PubMed Health⌕ Search

Biomedical subjects

P Winter

Publications and source records attributed to P Winter.

At least 19 recordsLinked to original sources
PubMed1992

Center differences and cross-national invariance in help-seeking for panic disorder. A report from the cross-national collaborative panic study.

Help-seeking behaviour for treatment of panic disorder was investigated in the sample of the Cross-National Collaborative Panic Study Second Phase. A total of 1168 patients were entered into this trial in 14 countries. Although there were significant center differences in prior treatment and utilization of health services there were also similarities. Treatment had been provided mainly by general practitioners. Drug treatment consisted mostly of prescription of classical tranquilizers and had a longer duration than treatment by psychotherapy. Patients with agoraphobic avoidance, past major depression and longer duration of illness used medical and psychiatric treatment facilities more intensely. Older and more severely disabled subjects were more frequently treated by medical health care providers and were more likely to receive psychotropic drugs. The results indicate that general practitioners carry an important load in the treatment of panic disorders but may need more information about recent development in pharmacotherapy for this condition.

Adult↗
PubMed1992

Differentiation between major and minor depression.

Though the concept of Major Depression was generated by clinicians using depressed inpatients as models, a polydiagnostic study in 600 psychiatric inpatients with heterogenous psychological disturbances revealed that all six competing operational definitions of Major Depression (including DSM-III-R and ICD-10) were too restrictive to serve as a general concept of depression. Another polydiagnostic study in 500 primary care outpatients showed that more than two-thirds of all non-chronic depressed cases were below the severity threshold of Major Depression: these patients are classified as Depression Not Otherwise Specified (NOS) by DSM-III-R. Loosening of the over-restrictive time criteria would broaden the concept of Major Depression so as to meet the requirements of a general concept of depression, while the definition of Minor Depression below the threshold of Major Depression would add to a reduction of cases of NOS Depression by more than 80%. For the evaluation of antidepressant drugs in outpatient samples, we propose that patients with these modified definitions of Major and Minor Depression be included, provided they meet a minimum severity criterion of 13 or more points on the Hamilton Depression Scale; four-fifths of the modified Major Depression group and one-third of the Minor Depression group do in fact meet this criterion.

Depression↗
PubMed1991

Identification of minor affective disorders and implications for psychopharmacotherapy.

Five hundred general practice patients with functional complaints were studied with the Polydiagnostic Interview (PODI) to see whether DSM-IIIR criteria were able to specify affective disorders satisfactorily. Almost one third of the patients received the diagnosis of depression not otherwise specified (NOS). When Research Diagnostic Criteria were applied to these patients more than 70% received specific diagnoses. A modification of DSM-IIIR algorithms enabled us to further specify diagnoses in subjects with depression NOS. On the 17-item Hamilton Depression Scale many of these patients reached scores of 13 or more which is severe enough to justify a therapy trial with antidepressants.

Adjustment Disorders↗
PubMed1991

Identification of CpG islands in a physical map encompassing the Friedreich's ataxia locus.

The Friedreich's ataxia locus has been previously assigned to chromosome 9q 13-21.1 by the demonstration of tight linkage to two anonymous DNA markers. MCT112 (Z greater than 80, theta = 0) and DR47 (Z greater than 50, theta = 0). The absence of recombination between these three loci has prevented the resolution of gene/probe order in this region, impeding strategies for gene isolation. We report physical mapping over a 4-Mb genomic interval, linking the markers MCT112 and DR47 on a common 460-kb NotI fragment and identifying 11 CpG islands in the 1.7-Mb interval most likely to contain the Friedreich's ataxia locus. Four of these islands were detected only by analysis of three YAC clones spanning a 700-kb interval including the MCT112/DR47 cluster. Without clear evidence of the precise location of the disease locus from recombination events, each of these regions must be considered as specifying a potential "candidate" sequence for the mutated gene.

Chromosome Mapping↗
PubMed1991

Mortality and incidence of cancer at four factories making phenoxy herbicides.

To assess the possible carcinogenicity of phenoxy herbicides and related chlorophenols and dioxins, the International Agency for Research on Cancer is coordinating an international collaborative study of workers exposed to these compounds in their production or use. Four British cohorts of chemical manufacturers which have been recruited to the survey are described. They comprise a total of 2239 men employed during 1963-85. These subjects were traced to 31 December 1987 through the National Health Service Central Register and the National Insurance Index, and their mortality compared with that in the national population. Two deaths were from non-Hodgkin's lymphoma with 0.87 expected. Both deaths occurred more than 10 years after first exposure to phenoxy compounds. One further non-Hodgkin's lymphoma was registered in a living subject with probable exposure to phenoxy compounds. No cases of soft tissue sarcoma or Hodgkin's disease were recorded. A nonsignificant excess of lung cancer (19 deaths observed, 14.2 expected) is probably attributable to chance or a confounding effect of smoking. In one cohort only there was increased mortality from circulatory disease (34 deaths observed, 20.4 expected). A nested case-control study did not point to any occupational cause for this excess, but further evaluation will be needed during continued follow up.

Cardiovascular Diseases↗
PubMed1991

Arytenoid subluxation: diagnosis and treatment.

Both arytenoid subluxation and recurrent laryngeal nerve paralysis (RLNP) may result from injury to the larynx, and they may be difficult to distinguish clinically. A patient with arytenoid subluxation who was initially believed to have RLNP was treated with medialization laryngoplasty 1 year after the injury. Preoperative magnetic resonance imaging and computed tomography effectively demonstrated the cricoarytenoid subluxation, which was confirmed by intraoperative electromyography (EMG) showing normal electrical activity in the thyroarytenoid muscle. Photographs from preoperative fiberoptic laryngoscopy are presented to identify the appearance of arytenoid subluxation. Computed tomographic findings and photographs from laryngoscopy of two patients with RLNP documented by intraoperative EMG evaluation are presented to help distinguish the clinical appearance of this disorder from arytenoid subluxation. An integrated approach to the diagnosis and treatment of arytenoid subluxation is presented.

Adult↗
PubMed1990

On the necessity of adrenal extirpation combined with radical nephrectomy.

Adrenal metastasis of renal cell carcinoma usually is an autopsy finding and seldom a clinical diagnosis. The incidence of ipsilateral suprarenal gland involvement also can be identified by histological examination of the organ with radical nephrectomy. The necessity of adrenalectomy performed in combination with nephrectomy is discussed. After a retrospective examination of our patients we discovered 8 adrenal metastases among 138 radical nephrectomies. Five patients who also had metastases in the lymph nodes (stages pN1 to pN2) died after an average of 26.4 months. Three patients without lymph node involvement are free of tumor. In these cases routine adrenalectomy must be regarded as a possible curative treatment.

Adrenal Gland Neoplasms↗
PubMed1990

Helping to die.

Explore the source record for details and available documents.

Coma↗
PubMed1990

[Nephroblastoma in adults].

Nephroblastoma is very rare in adults and must be differentiated from renal cell carcinoma. The diagnosis can only be made by means of histological examination, which can cause problems because of the various morphological types of the tumor. In this paper an account is given of the authors' experience in the diagnosis and treatment of four Wilms tumors in stages I (n = 1), II (n = 1), III (n = 1) and IV (n = 1) in adult patients. One patient died of a relapse, two patients are taking part in a follow-up study and one patient is undergoing chemotherapy.

Adolescent↗
PubMed1990

[Diagnosis and therapy of single kidney cysts].

By means of observation of 191 own patients suffering from a symptomatic single renal cyst and a literature review, epidemiology, clinical presentation, diagnostic procedures and therapy are presented. The significance of ultrasonography and computerized tomography are emphasized. For single, symptom-free cysts besides regular ultrasonographic examinations no further therapy is necessary. In case of a required therapeutic procedure, an open resection of the cyst should be preferred to percutaneous a required therapeutic procedure, an further therapy is necessary. In case of a required therapeutic procedure, an open resection of the cyst should be preferred percutaneous approach.

Adult↗
PubMed1990

[Splenogonadal fusion].

The splenogonadal fusion is a rare but benign anomaly. The diagnosis is usually given at operation or histologically after operation. In about 50% of the patients who undergo surgery for scrotal tumor, an unnecessary orchidectomy is performed due to clinical unawareness of this rare condition. A case of splenogonadal fusion belonging to the continuous type is presented to illustrate problems of this anomaly and point out the importance of intraoperative microscopic sections.

Adult↗
PubMed1990

Application of luminol-dependent chemiluminescence to assay opsonizing antibodies to procyclic forms of Trypanosoma congolense in the sera of dogs experimentally infected with heterologous stocks.

Luminol-dependent chemiluminescence (LCL) responses of dog granulocytes were used to assay opsonizing antibodies to procyclic culture forms of T. congolense. A high degree of sensitivity was demonstrated and LCL levels were high, when the phagocytic cells were incubated with the sera of infected dogs even at dilutions as high as 1:400 as compared to pre-infection or negative sera. The levels of opsonizing antibodies were elevated in all the dogs throughout the time of observation. The technique was sensitive, could be automated and, therefore, allows a rapid evaluation of large numbers of serum samples for Trypanosoma specific antibodies.

Animals↗
PubMed1989

[Paraspinal conduction anesthesia from the viewpoint of the patient--exemplified by a selected urologic patient sample].

Patients operated because of benign prostatic hyperplasia in spinal cord close block anesthesia were interviewed by a questionnaire. The well known and accepted medical advantages of this method are completed by the results of an examination of the psychic situation. Only 6 out of 66 patients have negative feelings of awakeness during the operation.

Anesthesia, Spinal↗
PubMed1989

[Para-pelvic cysts: difficulties in differential diagnosis].

According to their different etiology, parapelvic cysts must be differentiated from simple renal cysts, pararenal pseudocysts, intramural renal pelvis cysts and suprarenal pseudocysts. An important criterium of parapelvic cysts is their epithelial lining. According to their radiological features, these cysts must be described as "parapelvically located cysts" until the definite histological diagnosis is made by the pathologist. The exact differentiation between a parapelvic cyst and a pararenal pseudocyst may be of forensic importance in posttraumatic patients.

Adult↗