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Biomedical subjects

M Ertl

Publications and source records attributed to M Ertl.

16 recordsLinked to original sources
PubMed2006

Opioid addicts at admission vs. slow-release oral morphine, methadone, and sublingual buprenorphine maintenance treatment participants.

With use of a randomized study design, quality of life (QOL) and physical symptoms of opioid addicts at admission were compared with slow-release oral morphine, methadone, and sublingual buprenorphine maintenance program participants after 6 months of treatment. The study was conducted from February to July 2004 in the outpatient drug user treatment center at University Department of Psychiatry at Innsbruck, providing maintenance treatment programs and detoxification in Tyrol, Austria. One hundred twenty opioid users seeking treatment were compared with 120 opioid-dependent patients retained for 6 months on a slow-release oral morphine, methadone, or sublingual buprenorphine maintenance program. The German version ("Berlin Quality of Life Profile") of the Lancashire Quality of Life Profile was used, and illicit opioid use was determined by urinalysis. Physical symptoms were measured by using the Opioid Withdrawal Scale. Urinalyses revealed a significantly lower consumption of cocaine and opioids in all three substitution groups than in patients at admission (p < 0.001 and p < or = 0.004, respectively). Both the buprenorphine and the methadone maintenance group showed significantly more favorable values than opioid clients at admission for stomach cramps (p < or = 0.002), muscular tension (p < or = 0.027), general pain (p < or = 0.001), feelings of coldness (p < or = 0.000), heart pounding (p < or = 0.008), runny eyes (p < or = 0.047), and aggressions (p < or = 0.009). Patients who received slow-release oral morphine treatment generally showed the least favorable QOL scores compared with patients at admission or sublingual buprenorphine and methadone clients. Patients in the sublingual buprenorphine or methadone program showed nearly the same QOL scores. The buprenorphine and the methadone maintenance group showed significantly more favorable values than opioid clients at admission regarding leisure time (p < or = 0.019), finances (p < or = 0.014), mental health (p < or = 0.010), and overall satisfaction (p < or = 0.010). Slow-release oral morphine is a well-established treatment for pain, but more research is required to evaluate it as a treatment for heroin dependence. The present data indicate that slow-release oral morphine could have some disadvantages compared with sublingual buprenorphine and methadone in QOL, physical symptoms, and additional consumption. The results further suggest that buprenorphine treatment is as effective as methadone in effects on quality of life and physical symptoms.

Adult↗
PubMed2006

Uncompromised quality of the cement mantle in Exeter femoral components implanted through a minimally-invasive direct anterior approach. A prospective, randomised cadaver study.

A complete cement mantle is important for the longevity of a total hip replacement. In the minimally-invasive direct anterior approach used at the Innsbruck University hospital, the femoral component has to be inserted into the femoral canal by an angulated movement. In a cadaver study, the quality and the extent of the cement mantle surrounding 13 Exeter femoral components implanted straight through a standard anterolateral transgluteal approach were compared with those of 13 similar femoral components implanted in an angulated fashion through a direct anterior approach. A third-generation cementing technique was used. The inner and outer contours of the cement mantles was traced from CT scans and the thickness and cross-sectional area determined. In no case was the cement mantle incomplete. The total mean thickness of the cement mantle was 3.62 mm (95% confidence interval 3.59 to 3.65). The mean thickness in the group using the minimally-invasive approach was 0.16 mm less than that in the anterolateral group. The distribution of the thickness was similar in the two groups. The mean thickness was less on the anteromedial and anterolateral aspect than on the posterior aspect of the femur. There is no evidence that the angulated introduction of Exeter femoral components in the direct anterior approach in cadavers compromises the quality, extent or thickness of the cement mantle.

Arthroplasty, Replacement, Hip↗
PubMed2005

Gender differences in health-related quality of life on admission to a maintenance treatment program.

We compared the gender differences in health-related quality of life (QOL) on admission to a maintenance program. 103 opioid users (65 men and 38 women) admitted to a maintenance treatment program during 2000-2002 were studied. During this period we assessed the QOL status using the German version ('Berlin Quality of Life Profile') of the Lancashire Quality of Life Profile. Physical symptoms were measured using the Opioid Withdrawal Scale. 312 urine screening tests were carried out to evaluate consumption. The female group showed significantly less additional consumption of other opiates (p = 0.043) compared with the male group. The male group showed significantly better QOL scores in self-esteem (p = 0.015), psychical health (p = 0.027), and law and security (p = 0.008). The outcome measures for withdrawal scores showed significantly less symptoms for males in twitching of muscles (p = 0.034), vomiting (p = 0.002), depressions (p = 0.004) and poor appetite (p = 0.008). In summary, both genders showed only a few significant differences on admission in terms of QOL and physical symptoms. The predominant effects of drug use appear to eclipse the gender-related role pattern. Further exploration of gender and QOL could have important theoretical and treatment implications.

Demography↗
PubMed2003

Buprenorphine versus methadone maintenance treatment in an ambulant setting: a health-related quality of life assessment.

BACKGROUND: To compare the effects on quality of life (QOL) of oral methadone with sublingual buprenorphine. METHODS: We performed an open-label, non-randomized, two-site (methadone-buprenorphine) study. During 6 months we assessed the quality of life status of 53 opioid-dependent patients admitted to a methadone or buprenorphine maintenance programme using the German version (Berlin Quality of Life Profile) of the Lancashire Quality of Life Profile. Physical symptoms were measured using the Opioid Withdrawal Scale. Five hundred and thirty urine screening tests were carried out randomly to detect additional consumption. RESULTS: Sixty-seven opioid-dependent subjects (38 on methadone and 29 on buprenorphine) were enrolled in the study, and 53 completed it (30 subjects treated with buprenorphine and 23 subjects with racemic methadone). The subjects were comparable on all baseline measures. At the first follow-up (week 8), the buprenorphine-maintained group showed significantly less additional consumption of opioids (P = 0.013) compared with the methadone group. Patients retained in the buprenorphine or methadone programme (week 24) showed no significant differences in all quality of life scores. At the end of the study period, the buprenorphine-maintained group showed significantly less additional consumption of opioids (P = 0.001) and cocaine (P = 0.018) compared with the methadone group. The outcome measures for withdrawal symptoms after 24 weeks of treatment with buprenorphine showed slight advantages in stomach cramps, fatigue or tiredness, feelings of coldness and heart pounding. CONCLUSIONS: These results suggest that buprenorphine treatment is as effective as methadone regarding effects on quality of life and withdrawal symptoms. Buprenorphine has the potential to reduce the harm caused by drug abuse. Further research is needed to determine if buprenorphine is more effective than methadone in particular subgroups of patients.

Adult↗
PubMed2001

[Subjective wellbeing and somatic markers in methadone substitution. Evaluation of 61 heroin addicts].

AIM: In 61 patients with the ICD-10 diagnosis "heroin dependence" an evaluation of subjective well-being with consideration given to coexisting symptoms prior to and 4 months after initiation of methadone maintenance. METHOD: The Lancashire Quality of Life Profile and, for the clinical physical side effects, the opioid withdrawal scale proposed by Bradley and Seldenburg, were used. Additionally, urinalysis was performed. RESULTS: Statistically appreciable differences were found between the two groups in terms of drug-specific side effects, somatic satisfaction scales, and consumption of medications and co-use of addictive drugs. Further statistically evident inter-group differences were seen with regard to mental well-being. CONCLUSION: Overall, methadone maintenance leads to a rapid improvement in subjective well-being and to a relevant reduction in concurrent physical symptoms.

Adult↗
PubMed1999

Long-term exposure to wood-preserving chemicals containing pentachlorophenol and lindane is related to neurobehavioral performance in women.

BACKGROUND: The adverse neurobehavioral effects of long-term low exposure to wood-preserving chemicals (WPC) containing solvents, pentachlorophenol (PCP) and gamma-hexachlorocyclohexane (gamma-HCH; lindane), and other neurotoxicants were investigated in a neuropsychological group study. METHODS: Out of a population of 2,000 women visiting the outpatient practice of a gynecological department, a sample of 15 women aged 31-56 (mean 43) with long-term exposure to WPC verified by self-report, biological monitoring, and environmental samples was investigated. Fifteen controls aged 42 (31-56) years were drawn from the same population and pair-wise matched with respect to sex, age, education, and estimated intelligence. RESULTS: For the exposed group, mean PCP serum level was 43.6 micrograms/l and mean gamma-HCH blood level was 0.085 microgram/l. Mean duration of exposure was 10 (5-17) years. Intellectual functioning, attention, memory, and visuo-motor performance were examined, suggesting significant group differences in visual short-term memory (Benton Test; d = 1.5, P = .005), verbal memory (paired associate learning and Peterson paradigm; d = 4.3 and 1.6, P < .001), and an incidental learning task (d = 2.3; P = .001). Frequent subjective complaints as assessed by questionnaire were attenuated motivation (d = 1.7; P = .001), increased fatigue (d = 1.6; P = .001), distractibility (d = 1.0; P = .003), and depressed mood (d = 1.9; P = .004). PCP blood level was significantly associated with paired-associate learning, Benton Test, and reading/naming speed. CONCLUSIONS: Long-term low-dose exposure to WPC in the domestic environment could be related to subjective complaints (attention, mood, and motivation) and to subtle alterations of neurobehavioral performance (e.g., working memory) in women.

Adult↗
PubMed1998

Problem-solving in relation to abuse by a partner.

The present study investigated the usefulness of the construct of abuse-related problem-solving in relation to the reported experience of abuse by a partner in both clinical and nonclinical samples of women. Data were collected from a clinical sample of 101 women who were receiving treatment at a domestic violence shelter and from a nonclinical sample of 635 female undergraduates attending a medium-sized university. Analysis indicated that women in both samples who possessed good abuse-related problem-solving ability reported experiencing less abuse from their partners. The usefulness of this construct as well as its limitations were noted.

Adaptation, Psychological↗
PubMed1993

3H-spiperone binding capacity in mononuclear cells: a family study.

1. A family study was carried out using a putative biological vulnerability trait in families of schizophrenics and schizoaffective indexprobands to investigate, if the clinical phenotype and a biological marker for schizophrenia are cosegregating within families. 2. The binding capacity of the dopamine antagonist spiperone to mononuclear cells was investigated in 21 indexprobands and a total of 147 first and second degree relatives. 3. Increased binding capacity could be found in 17 indexprobands and in their affected relatives, independently from clinical diagnosis and in 22% of their normal relatives. 4. No increased binding capacity was found in 4 indexprobands and in their affected relatives and not n any of the unaffected relatives. These results indicate, that increased spiperone binding may cosegregate with the risk for functional psychoses and that families, loaded with psychiatric disturbances may be distinguished on a biological basis.

Adult↗
PubMed1987

Evidence for spirochetal origin of circumscribed scleroderma (morphea).

Acrodermatitis chronica atrophicans (ACA) and morphea are clinically distinct skin diseases with some common features and possible coexistence. We found antibodies to Borrelia burgdorferi in eight of fifteen patients with morphea. Six of them had IgG antibodies and two both IgG and IgM antibodies. Four of the eight seropositive and five of the seven seronegative patients had been treated with high dose penicillin previously. Spirochetal organisms could be cultured in Barbour-Stoenner-Kelly's medium from a skin biopsy of one seropositive untreated patient. Spirochetes were recovered from histological sections in three of eight, two seropositive and one seronegative morphea and in one of three erythema chronicum migrans patients by an avidin-biotin immunoperoxidase method. The similar clinical picture of ACA and morphea, the response to penicillin therapy in both entities, the presence of antispirochetal antibodies, the isolation of spirochetes in culture and the detection of spirochetal organisms on histological sections suggest a close relationship among these diseases. We conclude that morphea may represent a Borrelia infection. The correlation to ACA is discussed.

Adolescent↗
PubMed1980

[A further case of gastric microcarcinoidosis (author's transl)].

A diffuse neoplastic peptide-microcarcinoidosis, concentrated in the oral half of the stomach, with 3 small invasive mucosal carcinoids without metastases, was found in a 55 years old woman with a healed duodenal ulcer, cholelithiasis, and obsolete chronic cholecystitis and gastritis. The findings are to be considered within limits as malignant. The only sure hormonal consequence of the microcarcinoidosis was hyperthrophy of the muscularis propria et mucosae (perhaps a Motilin effect?), which was also seen in a previous case. In the clinical picture the symptoms of a chronic gastritis were obscured by gall-stone attacks. The case is of clinical interest as it shows that a diffuse microcarcinoidosis can occur together with one or serveral small gastric carcinoids which have been detected by biobsy and histology. For clarification new biopsies have to be performed.

Carcinoid Tumor↗
PubMed1980

[Results of surgical treatment in 558 patients with carcinoma of the rectum (author's transl)].

Reviewing 558 patients with carcinoma of the rectum the symptomatology and diagnosis, the different surgical methods and especially the indication for amputation and resection are discussed. Although only 5.5% of 344 (61.6) patients, who had a radical surgical treatment (mortality rate 6.9%), were classified as Dukes A cases, 118 (34.3%) were cured for at least 5 years. The importance of early diagnosis and radical surgery strictly according to the principles of either amputation or resection are stressed. Local techniques in suitable cases are described also.

Adenocarcinoma↗