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S Kaumeier

Publications and source records attributed to S Kaumeier.

15 recordsLinked to original sources

Subclinical hyperthyroidism: physical and mental state of patients.

We investigated whether subclinical hyperthyroidism [subnormal basal thyroid-stimulating hormone (TSH) level, attenuated TSH response to thyrotropin-releasing hormone (TRH) stimulation, peripheral thyroid hormones within normal range] is accompanied by physical and mental changes. Thirty-five subclinically hyperthyroid patients (27 female, 8 male) were compared with 60 overtly hyperthyroid patients (51 female, 9 male) and with 28 euthyroid control patients (18 female, 10 male) with respect to physical symptoms, affective state, short-term memory, ability to concentrate and psychomotor performance. Patients with subclinical hyperthyroidism ranged between the other two groups. The major difference between controls and subclinically hyperthyroid patients was an increase in frequency of nervous symptoms and symptoms due to an increase of metabolic rate and thermal regulation changes. The major differences between subclinically hyperthyroid and overtly hyperthyroid patients were psychomotor impairment and symptoms of increased metabolic rate. Self-ratings of affective state tended to be similar in patients with subclinical and overt hyperthyroidism. The ability to concentrate and short-term memory were not impaired in any group. Symptoms in patients with subclinical hyperthyroidism probably result from central changes which lead to attenuated TSH responses to TRH, or from elevated but still normal thyroxine levels, which possibly enhance the effect of catecholamines.

Adult

Trimipramine--an atypical neuroleptic?

Trimipramine and clozapine show some similarities in their receptor binding profiles. Since both have the same affinity for the D2 receptor and since the affinity for this receptor correlates closely with the antipsychotic potency of a drug, an antipsychotic efficacy of trimipramine in acute schizophrenia could be expected. Therefore 28 schizophrenic patients in an acute phase were treated with trimipramine up to 400 mg/d in an open clinical trial. For the whole group of patients the BPRS total score changed from 58 +/- 5 before treatment to 46 +/- 18 at the last rating (p less than 0.05). According to our clinical judgement the patients were divided into three subgroups. Thirteen patients showed a good remission under trimipramine so that they could be discharged on a trimipramine maintenance treatment. They improved on the BPRS from 58 +/- 6 before treatment to 32 +/- 8 at endpoint. Six patients deteriorated during the first week of treatment and had to be withdrawn from the study. Nine patients showed insufficient improvement or became worse after an initial improvement. The observed side-effects (dry mouth, sedation, sweating, increased appetite, constipation, tremor, vertigo) are well known under trimipramine and were therefore expected. Beyond these, one patient developed a cardiac insufficiency. No clinical relevant extrapyramidal side-effects occurred. Since the improvement of florid psychotic symptoms seems to be markedly higher under trimipramine than the one reported under placebo, our results indicate that trimipramine may have an antipsychotic potency.

Acute Disease

Sequential psychological testing during the course of autoimmune hyperthyroidism.

Although the psychological disturbances accompanying Graves' disease are well known, the time required for normalisation of these disturbances during antithyroid drug treatment is not known. Therefore sequential psychological testing during the course of Graves' disease was done. There are also contradictory results concerning the possible correlation of neurophysiological and psychological test results during the course of Graves' disease with thyroid hormone values. Finally, psychological disturbances have been proposed as possible etiologic factors in Graves' disease. In our study, a significant decrease in anxiety and irritability could be observed at the time euthyroidism was achieved. Self-evaluations of depressivity, activity, exhaustion, well-being, extraversion, introversion, and the ability to concentrate changed 1 or 2 months after euthyroidism was induced. Similar test results could be observed after induction of euthyroidism by antithyroid drugs and subtotal thyroid resection. Therefore the mode of therapy does not seem to influence the course of normalisation of psychological parameters. In contrast to other investigations there was hardly any correlation between thyroid hormone values and psychological test results or the ability to concentrate. Nontheless, patients with Graves' disease showing high scores for depression and anxiety exhibit abnormal peripheral helper/suppressor T-lymphocyte relations. Furthermore, patients suffering from Graves' disease tend to be more anxious than controls. It remains to be determined whether an increased susceptibility to psychological disturbances has led to these alterations of lymphocyte subsets in Graves' disease patients with severe depression and anxiety.

Adult

[The role of TSH psychological and somatic changes in thyroid dysfunctions].

The characteristic psychic and somatic features found in patients with overt hyper- or hypothyroidism are usually attributed to elevated or diminished levels, respectively, of thyroid hormones. This concept does not sufficiently explain our previous investigations in which the same symptoms, albeit attenuated, were also seen in patients suffering from so-called latent disturbances of thyroid function. This state of disorder, however, exhibits normal concentrations of peripheral thyroid hormones. Only the response of thyroid-stimulating hormone (TSH) to thyrotropin-releasing hormone (TRH) stimulation is in accordance with the behaviour of the overt thyroid dysfunction and enables its differentiation from the euthyroid state. In this context, we investigated the question as to whether pathologic signs in thyroid disorders are correlated to alterations of peripheral thyroid hormones or to changes in the hypothalamus pituitary axis. Therefore, we investigated two groups of ten patients each who suffered from latent hyper- or hypothyroidism, respectively, and ten euthyroid controls. All were matched from sex and age. Endocrine function was estimated by TRH testing, TT3, TT4 and thyroxine binding globulin (TBG). Psychologic testing was performed by questionnaires concerning subjective somatic symptoms, emotional disturbances, psychomotoric performance, cognitive impairment and personality. Patients with latent hyperthyroidism were more subject to somatic symptoms and affective complaints than were those who had latent hypothyroidism. As compared with controls, there were significant differences in exhaustion and pain in the limbs and heart. In terms of affective complaints, patients were more depressive, anxious, touchy and irritable; their personalities showed a higher degree of emotional lability, excitement and irritability.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

The effect of the composition of food on the absorption of sulfameter.

The present investigation is concerned with the influence of the composition of food on the absorption of sulfameter. Six physically healthy patients each were given 2 g of sulfameter simultaneously with a high lipid, high protein and high carbohydrate test meal. This experiment was designed as a threefold crossover study, and there was a randomized assignment of patients to the different conditions. The results show that sulfameter is significantly better absorbed when administered with a high lipid meal than when given with a high protein or high carbohydrate meal, demonstrated by the areas under the serum concentration curves (AUC), by the peak serum concentration and by the cumulative renal excretion.

Adult

[Parkinsonism].

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Amantadine

Open study with bromperidol (C-C 2489), a new neuroleptic, for the determination of the neuroleptic threshold and the neuroleptic-therapeutic range.

In an open study involving 30 schizophrenic patients the neuroleptic threshold dose (measured via Haase's graphopathological test), the maximum dose, and the maintenance dose were determined. The neuroleptic threshold dose was 5.6 mg/day (0.08 mg/kg body weight); the maximum dose was 11 mg/day (0.16 mg/kg body weight); and the maintenance dose was 6 mg/day (0.09 mg/kg body weight). With reference to the effectiveness, good to very good results were obtained in 19 cases. Regarding side effects 15 patients complained of extrapyramidal disturbances, this was to be expected in view of the study design aiming at the determination of the maximum dose level. When administered in one single dose in the evening, bromperidol influenced the night sleep positively, so that sleep-inducing drugs could be reduced, and, in some cases, even dispensed with.

Adolescent

The pharmacokinetic aspects of therapy with psychotropic agents.

This contribution is concerned with a critical appraisal of the concept that plasma levels of psychotropic agents govern their pharmacodynamic action. In this regard, there are at least three problems: 1. identification of the chemical course of reaction between the introduced pharmacon and its resultant metabolites in reference to the totality of the organism and its biochemical reaction pattern; 2. the course of this reaction relative to intra- and interindividual differences; and 3. the influence of the kinetics as a result of concentration diversities, conditioned by different distributing patterns within the organism. Decisive factors here are: mode of application, blood distribution volume, reaction and/or elimination rate, and, finally, interaction of combined drugs.

Acid-Base Equilibrium

[On the pharmacokinetics of gentamycin. / Clinico-pharmacological study on the course of gentamycin concentrations in serum during large-volume infusions (author's transl)].

Infusions of large volumes have a remarkable influence on the blood levels of gentamycin insofar that with normal dosages no effective concentrations can be found in the serum of the patient. The present investigation was planned as a pharmacokinetic model with the aim of finding out the possible reasons for this phenomenon. The results show that the infusions enhance the total clearance tremendously. Furthermore the elimination half-life of gentamycin is much shorter under infusion conditions. This explains the subtherapeutic blood levels.

Gentamicins

[Comparison of the effects of the anthracene derivative danitracen (WA335-BS) and amitriptyline in depressive patients (author's transl)].

9,10-Dihydro-10-(1-methyl-4-piperidylidene)-9-anthrol (danitracen, WA 335) is a substance with a stronger peripheral and partly central antiserotonin and antihistamine effect than cyproheptadine. In 5 different hospitals, WA 335 (3 X 1 mg/die) was investigated versus amitriptyline (3 X 50 mg/die) in a double-blind study in 116 depressive patients of different nosology. In the end of the investigation period (20 days), under WA 335 treatment 67.7% and under ami-riptyline treatment 66.7% of the patients showed an improvement of 50% = decrease in the Hamilton depression score. However, a decrease of 50% in the selfrating scale (von Zerssen) was only shown by 57% of the patients under WA 335 administration and 51% under amitriptyline administration. There were no significant differences seen as regards course and side effects of the two drugs. Like amitriptyline, WA 335 shows sedative properties at the beginning of therapy.

Adult

Neuroleptic potency of bromperidol.

The following statements can be made on the basis of our study. 1. The butyrophenone bromperidol is an absolutely effective drug of the series of very high-potency neuroleptics, with a mean neuroleptic threshold dose of 5.6 mg/day. The mean optimum dose is 6 mg/day, and the mean maximum dose reaches 11 mg/day, i.e. twice the neuroleptic threshold dose. 2. The substance is generally well tolerated; when it was administered to one third of all cases in one single dose in the evening, it not only had the same beneficial neuroleptic-antipsychotic effect as on administration t.i.d., but also positively influenced sleep, so that sleep-inducing drugs could be reduced and, in some cases, even dispensed with. This relatively long-lasting effect confirms the finding made in animal experiments.

Adult