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Biomedical subjects

S Thiemann

Publications and source records attributed to S Thiemann.

10 recordsLinked to original sources
PubMed1992

Physician-patient sexual contact. Prevalence and problems.

To document the current prevalence of physician-patient sexual contact and to estimate its effect on involved patients, 10,000 family practitioners, internists, obstetrician-gynecologists, and surgeons were surveyed. Of the 1,891 respondents, 9% acknowledged sexual contact with 1 or more patients. Even in the unlikely case that none of the nonrespondents had sexual contact with patients, its prevalence among all 10,000 physicians surveyed would still be 2%. Of respondents, 23% had at least 1 patient who reported sexual contact with another physician; 63% thought this contact was "always harmful" to the patients. Almost all (94%) responding physicians opposed sexual contact with current patients; 37% also opposed sexual contact with former patients. More than half of respondents (56%) indicated that physician-patient sexual contact had never been addressed in their training; only 3% had participated in a continuing education course focusing on this issue. Clear and enforceable medical ethics codes concerning physician-patient sexual contact are needed, as well as preventive educational programs for medical schools and residency programs.

Ethics, Medical↗
PubMed1989

Retraction.

Explore the source record for details and available documents.

Retraction Notice↗
PubMed1989

A strategy to use soft data effectively in randomized controlled clinical trials.

Soft data are defined as measures having substantial intrasubject variability due to errors of measurement or to the inconsistency of subjects' responses. Such data are often important measures of response in randomized clinical trials. In this context, we show that using an intensive design and the slope of response on time as the outcome measure (a) maximizes sample retention and (b) decreases within-group variability, thus (c) maximizing the power of test procedures without requiring increased sample sizes.

Clinical Trials as Topic↗
PubMed1987

Rating scales in research: the case of negative symptoms.

Two measures of negative schizophrenic symptoms, the Scale for the Assessment of Negative Symptoms and the withdrawal-retardation subscale of the Brief Psychiatric Rating Scale, are found to be redundant when used together. Studies incorporating redundant measures have numerous disadvantages. Using multiple scales increases the cost and effort for the investigator, places a greater burden on research subjects, and compromises the interpretability of findings by increasing the probability of both Type I and Type II errors. A strategy for evaluating the use of multiple rating scales is suggested, and the theoretical basis of this strategy is discussed.

Humans↗
PubMed1987

Depression, parkinsonian symptoms, and negative symptoms in schizophrenics treated with neuroleptics.

To determine whether depression and neuroleptic-induced parkinsonism confound the clinical assessment of negative symptoms in schizophrenics, we evaluated 45 outpatient schizophrenics for depression, parkinsonian symptoms, and negative symptoms using standard clinical rating scales. Neuroleptic and anticholinergic dose and plasma activity were also determined. Associations between negative symptoms and these clinical and drug variables were examined using a multivariate statistical model. Negative symptoms were significantly correlated with several parkinsonian symptoms, some vegetative features of depression, and with anticholinergic dose. No significant correlations were found between negative symptoms and cognitive features of depression, or neuroleptic and anticholinergic plasma activity. These findings suggest that assessment criteria for negative symptoms, depression, and drug-induced parkinsonism overlap in treated schizophrenics. Strategies for differentiating these clinical syndromes are discussed.

Adult↗
PubMed1986

Neurochemistry of dopamine in Huntington's dementia and normal aging.

We measured the dopamine metabolite homovanillic acid (HVA) in cerebrospinal fluid (CSF) before and after probenecid administration in normal controls and in patients with Huntington's disease. Baseline CSF HVA concentrations correlated positively with age in normal control subjects. Baseline CSF HVA concentrations were reduced in patients with Huntington's disease, and the degree of this reduction correlated with the severity of dementia and with the duration of disease. These results suggest that changes in the metabolism of dopamine by dopaminergic neurons may be associated with the dementia of Huntington's disease as well as with normal aging. These changes in dopaminergic functioning are apparently different in Huntington's disease than in normal aging and can be detected by measuring CSF HVA concentration.

Adult↗
PubMed1986

Monoamine interactions in narcolepsy and hypersomnia: a preliminary report.

Principal component analysis was performed on data obtained for the concentrations of 3,4-dihydroxyphenylacetic acid, 3-methoxy-4-hydroxyphenylethylene glycol, homovanillic acid, and 5-hydroxyindoleacetic acid in lumbar cerebrospinal fluid from a group of normal volunteers (n = 40), hypersomniac patients (n = 13), and narcoleptic patients (n = 8). All four compounds were shown to be highly intercorrelated in the normal volunteers. In the hypersomniac patients, 3-methoxy-4-hydroxyphenylethylene glycol did not appear to be correlated with the other three compounds. In the narcoleptic patients, homovanillic acid and 3,4-dihydroxyphenylacetic acid appeared not to be correlated with the other two metabolites. The results provide tentative support for a neurochemical distinction between narcolepsy and hypersomnia and suggest that attention should be given to a possible malfunction of the dopamine system in narcolepsy and norepinephrine in hypersomnia.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1985

Serotonin and schizophrenia: correlations between serotonergic activity and schizophrenic motor behavior.

Increased serotonergic activity in animals has been associated with a variety of stereotyped motor behaviors. In addition, serotonin facilitates brainstem, reticular, and spinal motor neuronal activity implicated in the expression of these behaviors. This report presents positive correlations between both peripheral (platelet serotonin levels) and central (cerebrospinal concentrations of 5-hydroxy-indoleacetic acid) measures of serotonin metabolism and the symptom of peculiar or unusual mannerisms and posturing in schizophrenic patients. The findings are discussed in light of the animal behavioral correlates of increased serotonergic activity and the stereotyped affectomotor behavior seen in some schizophrenic patients.

Adult↗