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Biomedical subjects

H Helmchen

Publications and source records attributed to H Helmchen.

At least 19 recordsLinked to original sources
PubMed1991

[Pathobiochemistry and pharmacotherapy of alcohol withdrawal delirium].

The spectrum and time course of different symptoms during alcohol withdrawal may be caused by the involvement of various neurotransmitter systems that are differentially vulnerable to the effects of ethanol. Withdrawal symptomatology results from increased activity of excitatory mechanisms (NMDA-receptor, catecholamines among others) and from reduced functioning of inhibitory receptors (GABAA-, alpha 2-adreno-receptor among others). The neuronal mechanisms are subject to different dynamics of restitution following intoxication. Some of these probably contribute to long-lasting changes in CNS functions by "kindling" processes. Therapeutic guidelines are deduced from results of basic research and clinical trials. It is concluded that clomethiazole and benzodiazepines are superior in treating delirium tremens and certain risk-patients, whereas carbamazepine and clonidine may be helpful in moderate withdrawal syndromes or as adjunctive agents. However, the need for improved methodological standards of method in clinical research is evident.

Alcohol Withdrawal Delirium↗
PubMed1990

Summary of the qualitative criticisms made during the ICD-10 field trial and remarks on the German translation of ICD-10.

The 1987 draft of ICD-10 presents many new aspects of the psychiatric diagnostic evaluation. Some were readily accepted by the participants of the field study, including: the purely descriptive approach with the abautonment of many theoretical concepts; the more operationalized descriptions of the diagnoses; similarity in structure and terms to DSM-III-R. Others proved controversial: extension of the term dementia to include even mild and moderately severe organic psychosyndromes; inclusion of all forms of depression in one chapter, and their subdivisioning only by severity; different time criteria for the diagnosis of schizophrenia in DSM-III-R (6 months) and ICD-10 (1 month). Considerable criticism was levelled at the overly long and often tediously formulated text, and the lack of didactic organisation. A number of examples of translation difficulties are given, and the differences between a too literal and a technically correct equivalent translation disu-used.

Adolescent↗
PubMed1990

The problem of informed consent in dementia research.

The increasing frequency of dementia has considerable impact on the ill person, his relatives, and society. However, an effective therapy does not yet exist. This indicates a compelling need for dementia research. But the necessary informed consent often cannot be given by the ill person, since the dementing disease diminishes or destroys his consent capability. Possible solutions to this problem are put forward.

Aged↗
PubMed1979

Depression and monoamine oxidase.

1. The first part of the paper is devoted to a critical review on the possible relationships between depression and monoamine oxidase. 2. This study describes the results of an investigation of MAO-activity in depression, using new approaches and methodology. This methodology was developed because the literature data indicated that a) previous results are difficult to compare because of varying methods and diverse target populations used; b) previous methodological deficiencies do not allow to draw definite conclusions about the relationship between MAO-activity and depression. 3. The present investigation selected 35 psychiatric patients according to clearly defined diagnostic criteria (20 endogenous depressive, 10 neurotic depressive, and 5 manic patients) matched to 25 healthy control-subjects. 4. The Michaelis-constant (Km), the maximum reaction speed (Vmax), and the 50% enzyme inhibition by tranylcypromine (IC50) of platelet-MAO were determined during and after recovery from the depressive or manic episode using 3 substrates (tyramine, tryptamine, and phenylethylamine). 5. The present investigation, in contrast to conventional methodology, utilized three different substrates at different concentrations. Significant correlations were demonstrated for the Vmax-values of each of the three substrates, whereas the Km and the IC50 (tranylcypromine)-values varied for each substrate. 6. The results show that there were no differences between the characteristics of the platelet-MAO in depressive or manic patients and those of normal subjects. Furthermore, treatment with tricyclic antidepressants had no effect on MAO-activity. A previous investigation indicated that the MAO-properties in human brain tissue were similar to that in human platelets.

Adult↗
PubMed1979

[Psychiatric prognosis in epilepsies].

It was illustrated by examples how psychical disturbances of epileptics can be used as indicators a) for brain lesions which cause the epilepsy too, b) for epileptic activity of the brain itself, and c) for the consequences of epilepsies of long duration. Furthermore, how they can be used as predictors for the success of the epileptic during his life. This course-related arrangement of psychical disturbances which predict a negative prognosis corresponds with measures for prevention of the development of psychical disturbances, for therapeutic diminishing or removal of existing psychical disturbances, and for prophylaxis (or tertiary prevention resp.) of negative psychical consequences or relapses of epilepsy. These measures should improve the life-success of the epileptic patient.

Affective Symptoms↗
PubMed1978

[Ethical and legal problems in first clinical trials of psychotropic drugs (author's transl)].

Starting with the relevant national and international guidelines and legal regulations for clinical trials and with the distinction of therapeutical experimentation, therapeutical trial ("Heilversuch") and standard therapy the following points are discussed: a) informed consent in psychically ill patients with restricted capacity for stress and for insight and consent, b) consequences for insurances, c) advice and control for the researcher regarding the design, the performance and the judgment of the results of clinical trials of psychotropic drugs.

Age Factors↗
PubMed1977

[Frequency of depressive diseases (author's transl)].

Depressive diseases are among the most frequent illnesses. They are only partly recognized and treated. The largest number of depressed patients are found in the offices of the general practitioner and internist. Only a small fraction of patients with severe, predominantly endogenous psychotic depressions are treated in hospital. The following consequences arise from this frequency distribution: by improvement of diagnostic methods to recognize, if at all possible, all depressed patients requiring therapy and to treat them suitably; by improvement of prevention, primary in risk groups and tertiary in prophylaxis of recurrence, to lower the morbidity of depression; and by improvement of ambulant therapy with regard to controlling suicidal tendencies and anxiety and prevention of chronicity and resistance to therapy to reduce the necessity for hospitalization.

Adult↗