Biomedical subjects

M Albers

Publications and source records attributed to M Albers.

At least 19 recordsLinked to original sources

PubMed2006

[Problems in the vocational rehabilitation of mentally ill subjects--a simple procedure to identify persons with an increased risk for premature termination of a training programme].

UNLABELLED: A small number of young mentally ill persons consumes a disproportionate amount of psychiatric service resources. These persons are characterised by emotional instability, aggressive or delinquent behaviour, substance misuse and personality disorders. They are sometimes referred to as young adult chronic patients (YACP). To date there has been no investigation as to what impact this pattern of problem behaviour has on vocational rehabilitation. AIM: The aim of this study was to find out whether belonging to the YACP group, as determined by an operational definition, reduces the outcome of vocational rehabilitation. METHOD: A chart review was done of the files of all 174 participants of a 15-month vocational training course held between 1.1.1993 and 2.5.1998 in the vocational training centre at Cologne. A 15-item score was used to assess YACP status. RESULTS: 30 % were classified as high scorers, i. e. YACP. 59 % of the high scorers vs. 22 % of the low scorers terminated training prematurely. Of the high scorers who completed training, only 47 (vs. 74 % of low scorers) were judged to be able to work at the end of training. CONCLUSION: At the very beginning of the vocational training persons in need of a highly individualised format can be discerned by a few, easy to assess items. Concepts of vocational training should be developed to better suit the needs of young mentally ill persons with personality disorders and substance abuse.

Adult↗

PubMed2005

The distal zone of the deep femoral artery as the inflow site in femorodistal bypass grafting.

The distal zone of the deep femoral artery has been used as an inflow site for femorodistal bypass grafts. Eleven such bypass grafts were performed in patients who had critical limb ischemia either to avoid a hostile groin (n=7) or because of an insufficient length of vein (n=4). The posteromedial route was used. Two of the 11 grafts had early failure and a third failed at 3 months: redo surgery restored arterial blood flow to the limb in all three patients. The procedure was safe and is a widely applicable, effective alternative that extends the limits of infrainguinal vein bypass grafting.

Aged↗

PubMed2004

Meta-analysis of allograft bypass grafting to infrapopliteal arteries.

OBJECTIVE: To determine graft patency and limb preservation after allograft bypass grafting to infrapopliteal arteries for different allograft materials. DESIGN: Meta-analysis of case series that used survival analysis to describe outcomes. METHODS: Studies published from 1982 through 2003 were identified from electronic databases and pertinent original articles. Four series of cryopreserved arterial allografts, 10 series of cryopreserved vein allografts, three series of cold-storaged vein allografts, and 16 series of umbilical-cord vein allografts were included in separate random-effects meta-analyses. RESULTS: A graphical display of pooled survival curves of graft patency showed cold-storaged veins to have the best outcome in the first 4 years, followed by cryopreserved arteries, umbilical-cord veins, and cryopreserved veins. The respective 5-year pooled patency were 24, 21, 30, and 19%. For foot preservation, the best outcome was achieved with cryopreserved arteries followed by cryopreserved veins, umbilical-cord veins, and cold-storaged veins. A reference meta-analysis of polytetrafluoroethlylene grafts occupied the top position for graft patency and the second position for foot preservation. CONCLUSION: In leg revascularisation for critical ischaemia, graft patency is poor for allografts generally, but using peripheral allografts in repeat attempts at revascularisation is a valid strategy to prevent major amputation. A role for umbilical-cord vein allografts remains uncertain.

Arterial Occlusive Diseases↗

PubMed2003

Epidemiological aspects and early detection of chronic obstructive airway diseases in the elderly.

The burdens of chronic obstructive airway diseases among the elderly in Europe, and worldwide, are increasing. Although asthma is common in all ages, the main airway disease affecting the elderly is chronic obstructive pulmonary disease (COPD). The aim of this paper is to review the prevalence and incidence of COPD on the basis of population studies. As the prevalence estimates of asthma are probably well known, only the incidence and remission of asthma will be discussed. The underdiagnosis of obstructive airway diseases is huge. A Dutch programme for early detection of obstructive airway disease among the elderly has, thus, been included in the presentation. A prerequisite for fighting COPD is to acquire data on illnesses and death. COPD has only recently been defined by cut-off points of spirometric outcomes, which is why measures of the prevalence of COPD have been distorted by use of a large number of different diagnostic terms and lung function criteria. The prevalence of clinically-relevant COPD has been estimated in several community studies to 4-6% in adult population samples, with a considerable increase by age, particularly among smokers. The incidence of COPD not only increases heavily with age and smoking, but also occupational exposure to dust, gas and damp. Precise estimates of the incidence of COPD or spirometric airflow limitation are not available. Demographic changes will result in a further substantial increase of chronic obstructive airway disorders, mainly chronic obstructive pulmonary disease, among the elderly. The increasing burden of chronic obstructive pulmonary disease has to come to the awareness of the public, governments, health authorities, and industry.

Aged↗

PubMed2001

Discovery and evaluation of piperidinyl carboxylic acid derivatives as potent alpha(4)beta(1) integrin antagonists.

Piperidinyl carboxylic acid-based derivatives were prepared as antagonists of the leukocyte cell adhesion process that is mediated through the interaction of the alpha(4)beta(1) integrin (VLA-4, very late antigen 4) and the vascular cell adhesion molecule 1 (VCAM-1). Compounds 2a-h inhibited the adhesion in a cell-based assay in the low and sub micromolar range, a pharmacokinetic study of 2d is reported.

Area Under Curve↗

PubMed2001

Cerebral blood flow velocity in untreated panic disorder patients: a transcranial Doppler ultrasonography study.

BACKGROUND: The aim of this study was to compare resting cerebral blood flow velocity values of unmedicated patients in the acute phase of panic disorder with resting values of healthy control subjects. METHODS: Nineteen unmedicated panic disorder patients were assessed for degree of anxiety using the Hamilton Anxiety Scale. The patients and 20 healthy age-matched control subjects were then insonated at rest using transcranial Doppler ultrasonography (TCD). For TCD, the anterior, the middle, and the posterior cerebral arteries were insonated bilaterally in all patients. RESULTS: Compared with healthy age-matched control subjects, acute unmedicated panic disorder patients showed a significant increase in cerebral blood flow velocity, bilaterally in the middle and the anterior cerebral artery, and unilaterally in the left posterior cerebral artery. Cerebral blood flow velocity in the right middle cerebral artery correlated positively to the item "Fear" on the Hamilton Anxiety Scale, whereas pulsatility index in the posterior cerebral artery bilaterally and in the left middle cerebral artery correlated negatively to the item "Mood." CONCLUSIONS: Transcranial Doppler ultrasonography agrees well with validated psychometric methods. If follow-up studies confirm our findings, TCD could allow an objective assessment of the mental state of panic disorder patients and reliably discriminate panic disorder patients from normal control subjects.

Adult↗

PubMed2001

Prospective comparison of arm veins and greater saphenous veins as infrageniculate bypass grafts.

OBJECTIVES: to compare arm and saphenous veins for infrageniculate bypass grafting. DESIGN: prospective non-randomised study. MATERIALS: two hundred patients, of which 197 had ischaemic tissue loss or rest pain. METHODS: two hundred and eleven infrageniculate vein bypass procedures using 176 greater saphenous veins and 35 arm veins. RESULTS: the cumulative primary graft patency rate at 1-month and 2 years was 80% and 61% for saphenous vein and 89% and 42% for arm vein. The corresponding rates for secondary patency were 84.5% and 68%, and 91% and 57%, respectively. These results corresponded to a relative risk of secondary failure of 1.53 (95% CI 0.71, 3.31) for arm vein grafts. In subgroup analyses, this estimate was 0.93 and 2.1 for primary vs secondary bypasses and 0.38 and 2.06 for single-vein vs spliced-vein bypasses. Among arm veins, cephalic vein grafts performed better than basilic vein grafts. Early mortality was 14% for arm vein and 10% for saphenous vein. CONCLUSION: in the setting of infrageniculate bypass grafting, arm vein grafts are not equivalent to greater saphenous vein grafts, but contribute importantly to a policy of using autologous veins. The possibility of equivalence remains for the arm vein graft that uses a cephalic vein or is a primary procedure.

Aged↗

PubMed2001

A meta-analysis of infrainguinal arterial reconstruction in patients with end-stage renal disease.

OBJECTIVES: to determine graft patency, limb salvage, and patient survival following infrainguinal bypass grafting in patients with end-stage renal disease (ESRD). METHODS: studies published from 1987 through 2000 were identified from the PUBMED database and pertinent original articles. Sixteen studies were found that used survival analysis to report the outcomes of interest. Two investigators independently extracted the data from standard life-tables, survival curves and texts. A new method was developed for meta-analysis of uncontrolled studies that use survival analysis with different follow-up intervals. RESULTS: random-effects modelling yielded the following summary estimates at one- and two-year follow-up: 79% (95% CI, 70-87%) and 74% (63-85%) for graft patency; 77% (69-84%) and 73% (64-81%) for limb salvage; and 59% and 42% for patient survival. CONCLUSION: despite a severely limited life span, infrainguinal bypass grafting for the treatment of critical ischaemia is worthwhile in selected patients with ESRD.

Graft Survival↗

PubMed2000

Bypass to the genicular arteries for revascularisation of the lower limb.

OBJECTIVE: To describe an initial experience with infrainguinal bypass grafts inserted distally in a genicular artery. DESIGN: Retrospective case series study. SUBJECTS AND METHODS: Eleven patients with Grade III chronic limb ischaemia in whom arteriography showed femoropopliteal occlusive disease and at least one genicular branch suitable for receiving a bypass. Bypass grafts were done to the descending genicular artery (n=4) or the medial sural artery (n=6) using segments of autologous veins; one bypass was not completed. RESULTS: Primary graft patency and foot salvage rates were 73% at 1 month and 24 months of follow-up. Patient survival rate was 100% and 90%, respectively. Major amputation was required in two of three patients following early graft failure. Of the eight patients who had a patent graft, the Doppler ankle-brachial systolic pressure index showed no change in one patient, an increase of 0.13-0.66 in six patients, and was not measured in one patient. The former patient underwent a below-knee amputation whereas the other seven patients showed complete healing of their skin ulcers and sites of minor amputation. CONCLUSION: The genicular bypass is a useful alternative that may extend the limits of infrainguinal arterial reconstruction with autologous tissue and the potential for long-term patient benefit.

Aged↗

PubMed2000

Neuroimaging and behavioral correlates of recovery from mnestic block syndrome and other cognitive deteriorations.

OBJECTIVE: We conducted a follow-up study on a patient with enduring psychic shock-induced cognitive impairment to study by neuropsychological and functional imaging methods the degree of his recovery process on the brain and cognitive levels. BACKGROUND: Based on the assumption that trauma and stress conditions can alter the functions of the nervous systems, we report on a patient whom we studied 2 and 12 months after he suffered "mnestic block syndrome" and additional cognitive deterioration symptoms. METHODS: We report on a patient studied 2 and 12 months after he suffered "mnestic block syndrome" and additional cognitive deterioration symptoms. Magnetic resonance imaging and fluorodeoxyglucose positron emission tomography were used for neural and detailed neuropsychological testing for cognitive deficits. RESULTS: The patient initially manifested severe intellectual decline, including severe anterograde and retrograde amnesia. His symptoms were correlated with major, although selective, reductions in his brain metabolism (2-3 SD below those of controls). Presently, he shows a normal brain metabolism and has regained parts of his memory and many of his other intellectual capabilities. Nevertheless, he still has long-term memory impairments. CONCLUSIONS: This case demonstrates a close relation between brain metabolism and cognitive performance, with major deficits of both at 2 months and major recovery of both at 12 months after a shocking event. It can serve as an example for possible stress-related deteriorations in certain brain regions, which can be partly corrected by psychotherapeutic interventions, passing time, and favorable environmental conditions.

Amnesia↗

PubMed1999

Superficial femoral eversion endarterectomy combined with a vein segment as a composite artery-vein bypass graft for infrainguinal arterial reconstruction.

OBJECTIVE: The purpose of this study was to determine the results of composite artery-vein bypass grafting for infrainguinal arterial reconstruction. METHODS: This study was designed as a retrospective case series in two tertiary referral centers. Forty-eight of 51 patients underwent the procedure of interest for the treatment of ischemic skin lesions (n = 42), rest pain (n = 3), disabling claudication (n = 1), and infected prosthesis (n = 2). The intervention used was infrainguinal composite artery-vein bypass grafting to popliteal (n = 18) and infrapopliteal (n = 30) arteries, with an occluded segment of the superficial femoral artery prepared with eversion endarterectomy and an autogenous vein conduit harvested from greater saphenous veins (n = 43), arm veins (n = 3), and lesser saphenous veins (n = 2). The main outcome measures, primary graft patency rates, foot salvage rates, and patient survival rates, were described by means of the life-table method for a mean follow-up time of 15.5 months. RESULTS: The cumulative loss during the follow-up period was 6% and 24% at 6 and 12 months, respectively. The primary graft patency rates, the foot salvage rates, and the patient survival rates for patients with popliteal grafts were 60.0% +/- 9.07%, 75.7% +/- 9.18%, and 93.5% +/- 6.03%, respectively, at 1 month; 53.7% +/- 11.85%, 68.9% +/- 12.47%, and 85. 0% +/- 9.92% at 1 year; and 46.7% +/- 18.19%, 68.9% +/- 20.54%, and 53.1% +/- 17.15% at 5 years. For infrapopliteal grafts, the corresponding estimates were 72.4% +/- 7.06%, 72.9% +/- 6.99%, and 92.7% +/- 4.79% at 1 month; 55.6% +/- 10.70%, 55.4% +/- 10.07%, and 77.9% +/- 9.02% at 1 year; and 33.6% +/- 22.36%, 55.4% +/- 30.20%, and 20.8% +/- 9.89% at 5 years. CONCLUSION: The composite artery-vein bypass graft is a useful autogenous alternative for infrainguinal arterial reconstruction when a vein of the required quality is not available or when the procedure needs to be confined to the affected limb.

Aged↗

PubMed1999

Quality of life in low-income patients with metastatic prostate cancer: divergent and convergent validity of three instruments.

Few studies have evaluated Quality Of Life (QOL) among low-income patients with cancer. Information is needed about the feasibility and psychometric characteristics of QOL instruments in these populations. The purpose of this study was to examine the convergent and discriminant relationships between scales of three QOL instruments: European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC), Functional Assessment of Cancer Therapy--General (FACT), and Quality of Life Index (QLI). Participants included 110 men with metastatic prostate cancer of whom 94% were low income and 62% were African-American. Interviewers administered the questionnaires. Cronbach alpha internal consistency reliabilities were 0.57 to 0.90 for the EORTC, 0.65 to 0.86 for the FACT, and 0.63 for the QLI. Convergent validity was supported for the EORTC and FACT scales measuring emotional, physical, and role/functional dimensions (r = 0.54 to 0.72), but not on scales measuring social function (r = 0.12). Divergent validity was supported between dissimilar scales (r = 0.14 to 0.38). Analysis with receiver operating characteristics curves provided empirical support for the EORTC and FACT as multidimensional measures. These findings suggest that, even in busy clinical settings with low literacy patients, interviewer-administered EORTC and FACT QOL instruments can provide valid and reliable information.

Aged↗

PubMed1999

[Biological addictive drugs--is there a change in drug taking behavior of young drug addicts?].

Abuse of natural products was frequently noticed among young patients with multiple substance abuse. 180 patients of a rehabilitation clinic for young addicts filled out a questionnaire regarding their regularly consumed drugs. Ayahuasca and cactus, the natural drugs of the 70's are rarely found. The patients frequently consumed psilocybin, amanita and datura. We inform about the toxicological basis of the used drugs. A specific exploration of patients with multiple substance abuse in regard to the use of biological drugs is an necessary as random and multicentre follow-up-studies.

Adult↗

PubMed1998

[Long-term treatment of chronic schizophrenia].

Long-term treatment of patients with chronic schizophrenias requires integration of many therapeutic approaches, co-operation of several professions, and regard for the views of patients and relatives. This review deals with practical aspects of pharmacotherapy, psychotherapy, cognitive resp. psychological treatments, social resp. milieu therapy, rehabilitation, interventions based on the concept of Expressed Emotions (EE), psychoeducation and work with relatives. Continuous neuroleptic treatment is indispensable in most cases to achieve social integration. Indications for adding on antidepressants, lithium, carbamazepine, benzodiazepines and other drugs are discussed, as well as treatment of negative symptoms, depression and management of treatment-resistant symptoms. Psychotherapy needs to regard the possibilities of the patient. In the context of a stable long-term relationship, the patient is supported in experiencing himself as a subject capable of action. Effectiveness of cognitive treatments to date is limited. The best results are achieved by social skills training. Social therapy, which aims at the improvement of functional aspects of the patient, is of paramount importance. Improved possibilities for work rehabilitation are contrasted by difficulties in financing long-term social rehabilitation. Interventions based on the EE concept are highly effective, but are rarely used. Programs that merely convey information without targeting behaviour modification are ineffective. The functions of facilities of treatment in the community are explained, the integrative role of case-management is stressed.

Antipsychotic Agents↗

PubMed1998

Psychic trauma causing grossly reduced brain metabolism and cognitive deterioration.

While amnesia and other cognitive disturbances are usually caused by structural brain damage, there are a few instances in which environmental stress may induce neuronal death in memory-sensitive brain regions such as the hippocampus. Here we report on a patient who, after a single brief exposure to an event reminding him of a similar stressful event from his childhood, deteriorated immediately and persistently without manifesting structural, but manifesting functional, brain damage as measured by position emission tomography. This patient probably represents the first case in which a direct relation between a single psychic event and the occurrence of brain malfunctioning in cognition is documented by dynamic neuroimaging methods. Psychic shock may cause lasting reductions in brain metabolism with the consequence of severe intellectual malfunctioning.

Adult↗

PubMed1998

Cerebral blood flow velocity in acute schizophrenic patients. A transcranial Doppler ultrasonography study.

BACKGROUND AND PURPOSE: The aim of this study was to determine whether acutely psychotic first-episode schizophrenics show an increased cerebral blood flow velocity and whether this condition is reversible on psychopathological improvement. METHODS: In the first of two examinations, transcranial Doppler ultrasonography and assessment with the Positive and Negative Syndrome Scale (PANSS) were performed on 28 acutely psychotic, neuroleptically naive, first-episode schizophrenics. In the second examination, the same patients were assessed psychometrically (PANSS) as well as with Doppler ultrasonography after psychopathological improvement. RESULTS: Acutely psychotic first-episode schizophrenics showed a significant increase of the mean velocity on both sides in the middle and anterior cerebral arteries and in the right posterior cerebral artery. Blood flow showed significant correlations with productive psychotic symptoms. After psychopathological improvement there was a bilateral normalization of the mean velocity in the middle, anterior, and posterior cerebral arteries. CONCLUSIONS: Acutely psychotic first-episode schizophrenics show a significantly increased bilateral cerebral blood flow velocity, which normalizes on psychopathological improvement. There were significant correlations of cerebral blood flow velocity with psychopathology.

Acute Disease↗

PubMed1998

Quality of life in metastatic prostate cancer among men of lower socioeconomic status: feasibility and criterion related validity of 3 measures.

PURPOSE: Identification of metastatic disease progression is often difficult but important. Previous studies of quality of life in metastatic disease have been limited by the small number of respondents who were not white or of lower socioeconomic status. Quality of life assessment is generally done using self-administration techniques but this method is of limited usefulness for patients of low socioeconomic status, many of whom have limited reading abilities. We evaluated the feasibility and validity of interviewer administration of 3 quality of life instruments for patients of low socioeconomic status with metastatic prostate cancer. MATERIALS AND METHODS: We used instruments previously validated with self-administration methodology, including the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire-30, Functional Assessment of Cancer Therapy-General Scale and Quality of Life Index. Subjects were men with metastatic prostate cancer with stable (78) or progressive (32) disease at 4 Veterans Affairs medical centers and 1 other site. Of the patients 94% were Veterans Affairs patients and more than 60% were black. RESULTS: Each quality of life instrument required less than 10 minutes of interviewer administration and was able to discriminate between patients with stable versus progressive disease on several health status domains. CONCLUSIONS: These data support the feasibility and validity of quality of life measurement in patients of low socioeconomic status with metastatic prostate cancer. Consideration should be given to adding quality of life instruments to patient encounter even among low socioeconomic status, low literacy populations.

Aged↗

PubMed1997

The nucleotide sequence of Saccharomyces cerevisiae chromosome VII.

The complete nucleotide sequence of Saccharomyces cerevisiae chromosome VII has 572 predicted open reading frames (ORFs), of which 341 are new. No correlation was found between G+C content and gene density along the chromosome, and their variations are random. Of the ORFs, 17% show high similarity to human proteins. Almost half of the ORFs could be classified in functional categories, and there is a slight increase in the number of transcription (7.0%) and translation (5.2%) factors when compared with the complete S. cerevisiae genome. Accurate verification procedures demonstrate that there are less than two errors per 10,000 base pairs in the published sequence.

Base Sequence↗