontation with neutral, panic-relevant, anxiety-relevant but panic-irrelevant, or anxiety-irrelevant but emotionally relevant stimuli, and performance of a motor task. Their emotional state during these conditions was assessed by the Self-Assessment Manikin. RESULTS: In patients with panic disorders, there were asymmetries in frontal hemisphere activation during resting phases and when confronted with anxiety-relevant stimuli. Their right frontal alpha power was significantly decreased compared with the left, while control participants did not show frontal brain asymmetry during these phases. There was no frontal brain asymmetry when patients observed an emotionally neutral picture or performed a motor task. Under these conditions, left and right frontal hemisphere alpha activation of patients with panic disorder and healthy participants were comparable. CONCLUSIONS: These data support the hypothesis that patients with panic disorder are characterized by greater activation of a right frontal avoidance-withdrawal system in negatively valenced situations. The findings are interpreted as biological evidence for a disturbed cortical processing in patients with panic disorder.

Adult↗

PubMed1999

Principles and results of family therapy in schizophrenia.

There is growing evidence that social factors contribute significantly to the course and outcome in schizophrenia. In particular, the relationship between high EE and schizophrenic relapse has been documented by many investigators. Since 1980, several psychoeducational family management programs have been evaluated showing a significant reduction in relapse when compared to standard psychiatric care. To prevent tardive dyskinesia, alternative medication strategies have been introduced, e.g. low dose and targeted medication. In the Munich treatment study the combined effects of behavioral family management (BFM) and standard dose (SD) or targeted neuroleptic medication TM) on relapse and social functioning of the patient as well as coping and burden of the family have been investigated. N = 51 patients with 73 relatives were randomly assigned to the two groups (BFMSD = 27, BFMTM = 24). Relapse rates at 18 month were: BFSD = 3.9%, BFMTM = 33.8%. In summary, psychoeducational family management in combination with standard dose medication proved to be highly effective in preventing relapse in schizophrenia. These results are in line with findings of anglo-american studies and call for a more widespread application of these new psychosocial approaches in order to provide the best services available for the chronically ill schizophrenic patient and their families.

Antipsychotic Agents↗

PubMed1999

Pain sensitivity, cerebral laterality, and negative affect.

The right hemisphere is assumed to play a unique role for pain sensitivity and negative affect. Pressure pain thresholds were assessed daily in eight right-handed participants over a 6-week period in order to obtain reliable measures of pain sensitivity unaffected by situational influences. In an additional session, cerebral laterality was assessed with behavioral and an EEG measures. Psychometric measures were used to examine emotionality (depression, neuroticism). Pain thresholds were lower on the left compared with the right hand, and pain thresholds increased within the first 3-measurement weeks. Enhanced pain sensitivity as reflected in weekly pain threshold was associated with a increased right frontal compared with left frontal brain activity as indicated by EEG, with a left-visual field advantage in the perception of emotional faces, and with increased negative affect (depression, neuroticism). In addition, a significant positive correlation between a relatively increased right frontal brain activity and depression was found. Correlations between pain thresholds and 'non-emotional' laterality measures (central or parietal EEG asymmetry, dichotic consonant-vocal-recall test) were not significant. We conclude that a right frontal brain hyperactivity might be a biological marker for enhanced pain sensitivity and negative affect.

Adult↗

PubMed1999

Associations between cortical slow potentials and clinical rating scales in panic disorder: a 1.5-year follow-up study.

In a previous study of 15 panic patients, we demonstrated that body-related (somatic) word stimuli elicited an enhanced positive cortical slow wave compared to non-somatic word stimuli. Healthy controls did not show this difference. The present paper reports on psychometric ratings in relation to cortical slow waves in these patients. Patients were clinically reexamined after about 1.5 years. Although no significant correlations between neurophysiology and psychometric measures could be found at the onset of the study, there was a significant correlation between improvement over the follow-up period and neurophysiology. A decline in the Hamilton Anxiety Scale (HAMA), which proved to be the best estimate for improvement, was associated with the relative magnitude of the positive slow wave elicited by somatic stimuli. Our findings support cognitive models of panic disorder, which stress that abnormal processing of bodily symptoms is relevant for the development and/or maintenance of the disorder.

Adult↗

PubMed1999

Pressure pain thresholds asymmetry in left- and right-handers: Associations with behavioural measures of cerebral laterality.

Pressure pain threshold (PPT) asymmetry of the left and right third digits was assessed in 12 right-handed and 12 left-handed subjects using an automatised pressure algometer. A clear PPT asymmetry was found in right-handed participants, while left-handed participants revealed no PPT asymmetry. The PPT asymmetry of right-handed participants was due to a reduced PPT or increased pain sensitivity at the left hand. Behavioural laterality tests revealed a right ear or left hemisphere advantage for the processing of verbal material (consonant-vocal syllables) and a left visual field or right hemisphere advantage for the processing of emotional faces in all participants. PPT asymmetry was not associated with cerebral laterality assessed with these tests. We conclude that PPT asymmetry is associated with handedness, but neither PPT asymmetry nor handedness are closely associated with measures of cerebral laterality. Copyright 1999 European Federation of Chapters of the International Association for the Study of Pain.

Journal Article↗

PubMed1998

Decreased duration and altered topography of electroencephalographic microstates in patients with panic disorder.

The topography and temporal sequence of scalp electrical fields were analyzed by adaptive segmentation of the continuous electroencephalogram (EEG) in 27 patients with panic disorder and 28 control subjects during rest phases and during the viewing of a neutral (mushroom) or an emotionally relevant (casualty) picture. The results indicate decreased duration of brain microstates in panic patients during all conditions. Comparison of the resting phases with the viewing conditions revealed a significant acceleration of EEG microstates in both the patients and the control subjects. Patients and control subjects differed in the topography of the fields during rest: control subjects showed a left-anterior/right-posterior orientation, while panic patients showed a predominantly right-anterior/left-posterior orientation. Neither group displayed any topographic changes when viewing the mushroom picture. However, when viewing the anxiety-specific casualty picture, panic patients shifted fields in a different way than did control subjects. Centroid topography does not permit clear localization of the cortical generators. It is concluded that panic patients show a generally increased cortical activation compared with healthy control subjects, and activate different neuronal arrays when viewing an anxiety-specific stimulus.

Adult↗

PubMed1997

[Microproteinuria and enzymuria in fever and pyelonephritis in childhood. A prospective study of 180 children].

In 180 children (87 children belonging to a control group, 68 with fever of non-renal origin, and 25 with pyelonephritis) albumin and immunoglobulin G (markers for glomerular dysfunction), alpha-1-microglobulin and beta-NAG (markers for proximal tubular dysfunction) and apolipoprotein A1 (marker of "postrenal' dysfunction) were measured in second-voided morning urine. In children with fever of non-renal origin, glomerular dysfunction was encountered in 8.8%, tubular dysfunction in 17.6% and mixed glomerular-tubular dysfunction in 14.7% of cases. Among children with pyelonephritis, 28% revealed glomerular dysfunction and 44% mixed glomerular-tubular dysfunction. No case of solitary proximal tubular dysfunction was observed in children with pyelonephritis. There were highly significant differences in presence and expression of glomerular dysfunction between children with fever of non-renal origin and children with pyelonephritis (P < 0.0001), whereas with regard to proximal tubular dysfunction, the differences were only moderately significant (beta-NAG: P < 0.01) or of low significance (alpha-1-microglobulin: P < 0.05). This may indicate that morphologic changes occur during interstitial pyelonephritis due to inflammation of glomeruli, resulting in glomerular dysfunction, while proximal tubular dysfunction may additionally be due to fever-associated function processes.

Acetylglucosaminidase↗

PubMed1997

Behavioral and neurophysiological evidence for altered processing of anxiety-related words in panic disorder.

Body-related and nonsomatic words were presented tachistoscopically to 15 panic patients and 15 healthy controls at each participant's threshold for correctly identifying 50% of neutral words. Behavioral (proportion of words correctly recognized) and electrocortical (event-related brain potentials [ERPs]) measures were registered. Panic patients recognized more body-related than nonsomatic words, and body-related as compared with nonsomatic words elicited, in these patients, significantly larger P300 amplitudes and enhanced positive slow waves (600 to 800 ms after stimulus presentation). In healthy controls, the number of correct recognized words and the ERPs were not differentially affected by the 2 word types. These results are grossly consistent with cognitive models of panic disorders, assuming that certain bodily sensation are perceived and processed in an affective manner that differentiates panic patients from healthy controls.

Adult↗

PubMed1996

[Family therapy and work with relatives in various psychiatric diseases].

The use of family therapy and relatives' groups in various areas of psychiatry, e.g. schizophrenia, affective disorders, eating disorders, dependency disorders, psychogeriatrics, and adolescent and child psychiatry, is discussed. These forms of therapy have continued to increase in popularity, although relatively few controlled studies of their effectiveness had been undertaken until quite recently. For each disorder, the most frequently employed types of therapy are compared with each other on the basis of controlled studies of efficacy. More flexible combinations and integrated approaches are constantly being developed. These rely less on particular methods of treatment than on the patients themselves, their illnesses, and their attitudes towards their mental states and social environments. A few of these treatment strategies are discussed, and their most important features described. Controlled studies have provided increasing evidence of the efficacy of family therapy and relatives' groups in respect of various criteria: relapse rate, psychopathology, symptoms, quality of life (both of the patients and of their relatives), social integration, and subjective well-being, amongst others. The effectiveness of such treatment in many areas requires further investigation, for example in chronic mental illness and psychogeriatric disorders, which represent fields of ever-increasing interest. More basic research and continued assessment of the methods employed in practice will be required to clarify further the underlying principles and the best framework for carrying out family therapy and relatives' group sessions, and thereby develop successful methods of treatment based on firm theoretical principles.

Adolescent↗

PubMed1995

[Differential diagnosis of commonplace upper abdominal symptoms: hepatic echinococcosis].

A 17-year-old girl from Turkey had for 6 years been suffering from right-sided upper abdominal symptoms not usually related to food intake. Treatment of suspected gastritis remained ineffective. Laboratory tests were unremarkable, except for an accelerated erythrocyte sedimentation rate (12/30 mm), eosinophilia (6.4%) and albumin concentration of 52.6 g/l. Upper abdominal sonography revealed a cyst, about 10 cm in diameter, in the right liver lobe. Computed tomography showed the 8 x 8.5 cm cyst which was septated at its caudal portion and compressed the vena cava for 5.6 cm. The antibody titre against echinococcus antigen was 1:3200. At laparotomy the echinococcal cyst was found to have extended to the left adrenal gland, renal fat capsule and left part of the diaphragm. There was a pressure necrosis on the right lateral aspect of the vena cava. The affected parts were resected and the patient quickly recovered. Postoperative treatment consisted of the administration of mebendazole (1.5 g daily) for 18 months. The patient had come from an area where echinococcal infection is endemic. The disease could have been quickly and easily diagnosed and cured if sonography had been undertaken early, sparing the patient major surgery.

Adolescent↗

PubMed1995

The morphology of xenotransplanted human breast carcinoma MX-1 growing in nude mice. A light and transmission electron microscopic study.

The present investigation is concerned with the morphological features of the human breast carcinoma MX-1, transplanted subcutaneously into nude mice. Three weeks after transplantation the tumor tissue is clearly distinct from the dermis. Solid tumor cell groups are separated incompletely by thin connective tissue septa, giving rise to a lobular appearance. The tumor cells are characterized by very irregularly formed nuclei with three or more nucleoli. The cytoplasm of these cells displays some lysosomes, the cisternae of the rough endoplasmic reticulum, mitochondria and a variable number of ribosomes. The Golgi fields are frequently observed, particularly near the nucleus. The cells are connected to each other by desmosomes, which also persist during mitotic activity. Ductular formations can occasionally be seen. The ultrastructure of the blood vessels discloses the morphological features necessary for the regulation of blood flow. Capillaries present a sinusoidal aspect with distended and narrow lumina. Interruptions of the endothelial wall, however, were not observed. This morphological appearance was found in all the MX-1 tumors investigated, reflecting the stable growth of this tumor cell line in nude mice.

Animals↗

PubMed1994

[Diagnosis of an Ullrich-Turner syndrome in pension evaluation].

A 56-year-old woman of short stature (148 cm) was medically examined after applying for a disability pension on account of chronic back-pain. She gave a history of primary amenorrhoea (not examined further), slowly increasing deafness, type IIb diabetes mellitus, hyperlipoproteinaemia, hypothyroidism and osteoporosis. Physical examination showed hypoplasia of both breasts, shield chest and slight webbing of the neck. Ultrasonography of the thyroid revealed late stage of Hashimoto thyroiditis. Vaginal ultrasonography confirmed absence of uterus and adnexae. All these findings were compatible with the diagnosis of Turner's syndrome, which was confirmed by chromosomal examination of 50 analysable metaphases showing chromosomal mosaic 45,X/46,X, i(Xq), as well as two cells with 47 chromosomes, two with isochromosomes for the long arm of the X-chromosome. Treatment consisted of administration of L-thyroxin (75 micrograms/d) and oestrogen. There was no follow-up.

Female↗

PubMed1994

[Polycythemia in the late metastasis of an erythropoietin-producing renal-cell carcinoma].

An 85-year-old woman had a right-sided renal cell carcinoma removed 20 years ago. At haemoglobin concentration. Two years ago she had a syncope, at which time the haemoglobin concentration was 16.9 g/dl. Ultrasound and computed tomography (CT) revealed an extensive retroperitoneal space-occupying lesion, which however was not investigated further, and no therapeutic consequences were drawn. An erythrocytosis (7.5 x 10(6)/microliters) and elevated haemoglobin concentration (> 20 g/dl) were found when she was examined after a fall in which she had sustained only minimal injury. The retroperitoneal mass had slightly increased in size. Histological examination of a CT-guided fine-needle biopsy revealed metastases of the hypernephroid carcinoma. The serum erythropoietin concentration was increased (42.4 U/l) and failed to increase even after repeated venesections, indicating erythropoietin production by the late metastases of the renal cell carcinoma. There was no evidence for any systemic haematological disease. Six months after the diagnosis of metastases the patient died at home, presumably of a cerebrovascular accident.

Aged↗

PubMed1994

The effect of ifosfamide on tumor oxygenation at different temperatures.

In MX1 human breast cancer xenografts grown on the hind paw of thymusaplastic nude mice the effect of ifosfamide on tumor oxygenation, tumor pH and the concentration of lactic acid have been determined at mean tumor temperatures of 32 degrees C, 37 degrees C and 41 degrees C. For histological studies tumors were shock-frozen or fixed with formalin or glutaraldehyde. Treatment with Ifosfamide (250 mg/kg b.w.) reduced intratumoral laser Doppler flow, oxygenation and pH. This suggests that ifosfamide or its metabolites may have an effect on tumor vasculature.

Animals↗