Biomedical subjects

P M Brenner

Publications and source records attributed to P M Brenner.

7 recordsLinked to original sources

PubMed1994

[Partnership status in long-term home ventilation of amyotrophic lateral sclerosis patients].

Described is the development of the intrapartnership dynamics in a case of home ventilation of a spouse having amyotrophic lateral sclerosis. Led in a heated manner until recently, the ethical discussion on the pros and cons of long-term (home) ventilation could be greatly enriched by introducing relevant systemic views and reasoning. So far, however, there are no published observations in this field.

Amyotrophic Lateral Sclerosis↗

PubMed1993

Resistance to ischaemic nerve-fibre block in diabetes mellitus and in mitochondrial encephalomyopathies.

Thermal thresholds were measured during ischaemic compression block in the left forearms of 26 healthy subjects, 10 patients with diabetes mellitus and 6 patients suffering from different kinds of mitochondrial disorders. Cold and warm thresholds in the 6 patients with deficiencies in the respiratory chain increased earlier than in normals. When cold perception was impaired, cold stimuli were perceived as warmth and pinprick perception attenuated. In diabetics cold thresholds were less elevated during ischaemic block than in controls. This was paralleled by tingling paraesthesiae in all groups. The findings show that higher resistance to ischaemic nerve-fibre block in diabetes mellitus is not exclusively based on increased anaerobic metabolism.

Adult↗

PubMed1991

Benzodiazepine dependence: detoxification under standardized conditions.

In an analysis of the withdrawal syndrome of 12 patients dependent on benzodiazepines (BZD), important factors such as underlying psychiatric disease, precipitating life events, complaints leading to BZD use, and also positive and negative psychological and social consequences, duration of intake, dose and type of BZD dependence are discussed. Withdrawal was completed under standardized inpatient conditions reducing the BZD dose to 50% of the previous dose once every 5 days and maintaining control through regular measurements of the BZD urine concentrations. The course of the somatic, psychological and perceptual withdrawal phenomena was documented according to Lader's BZD withdrawal symptom checklist (Lader, M. (1983) J. Clin. Psychiatry 44, 121-127). The reduction scheme proved to be safe and efficient; no major withdrawal syndromes developed. Abstinence phenomena largely disappeared within 10 days of discontinuation.

Adult↗

PubMed1990

[Ocular changes in MELAS syndrome].

The present paper reports on the clinical findings of a 34-year-old male patient with MELAS syndrome. MELAS syndrome (mitochondrial encephalomyopathy, lactic acidosis and strokelike episodes) belongs to a group of syndromes called mitochondrial encephalomyopathies that are characterized by changes of the mitochondrial respiratory chain and the histological finding of "ragged red fibers" in muscle biopsy. In our case the diagnosis was confirmed by multiple neurologic tests including muscle biopsy and biochemical analysis of the respiratory chain. The ocular findings included reversible, homonymous hemianopic visual field loss documented six years earlier, atypical retinitis pigmentosa with marked attenuation of the scotopic ERG, myopia and nuclear cataract of the right eye. An extracapsular cataract extraction with implantation of a posterior chamber lens was performed on the rigt eye, the course was unremarkable and vision improved. In dealing with patients presenting with ocular or neurologic signs indicating mitochondrial encephalopathy, the ophthalmologist should consider MELAS syndrome or any other of the mitochondrial encephalomyopathy syndromes as a possible etiology and take the necessary steps for further medical and neurologic evaluation of the patient.

Acidosis, Lactic↗

PubMed1989

Benzodiazepine abuse and dependence in psychiatric inpatients.

Over a period of five and a half years, 792 inpatients with benzodiazepine (BZD) abuse and dependence in accordance with the WHO definition were registered at a university psychiatric hospital. One-quarter of them abused BZD exclusively, while three-quarters suffered from polytoxicomania or were alcohol dependent as well. It was possible to distinguish two groups of patients: one with primary, mainly low-dose, dependence preferring lorazepam and the other with secondary, often high-dose, dependence with diazepam as the main drug. In 108 patients with isolated BZD dependence, withdrawal symptoms of somatic, psychological, or perceptual quality were observed. The severity of the withdrawal syndrome seemed to depend on the time of consumption, dose, mode of withdrawal, and type of BZD compound. Following abrupt cessation, 11 patients with long-standing dependence on high BZD doses developed withdrawal psychoses, presenting a delirious, paranoid-hallucinatory, or depressive-anxious syndrome.

Adult↗

PubMed1989

[The study of the central motor conduction time to the leg: normal findings and methodologic observations].

Central motor conduction time (CMCT) is calculated by subtracting latencies from each other measured to a target muscle after transcranial brain stimulation and after stimulation of lumbar spinal nerve roots. Transcranial magnetoelectrical stimulation of the motor cortex has proved to be the most useful method. However this is not true for transcutaneous stimulation of lumbar roots. In healthy subjects electrical root stimuli given at T12/L1 produced compound muscle responses in Tibialis anterior muscles in all 18 trials. However, magnetoelectrical stimulation (100% stimulus strength) evoked responses in only 8 (Novametrix) and 12 out of 18 trials (Cadwell). Stimulation with the Digitimer D190 was less effective. Additionally compound responses after electrical root excitation were more consistent and they had a higher amplitude compared with magnetoelectrical stimulation. Regarding to these results electrical lumbar root stimulation is thought to be the advantageous method despite it is slightly more uncomfortable. Therefore normal results of CMCT to Tibialis anterior (shown in Table 1) are measured after magnetoelectrical transcranial (Digitimer D190) and transcutaneous electrical stimulation of spinal nerve roots. If the peripheral motor conduction is delayed normal values have to be adapted since CMCT is thought to involve a proximal anterior root segment. An intraspinal motor conduction time can be calculated from CMCT to upper and lower extremities.

Brain↗

PubMed1988

Benzodiazepine dependence--aetiological factors, time course, consequences and withdrawal symptomatology: a study of five cases.

The development and time course of benzodiazepine (BZD) dependence is reported for five case histories. The underlying psychiatric disorders, life-events as potential initiators of BZD use/abuse and psychosocial consequences are discussed. The abstinence symptoms appearing during a course of standardized withdrawal therapy are described in detail. The case reports clearly demonstrate the chronic nature of the development of BZD dependence and of the tendency to increase the dosage which may occur only after years of intake and the gradual appearance of negative effects of chronic BZD intake.

Adult↗