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Biomedical subjects

H P Kapfhammer

Publications and source records attributed to H P Kapfhammer.

At least 19 recordsLinked to original sources
PubMed2005

[Mild cognitive impairment: A review of the literature].

People with MCI suffer from a moderate memory impairment, from deficits in attention and cognitive flexibility but do not fulfil the diagnostic criteria of dementia. These patients feel forgetful, and sometimes may have problems with their jobs and families because of their forgetfulness. In many cases (10-15% per year), MCI is leading to Alzheimer's disease. The sooner MCI is diagnosed and treated, the better the transition into Alzheimer's disease may perhaps be delayed. The diagnostic instruments are the same as for the diagnosis of Alzheimer's disease: biomarkers of the cerebrospinal fluid, neuroimaging and neuropsychological testing. Neuropsychological testing already shows deficits, even when neuroimaging findings still seem to be normal. Therapy of MCI is basically like the treatment of Alzheimer's disease: symptomatic treatment with cholinesterase-inhibitors or antioxidants, and compensatory psychological approaches.

Aged↗
PubMed2005

[Personality profile and psychic deviations in offenders examined for psychiatric-forensic appraisal].

Personality is one factor within the multidimensional structure of conditions involved in the development of an offender. The aim of this study is to contribute to a better accuracy of discrimination of risk factors and prediction of delinquent behaviour. For psychiatric-forensic opinions, social, forensic and psychiatric history as well as type of the last offence and its course for adjudged delinquents (n=128) was recorded. For determining personality structure, the "Freiburger Personlichkeitsinventar" (FPI-R) and the "Fragebogen zur Erfassung von Aggressivitatsfaktoren" (FAF) was used. Psychiatric diagnosis was based on criteria of ICD-10. Using a hierarchical cluster analysis including the dimensions of the FPI-R, three personality profiles could be separated. First offenders and re-offenders could be discriminated by family environment and age at the first delict. The importance of classification for risk estimation of delinquent behaviour and its significance for providing forensic opinions is discussed.

Adult↗
PubMed2004

[Chronic fatigue syndrome].

The symptoms of fatigue and exhaustion, which are central to chronic fatigue syndrome and neurasthenia, can lay claim to being"psychopathological entities" in their own right. Although ubiquitous, they by no means reflect a homogeneous clinical picture. Chronic fatigue may occur after physical illness, such as viral infections, or be associated with a range of different psychiatric disorders. There is wide overlap with affective, anxiety, somatoform, and personality disorders, and this should be borne in mind when it comes to classifying these symptoms. To investigate the etiopathogenesis, multifactorial models are required. For treatment, adapted cognitive-behavioral therapy, possibly accompanied by an antidepressant, is effective.

Antidepressive Agents↗
PubMed2004

[The fibromyalgia syndrome].

The Fibromyalgia Syndrome Fibromyalgia is a "pain disorder" and is diagnosed in accordance with the criteria of the American College of Rheumatology. The clinical presentation involves a complexity of symptoms with pains occurring at numerous sites identified by "tender points", disturbed sleep, increased fatigue, and numerous psychovegetative and psychic symptoms. Epidemiological data reveal high prevalence figures for fibromyalgia, and the disease is usually chronic. The etiopathogenesis can be described only within a multifactorial model. Numerous neurobiological and psychosocial factors militate in favor of a central disturbance of stress coping and pain perception. Multimode therapeutic approaches need to be individualized, but in many cases continue to be only moderately successful.

Adult↗
PubMed2003

[Sick building syndrome or fungal allergy? When houses cause illness].

In modern societies, the sick building syndrome (SBS) is a very common building-related complex of unspecific symptoms affecting groups of persons. Most frequently, complains include irritation of the eyes and respiratory tract that are believed to be related to negative ambient factors at the workplace. The etiology is multifactorial. In persons showing typical anxiety about the environment, SBS may also be considered a variant of a somatoform disorder. SBS must be clearly differentiated from building-related illness. Diagnostic measures and therapeutic implications are discussed.

Air Pollutants, Occupational↗
PubMed2002

[Acute liver failure in nefazodone therapy? A case report].

Antidepressant-induced hepatotoxicity is generally considered of minimal clinical importance and is not well recognized. We report on a patient with recurrent major depression who was treated with nefazodone. Six weeks after initiation of therapy with nefazodone, he developed fatal liver failure. After cessation of the drug, the patient did not recover. He underwent liver transplantation but unfortunately died.

Antidepressive Agents↗
PubMed2001

The effect of stress doses of hydrocortisone during septic shock on posttraumatic stress disorder in survivors.

BACKGROUND: Exposure to intense physical and psychological stress during septic shock can result in posttraumatic stress disorder in survivors. Patients with chronic posttraumatic stress disorder often show sustained reductions in serum cortisol concentration. This investigation examines whether increasing serum cortisol levels with hydrocortisone treatment during septic shock reduces the incidence of posttraumatic stress disorder in survivors. METHODS: Patients (n = 20) were recruited from a prospective, randomized double-blind study on the hemodynamic effects of hydrocortisone during septic shock. Eleven patients had received placebo and nine stress doses of hydrocortisone. Posttraumatic stress disorder was diagnosed 31 months (median) after intensive care unit discharge using SCID-IV (DSM-IV-criteria). Furthermore, the number of categories of traumatic memory from ICU treatment was determined in both groups at that time. RESULTS: Only one of nine patients from the hydrocortisone group developed posttraumatic stress disorder, compared with seven of 11 patients in the placebo group (p =.02). There was no significant difference with regard to the number of categories of traumatic memory between the hydrocortisone and placebo groups. CONCLUSIONS: The administration of hydrocortisone during septic shock in a dosage similar to the endogenous maximal production rate was associated with a lower incidence of posttraumatic stress disorder in long-term survivors, which seems to be independent of the number of categories of traumatic memory.

Adult↗
PubMed2001

[Somatoform disorders. Historical development and modern diagnostic conceptualization].

Patients with "medically unexplained" bodily symptoms form a major group in the medical care system. Diagnostic and therapeutic problems very often arise, and the concept of "somatization" promotes a better understanding of this patient group. Important historical stages in the development toward a modern diagnostic classification of somatoform disorders are outlined. A critical comment on the diagnostic approaches according to DSM-IV and ICD-10 follows.

Conversion Disorder↗
PubMed2001

[Somatization--somatoform disorders--etiopathological models].

A multifactorial model is obligatory to comprise the etiopathogenesis of somatization. Thereby, different aspects of genetics, neurology, neurophysiology, psychophysiology, endocrinology, psychology of personality, perception and cognition, social learning, knowledge of illness, public conceptualisation of illness, negative life events, chronic psychosocial stressors, reduced coping skills, lacking supporting systems, systems of social reinforcement, coexistence/comorbidity of psychiatric disorders, traumapsychology and psychodynamics can be outlined.

Humans↗
PubMed2000

Pulmonary function and health-related quality of life in a sample of long-term survivors of the acute respiratory distress syndrome.

OBJECTIVE: We performed a follow-up cohort analysis in order to delineate the correlation between pulmonary function (PF) and health-related quality of life (HRQL) in patients after ARDS. DESIGN: Follow-up cohort study. SETTING: A 20-bed ICU of a university teaching hospital. PATIENTS: A cohort of 50 long-term survivors of ARDS. MEASUREMENTS AND RESULTS: Measurements of PF (FVC, FEV1, TLC, D(LCO)) and HRQL (SF-36 Health Status Questionnaire) were made 5.5 years (median value) after discharge from the ICU. Impairments in PF (defined as PF results below 80% of the predicted value) were frequent but generally mild. Twenty patients had a single PF impairment (with limitations in FEV1/FVC ratio in 12 patients being the most common), four patients had two (with D(LCO) and FEV1/FVC ratio impairment the most common) and three patients had pathologic results in three PF tests (FEV1/FVC ratio, TLC and capillary pO2 during exercise in one case, FVC, TLC and capillary pO2 during exercise in the second patient and FVC, TLC and D(LCO) in the third). Compared to normal controls, survivors of ARDS showed impairments in all SF-36 health dimensions (p < 0.001). Patients with multiple (> 1) PF impairments described the lowest HRQL with major limitations in all SF-36 categories (p < 0.037) including physical and mental summary scores (36.5 vs 46.9, p = 0.037 and 31.3 vs 51.4, p = 0.003) when compared to patients with no or only one PF impairment. CONCLUSIONS: Long-term survivors of ARDS have a significant reduction in HRQL and the presence of multiple PF impairments is associated with maximal decrements in HRQL.

Adult↗
PubMed2000

Suicide attempt by pure citalopram overdose causing long-lasting severe sinus bradycardia, hypotension and syncopes: successful therapy with a temporary pacemaker.

In few cases, pure citalopram overdose at doses above 600 mg showed electro-cardiographic changes with prolonged QT intervals and sinus bradycardia gradually resolving within 12-24 hours after intoxication. We report on a 32-year-old patient with borderline personality disorder (BPD) who ingested a total of 800 mg citalopram to attempt suicide due to an interpersonal disappointment. She developed severe sinus bradycardia with a minimal pulse rate of 41/min within about 4 hours after intoxication lasting up to six days during intensive care unit (ICU) treatment. Further, hypotension and syncopes occurred. No QT interval prolongations were recorded. To our knowledge, this is the first case report of pure citalopram overdose-induced long-lasting sinus bradycardia associated with severe hypotension and intermittent syncopes that required therapy with a temporary pacemaker.

Adult↗
PubMed2000

Health-related quality of life and post-traumatic stress disorder in patients after cardiac surgery and intensive care treatment.

OBJECTIVES: Health-related quality of life and patient satisfaction have become important end points in cardiac surgery. Post-traumatic stress disorder has been described in patients with life-threatening heart disease. In this study, we investigated the occurrence of post-traumatic stress disorder in a sample of patients after cardiac surgery and compared health-related quality of life and patient satisfaction between patients with and without evidence of post-traumatic stress disorder. METHODS: We studied 80 patients serially admitted to the intensive care unit after cardiac surgery (bypass grafting, n = 51; aortic valve replacement, n = 29). Health-related quality of life was assessed with the use of the SF-36 Health Status Questionnaire. Post-traumatic stress disorder was measured with a previously validated instrument (the Post-Traumatic Stress Syndrome 10-Questions Inventory), and 20 different aspects of life satisfaction were quantified on a scale ranging from 0 to 10. For measurements of health-related quality of life and post-traumatic stress disorder, age- and gender-comparable healthy individuals, as well as patients with cardiovascular diseases, served as control groups. RESULTS: Patients who had cardiac surgery described high life satisfaction summary scores (156 of a maximum of 200 points) and only small impairments in physical and mental SF-36 summary scores when compared with healthy control groups (median reduction 7.15, P <.05). Patients with evidence of post-traumatic stress disorder (n = 15) reported the lowest SF-36 mental health summary scores when compared with patients without stress disorder (38.3 vs 48.4, P =.004) and rated their life satisfaction lower (121.5 vs 162.0, P =.002). CONCLUSIONS: Patients who have had cardiac surgery demonstrate a high life satisfaction with an acceptable degree of physical and mental health-related quality of life. Impairments in psychosocial function and life satisfaction were found in a subgroup of patients with evidence of post-traumatic stress disorder.

Aged↗
PubMed2000

Psychopathological changes preceding motor symptoms in Huntington's disease: a report on four cases.

Neurodegenerative disorders often exhibit "classical" psychiatric symptoms as an initial presentation of the disease. Here we present four patients with different psychopathological abnormalities who were later diagnosed as having Huntington's disease. The range of symptoms covered affective and psychotic symptoms, antisocial behavior, cognitive problems reminiscent of dementia and suicidal idealisation. The pattern of progress of neuronal degeneration may be helpful in explaining the antecedent manifestation of psychiatric symptoms.

Adult↗