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Biomedical subjects

R Castell

Publications and source records attributed to R Castell.

At least 19 recordsLinked to original sources
PubMed2002

Combination therapy for erectile dysfunction: a randomized, double blind, unblinded active-controlled, cross-over study of the pharmacodynamics and safety of combined oral formulations of apomorphine hydrochloride, phentolamine mesylate and papaverine hydrochloride in men with moderate to severe erectile dysfunction.

Oral therapy has become first line treatment for patients with mild to moderate erectile dysfunction (ED). Studies have shown that sildenafil may not be effective in all patients, and has been associated with a variety of adverse effects and an adverse interaction with nitrates and inhibitors of cytochrome P450 enzymes. The objective was to compare the efficacy and safety of three different oral combinations with the highest dose of sildenafil in men with moderate to severe ED. Randomized, double blind, unblinded active-controlled, Phase II study was carried out at three sites in Mexico. After a 4-week placebo run-in period, patients received all four of the following treatments using a 4-way cross-over design: 40 mg phentolamine (PM) +6 mg apomorphine (Apo); 40 mg PM +150 mg papaverine (Pap); 40 mg PM +6 mg Apo +150 mg Pap (Tricombo); 100 mg sildenafil (SC). With the exception of sildenafil tablets, all study medication was blinded. Moderate to severe ED was defined as a less than 50% vaginal penetration success rate during the placebo run-in period. A total of 44 patients were enrolled, of whom 36 completed all four treatment periods. All treatments produced a significant effect in primary efficacy variable (Sexual Encounter Profile) compared to baseline, however, no statistically significant differences were found between treatments. A significant period effect was observed. Also, the four treatments were found not to differ significantly in five out of six secondary efficacy variables. The lowest incidence of treatment-related adverse events (AE) occurred in the 40 mg PM +6 mg Apo group (9.8%), followed by 100 mg SC (15%), and the other two combinations (16.7 and 17.5%, respectively). Nasocongestion and headache were the most frequently reported AE. An oral combination of vasoactive agents may provide an alternative approach to sildenafil. Based on these results a combination of phentolamine and apomorphine warrants further clinical investigation.

Adrenergic alpha-Antagonists↗
PubMed2001

["Euthanasia of children" during dictatorship of national socialism: "special children's department" Ansbach in Germany].

Focus of this paper is a description of "child euthanasia" during National Socialism 1939-1945 in the "specialized children's department" of the Ansbach state hospital. The historical and ideological bases for euthanasia and the development of child and adolescent psychiatry are explained. Material was found in public archives and trial records of German courts. 156 case histories of children who were killed in the Ansbach state hospital were evaluated. Child euthanasia in Ansbach was done in the same stereotyped way as in other specialized children's departments. The 156 children were aged between one week and 16 years. 39 children died within the first three months, 31 children died within three to six months in hospital. Most children were autopsied, at least 86 brains were examined neuropathologically. The trials against the involved physicians were quashed finally in 1968.

Adolescent↗
PubMed2001

[Chairman of the German Society for Child Psychiatry and Educational Therapeutics in World War II].

Hans Heinze was one of the three experts on child euthanasia in the "Reichsausschuss zur wissenschaftlichen Erfassung erb- und anlagebedingter schwerer Leiden" and head of the first "Kinderfachabteilung" in Brandenburg-Görden, Germany. He was one of the experts in the euthanasia "Aktion T4". He became nominated president of the "Deutsche Gesellschaft für Kinderpsychiatrie und Heilpädagogik" after Paul Schröder who died in 1941. The documents about his function exist in five German archives.

Child↗
PubMed2000

[Promoting reading and spelling in children with computer programs].

OBJECTIVES AND METHODS: Sixteen students trained their reading and spelling skills with the computer programmes Budenberg 1 and 2 and the Comles Package for 1000 minutes over a one-month period. RESULTS: Following one month of computer training, reading test scores had improved for seven of the 16, and spelling test scores for three children whose basic performance had been poor. Three and a half months of school instruction later, the reading test scores had improved for nine children, while there was no effect upon the spelling scores for most of the students.

Child↗
PubMed1999

[Discriminant analytic determination of prognostic variables from child psychiatric examination for school achievement in special education studies].

Scores on tests administered to learning disabled children in grade one during their examination by a child psychiatrist were analyzed for their predictive value with regard to the children's subsequent academic careers and type of school later attended. Upon starting school the learning disabled children exhibited marked deficits in intelligence and language and motor development. Variables predictive of the type of school to be attended later were intelligence scores and motor performance.

Achievement↗
PubMed1998

[Conditions facilitating social behavior disorder in children and adolescents in a clinic referred sample].

The patients referred to our center from 1989 to 6/1994 (n = 1076) were divided into three groups: "conduct disorder" (n = 235), "none psychiatric diagnosis" (n = 324) and "other psychiatric diagnosis" (n = 517). These groups were compared with regard to frequency, age, sex, the frequency of specific developmental disorders, the IQ, and the frequency of abnormal psychosocial circumstances. Additional the religiosity of the families and the televiewing of the children were investigated. Abnormal psychosocial circumstances and enlarged televiewing of the children were significantly associated with conduct disorders.

Adolescent↗
PubMed1995

[Follow-up of psychiatric disorders and specific developmental delay disorders in special education students].

In a prospective longitudinal study 72 children who were attending a special school for children with learning disabilities in Erlangen were examined in 1990 and again in 1992/93. At the first examination the children's mean age was 7 years 1 month and at the second 8 years 10 months. The sample contained many more boys than girls. Reported here are the findings on the course of the psychiatric disorders and the specific developmental disorders of speech and language and motor function. There was a marked decrease in the prevalence of psychiatric disorders. Of the 17 children with a psychiatric disorder at follow-up, 13 (76%) also had a disorder at the start of the study and of the 23 with a psychiatric disorder at the start 13 (57%) still had a disorder at follow-up. Children with enuresis and those with disturbances of activity or attention had the best prognosis. The special school had a positive effect on conduct. The prevalence of specific developmental disorders also decreased over the two-year period. As expected, specific speech articulation disorders had the best prognosis. All other disorders had a poor prognosis. Increases in prevalence were mainly the result of different cutoff points for a given diagnosis at different ages. The high number of specific disorders of motor function at both time points is especially noteworthy.

Child↗
PubMed1993

[Reliability of the Child Behavior Checklist in a population of 6 to 8-year-old special education students].

66 children attending first grade at a special school for educationally subnormal children were examined medically and psychologically. Classification was done according to ICD-10. In addition, the parents were asked to rate their children's behavior with the "Child Behavior Checklist" by Achenbach and Edelbrock. The most common symptoms rated in this group of 6- to 8-year-old children were lack of concentration, speech and language problems, hyperactivity, demand for attention and arguing. The mean total score (cut-off score: 30) and the number of crucial items (cut-off score: at least two crucial items) differed significantly between the children with and those without psychiatric disorders. No significant correlation was found between the mean total score or the number of crucial items and the sex of the children or the other axes of the Multi-axial Classification of Child Psychiatric Disorders.

Affective Symptoms↗
PubMed1993

[Multiple diagnoses and stresses in children of primary school age].

The study was conducted to assess the consequences of multiple diagnoses and handicaps in children aged 6 to 8 years. Children were considered to be "multiply handicapped" if they suffered from two or more disorders or impairments included in the Multi-axial Classification Scheme. To this end children in special schools were compared with a random sample of children from three communities in Bavaria. As expected, all prevalences found in the population of children from special schools were substantially higher than those found in the random sample. Furthermore, the proportion of children with multiple handicaps in the special schools far exceeded what one would have expected based on the findings for the random sample. Most of the disturbances did not differ in respect to their comorbidity. But the mentally retarded children in the special schools were all "multiply handicapped". The importance of "multiple handicaps" for the assignment to special schools is discussed, as are the implications for the planning of services.

Child↗
PubMed1992

[Speech production and speech comprehension of dysgrammatic speech of preschool children].

The language comprehension and production abilities of 15 preschool children with developmental language disorders (LD) (4;11 yrs.-7;1 yrs.) and 15 control children (3;8 yrs.-4;7 yrs.) were investigated. For this purpose a test consisting of 135 picture cards was devised. On the production task (plural and comparative forms) the majority of the LD children performed significantly poorer than the control children. The results of the comprehension tests (plural and comparative forms and short sentences) showed marked deficits for the majority of the LD children (11 of 15), especially (but not only) in the identification of single forms. These combined expressive-receptive deficits should be considered in an etiological concept of developmental dysphasia. It is discussed whether these deficits are indicative of far-reaching disorders in the processing of language.

Aphasia, Broca↗
PubMed1988

Prevalence and treatment of psychiatric disorders in 3 to 14-year-old children: results of a representative field study in the small town rural region of Traunstein, upper Bavaria.

In a representative sample (n = 358) 18.4% of the children aged 3 to 14 were classified as having psychiatric disorders, mostly special symptoms (13.4%) (ICD 307). Using the multiaxial classification of child psychiatric disorders developed by Rutter et al. (1), connections between a psychiatric diagnosis on the one hand and developmental delays, medical conditions and abnormal psychosocial circumstances on the other are pointed out. Finally, the situation regarding help for children with psychiatric disorders is discussed. Only 2.0% of the children were receiving treatment for such conditions.

Adolescent↗
PubMed1980

[Incidence of psychic disorders in children and adolescents (author's transl)].

The paper summarizes the most important findings of an epidemiological investigation in child psychiatry on the incidence of psychic disturbances and behavioral pecularities in patients aged from 3 to 14 years. Connections between psychic disturbances and behavioral peculiarities on the one hand and developmental residues, bodily symptoms and abnormal psychosocial circumstances on the other are pointed out. Finally the situation regarding provisions for psychically disturbed children and those with behavior peculiarities is discussed.

Adolescent↗
PubMed1976

[Agreement between traditional and computer diagnosis in psychiatric outpatients (author's transl)].

Psychiatric diagnosis based on personal interviews with 100 clinic outpatients was made and the data thus obtained were documented in Spitzer's and Endicott's CAPPS (Current and Past Psychopathology Scales). Two clinicians and the computer program DIAL - a modification of the DIAGNO II program of the same authors - diagnosed the same patients independently of each other basing their diagnoses solely on the entries in the CAPPS. The diagnostic agreement between the different diagnoses was evaluated and results compared with earlier findings by Schmid et al. These authors had, however, used CAPPS data gathered from case histories and not from direct interviews of patients. The modification in the procedure of gathering the data resulted in a slight, but statistically insignificant improvement in diagnostic agreement. The possibility of improving diagnostic agreement by the use of another scale is discussed.

Ambulatory Care↗
PubMed1975

[Results of catamnestic, neurological and psychological investigations in children suffering from cytomegaly virus infection, diagnosed in neonates (author's transl)].

Report on results of follow-up in 10 children, in 9 of whom clinical findings at the age between 6 and 11 months suggested the diagnosis of connatal cytomegaly. All 10 children secreted cytomegaly virus in the urine. In 3 of them post-natal infection appears probable. Follow-up was carried out at the ages between 3 and 5.9 years. Physical development was delayed in 4, severe neurologic damage occurred in 2, medium severe or minimal, in part reversible, neurologic signs in 3 childrens. The 2 most severely neurologically damaged children could not be examined psychologically. The IQ of the other 8 was between 92 and 105. 3 children showed in individual other tests only minor, insignificant loss of performance, 2 more pronounced defects which suggested cerebral damage.

Brain Diseases↗