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T Held

Publications and source records attributed to T Held.

At least 127 records · Page 7Linked to original sources

[Psychoses and driving fitness--development of criteria for clinical assessment].

The legal foundations for driver fitness evaluation in psychiatric conditions are enumerated in the 1985 "Illness and road traffic" expert opinion of the advisory medical council with the Federal Ministry of Transport. In case of the endogenous psychoses, in-patient episodes will invariably give rise to a call for expert psychiatric appraisement, notwithstanding the fact that reliable and valid criteria, with the exception of a standardized driving sample, continue to be almost non-existent. Carried out between 1989 and 1991 with support from the Federal Employment Institute in the framework of an employment creation project as well as from Bundesanstalt für Strassenwesen, the present study hence had been aimed at correlation-statistical identification of as valid driving ability predictors as possible in post-acute patients with a diagnosis of schizophrenic psychosis (ICD 295.3). The patients' pre-discharge fitness for driving, for one, was assessed using a number of psychological procedures and, for the other, was examined during a 60 minute practical driving sample, involving both city and autobahn driving. Driving behaviour during the practical trial was taken down according to pertinent categories, with subsequent judgment of overall driving performance both by self-ratings and by driving instructor ratings by means of a school grades scale of 1 to 6. With reference to pertinent studies elsewhere, our test battery had consisted of procedures for testing visual perception, reaction, selective and split attention, personality structure, anxiety, and risk-taking.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Pro and contra: psychotherapy and psychopharmacotherapy attitude of the public].

As shown by the results of a representative survey carried out in the FRG in 1990, psychotherapy is much favoured over psychotropic drug treatment by the lay public. This holds similarly for the treatment of schizophrenia, depression, and panic disorder. The decision in favour of psychotherapy is primarily motivated by the assumption that this treatment modality provides an opportunity for personal exchange and that it will be carried out by a competent therapist. The lays' beliefs about psychotherapy are rather global. They are very much influenced by the social representations of psychoanalysis as a method that treats the cause of the problem. The knowledge of psychotropic drugs, as well, is rather unprecise. Their image is mostly determined by that of the tranquilizers as drugs with a high risk of dependency and a primarily sedative effect.

Anxiety Disorders↗

[Malaria tropica].

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Exchange Transfusion, Whole Blood↗

Malaria therapy in 452 patients, with special reference to the use of quinine.

We investigated the efficacy and toxic potential of antimalarial therapy regimens in 452 malaria patients treated between 1980 and 1990. Drug regimens in 330 non-immune travellers were compared with those of 122 semi-immunes with acute malaria; 71% patients acquired their infection in tropical Africa, and the 288 Plasmodium falciparum infections were the most prevalent species. Because of increasing drug resistance or toxicity of chloroquine, pyrimethamine-sulfadoxine and even mefloquine, quinine proved to be the most effective antimalarial against P. falciparum and the only one which did not lead to recrudescences. These occurred in 10% patients after chloroquine and 6% after mefloquine. Cinchonism occurred in 25% of those treated with quinine, but it was fully reversible and never necessitated withdrawal of the drug. We conclude that quinine is highly effective in the treatment of P. falciparum infection and is mandatory if the clinical condition requires a fast-acting blood schizonticide, in cases of hyper-parasitaemia and if multi-drug resistance occurs; its use should not be restricted by reversible side-effects such as cinchonism.

Adolescent↗

[Tuberculosis of the larynx, oral cavity and pharynx].

A 44-year-old man, a heavy smoker over many years, complained of hoarseness for 8 weeks with weight loss and dysphagia. Malignant tumour of the pharynx was suspected. Examination revealed a swelling of the right upper lip, tumorous changes in the right buccal mucosa, about 6 x 6 cm in size, as well as enlargement of the cervical lymph-nodes. Microlaryngoscopy revealed a three-level tumour of the entire side of the right larynx. Histological examination of biopsies of the right false and true vocal cords as well as the buccal mucosa demonstrated numerous, partly caseous epithelioid granulomas with Langhans giant cells. Ziehl-Neelsen staining showed acid-fast rods. Combined tuberculostatic treatment with isoniazid, rifampicin, ethambutol and pyrazinamide achieved regression of all signs and symptoms within two months. This case emphasizes the need for including laryngeal tuberculosis in the differential diagnosis of seemingly malignant laryngeal tumours.

Adult↗

Genetic recombination in Streptomyces michiganensis DSM 40,015 revealed three genes responsible for the formation of melanin.

By UV and NTG mutagenesis numerous auxotrophic, antibiotic-resistant and melanin-negative mutants were isolated from Streptomyces michiganensis DSM 40,015 which proved to possess a efficient photoreactivation system. Using a mel- test strain with three auxotrophic markers and a antibiotic resistance for crosses with numerous prototrophic mel- strains three classes of mutants (melA, melB and melC) could be found. This classification was further supported by a series of crosses. The melC locus seemed to correspond to the melC locus of S. glaucescens which contains the tyrosinase structural gene.

Chromosome Mapping↗

Neuropsychiatric side effects after the use of mefloquine.

This study describes neuropsychiatric side effects in patients after treatment with mefloquine. Reactions consisted mainly of seizures, acute psychoses, anxiety neurosis, and major disturbances of sleep-wake rhythm. Side effects occurred after both therapeutic and prophylactic intake and were graded from moderate to severe. In a risk analysis of neuropsychiatric side effects in Germany, it is estimated that one of 8,000 mefloquine users suffers from such reactions. The incidence calculation revealed that one of 215 therapeutic users had reactions, compared with one of 13,000 in the prophylaxis group, making the risk of neuropsychiatric reactions after mefloquine treatment 60 times higher than after prophylaxis. Therefore, certain limitations for malaria prophylaxis and treatment with mefloquine are recommended.

Adult↗

[Clinical experiences with mefloquine in tropical malaria--a prospective study].

The therapeutic effects and side effects of mefloquine in falciparum malaria were investigated in an open prospective trial involving 20 patients. None of them had a history of neurologic or psychiatric disorders. Mefloquine was given in a total dose of 1500 mg base. The cure rate was 100%, fever and parasitemia subsided within 3 days. Side effects were vomitus and nausea in 25% of the patients. No neurological or psychiatric disorders were observed. Mefloquine was shown to be a safe therapeutic agent in the dosage used. However, regular follow-up examinations should be done in short intervals because of the possibility of late neuropsychiatric side effects; the patients and their relatives should be informed about this fact.

Adolescent↗

[Multiple amebic liver abscesses: ultrasound diagnosis and ultrasound-controlled puncture].

Amebic colitis and amebic liver abscess were diagnosed in a 45-year-old patient who had returned from Thailand. Ultrasound scans performed after starting treatment with metronidazole showed an abscess located above the right kidney that had enlarged to a maximum diameter of 9.7 cm. Since rupture of this lesion was felt to be imminent, ultrasound-guided needle biopsy was performed and 300 ml of abscess fluid evacuated. The patient experienced rapid relief of his symptoms. The role of ultrasound imaging in the diagnosis and follow-up of amebic liver abscesses and the indications for ultrasound-guided needle aspiration are discussed.

Animals↗