Biomedical subjects

S Koppi

Publications and source records attributed to S Koppi.

13 recordsLinked to original sources

PubMed1998

[Use of cerebrolysin in the treatment of ischemic stroke].

Comparative analysis was performed of results of the treatment of patients with ischemic stroke, including 140 ones treated by means of hemodilution method (control group) and 40 patients treated with cerebrolysin (test group). Barolin's scale of the neurorehabilitation was used for the analysis of the results. Statistically significant results of rehabilitation were better in the test group. Improvement of the parameters characterizing social contacts, working activity and behaviour was more pronounced than an improvement of motor functions. Cerebrolysin had accelerating effect on restoration of damaged functions, by creating more stable basis for rehabilitation.

Amino Acids↗

PubMed1996

Transcranial magnetic stimulation: a novel antidepressive strategy?

Transcranial magnetic stimulation (TMS) is a well-established diagnostic probe in neurological practice. The increasing knowledge of biological mechanisms in electroconvulsive therapy presents a clear case for studying the applicability of TMS as a therapeutic tool in psychiatry. Based on the results of our pilot study showing a possible antidepressive effect of TMS, we conducted a controlled clinical trial on patients affected by major depression (DSM-III-R). Group 1 (n = 12) underwent TMS as add-on therapy to standard antidepressive medication, while group 2 (n = 12) was treated only with antidepressive medication. Already after the third add-on TMS session, a statistically significantly greater remission of depressive symptoms occurred in the patients of group 1 (p = 0.003). This statistically significant difference between the groups became even more marked on the last day of the study (p = 0.001, Wilcoxon). The results and further implications of TMS in psychiatric disorders are discussed.

Adult↗

PubMed1996

[Hemodilution therapy with neuron metabolism specific therapy in ischemic stroke--encouraging results of a comparative study].

Treating ischemic stroke we could compare a (control-)group of 318 patients under up to date hemodilution therapy to a group of 100 patients receiving exactly the same treating scheme but including an add-on administering of Cerebrolysin. It proved a statistically validated better outcome within the Cerebrolysin add-on treated group evaluated by the Barolin-Neuro-Rehabilitation Scale. 1) More effect on social and occupational parameters than on motor functions, but also including some of those. 2) Cerebrolysin accelerates recovery and therewith offers better starting points for rehabilitation. As stroke is one of the main social-medical neuro-rehabilitation and gerontological problems of our days these results should be recognized in a general therapeutical use.

Activities of Daily Living↗

PubMed1996

[Transcranial magnetic stimulation in depressed patients: a new antidepressive therapeutic principle? Presentation of a pilot trial].

So far Transcranial Magnetic Stimulation (TMS) has been established as a technique for studying function of the pyramidal tract in diverse neurological diseases, being both safe and practically free from undesirable side-effects. 5 depressive patients, diagnosed as ICD 9, 296.1 and 296.3 were treated with amitryptiline and TMS, either immediately at onset or as therapy-refractory patients up to 5 weeks after the beginning of their respective episodes. The results of this pilot study document a significant and swift decrease of depressive symptoms scored on the Hamilton rating scale. A single catatonic patient, ICD 9 295.7, presented a clinically impressive but transient improvement of her psychotic condition. Possible analogies between TMS and ECT are discussed as tentative hypotheses for the postulated efficacy of TMS. Further investigations seem warranted, as this method appears to be swift and effective in the treatment of depressive illness.

Adult↗

PubMed1995

[Outcome-oriented Barolin Neurorehabilitation Scale: 476 cases over 6 years--multi-nodal statistical correlation of neurorehabilitation groups in diagnosis, prognosis and outcome].

This evaluation documents practicability and scientific value of the scale, since many years developed in our institute and in use there. Patients with left hemispheric lesions suffer from stronger disturbances of eating than others. Systematic neurological rehabilitations leads to a marked increased unnecessity of catheterism and by that to a marked better social integration. Associate depression (after Barolin) is a main source of rehabilitation hospitalism (as called by Barolin). Multiple sclerosis and Morbus Parkinson give better outcomes than cerebro-vascular patients. A new finding that also proofs to be neurophysiologically interesting is that higher agedness is mostly a non-limiting factor for rehabilitation, as far as not lesser endavours produce a self fulfilling prophecy. However a slight limitation in higher age groups is to be found in the patients with lesions on the dominant hemisphere, whereas lesions on the subdominant hemisphere produce no limitation to rehabilitation at all by higher age.

Activities of Daily Living↗

PubMed1991

Central motor conduction in a family with hereditary motor and sensory neuropathy with pyramidal signs (HMSN V).

Two generations of a family affected by hereditary motor and sensory neuropathy with pyramidal signs (HMSN V) were clinically and electrophysiologically examined. Apart from electroneurographic studies, the central motor conduction (CMC) to arm and leg muscles was assessed using magnetic transcranial motor cortex stimulation. Abnormal CMC was confined to the clinically affected members, with the exception of an unaffected subject who had a diminished but normal latency response in a leg. The typical pattern was a significant diminution of the compound muscle action potential from the tibialis anterior and a moderately prolonged cortico-muscular conduction time (CoMCT) to this muscle.

Adult↗

PubMed1991

[15-year-factor analysis of multiple sclerosis].

The authors have conducted a longitudinal survey for a period of 14 years with 171 patients suffering from multiple sclerosis. In each case, therapeutic and diagnostic procedures were in accordance with the latest development. In almost half of the cases with a duration of illness up to 20 years the degree of impairment can be regarded as minimal, which can be used as an argument in favour of conscientious and continuous rehabilitative measures, including psychotherapy (this in opposition to a "rehabilitative pessimism"). Two thirds of the patients have been in employment with full working capacity during the first ten years of their illness. The consequences for social medicine and social policy are self-evident and imperative. In accordance with earlier studies, motor pareses are predominant among the first symptoms of multiple sclerosis, whereas disorders of cranial nerves, of urinary excretion and of cerebral function appear later in the course of the disease. Factor analysis did not yield any clues with respect to the predictability of the development of illness. Psychoreactive depression is relatively common in the earlier stages, later we can find somatogenic (psycho-organic) depressions, which respond relatively poor to treatment. Among the diagnostic tool, analysis of the critical flicker fusion frequency (CFFF) has proved to be very sensitive, by far not as cumbersome as visually evoked potentials and at least as reliable as the later. Therapeutic strategies should include: early treatment of any acute attack, consequent long-term care with modern nursing methods and rational concomitant medication, prophylaxis against infection. Multiple sclerosis represents itself as a problem of long-term rehabilitation, thus emphasizing the necessity of increased commitment to rehabilitation within a general framework of health care, which should include: a) better representation of rehabilitation as a discipline at the universities. b) systematic concomitant research in rehabilitation, c) legal and administrative adaptations, d) the development of a general "rehabilitation mentality" (as we have come to call it), which means involvement with the patient and his environment throughout his entire life-span.

Adult↗

PubMed1991

[Valduna Rehab Scale in evaluating the correlation of clinical outcome and laboratory values in follow-up of encephalomalacia].

The clinical outcome of 65 patients with malazia alba of the brain was documented by the use of our "Valduna-Disability-Score" examining the patients at defined points of time. Simultaneously several rheological parameters of venous blood gained by punction of the cubital veine were examined before and after hemodilution therapy using dextran 40. The items or progress concerning clinical outcome and changes of the rheological parameters were correlated. There was not found any significance. We conclude, that the changes of rheological parameters in venous blood are not able to predict the clinical outcome after hemodilution therapy. The important role of disability scores--in our case the "Valduna-disability-score"--is to be stressed.

Activities of Daily Living↗

PubMed1990

[Predictors of multiple sclerosis development trends with special reference to "questionable initial manifestations"].

Within 10 years we have had evidence in our department of 173 cases of proven multiple sclerosis (MS) and 63 cases which primarily were called by us: "bland entzündliches Geschehen" (BEG) instead of "possible first onset of multiple sclerosis". 44% of these cases remained as a singular manifestation, whereas 56% developed to established MS. This underlines our proposition of a new classification which does not call such questionable first symptoms as "possible first onset of MS" but as "bland entzündliches Geschehen". This is much less severe and prejudicatory for the bearers of such symptoms. Furthermore we could demonstrate clear correlations between clinical and laboratory findings and the probability of development of MS and the improbability of such a development, respectively. We could not find such predictors up till now in the literature. The several laboratory parameters, relevant for MS (not only with regard to BEG, but also to the whole population which clinically proven MS) could be tested regarding their sensitivity. As a remarkable result, to our knowledge not mentioned so far in the literature, we could demonstrate the flicker-fusion-analysis to be the leading laboratory test. In addition it is a very simple laboratory method, as far as time and money are concerned. It is at least as valid as visual evoked potentials which in the literature are considered to be the most sensible test. Taking into account the few cases examined with the magnet resonance tomography until today, this method, seems to be less sensitive than flicker-fusion-analysis. We do not have a 100% laboratory method at our disposal.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1988

[Differential diagnostic significance of C-reactive protein in meningoencephalitis].

The assessment of C-reactive protein (CRP) serum levels is very specific and sensitive with respect to differential diagnosis between viral and bacterial meningoencephalitis. Its validity surpasses by far all other parameters having been in use up to now. We could prove this with an investigation comprising 43 patients. It appears to be reasonable to include the assessment of CRP serum levels in the routine methods of neurological differential diagnostics. It is simple and offers a quick primary information as well as a regular evaluation of the effect of antibiotic therapy in the course of treatment.

Bacterial Infections↗

PubMed1988

[Stroke. Status and general practice of conservative treatment and rehabilitation].

Adequate help for the apoplectic patient according to recent standards can be given only by simultaneous and equivalent orientation towards both acute therapy and rehabilitation, which should merge smoothly into each other. This can be achieved only by specialised hospitalisation. The idea of totally domestic treatment, as advocated in times past, has to be abandoned for good. In the foreground of acute therapy are treatment of edema, cardiac output and blood pressure, rheological factors: blood viscosity, thrombocyte aggregation, erythrocyte elasticity. In the foreground of rehabilitation efforts we place the principle of "totality and permanence" regardless of prognostic selectivity. The principle of permanence refers to rehabilitative efforts from the very beginning to long-term rehabilitation for months and years with the help of our special rehabilitation service and systematic training of relatives. At least, it has to be stressed that the rehabilitation patient is not a medical waste product and not a symbol of medical surrender either. It would be unfair and senseless to help him through the acute phase and leave him alone during his rehabilitation period. Permanent attention for the apoplectic patient is essential within a system of social medicine. Much is lacking in this respect, as far as academic institutions, advanced training, and information is concerned. We hope that we herewith demonstrate that not only the acute therapy, but also the rehabilitation of the apoplectic patient is a field of scientific fascination, still being in consequent further development. It is intended to give an additional stimulus for the optimal after-care of the apoplectic.

Cerebrovascular Disorders↗

PubMed1987

[Old age in discussion].

Many questions have arisen in connection with the problems of advanced age. They cannot be solved by means of our overcome medical knowledge alone, but require constant open-mindedness. It could be demonstrated how important the dialogue is between legislation, administration, medicine, sociology, and psychology. Only this will enable us to keep pace with the increased significance of the complex problems of advanced age. Accordingly, dialogues like the present one should be continued, as we sincerely hope.

Aged↗

PubMed1987

Calcium-channel-blocking agent in the treatment of acute alcohol withdrawal--caroverine versus meprobamate in a randomized double-blind study.

We present a randomized double-blind study on the efficacy of caroverine in the treatment of alcohol withdrawal symptoms. The group B Ca2+ channel blocking agent caroverine was tested against meprobamate in inpatient treatment of alcohol withdrawal. Patients of both groups were similar in age, weight, duration of drinking, ingested quantities of alcohol and intensity of withdrawal symptoms in both groups. The symptoms were quantified daily by Syndromkurztest (SKT), Nurses' Observation Scale for Inpatient Evaluation (NOSIE), NGI; the Webster scale was applied to rate tremor, speech and coping. Duration of study was scheduled for 5 days after which other medication, e.g., levopromazine was applied if needed. As caroverine is registered and used as a spasmolytic drug in Austria, patients' verbal consent was sufficient. In both compounds we registered no difference of clinical efficacy, though caroverine presented less sedative side effects. This may be an important factor in the treatment and management of alcohol withdrawal symptoms. Dose ranges were 120 mg/day vs. 2,400 mg/day of caroverine and meprobamate, respectively. Thus, drug loading and metabolism can be thoroughly reduced by the application of caroverine--another important point in treatment of alcoholism. In 4 cases of manifest delirium tremens the infusional application of caroverine was openly tested with dose ranges of 2.5-5.0 mg/kg (24 h). Clinical effects were estimated to be similar with oral application as was therapeutic efficacy. This novel indication of a group-B Ca2+ channel blocker presents an interesting feature, which seems to warrant further investigation.

Adult↗