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Biomedical subjects

T Platz

Publications and source records attributed to T Platz.

At least 37 records · Page 2Linked to original sources
PubMed1996

Comparison of acamprosate and placebo in long-term treatment of alcohol dependence.

BACKGROUND: About 50% of alcoholic patients relapse within 3 months of treatment. Previous studies have suggested that acamprosate may help to prevent such relapse. The aim of our study was to assess the efficacy and safety of long-term acamprosate treatment in alcohol dependence. METHODS: In this multicentre, double-blind, placebo-controlled study, we recruited 455 patients, aged 18-65 years, with chronic or episodic alcohol dependence. Patients were randomly allocated treatment with acamprosate (1998 mg daily for bodyweight > 60 kg; 1332 mg daily for < or = kg) or placebo for 360 days. Patients were assessed on the day treatment started and on days 30, 90, 180, 270, and 360 by interview, self-report, questionnaire, and laboratory screening. Patients were classified as abstinent, relapsing, or non-attending. Time to first treatment failure (relapse or non-attendance) was the primary outcome measure. FINDINGS: Seven patients were excluded from the intention-to-treat analysis because they did not attend on the first treatment day and therefore received no medication. The acamprosate (n = 224) and placebo (n = 224) groups were well matched in terms of baseline demographic and alcohol-related variables. 94 acamprosate-treated and 85 placebo-treated patients completed the treatment phase: of those withdrawn, 104 (52 in each group) relapsed, 69 (33 vs 36, respectively) were lost to follow-up, 63 (31 vs 32) refused to continue treatment, 16 (15 vs 11) had concurrent illness, three (two vs one) died, ten (six vs four) had adverse side-effects, one (acamprosate treated) received the wrong medication, and three (placebo treated) were non-compliant. The proportion without treatment failure was higher in the acamprosate than in the placebo group throughout the treatment period (p < 0.001, Mantel-Cox). At the end of treatment, 41 (18.3%) acamprosate-treated and 16 (7.1%) placebo-treated patients had been continuously abstinent (p = 0.007). Mean cumulative abstinence duration was significantly greater in the acamprosate group than in the placebo group (138.8 [SD 137.5] vs 103.8 [119.0] days; p = 0.012). 148 patients (79 acamprosate, 69 placebo) completed 27 months follow-up: 27 (11.9%) acamprosate-treated and 11 (4.9%) placebo-treated patients remained continuously abstinent, and the mean cumulative abstinence duration was 230.8 days (259.1) and 183.0 days (235.2), respectively. Apart from occasional diarrhoea, there was no difference in side-effects between groups. INTERPRETATION: Acamprosate is an effective and well-tolerated pharmacological adjunct to psychosocial and behavioural treatment programmes for treatment of alcohol-dependent patients.

Acamprosate↗
PubMed1996

Tactile agnosia. Casuistic evidence and theoretical remarks on modality-specific meaning representations and sensorimotor integration.

Somaesthetic, motor and cognitive functions were studied in a man with impaired tactile object-recognition (TOR) in his left hand due to a right parietal convexity meningeoma which had been surgically removed. Primary motor and somatosensory functions were not impaired, and discriminative abilities for various tactile aspects and cognitive skills were preserved. Nevertheless, the patient could often not appreciate the object's nature or significance when it was placed in his left hand and was unable to name or to describe or demonstrate the use of these objects. Therefore, he can be regarded as an example of associative tactile agnosia. The view is taken and elaborated that defective modality-specific meaning representations account for associative tactile agnosia. These meaning representations are conceptualized as learned unimodal feature-entity relationships which are thought to be defective in tactile agnosia. In line with this hypothesis, tactile feature analysis and cross-modal matching of features were largely preserved in the investigated patient, while combining features to form entities was defective in the tactile domain. The alternative hypothesis of agnosia as deficit of cross-modal association of features was not supported. The presumed distributed functional network responsible for TOR is thought to involve perception of features, object recognition and related tactile motor behaviour interactively. A deficit leading primarily to impaired combining features to form entities can therefore be expected to result in additional minor impairment of related perceptual-motor processes. Unilaterality of the gnostic deficit can be explained by a lateralized organization of the functional network responsible for tactile recognition of objects.

Agnosia↗
PubMed1995

Human motor planning, motor programming, and use of new task-relevant information with different apraxic syndromes.

Patients with ideomotor apraxia (n = 2) or ideational apraxia (n = 2) after left brain stroke and patients with constructional apraxia (n = 2) after cerebrovascular accident of the right hemisphere, as well as 16 non-brain-damaged control subjects, were given a standardized simple motor task: they were asked to make triangular arm movements of specific size, configuration and spatial orientation without visual control. Motion was analysed three-dimensionally in great detail prior to and after kinaesthetic training using a triangular stencil, and 1 day later. The experiment was conceptualized to assess three aspects of motor behaviour: (i) motor planning, operationalized as specification of content parameters of the movement as a whole; (ii) motor programming, the specification of spatiotemporal parameters of movement segments; and (iii) the ability to make use of task-relevant information provided by the training. Patients with ideational apraxia showed signs of impaired motor planning: they had difficulty in selecting the body parts to be moved, and movement concept and configurational aspects were deficient. The kinaesthetic sensorimotor training given seemed not adequate to reduce behavioural deficits. Kinematic peculiarities of patients with ideomotor apraxia can be understood as deficits in programming movement elements. Submovements were more segmented, showed irregularities as well as additional, not-requested elements. Their impairments could be reduced by task-specific sensorimotor training. Patients suffering from visuoconstructive apraxia after right brain damage might have difficulties in making use of new sensorimotor information relevant for spatial-motor aspects, as suggested by training-induced behavioural impairment with a severely constructional apraxic patient.

Aged↗
PubMed1995

Multicenter double blind study of paroxetine and amitriptyline in elderly depressed inpatients.

Paroxetine is a phenylpiperidine compound which is a selective serotonin reuptake inhibitor (SSRI). Ninety-one hospitalised patients with a major depression (DSM-III) aged 65 and over from six Austrian and one German center were entered into the study, which compared the efficacy and tolerability of paroxetine versus amitriptyline. After 6 weeks both groups showed similarly good therapeutic results. In the paroxetine group, 64.3% of the patients had a 50% or more reduction of the HAMD total score compared to 58.1% in the amitriptyline group. Side effects were distributed similarly in both groups. Patients in the paroxetine group showed a higher incidence of anxiety and agitation; anticholinergic side effects were registered more often in the amitriptyline group.

Aged↗
PubMed1994

Motor learning after recovery from hemiparesis.

Twenty patients who had almost completely recovered from hemiparesis following unilateral cerebrovascular accident and 16 control subjects had to perform motor learning tasks including a three-dimensional motor problem and two standard precision tests. The ability of hemiparetic patients to solve simple spatial-motor problems and to gain by training was preserved with limitations concerning high precision control. However, hemiparetic patients had a higher demand for time and corrections, as well as a reduced consistency of performance. Thus recovery from hemiparesis was accompanied by reduced skillfulness and automaticity of motor control.

Adult↗
PubMed1994

A multicenter double-blind trial of paroxetine versus amitriptyline in depressed inpatients.

The phenylpiperidine derivative paroxetine is a selective serotonin reuptake inhibitor. In a double-blind 6-week trial, paroxetine was compared with amitriptyline in hospitalized patients suffering from major depression (DSM-III). One hundred fifty-three patients were enrolled in the study in seven centers in Austria and Germany. Results showed similar efficacy of both drugs after 6 weeks. The differences between groups in Montgomery-Asberg Depression Rating Scale and Clinical Global Impression ratings did not reach statistical significance at any time. Side effects were distributed similarly but with a significantly higher incidence of anticholinergic effects in patients treated with amitriptyline (p < or = 0.001), whereas agitation and insomnia were registered more often in the paroxetine group. This study supports the antidepressive efficacy of paroxetine in a sample of severely depressed inpatients.

Adolescent↗
PubMed1993

Is there a typical conflict in gastric complaints? An epidemiologic-psychoanalytic contribution to the question of conflict specificity in psychosomatic medicine.

The question of conflict specificity for subjects with gastric complaints was investigated in the context of a representative, epidemiologic-psychoanalytic field study. Out of a population of 600 adults probands with dyspepsia were compared with individuals with musculoskeletal symptoms and 'healthy' subjects. Using interview protocols 2 'blinded' raters judged whether a dependency-independency conflict was present in different aspects of life. Findings supported the higher prevalence of the conflict among subjects with dyspepsia. Therefore, the conflict was considered typical, but not specific for the experimental group.

Adult↗
PubMed1993

[Is there a typical conflict in dyspepsia? An epidemiologic psychoanalytic contribution to the topic of a specific conflict in psychosomatic medicine].

The question whether a dependency-independency-conflict is specific for subjects with gastric complaints was investigated by means of a representative, psychoanalytic-epidemiologic field study (Mannheimer Kohortenprojekt). Out of a population of 600 adults probands with dyspepsia were compared with individuals with musculoskeletal symptoms and "healthy" subjects. Using interview protocols of these individuals two "blinded" raters judged whether the conflict under consideration was present in different aspects of life. It could be confirmed that subjects with gastric complaints showed the conflict significantly more often than either control group. However, the conflict was also found among individuals of either control group. It can be concluded that the dependency-independency-conflict is typical, but not specific for subjects suffering from dyspepsia.

Adult↗
PubMed1991

[Psychiatric reform in Kärnten: overcoming political cynicism?].

The development of psychiatry in Carinthia is described in its sociological context. There appears to be a correlation between the self-esteem of the population and its attitude to fellow human beings with psychomedical problems. Responsible social policy is important in constellations in which anxiety, power and cynicism are latent owing to major emotional conflicts.

Austria↗
PubMed1986

[Ulcer disease. Studies of patients with chronic recurrent duodenal ulcer in an attempt to differentiate subgroups based on age at disease onset, psychopathologic and biographical data].

A group of 47 patients suffering from chronic recurrent duodenal ulcers was subdivided into two groups according to whether the first manifestation of the disorder occurred early or late in the life of each individual. A comparison of the two groups revealed that the patients in group I (early manifestation) had a larger number of constitutional handicaps along with a higher incidence of dispositional prior experience with regard to object loss and that they assumed social responsibility at an early age. Group II (late manifestation) was characterized by a larger number of depressive psychoses, a higher incidence of alcohol abuse, and by attempts at suicide. Apart from this, the patients in group II often complained of muscular pain syndromes. Patients in group I frequently exhibited the characteristics of the ulcer type described by Alexander as well as chronic anger. Patients in group II most often had the personality structure of so-called psychosomatic patients or suffered from depressive disorders affecting their personalities and from chronic anxiety. The two characteristics which were most typical for recidivation were: 1. Actualization of experienced bereavement and 2. unspecific activation as a result of the will to assert themselves in stress situations. In 41% of the cases there was evidence of somatic factors as e.g. starvation, abuse of alcohol or abuse of analgetics. Long-term prophylaxis has been effected by psychopharmacological agents as well as by psychotherapeutic techniques.

Adaptation, Psychological↗
PubMed1985

Cerebrovascular lesions and livedo reticularis (Sneddon's syndrome)--a progressive cerebrovascular disorder?

Four cases are described in which livedo reticularis was associated with repeated cerebrovascular accidents, which eventually resulted in severe disability in two cases. Patients with severe disability had a history of many years, whereas two patients with little or moderate residual disability had a follow-up of 3 years each. CT scan revealed multifocal cerebral infarctions and cortical atrophy in all cases. Repeated cerebral angiograms, done in three cases, showed no signs of a vascular disease. There were no parameters that pointed to active immunological or inflammatory disorder. Neither clinical evidence of heart or large vessel disease was found. Observations suggest that a so-far unknown progressive cerebral vessel disease associated with livedo is the cause of a steady increase in multiple small cerebral infarctions. Because of the progressive character of the disease the search for effective therapy is needed.

Adult↗
PubMed1984

[Therapy of acute schizophrenic psychoses--a multidimensional approach].

The concept of "basic discorders" facilitates the developement of more widely differentiated therapy models even for acute forms of schizophrenia. Psychopharmacological, psychotherapeutic and sociotherapeutic aspects are presented in light of a case report. This multidimensional strategy is based on catamnestic and epidemiological results of our own studies.

Adult↗
PubMed1984

[Possibilities and limits of cranial computerized tomography for clinical psychiatry].

The interpretation of the computer-tomogramm is of practical value for diagnostic, therapeutic and prognostic aspects (Seitz [21]). Brain-atrophy is a pathomorphological change caused by a number of facts. Only the consideration of the patient's age, the degree of hydratation, serious internal or neurological diseases, endo- or extotoxic variables respectively, postnarcotic incidents or minimal brain damage allows an interpretation in accordance with the psychopathological symptoms.

Adult↗
PubMed1984

[Psychopathology of organic psychoses with reference to differential diagnostic, epidemiologic and morphologic aspects].

Following a brief discussion of the historical development of the term "Organic Psychosis", detailed consideration is given to the phenomenology and differential diagnosis of this group of diseases. The published epidemiological data is compared to the results of our own study. The cranial CT makes it possible to correlate clinical and morphological findings. In our investigation 72.5% of the patients with severe chronic organic psychosis show considerable brain atrophy. The morphological aspect is a determining factor for the therapeutic measures and for the prognosis.

Adult↗