Biomedical subjects
T Fuchs
Publications and source records attributed to T Fuchs.
Reproducibility of patch tests. A multicenter study of synchronous left-versus right-sided patch tests by the German Contact Dermatitis Research Group.
BACKGROUND: The efficiency and reproducibility of patch tests remain controversial. OBJECTIVE: Our purpose was to determine the efficiency and reproducibility of patch tests and to identify factors influencing these features. METHODS: We double-tested 1285 patients concomitantly with 10 standard allergens by manually filled test chambers. Additional information was obtained from all patients with a standardized protocol. RESULTS: Patch test efficiency was good (> or = 0.94) with all 10 allergens. In contrast, nonreproducibility of patch tests was strongly allergen dependent, ranging from 0.2 for nickel sulfate to 0.6 for formaldehyde. The likelihood of nonreproducible allergic reactions increased when more than four positive reactions were seen at the same time, and with another positive reaction located in close proximity to an allergic reaction. Sex and age of patients, atopy, dermatitis at distant sites, sleeping habits, and the time of allergen exposure (24 or 48 hours) did not affect the rate of nonreproducible results. CONCLUSION: To increase patch test reproducibility, specific preparations of patch test allergens need to be improved. Furthermore, amplification effects by synchronous neighboring positive reactions should be excluded.
[The world as inner space. Kafka's "The Burrow" as a paradigm of paranoid spatial experience].
The paranoid's experience of space is illustrated in the present study by means of an investigation of paraphrenic senile psychosis and an analysis of Kafka's short story, "The Burrow". This may be characterized as an experience of increasing permeability and disintegration of boundaries between one's own, private space and that belonging to others, or between inside and outside. At first, a latent ego-weakness is compensated by shifting the self-boundaries onto the territory of one's dwelling which serves as an "external shell" for the self. The emphasis on fencing-off and isolation from the external world, however, renders the hidden, inner spaces ever more threatening. The protecting barriers change into fragile facades through which enemies are able to attack. Finally, the sheltering but, nevertheless, exposed inner spaces fall prey to threats from the outside. Paradoxically, the disintegration of the inner space of self comes about by the paranoid constantly taking the view point of his fictitious enemies; he, thereby, sees through and penetrates the very barriers which he himself has erected.
[Acute therapy of anaphylactoid reactions. Results of an interdisciplinary consensus conference].
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[Acute therapy of anaphylactoid reactions. Results of an interdisciplinary consensus conference].
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[Anchises and Laios. On the historical and ethical background of geriatric psychiatry].
In spite of the lifelong biographical formation of individuality, the fate of the elderly is also determined by general social tendencies and cultural attitudes from which it may not be separated. A historical survey describes the changing views and judgements on old age, especially the alteration of high and low esteem of this period of life; finally, the status of the elderly in present society is considered.
["Protective powers" in senile paraphrenia].
A 75-year-old woman suffering from chronic late paraphrenia presented with the unusual delusion of being accompanied and protected by an invisible dwarfish being. By analogy with the "transitional objects" and "imaginary companions" of childhood development the delusion is interpreted as a regression phenomenon.
[Position of the German Contact Allergy Group of the German Society of Dermatology on amalgam allergy].
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[Delusion syndromes in sensory impediment--overview and model presentation].
Since Kraepelin's description of the "paranoia of the deaf" in 1915, the connection between sensory impairment and paranoid states in old age has been repeatedly confirmed. Parallels may be drawn to delusional syndromes caused or triggered by linguistic isolation, sensory aphasia and the perceptual disturbances in early schizophrenia. An overview on the different delusional phenomena in sensory-perceptual dysfunction is given, followed by a pathogenetic model proposed in analogy to the "perceptual-release" theory of hallucinations: Reduction of sensory input and blurring of afferent schemas in the perception process result in a compensatory stimulation and "release" of paranoid patterns of information processing. Consistency of perception is reestablished at the price of rigid, delusional interpretation of ambiguous social situations.
A strange manifestation of occupational contact urticaria due to mouse hair.
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Contact allergy due to 4-N,N-dimethylaminobenzene diazonium chloride and thiourea in diazo copy paper.
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Influence of implantable cardioverter-defibrillators on the long-term prognosis of survivors of out-of-hospital cardiac arrest.
BACKGROUND: Survivors of out-of-hospital cardiac arrest not associated with acute myocardial infarction are at high risk for recurrent cardiac arrest and sudden cardiac death. The impact of the implantable cardioverter-defibrillator on long-term prognosis in these patients is uncertain. METHODS AND RESULTS: Three hundred thirty-one survivors of out-of-hospital cardiac arrest (age, 56 +/- 13.7 years) underwent electrophysiologically guided therapy. Implantable defibrillators were placed in 150 patients (45.3%), and 181 patients (54.7%) received pharmacological and/or surgical therapy alone. Left ventricular ejection fraction was 35.2 +/- 16.6% in defibrillator recipients and 45.3 +/- 18.2% in nondefibrillator patients. Median patient follow-up was 24 months in the defibrillator group and 46 months in the nondefibrillator group. In a proportional hazards model, the independent predictors of total cardiac mortality were left ventricular ejection fraction of less than 0.40 (relative risk, 4.55; 95% confidence interval, 2.44 to 8.33; P = .0001), absence of an implantable defibrillator (relative risk, 2.70; confidence interval, 1.41 to 5.00; P = .017), and persistence of inducible sustained ventricular tachycardia (relative risk, 1.84; 95% confidence interval, 0.97 to 3.49; P = .045). The 1- and 5-year probabilities of survival free of cardiac mortality in patients with left ventricular ejection fraction of less than 0.40 were 94.3% and 69.6% with a defibrillator and 82.1% and 45.3% without a defibrillator, respectively. For patients with left ventricular ejection fraction of 0.40 or more, the 1- and 5-year probabilities of survival free of cardiac mortality were 97.7% and 94.6% with a defibrillator and 95.4% and 86.9% without a defibrillator, respectively. CONCLUSIONS: In survivors of out-of-hospital cardiac arrest, the implantable defibrillator is associated with a reduction in cardiac mortality, particularly in patients with impaired left ventricular function.
Influence of injection speed on the subarachnoid distribution of isobaric bupivacaine 0.5%.
The purpose of this study was to compare the anesthetic characteristics after two radically different speeds of intrathecal injection of isobaric 0.5% bupivacaine during continuous spinal anesthesia. Forty consenting patients, undergoing hip surgery using continuous spinal anesthesia, were allocated randomly to two groups of 20 each according to the rate of injection of 2 mL (10 mg) of isobaric 0.5% bupivacaine: FI (fast injection = 2 mL during 2 to 3 s or approximately 0.75 mL/s) or SI (slow injection = 1 mL/min). No difference was observed between the two groups in terms of sensory and motor block or hemodynamic changes. However, the onset time to maximal sensory level was significantly shorter in the SI group (16 +/- 9 min vs. 24 +/- 6 min; P < 0.05). Those patients requiring reinjection entered the second part of the study (n = 23; 15 in the FI group and 8 in the SI group). Each of these remaining patients was used as his or her own proper control. Those in the FI group received a slow reinjection and those in the SI group received a fast reinjection which consisted in all cases of 10 mg (2 mL) of isobaric 0.5% bupivacaine. When looking at the anesthetic characteristics after reinjection, maximal sensory levels, as well as onset times, were very similar in both groups. At all times, the maximal sensory level obtained after reinjection was two dermatomes higher than after the initial injection. Duration of sensory block, which was calculated only in these 23 patients, was also comparable (126 +/- 44 min for FI and slow reinjection group vs 146 +/- 25 min for SI and fast reinjection group). In conclusion, regardless of the speed of injection, there are no differences in anesthetic characteristics of spinal anesthesia using isobaric 0.5% bupivacaine.
Successful pregnancy in a 28-year-old patient autografted for acute lymphoblastic leukemia following myeloablative treatment including total body irradiation.
We report a successful pregnancy in a woman who at the age of 28 years received total body irradiation (TBI; 7.5 Gy) and high-dose chemotherapy prior to autografting of purged bone marrow for acute lymphoblastic leukemia. Four years after transplantation she delivered a healthy girl. Only five previous cases of successful pregnancies are described in the literature after conditioning regimens including TBI. This case shows that restored ovarian function is possible after TBI in spite of prolonged exposure to chemotherapeutic agents during induction and consolidation therapy and relatively high age at the time of transplantation.
[Benzalkonium chloride--a relevant contact allergen or irritant? Results of a multicenter study of the German Contact Allergy Group].
At eight dermatological clinics, a total of 2146 patients were tested between May 1990 and December 1991 to determine the significance of the preservative benzalkonium chloride in inducing allergic contact dermatitis and to evaluate recommendations for patch testing. In 225 cases an allergic reaction was proven, with 258 irritant reactions in addition. Only 12 cases were clinically relevant. Therefore, benzalkonium chloride is considered a weak allergen. A doubtful (erythema) or an incipient positive (with occasional papules) reaction may be regarded as an irritant reaction. In isolated cases a "repeated open application test" (ROAT) should be applied to determine clinical relevance. Our recommendation for patch testing is 0.1% benzalkonium chloride in vaseline, and also in water for special cases.
[Comments on the contribution by X. Baur and J. Ammon. Diagnosis of allergy].
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[Patients of the geriatric psychiatry day clinic and their treatment--report of experiences].
Patient characteristics and treatment modalities of a psychogeriatric day hospital are analyzed on the basis of demographic, illness- and treatment-related data from a 5-year-period. Specific potentials and tasks of the day hospital in the care of the mentally ill elderly are discussed.
[A case of "delusional growth". On the origin and nosologic classification of somatic dysmorphic disorder].
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