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Biomedical subjects

R Grohmann

Publications and source records attributed to R Grohmann.

At least 73 records · Page 4Linked to original sources
PubMed1984

Assessment of adverse drug reactions in psychiatric hospitals.

A system for monitoring adverse drug reactions (ADR) in psychiatric inpatients was introduced in psychiatric hospitals in the FRG in May 1979. It consists of intensive drug monitoring (IDM) and a so-called "organized spontaneous reporting system" (OSR). ADR are rated separately according to impact on therapy and probability of causal relationship. With IDM all ADR (Grades I-III) are assessed in a randomly selected sample of inpatients. With OSR only ADR leading to discontinuation of the drugs in question (= ADR Grade III) are assessed. In 406 drug-treated inpatients monitored by IDM in the psychiatric hospitals of Berlin and Munich from May 1979 to Dec. 1981, ADR were observed in 60,4%. In 15% of IDM-patients ADR led to discontinuation of the drugs in question; with OSR the relative frequency of these Grade III ADR was 9,0% in 5096 patients monitored throughout the entire period. Life-threatening events were observed in 1,2% of patients undergoing IDM as well as 1.2% of those undergoing OSR. The most frequently observed ADR by IDM were sedation, extrapyramidal signs, disturbances of the autonomic nervous system and increase in transaminases, and by OSR Parkinsonism, akathisia, sedation, toxic delirium and increased transaminases. The relative frequency of Grade III ADR was similar for neuroleptics and antidepressants (5,4% and 5,3% in OSR); a very low relative frequency of ADR Grade III was found for tranquilizers and hypnotics (0,7% and 0,2%). Methodological aspects of this drug monitoring system are discussed in the light of current literature.

Antidepressive Agents↗
PubMed1984

Adverse drug reactions. An epidemiological study at psychiatric hospitals.

A drug monitoring system has been established at psychiatric university hospitals in Berlin, Goettingen, and Munich since 1979 in order to investigate adverse reactions to psychotropic drugs. This report describes the system and presents results obtained over 3 years. 504 randomly selected patients were observed by Intensive Drug Monitoring; 75% of them had an adverse drug reaction (ADR) during hospitalization that was assessed as possible, probable, or definite including all grades (I-III) of severity. 5,096 other patients were monitored by Organized Spontaneous Reporting during treatment with psychotropic drugs: ADRs were responsible for drug withdrawal (severity grade III) in about 10% of them. Parkinsonism, psychomotor disturbance, akathisia, delirium, oversedation and increased transaminases were the most frequent ADRs of this kind. The relative frequency of ADRs was calculated, and ADR-profiles established for drugs most frequently withdrawn. The impact of ADRs on ongoing therapy of patients was assessed. Reliable data obtained by drug monitoring systems can be expected to aid in therapeutic decisions in patients with special risks of side effects to psychotropic drugs.

Adult↗
PubMed1983

[Evaluation of electronystagmographically registered spontaneous nystagmus in healthy persons].

The the exception of nystagmus of ocular origin, any spontaneous and provocation nystagmus have so far been regarded as a pathological manifestation of the vestibular system. However, in recent years the existence of a physiological spontaneous nystagmus has also been discussed. To examine this question, 150 healthy persons were subjected to the standard registration according to Frenzel and Tonndorf. The evaluation of the horizontal nystagmus registered was carried out in accordance with the specified evaluation criteria for uncertain and certain nystagmus movements by means of Frenzel arrow symbols. The results were shown graphically and separately for the individual registration position. The known phenomenon of an increased occurrence of nystagmus on decrease of inhibitory factors was confirmed. In the observation of a nystagmus in registration corresponding to the fluorescent spectacles, a definite nystagmus was registered in less than 10% of the normal subjects. In visual fixation, this number was reduced to less than 5%. The results of these registrations do not justify postulation of a physiological spontaneous nystagmus. Despite the greater frequency of a nystagmus in unilluminated and closed eyes, this term should not be adopted in medical terminology without more precise knowledge of vestibulo-ocular coupling.

Adolescent↗
PubMed1982

[An interactive computer system for control, handling and recording of vestibular tests].

One processor controls and records the standard leakage of spontaneous nystagmus and the rotatory and caloric tests in three laboratories. It cyclicly scans the horizontal and vertical electronystagmographic leakage from all rooms and it stores the results of its measurement on to a magnetic disk. If these data are to be archived, the computer first calls for the patients's records and then it transfers the test data from the magnetic disk on to an analogous magnetic tape with a tenfold reduction of the time interval. A 3,600-feet-long magnetic tape contains the results of test measurements for a total of 256 h, corresponding to 800-1,000 vestibular tests. With the computer, it is possible to introduce modifications of all vestibular tests, to stop a test at any time, or to plot an electronystagmogram on a curve tracer.

Computers↗
PubMed1980

[On the practice of clinical therapy with psychotropic drugs -- retrospective investigation of physicians prescribing practices in a psychiatric hospital (author's transl)].

1. At the psychiatric hospital of the University of Munich physicians' practices in prescribing psychotropic drugs have been analyzed retrospectively for 1974. Case report of 2,100 patients from a total of 2,118 newly admitted inpatients in 1974 have been evaluated and various methods of analyzing data are compared. 2. 414 (19.7%) patients out of a total of 2100 have not been medicated by any drugs. On the average 2.7 psychotropic drugs/patient have been precribed in the remaining 1,186 patients (80.3%). 3. 37.4% of 4627 applications made have been allotted to neuroleptics. Clozapine has been found to be the drug most extensively used (37.4%). It was prescribed to 595 patients, followed by chloralhydrate (425 patients) and amitriptyline (374 patients). 4. Out of a total of 5373 prescriptions, 2,004 were allotted to a single substance and 3,369 to a combination of different drugs. With regard to combined medications, in 1,856 prescriptions two drugs were combined, in 1,015 three, in 404 four, in 70 five, in 18 six and finally in 6 prescriptions seven medications were applied to one patient. 5. Antidepressants and neuroleptics have been combined on the same patient in 768 prescriptions. As to neuroleptics most frequently clozapine and haloperidol have been prescribed together. 6. The mean time during which a defined combination of drugs was given continuously, never exceeded a quarter of the total time the individual had been admitted to the hospital. 7. It is evident that in clinical practice the combinations of psychotropic drugs are widely used. This pattern of psychopharmacological drug treatment is in conflict with the present accepted rules of psychotropic pharmacotherapy. Furthermore it is a remarkable result of the present studies that in therapeutical practice the single components of drug combinations are changed very often. Compounds with sedative effects are preferred within all classes of psychotropic drugs.

Antidepressive Agents↗
PubMed1980

[Drug monitoring in psychiatry (author's transl)].

The Study Group for Drug Surveillance in Psychiatry (AMUP) has been working since July 1978 as a task force group of the "Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie" (AGNP). A protocol was designed for the initiation of drug monitoring in psychiatric hospitals. With support of the Bundesgesundheitsamt, Berlin, the first part of this project was started as a practicability study in the psychiatric hospitals of the Universities of Berlin, Göttingen, and Munich and in the municipal hospital of Schleswig. The study includes 7650 in-patients. It is based on the following methods: intensive drug monitoring, organized spontaneous monitoring of adverse drug reactions and registration of drug applications. This drug monitoring system in psychiatry will be expanded to other psychiatric hospitals, and eventually to out-patient clinics as well as private practices within the next two years.

Costs and Cost Analysis↗
PubMed1979

[Investigations for simplification of the clinical rotation test of irritability of the human vestibular organ (author's transl)].

Fifty ear-sound adolescents were rotated by constant acceleration and deceleration. These investigations yielded three results. 1. The nystagmus of acceleration and deceleration period permits a more exact statement about rotation irritability of peripheral vestibular organ than the per-rotatoric fading nystagmus during constant rotation. 2. The stop out of constant rotation causes only a fading nystagmus, the postrotatorius I. Consequently, deceleration should substitute the stop with regard to its greater exactness. 3. Statistical comparison shows that electronystagmograms of acceleration and deceleration correspond to electronystagmograms of right and left rotation. Therefore, the clinical rotation test is practicable with only one direction of rotation. In this case, deceleration has to be of the same strength and duration as the acceleration.

Adolescent↗
PubMed1977

[The problems of electronystagmography in the clinical diagnosis of vestibular diseases (author's transl)].

The aim of a documentation in electronystagmography, that is to record as complete and definite as possible the information of a nystagmus relative to all its distinctive marks, hitherto has been reached just as little as the attempt, to develop a fine-quantitative investigatory method suitable for standardization for medical practice. The sources of error caused by the equipment and of physiological nature within a recorded nystagmus trace are exposed and illustrated by respective examples. Outgoing from the theory of the rotatory nystagmus based on the rotation test of the human vestibular system the fundamentels are developed for a complete evaluation method of an electronystagmogram including the elimination of artefacts by the authors' own research work in this field. However the pointed out problems of the electronystagmography are not yet answered in the clinical diagnostic of vestibular diseases, the systematic examination of spontaneous nystagmus and provoked nystagmus still represents the most important, most profitable and well-grounded part of the vestibular investigation in the medical practice.

Diagnostic Errors↗
PubMed1975

[Evaluation and documentation of electronystagmorgrams (author's transl)].

Subsequent to a critical consideration of the ambiguous methods of evaluation and documentation of electronystagmograms (ENG) practised up to now, in particular the butterfly-scheme and the L-scheme, a method is being introduced unequivocally describing the vestibular reaction, on the basis of primary nystagmus functions. Deducted from the theory of rotary nystagmus, this procedure may be transferred to any other experimental vestibular test - taking the knowledge of the primary nystagmus relations for granted - and any ENG registered correspondingly may be documented in the form as described above, and may be reproduced in an idealized state any time. Thus the goal of a documentation in electro-nystagmography, i.e. the most comprehensible recording possible of the information contents of a registered nystagmus, is widely reached. There still remains to insert the speed of the quick phase into the evaluation scheme.

Documentation↗