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Biomedical subjects

U Mielke

Publications and source records attributed to U Mielke.

At least 19 recordsLinked to original sources
PubMed1999

Psychopathologic and zoological aspects of acarophobia.

Acarophobia represents a nosologically inconsistent psychiatric clinical picture which is exceptional in that it is noticed among the clientele of those in charge of pest control, hygienists, health department medical officers and dermatologists rather than in psychiatric practice or mental hospitals. Apart from acarophobia in the course of schizophrenic, affective and organic psychoses as well as cases in which the phobia was induced by another individual, roughly half of the cases were 'pure' forms, i.e. monosymptomatic psychoses mainly occurring at advanced age and in females. Putative parasitisation relates not only to the subject's skin, but also to the premises where the person affected is living. Social isolation appears to rank high among essential causes. Four cases from a pest controller's practice are reported which could not be properly treated because of the subjects' lack of insight into their condition. In this light, it was the aim of the present study to focus the attention of pest controllers and hygienists on interdisciplinary co-operation with psychiatrists as well as with public health departments.

Aged↗
PubMed1997

Nosocomial myiasis.

When the larvae of flies invade man the clinical picture is referred to as 'myiasis'. When myiasis occurs in a patient after hospitalization the disease is termed nosocomial myiasis, a very infrequent phenomenon. The present investigation was conducted to record the cases of nosocomial myiasis documented worldwide. Twenty-three cases of this hospital infection, which have occurred in a number of countries were found in the literature, and analysed. Myiasis-related factors with respect to the patients and their hospitals are discussed.

Adolescent↗
PubMed1996

[Subarachnoid hemorrhage from the anterior communication artery in a sex offender. Considerations regarding liability].

A 32-year-old man was accused of attempted rape. While urinating at the side of the road he felt an erection. He approached a 9-year-old girl who happened to be coming along and pressed his penis between her legs until ejaculation. Shortly afterwards he was arrested. He confessed, but claimed partial amnesia and had no explanation for the offence, which he normally would never have thought of. Shortly before the event a witness had seen him nearby in a poor state of orientation. Three months later in prison he suffered massive subarachnoidal hemorrhage from an aneurysm of the anterior communicating artery. The evaluation of his legal responsibility must take account of a putative psychomotor seizure at the time of the offence. With regard to the aneurysm diagnosed later, a pathogenetic connection, in terms of a preceding warning leak, might be assumed.

Adult↗
PubMed1995

Changes in muscular activity after knee arthrotomy and arthroscopy.

The object of this study was to find out whether an arthrotomy of the knee would damage joint proprioception. Twenty patients who underwent arthrotomy, and 20 patients after arthroscopy, were tested on a modified ergometer and the electromyographic action of their quadriceps and hamstrings recorded. The quadriceps action started later and had a shorter duration (20 ms) after arthrotomy. The differences are statistically significant in intra-individual comparison both for vastus lateralis and medialis, in comparison with the normal group for only the vastus medialis. There were no significant differences in muscle control after arthroscopy. These results are in favor of preferring arthroscopy to arthrotomy whenever possible.

Adult↗
PubMed1994

[Pesticides as chemical indoor pollution and persistence in the hospital as an example in long term and short term studies].

It is because of combined hygienic, ecological, commercial and psychological aspects that controlling public health pests in the hospital becomes a complex problem area in which dubious practices and philosophies have had a tradition for decades. These include harmlessness assumptions considered as a carte blanche, ignoring the biological peculiarities of the species controlled, payment for consumption of chemicals or area controlled rather than for efficiency of control, and a contract policy between the pest control contractor and the hospital governed by a profit-oriented control frequency rather than by the actual infestation. Thus, the hospital environment has often experienced an unnecessarily high exposure to toxic and, in part, persistent substances which can adversely affect the chemical indoor situation in acute terms or on a long-term basis, and may give rise to sustained problems. Exposure and residues were determined to provide evidence of the acute risk to health after control measures using dichlorvos, as well as long persisting exposure as typically demonstrated for DDT. The conclusions drawn so as to minimise the risk of indoor pest control in the hospital are presented.

Air Pollution, Indoor↗
PubMed1993

[Conditions in stuttering. Results of an interdisciplinary study of 3- to 5-year-old children. Neurologic aspects].

Results recorded from neurological surveys are reported in the context of an interdisciplinary study conducted on 67 children aged three to five years at the onset of speech fluency disorders as well as investigations on 50 children of identical age and sex. The two groups (DS: disruption of speech; CG: control group) significantly differed from each other regarding family predisposition for stuttering. Sub-coordination and whole-body coordination were investigated. Both the occurrence of disorders and as the number of vegetative symptoms recorded from DS children were significantly higher than comparable values obtained from CG probands. Electroencephalographic recordings were taken only from the DS group, with 25 percent of them being interpreted as pathological. The conclusion is drawn that this study, once more, has provided evidence for the existence of somatic predisposition which, however, must not be considered identical with cerebral damage.

Autonomic Nervous System↗
PubMed1993

[Conditions in stuttering. Results of an interdisciplinary study of 3- to 5-year-old children. Child psychiatric aspects].

An interdisciplinary study was conducted with 67 children aged three to five years at the onset of speech fluency impairment as well as with 50 controls identical to the above group by age and sex. Findings reported are on psychic conditions which were obtained by interviews with and examinations of parents and children as well as by watching children at play and by means of questionnaires. Children with disruption of speech (DS) significantly differed from children in the control group (CG) with regard to prevailing mood, affect, psychic stability, capability of concentration, sociability and timidity. These personality traits and behaviours deviating from normal with differing intensity, are interpreted as stutter-specific condition for consolidation of the disorder rather than as cause of the latter. Ways of intervention will depend on several aspects, including the specific influence of psychic components on the condition of the individual.

Arousal↗
PubMed1993

[Social conditions of stuttering].

Sixty-seven stuttering and 50 non-stuttering children, all of them aged between three and five years, were investigated regarding their social conditions in an interdisciplinary study. Numerous studies so far conducted into family circumstances of stuttering children and adolescents have supported diverse conclusions regarding the parent-child relationship, personality traits of parents as well as their style of child raising and social status. Most of the resulting publications have concentrated on children from whom stuttering symptoms had been recordable for several years, so that it was not safely verifiable whether the parental behaviour described had been one of the causal factors for stuttering of children or a belated response to that stuttering. The author's own investigations showed significant differences with regard to presence in a day nursery in the child's first year, space conditions at home, attention given to the child, physical exercise, occupational satisfaction of mothers and self-appraising qualities of fathers. These differences, on balance, are interpreted to the effect that in the individual case stuttering may be affected by psychosocial conditions and would then call for therapeutic action, although it appears to be obvious that there are no stutter-specific social factors. These results are likely to confirm experience obtained from work with stuttering individuals by numerous medical doctors, teachers in lalopathology and psychologists who found that in general manifestations of stuttering may be caused and affected by a number of factors, both endogenic and exogenic.

Child, Preschool↗
PubMed1992

[Long-term treatment of Lambert-Eaton syndrome by 3, 4 diaminopyridine].

A patient with a 5 year history of slow-progressive Lambert-Eaton Myasthenic Syndrome (LEMS) was treated for a period of 12 months with 3,4-diaminopyridine (3,4-DAP). The therapy led to an objective increase in muscle power. During the treatment period, there was no increase in muscle weakness, but attempts at withdrawal of the drug confirmed a progression. The mouth dryness disappeared and autonomic regulation disturbances were improved. All of the laboratory parameters remained unchanged. A neoplasia was excluded by extensive endoscopic and radiological investigations. Side-effects included initial perioral paresthesia and, later, paresthesia down the skin and along the ulnar edge of the forearm. 3,4-DAP seems to be an effective and acceptable long-term symptomatic therapy in LEMS.

4-Aminopyridine↗
PubMed1992

[Rational neurologic diagnosis in fecal incontinence].

The effective therapy of a disturbance of anal continence requires an adequate preoperative diagnostics. In most cases this includes some kind of neurophysiological investigation. Close cooperation between the internist, the surgeon and the neurologist is advantageous. The initial history, clinical examination and electromyography of the pelvic floor will usually be enough to differentiate between aetiologies. In the first phase it is necessary to decide whether the problem is neurogenic or muscular, and then to see localising signs for a nerve defect (central or peripheral) or, respectively, signs of a defect in the skeletal musculature. It must be said that a peripheral nerve lesion (eg. a stretching injury of branches of the pudendal nerve) and a muscular defect may be combined. At the end of the diagnostic process the surgeon or internist and neurologist must decide together whether the diagnosis is appropriate, and then whether an operative or non-operative approach to treatment is fitting. In the second phase of diagnosis are further neurophysiological investigations, which are only indicated in more special circumstances. These investigations include: nerve conduction velocities, reflex latencies (anal-, bulbocavernosus-, and pudendoanal reflexes), evoked potentials, and the single fibre EMG to determine fibre density. These neurophysiological investigation in proctology allows the clinician a wider scope of diagnostic possibilities, which should lead to more sensible therapeutic options being taken.

Electromyography↗
PubMed1991

[Analysis of the public health status and assessment of vaccination status in maternal health services and child and adolescent preventive health care of a district city].

A total of 23 maternity centres and 8 youth welfare centres in the county town of Magdeburg were inspected in 1987 and 1988 to review the condition of buildings and layout of rooms. Checks were also made on anti-infectious routines and compliance with the vaccination regulations. In all of these areas a number of deficiencies were found, and the results of follow-up inspections clearly show that the attention being given to public health regulations for sterilization and disinfection and to the storage of vaccines, is still inadequate. Urgent action is also required to improve conditions which are beyond the control of staff, such as buildings in need of repair, lack of space and the installation of washbasins, toilets, etc.

Adolescent↗
PubMed1991

Therapeutic approaches to Lambert-Eaton myasthenic syndrome in the intra-individual comparison.

A patient with Lambert-Eaton myasthenic syndrome was clinically treated several times over a period of 9 months. During at least 3 weeks each time, the patient received prednisone, then underwent 9 plasmaphereses, and was given guanidine-hydrochloride (HCl) and 3,4-diaminopyridine (3,4-DAP). The muscle-power scoring, muscle function tests and the electrophysiological parameters showed a superiority of 3,4-DAP over the other pharmacological therapies. Good results were also obtained with plasmapheresis. Corticoid medication proved to be less effective. No improvement was seen with guanidine-HCl. For comparative judgement, two months after beginning the last therapy, the patient and the attending physician were questioned with regard to subjective therapeutic success. The answers largely match the objective results. Both favour 3,4-DAP. In contrast to the patient's opinion, the physician sees a distinct effect of plasmapheresis. All in all, the administration of 3,4-DAP may be seen as an effective and acceptable therapy in Lambert-Eaton myasthenic syndrome.

4-Aminopyridine↗
PubMed1989

[Acute multifocal placoid pigment epitheliopathy with inflammatory CSF findings. A special form of borreliosis?].

A 24-year-old woman with acute multifocal placoid pigment epitheliopathy in both eyes had no signs or symptoms other than the impaired vision. Visual evoked potentials demonstrated prolonged latency. Lumbar CSF showed inflammatory changes. Serum antibody titres against Borrelia burgdorferi were markedly elevated. Cortisone treatment was without success, but intravenous penicillin quickly brought about improvement in vision. Borrelia infection may thus have been the cause of the multifocal placoid pigment epitheliopathy.

Acute Disease↗
PubMed1989

[Isolated vitamin E deficiency].

Since the detection of vitamin E in 1922, nearly 50 years passed until the recognition that there is a pathogenic vitamin E deficiency in humans. Such a deficiency can be found mostly in a disturbed resorption or transport of the vitamin (mucoviscidosis, chronic cholestasis, abetalipoproteinaemia) and leads typically to a progredient spinocerebellar ataxia in combination with a polyneuropathy. Substitution of the vitamin may hinder a further progression or even lead to an amelioration of the symptoms. Prophylactic treatment in abetalipoproteinaemia prevents the otherwise unavoidable neurological deficits. Isolated vitamin E deficiency is a rare syndrome and the causes are still obscure. We observed a 26 year old male patient with such a isolated vitamin E deficiency who was hitherto thought to suffer from Friedreich's ataxia. The clinical feature showed in addition to the "classical" symptoms of vitamin E deficiency cranial nerve involvement, perioral dystonia and pyramidal signs. Histologically (M. gastrocnemius) we saw the described typical but not specific changes (neurogenic atrophy, phosphatase-positive vacuoles with myelin bodies, cores). An oral vitamin E resorption test yielded a very shortened serum half life. These results support the hypothesis that in the pathophysiology of isolated vitamin E deficiency malelimination plays an important role in addition the known malresorptions models.

Adult↗
PubMed1988

Progressive myopathy in trisomy 21.

A 23-year-old female patient with clinical manifestations typical of Down's syndrome progressively developed intensifying weakness of the proximal muscles from the age of 16 years. CK levels were distinctly elevated. Electromyography showed myogenic lesions and muscle biopsy a myopathic image with extensive fibre hypertrophy. Progressive sporadic myopathy in association with Down's syndrome has not been reported previously.

Adult↗
PubMed1986

Rheographic indications for reduced cerebral vasoconstriction after oral magnesium medication in tetanic patients, a double-blind, placebo-controlled trial.

Volume and tonus oscillations of cerebral blood vessels are measurable with rheoencephalography. A lowered amplitude under resting conditions and an increased reactivity after hyperventilation (with pronounced and prolonged vasoconstriction) was found in tetanic patients, 360 mg Mg/day (as magnesium citrate tablets) was administered in 17 tetanic patients (A) and a placebo in 18 patients (B) in a double-blind, placebo-controlled trial. After 4 weeks the hyperventilation-induced vasoconstriction was reduced significantly within group A compared to group B.

Adolescent↗