Biomedical subjects

M Schüpbach

Publications and source records attributed to M Schüpbach.

15 recordsLinked to original sources

PubMed2006

Neurosurgery in Parkinson disease: a distressed mind in a repaired body?

OBJECTIVE: To prospectively evaluate the impact of subthalamic nucleus (STN) stimulation on social adjustment in patients with Parkinson disease (PD). METHODS: Before and 18 to 24 months after bilateral STN stimulation, the authors assessed 29 patients with PD for motor disability, cognition (Mattis dementia rating scale, frontal score), psychiatric morbidity (Mini-5.0.0, MADRS, BAS), quality of life (PDQ-39), social adjustment (Social Adjustment Scale), and psychological status using unstructured in-depth interviews. RESULTS: Despite marked improvement in parkinsonian motor disability, the absence of significant changes in cognitive status, and improvement of activities of daily living and quality of life by the end of the study, social adjustment did not improve. Several kinds of problems with social adjustment were observed, affecting the patients' perception of themselves and their body, marital situation, and professional life. Marital conflicts occurred in 17/24 couples. Only 9 out of 16 patients who had a professional activity before the operation went back to work after surgery. CONCLUSION: After STN stimulation, patients experienced difficulties in their relations with themselves, their spouses, their families, and their socio-professional environment. The authors suggest a multidisciplinary psychosocial preparation and follow-up to help patients and their entourage cope with the sudden changes in their existence following successful neurosurgery.

Cognition Disorders↗

PubMed2006

Neurosurgery in Parkinson's disease: the doctor is happy, the patient less so?

Despite the overall excellent outcome of neurosurgery in patients with Parkinson's disease, there is often a contrast between the improvement in motor disability and the difficulties of patients to reintegrate a normal life. In this study, the personal, familial and professional difficulties experienced by patients two years after bilateral high frequency stimulation of the subthalamic nucleus were carefully analyzed. To avoid such socio-familial maladjustment, we strongly suggest taking into consideration the patients' psychological and social context before the operation and during the post-operative follow-up.

Deep Brain Stimulation↗

PubMed2005

[Pergolide associated valvulopathy: critical analysis of the literature and practical recommendations].

INTRODUCTION: Pergolide is a widely used antiparkinsonian dopamine agonist. Following occasional case reports, two studies recently suggested potentially frequent and severe valvular disease associated with pergolide intake. STATE OF ART: Although there is now strong evidence to consider that pergolide may induce valvulopathy, incidence, severity, and risk factors for this adverse effect remain to be clarified. Valvular disease associated with pergolide consists in fibrosis and resembles conditions described in carcinoid carcinoma and in patients taking fenfluramine therapy. The mechanisms leading to valvular fibrosis are unknown but involvement of 5-HT(2B) receptors, especially expressed in valvular fibroblasts, is suspected. PERSPECTIVES AND CONCLUSIONS: Following the recommendations of the Agence Française de Sécurité Sanitaire des Produits de Santé, we describe a clinical practice attitude for pergolide therapy in Parkinson's disease.

Antiparkinson Agents↗

PubMed1989

Standardization of the Tübingen flicker test.

In the Tübingen flicker test, the subjective brightness of a steady field is adjusted to that of a flickering test field at 50-0 Hz. This test has proven itself as a valuable and highly specific method in the diagnosis of optic neuritis (ON). This paper reports on the development of new judgement criteria and their standardization, based on a new cohort of 527 eyes, 138 of them with florid ON. After improving the conditions of examination and evaluation the optimal criteria for the definition of a pathological result were determined in an explorative manner that is described in detail. The criteria finally chosen are defined such that they preserve the high specificity (98%) of the test, while also retaining a high sensitivity (85.5%).

Flicker Fusion↗

PubMed1986

Mutagenicity testing experiments with the Cobas Bact.

The feasibility of mutagenicity assays with the Cobas Bact Automatic analyser was explored using selected model mutagens. The reduction of the latency period (the period until the growth of the mutant cells becomes optically measurable) was found to be a valid measure for the mutagenic activity of strong mutagens. For weaker mutagens an evaluation analogous to the fluctuation test seemed the more appropriate approach. The influence of various variables, such as concentration of histidine, size of inoculum, medium composition and S9 concentration, is described. Adaptation of the Cobas Bact system to the differential growth inhibition test is also mentioned.

Animals↗

PubMed1984

Preclinical safety evaluation of intravenously administered mixed micelles.

Mixed micelles, with their main constituents lecithin and glycocholic acid, form a new principle for the parenteral administration of compounds which are poorly water-soluble. Their composition of mainly physiological substances as well as their comparatively good stability substantiate their attractivity in comparison to existing solvents. A decomposition due to physical influences such as heat or storage for several years will almost exclusively affect the lecithin component in the form of hydrolysis into free fatty acids and lysolecithin. Their toxicity was examined experimentally in various studies using both undecomposed and artificially decomposed mixed micelles. In these studies the mixed micelles were locally and systemically well tolerated and proved to be neither embryotoxic, teratogenic nor mutagenic. Only when comparatively high doses of the undecomposed mixed micelles were administered, corresponding to approximately 30 to 50 times the anticipated clinical injection volume (of e.g. diazepam mixed micelles), did some vomitus (dogs), slight liver enzyme elevation (rats and dogs), and slightly increased liver weights (dogs) occur. After repeated injections of the artificially decomposed formulation (approximately 25% of lecithin hydrolyzed to free fatty acids and lysolecithin) effects such as intravascular haemolysis, liver enzyme elevations and intrahepatic cholestasis (dogs only) were observed but only when doses exceeding a threshold of approximately 40 to 60 mg lysolecithin/kg body weight were administered. All alterations were reversible after cessation of treatment.

Alkaline Phosphatase↗

PubMed1982