bluuebunny/crossref_metadata_2025 huggingface dataset:
One Size Does Not Fit All: Differences in HPV Knowledge between Haitian and African American Women
Authors: Kobetz Erin , Dunn Mendoza Angela , Menard Janelle , Finney Rutten Lila , Diem Joshua , Barton Betsy , Kornfeld Julie , McKenzie Nathalie
Published: February 2010

Background: Historically, all black persons, regardless of ancestry or country of origin, have been categorized as one group for cancer research and control efforts. This practice likely masks variability in exposure to determinants of disease, as well as in risk of cancer incidence and mortality. The current study examines potential differences in knowledge of human papilloma virus (HPV) between Haitian women living in Little Haiti, Miami, Florida, and a national sample of predominately African American women.

Methods: Data for Haitian women were collected in 2007 as part of an ongoing community-based participatory research initiative in Little Haiti. For purposes of comparison, we used data from a largely African American subsample of the 2007 Health Information National Trends Survey (HINTS). These data sources used identical items to assess HPV knowledge, providing a unique opportunity to examine how this outcome may vary between two very distinct populations who are often grouped together for research and disease surveillance.

Results: Relative to the HINTS sample, Haitian women were far less likely to have heard about HPV.

Conclusions: Study data highlight important differences in Haitian and African American women's knowledge of HPV, a known determinant of cervical cancer risk. Such findings suggest that continuing to classify persons of similar phenotype but different cultural backgrounds and lifetime exposures as one group may preclude opportunity to understand, as well as attenuate, health disparity. Cancer Epidemiol Biomarkers Prev; 19(2); 366–70
Sunitinib – vom Paradigmenwechsel zu einem Therapiestandard beim metastasierten Nierenzellkarzinom (mRCC)
Authors: Bergmann Lothar
Published: February 2010

Zielgerichtete Substanzen haben in der Behandlung des metastasierten Nierenzellkarzinoms (mRCC) zu einem Paradigmenwechsel gefÜhrt. Der Multi-Kinase-Inhibitor Sunitinib konnte sich innerhalb kurzer Zeit als ein neuer Standard in der Erstlinientherapie etablieren. In einem umfassenden Studienprogramm wurde Sunitinib ausgehend von Phase-II-Studien in der Zweitlinientherapie Über eine Phase-III-Studie zur Erstlinientherapie bis hin zum breiten Einsatz in der klinischen Praxis systematisch entwickelt. Die Prognose fÜr Patienten mit mRCC hat sich durch die EinfÜhrung des Multi-Kinase-Hemmers deutlich verbessert: GegenÜber Interferon-alpha wurde mit Sunitinib eine Verdopplung des progressionsfreien Überlebens und eine Vervierfachung der Ansprechrate erreicht. Die hohe Wirksamkeit Übersetzte sich auch in das mediane GesamtÜberleben von Über 2 Jahren im Sunitinib-Arm der Studie. Zusammen mit den konsistenten Ergebnissen des internationalen Sunitinib-Expanded-Access-Programms verfÜgt die Substanz Über eine breite Evidenzbasis und umfassende praktische Erfahrung fÜr den Einsatz in allen Patientenpopulationen. Dies spiegelt sich auch in den Empfehlungen nationaler und internationaler Fachgesellschaften wider. In Deutschland ist Sunitinib die am hÄufigsten eingesetzte Substanz beim mRCC.
Anti-Müllerian Hormone and Sertoli Cell Function in Paediatric Male Hypogonadism
Authors: Grinspon Romina P. , Rey Rodolfo A.
Published: February 2010

In the prepubertal male, Sertoli cells are the most active testicular cell population. Without stimulation tests, prepubertal hypogonadism can only be evidenced if Sertoli cell function is assessed. Anti-müllerian hormone (AMH) is a distinctive marker of the prepubertal Sertoli cell. Serum AMH is high from fetal life until puberty. In postnatal life, AMH testicular production is stimulated by FSH and potently inhibited by androgens. In anorchid patients, AMH is undetectable. In prepubertal males with fetal- or childhood-onset primary or central hypogonadism affecting the whole gonad, serum AMH is low. Conversely, when hypogonadism only affects Leydig cells (i.e., LH/human chorionic gonadotrophin receptor or steroidogenic enzyme defects), serum AMH is normal/high. AMH is also normal/high in patients with androgen insensitivity. In patients of pubertal age with central hypogonadism, AMH is low for Tanner stage – reflecting lack of FSH stimulus, – but high for age – reflecting lack of testosterone inhibitory effect. FSH treatment results in serum AMH rise, whereas human chorionic gonadotrophin treatment increases testosterone levels which inhibit AMH production. In conclusion, AMH determination is helpful in assessing gonadal function, without need for stimulation tests, and orientates the aetiological diagnosis of paediatric male hypogonadism. Furthermore, serum AMH is an excellent marker of FSH and androgen action in the testis.
T4 plus T3 Treatment in Children with Hypothyroidism and Inappropriately Elevated Thyroid-Stimulating Hormone despite Euthyroidism on T4 Treatment
Authors: Akcay Teoman , Turan Serap , Guran Tulay , Unluguzel Goksenin , Haklar Goncagul , Bereket Abdullah
Published: February 2010

Aims: To evaluate the effect of addition of T3 to L-T4 treatment in children with congenital hypothyroidism (CH) who have inappropriately elevated thyroid-stimulating hormone (TSH) levels despite high normal serum T4 levels on L-T4 treatment. Methods: Ten children (age 7.1 ± 2 years) with CH whose TSH levels were persistently high despite euthyroidism and can only be normalized with hyperthyroidism were included. L-T4 treatment was switched to T3+L-T4 combination (Bitiron® tablet 50 µg L-T4 + 12.5 µg triiodothyronine). The patients received 50% of their usual L-T4 dose as L-T4 and the remaining half as T3 in a 4:1 ratio. The dose of T3+L-T4 was titrated to achieve normal TSH levels. Thyroid hormones and biochemical markers were followed for 1 year. Results: Euthyrotropinemia was achieved at the 7th month (mean) of combination (T3+L-T4) treatment. Serum T4 and fT4 were lower and T3 was higher during combination compared to L-T4 treatment. LDL-cholesterol decreased and ALP increased in the euthyrotropinemic state. Vital signs were similar at hyperthyrotropinemia and euthyrotropinemia. Conclusion: T3+L-T4 treatment provides euthyrotropinemia without causing hyperthyroidism in children with CH and inappropriate hyperthyrotropinemia. Our data strongly suggest that decreased negative feedback due to lower T3 levels at the pituitary level is the main reason for persistent hyperthyrotropinemia.
Insulin VNTR and IGF-1 Promoter Region Polymorphisms Are Not Associated with Body Composition in Early Childhood: The Generation R Study
Authors: Maas Janneke A.J.B.M. , Mook-Kanamori Dennis O. , Ay Lamise , Steegers Eric A.P. , van Duijn Cornelia M. , Hofman Albert , Hokken-Koelega Anita C.S. , Jaddoe Vincent W.V.
Published: February 2010

Objective: The objective of this study was to examine the associations between insulin gene variable number of tandem repeats (INS VNTR) and insulin-like growth factor 1 (IGF1) gene promoter region polymorphisms with body composition in early childhood. Methods: This study was embedded in an ongoing prospective cohort study. Growth in early childhood (body mass index, total subcutaneous fat mass and waist-hip ratio) was assessed at birth and at the ages of 6 weeks and 24 months. DNA for genotyping was available in 738 children. Results: The genotype distribution of the INS VNTR gene was I/I 50.4%, I/III 40.4%, and III/III 9.2%. IGF1 genotypes were categorized in the following categories based on their 192-bp allele: homozygous (wild-type) 43.1%, heterozygous 45.8%, and noncarrier 11.2%. No differences were found in body mass index, total subcutaneous fat mass and waist-hip ratio in early childhood between the three groups for both the INS VNTR and IGF1 genotypes. We also did not find interactions between these genotypes and gender or birth weight on the effects of body composition measures. Conclusions: Our results do not support previous studies showing associations between INS VNTR and IGF1 promoter region polymorphisms with body composition in early childhood.
IL-6, IL-8 and IL-10 Levels in Healthy Weight and Overweight Children
Authors: Tam Charmaine S. , Garnett Sarah P. , Cowell Christopher T. , Heilbronn Leonie K. , Lee Jennifer W. , Wong Melanie , Baur Louise A.
Published: February 2010

Background/Aim: In adults, studies have shown that obesity is a chronic low-grade inflammatory state characterized by altered levels of cytokines. Studies in children have mainly focused on C-reactive protein and adiponectin, and there is limited data for other inflammatory markers in healthy weight and overweight children. The aim of this study was to measure IL-6, IL-8 and IL-10 levels in healthy normal weight and overweight children at 8 and 15 years. Methods: 118 normal weight and overweight children (59 boys) from the Nepean longitudinal study were recruited at age 8 years and followed up at 15 years. Serum IL-6, IL-8 and IL-10 levels were measured at both time-points. Results: At 8 years, we found no significant differences in cytokine levels between normal weight and overweight (owt)/obese (ob) groups. However, at 15 years, owt/ob girls (n = 23) had higher levels of IL-6 (p = 0.04), IL-8 (p = 0.04) and IL-10 (p = 0.03) compared to normal weight girls (n = 36), even after adjustment for puberty; no differences were seen in boys. Conclusion:The effects of obesity on IL-6, IL-8 and IL-10 levels vary with age and sex, with owt/ob girls at 15 years showing raised IL-6, IL-8 and IL-10 levels compared to healthy weight girls.
Insulin-Like Growth Factor-I Treatment in Primary Growth Hormone Insensitivity: Effect of Recombinant Human IGF-I (rhIGF-I) and rhIGF-I/rhIGF-Binding Protein-3 Complex
Authors: Tonella P. , Flück C.E. , Mullis P.-E.
Published: February 2010

Background/Aims: Growth hormone insensitivity syndrome (GHIS) is a rare cause of growth retardation characterized by high serum GH levels, and low serum insulin-like growth factor I (IGF-I) levels associated with a genetic defect of the GH receptor (GHR) as well post-GHR signaling pathway. Based on clinical, as well as biochemical characteristics, GHIS can be genetically classified as classical/Laron’s syndrome and nonclassical/atypical GHIS. Recombinant human IGF-I (rhIGF-I) treatment is effective in promoting growth in subjects who have GHIS. Further, pharmacological studies of a IGF-I compound containing a 1:1 molar complex of rhIGF-I and rhIGF-binding protein-3 (BP-3) demonstrated that the complex was effective in increasing levels of circulating total and free IGF-I and that the administration in patients with GHIS should be safe, well-tolerated and more effective than rhIGF-I on its own. Patient/Methods: We describe the long-term effect of various IGF-I preparations (rhIGF; rhIGF-I/rhIGFBP-3) in a single subject treated for more than 14 years while focusing on height, height velocity as well as on additional auxological and laboratory data. Results: This study confirms that rhIGF-I is effective in promoting growth in children with GHIS. However, on the combined rhIGF-I/rhIGFBP-3 treatment as well as off rhIGF-I therapy the height velocity decreased drastically (2 and 1.8 cm vs. overall 6.5 cm/year on rhIGF-I, respectively). On rhIGF-I treatment, serum IGF-I was found to be well within the normal range, whereas serum IGFBP-3 remained low. On the rhIGF-I/rhIGFBP-3 compound therapy, however, serum IGFBP-3 increased into the normal range, which was not the case for serum IGF-I. Importantly, the increase of the serum IGFBP-3 level excludes noncompliance. In addition, body mass index as well as dual-energy X-ray absorptiometry analysis underlined the positive effect of rhIGF-I treatment on body composition. Conclusions:The rhIGF-I/rhIGFBP-3 compound therapy seems to be not efficient in treating this individual patient with GHIS when compared with rhIGF-I alone.
Tissue-Engineered Transplants for the Treatment of Severe Hypospadias
Authors: Fossum Magdalena , Nordenskjöld Agneta
Published: February 2010

The surgical treatment of severe hypospadias can be very challenging. In selected cases with severe lack of tissue, cultured autologous urothelial cells can be used to create a transplanted neourethra. The algorithm for using tissue-engineering techniques for the surgical repair of the male urethra includes 3 main steps. First, the autologous urothelial cells are harvested from the patient, e.g. by bladder washing through a catheter with sterile saline. Second, the cells are propagated and expanded in the laboratory environment. Finally, the cells are transplanted back to the patient in the final surgical repair. We have used this technique in a clinical setting in severe hypospadias. Transplants for creation of the neourethra were used ventrally in an on-lay fashion with remaining skin dorsally in the urethra. Our follow-up shows a good clinical result including data concerning voiding position, urinary flow, artificial erection, cosmetic appearance, urethroscopy and biopsies. Tissue-engineering techniques can, however, benefit from further improvement and, thus, be developed for additional applications. We conclude that in hypospadias repair with cultured autologous urothelial cells is an option for the surgical treatment when there is a lack of local tissue for the repair.
Activation of GRP78 on Endothelial Cell Membranes by an ADAM15-Derived Peptide Induces Angiogenesis
Authors: Raiter Annat , Weiss Chana , Bechor Zafrir , Ben-Dor Itzik , Battler Alexander , Kaplan Boris , Hardy Britta
Published: February 2010

Impaired angiogenesis is one of the features of ischemic diseases. We have previously identified, by screening a phage display peptide library, a peptide that induces angiogenesis in endothelial cells under hypoxic conditions by binding the cell’s membrane heat shock protein GRP78. Protein data base search identified 4 amino acids (HWRR) of that synthetic peptide present on the ADAM15 metalloprotease domain, a protein considered to be involved in neovascularization. Three peptides were synthesized according to the ADAM15 sequence placing HWRR at different positions. Peptide ADoPep1 exhibited significant angiogenic properties under hypoxic conditions as determined by cell proliferation, migration and tube formation. In a mouse hind limb ischemia model, a single injection of the peptide restored blood perfusion. The identified peptide was found to activate GRP78 on endothelial cell membrane and siRNA directed against the GRP78 mRNA interfered with induction of angiogenesis by the peptide. The peptide binding induced a decrease in heat shock protein GRP78 that is overexpressed under hypoxic conditions. The mechanism of peptide-induced angiogenic activity involves inhibition of apoptosis as well as increased Akt phosphorylation and ERK 1/2 activation. The peptide did not induce VEGF receptor-2 protein synthesis and phosphorylation, suggesting a VEGF-independent mechanism of angiogenesis.
A Promising Therapeutic Approach for Treatment of Posterior Uveitis: Recombinant T Cell Receptor Ligand Protects Lewis Rats from Acute and Recurrent Experimental Autoimmune Uveitis
Authors: Adamus Grazyna , Karren Landon J. , Mooney Jeff , Burrows Gregory G.
Published: February 2010

Introduction: Chronic autoimmune uveitis is a major cause of vision loss from intraocular inflammation in humans. In this study we report that a recombinant TCR ligand (RTL220) composed of the α1 and β1 domains of MHC class II molecules linked to the uveitogenic interphotoreceptor retinoid-binding protein (IRBP) 1177–1191 peptide is effective in the suppression of acute and recurrent experimental autoimmune uveitis (EAU). Material and Methods: EAU was induced with IRBP1177–1191 peptide or by adoptive transfer of specific T cells in Lewis rats. The rats received 5 doses of RTL220 subcutaneously every other day starting at the onset of clinic signs of EAU. Results: The administration of RTL220 resulted in a delayed onset and a significant amelioration of the disease severity at clinical levels and showed protection of the retina from inflammatory damage at histological levels. In treatment of recurrent EAU, RTL220 administrated at the first or second onset of clinical disease significantly inhibited EAU, modulated immune responses and provided protection from relapses of uveitis. The systemic and local proinflammatory cytokines were significantly reduced, including IL-17. There was local and systemic increase in IL-10 and reduction in the expression of the proinflammatory chemokines CCL2, CCL3 and CCL5. Conclusions: Our studies demonstrate a successful treatment of acute and recurrent EAU with RTL220, which effectively suppressed the recurrence of inflammation and reversed clinical and histological EAU by altering cytokine and chemokine expression. These findings strongly support a possible clinical application of this novel class of peptide/MHC class II drugs for patients with autoimmune uveitis.
Der Einfluss von Umweltfaktoren auf die seelische Gesundheit
Authors: Häfner H.
Published: February 2010

Questions concerning the scope, theory and method of ecological research in psychiatry are discussed in the light of some prominent findings, which adumbrate the present state of knowledge of environmental influences on mental health. The epidemiological model is taken as a frame of reference. The special problems which arise in testing hypotheses, and their solution, are illustrated by the example of the ‘ecological fallacy’. Here, an attempt is made to progress from simple correlations between ecological variables and defined illness-rates, and speculation about their significance, to a careful analysis of unavoidable conditions, and of their relative importance.
Pollution and Mental Health, with Particular Reference to the Problem of Noise
Authors: Shepherd Michael
Published: February 2010

Though the adverse psychological effects of noise as an environmental pollutant are well-recognised, much of the relevant work has been focussed on the ambiguous concept of ‘annoyance’. A review of the evidence suggests that the relationship between noise and mental ill-health calls for more direct investigation. In particular, the marked individual variation in reactions to noise requires elucidation.
Social Class and Mental Disorder
Authors: Levy Leo
Published: February 2010

This paper reviews the literature on the relationship of social class status to the incidence and prevalence of mental disorder. For purposes of this review, social class is divided into three categories: the ‘affluent’, ‘working class’ and ‘poor’. Mental disorders referred to are: schizophrenia, manic-depressive psychosis, psychoneurosis, diseases of the senium, personality disorders and the combined category ‘mentally ill’. The general conclusion is drawn that the rate of existing mental disorder among the poor is substantially higher than among the affluent or working-class groups. This notwithstanding, low social-class status is held to be unrelated to the incidence of functional psychosis (i.e., schizophrenia and manic-depressive psychosis).
Zum heutigen Stand der Wahnforschung
Authors: Berner P.
Published: February 2010

Regarding the definition of the concept of delusion it is stated that up to now delusions can be diagnosed only with the aid of phenomenological intuition. The decisive criterion is the high subjective certainty in the sense of an elimination of the possibility of chance coincidences without any narrowing of affect. The current hypotheses are presented, concerning the choice of theme, the acute elimination of chance without narrowing of affect, the persistence of certainty and incorrigibility. The relationship between age at the onset of the illness and the choice of theme are discussed in the light of my own findings. Reasons emerge to believe that, depending on the respective cultural setting, certain age specific themes can play a role in the formation of the content of delusions. The acute subjective certainty, as well as the incorrigibility are linked with organic or endogenous syndromes.
Der Wahn als Ausdruck der Lebensgeschichte
Authors: Kretschmer Wolfgang
Published: February 2010

A brief review is given of the relative weight attributed to biographical factors in the origin of various delusional formations. The life history of a patient with sensitive delusions of reference is presented as an example to illustrate how in his particular case the delusions had grown out of certain life events and connections.
Nosologische Aspekte der paranoiden Psychosen
Authors: Retterstøl Nils
Published: February 2010

The author stresses the lack of nosological entities in psychiatry, and also the necessity of a classification system. Paranoid symptoms are found in most types of psychoses, both functional and organic psychoses. Among the functional psychoses the schizophrenias often have a paranoid picture, and paranoid traits may be found even in the affective psychoses. The Scandinavian concept of reactive psychoses is presented, including reactive psychoses of paranoiac, paranoid and schizophreniform type. Finally, the author presents his own personal follow-up study of paranoid psychoses after an observation time of 5–18 years. This study demonstrates 81 % cured, of the patients with the discharge diagnosis of reactive psychoses, as against 23 % cured, of the patients with the discharge diagnosis of schizophrenia. The author suggests a continuum of the paranoid psychoses from the schizophrenias via the schizophreniform and paranoid reactive psychoses to the more affective psychoses with slight tendency to paranoid symptomatology.
Klinisch-psychopathologische und elektroenzephalographische Untersuchungen bei Wahnkranken vom paranoischen und vom paraphrenen Typ
Authors: Presslich O. , Gabriel E. , Müller E. , Küfferle B. , Saletu B.
Published: February 2010

Clinical-psychopathological and electroencephalographic investigations are reported, carried out on patients with delusions of the paranoic and of the paraphrenic types. Abnormal EEGs were found more frequently in patients with a paraphrenic syndrome, and there was also a relatively more frequent response to flickering lights than in the paranoic group. There was also a more frequent response to flicker in patients with auditory hallucinations. Psychopathologically more florid delusional syndromes appear to produce abnormalities in the EEG more readily than do psychopathologically less elaborate syndromes.
Das Schicksal katathymer Wahnbildungen im Licht langfristiger Katamnesen
Authors: Gabriel E.
Published: February 2010

Two groups of patients with delusional illnesses (previous paranoics and previous ‘late schizophrenics’ with delusional syndromes) with similar backgrounds, were followed up after many years and were re-examined in the same way. They were compared with each other as regards further developments of delusional formations and their psycho-pathological determinants. In the group of ‘late schizophrenics’ the delusions disappeared more frequently than in the groups of paranoics, and the delusional productivity diminished more often. On examination of various psychopathological characteristics and their influence on the further development of delusional formations (core syndromes of the general psychiatric symptomatology, appearance of affective changes, further development of the delusional productivity) only tendencies are shown, never obligatory relationships. The order of the relationships which we found remains uncertain; it is not likely that we are dealing with relationships of the first order.
Über die individuellen Bedingungen pharmakogener Verwirrtheiten
Authors: Gabriel E. , Küfferle B. , Lenz G. , Schuster P.
Published: February 2010

The literature was surveyed concerning the frequency and conditions for confusional states and deliria following Amitriptyline and Clozapine treatment, and certain discrepancies were noted. As a result a retrospective comparative investigation was carried out as to the frequency and the conditions for such events in a group of patients treated along the same lines. While our experience with Amitriptyline is not different from that reported by others, this does not seem to be the case with Clozapine. Confusional states and deliria are four times as frequent as the average reported in the literature; it is clear that they depend on conditions different from those of confusional states and deliria due to Amitriptyline; there is a slightly significant (p < 0.05) correlation between the appearance of confusion and a temperature of over 37.5 °C. The anticholinergic properties of Amitriptyline and of Clozapine cannot explain the difference in frequency, nor the differing conditions for the appearance, of pharmacogenic confusional states and deliria with those two substances.
Lerntheoretische Konzepte der Depression
Authors: Zapotoczky H.G.
Published: February 2010

From a behavioural point of view, the phenomenon of depression was explored relatively late. Generally, the behavioural models of depression are related to a pattern characterized by a reduced social repertoire, e.g. by ‘a reduced frequency of emission of positively reinforced behaviour’ (Ferster). Accordingly, different models are distinguished today, e.g. the social-reinforcement model, the model of ‘learned helplessness’ (Seligman) and the avoidance model (Mc Auley and Quinn). It seems to be doubtful if the characteristic details of depression consist only of a deficiency in behaviour. Thus, ruminations or sleep disturbances, as stage-by-stage sleeping, can be considered as behavioural plus. Considering the importance of the psychophysiological results of Lader or the psychopathological considerations of Berner, more emphasis should be put on the influence of cognitive processes, the effect of proprioceptive stimuli or the significance of neurophysiological activation.
Suizid und Suizidversuch im Verlauf schizophrener Erkrankungen
Authors: Schüttler R. , Huber G. , Gross G.
Published: February 2010

During the years 1968–1973, a survey encompassing 755 patients who were formerly schizophrenic inpatients in the psychiatric clinic of the University of Bonn during the period 1945–1959 was conducted. Of the 755 patients, 147 were decreased, and of these, 30 (4 % of the total) were determined to have died as a result of suicide. 98 (19.5 % of the total) of the 502 personally examined had attempted suicide one or more times. The risk for those for whom the serious entertainment of suicide were demonstrable was 41.2 % and was not less than the suicide risk for cyclothymic patients. The suicide attempts show a relative independence from environmental influences and a coincidence with productive-psychotical symptoms.
Suicide in a General Hospital Psychiatric Department
Authors: Lerer Bernard , Avni Jacob
Published: February 2010

An analysis of the 7 cases of suicide in the Department of Psychiatry, Hadassah University Hospital, Jerusalem, during the period 1965–1974, is presented. The problems relating to the management of suicidal patients in a general hospital psychiatric department are considered. An accent on acute pathology, short hospitalizations and ‘problem cases’ in respect of diagnosis and treatment, are seen as factors of importance as well as the coexistence of different treatment models. The absence of adequate facilities for isolation and restraint is considered with reference to the controversy regarding the efficacy of precautionary measures in preventing hospital suicide. Problems not necessarily specific to the general hospital psychiatric department such as assessment of suicidal intent in the light of suicidal threats and ideation, the significance of previous suicide attempts and difficulties in the therapist-patient relationship, were also found to have played a crucial role in the cases presented.
Stress and Challenge of the Emergency Room of the General Hospital
Authors: Hes Jozef Ph.
Published: February 2010

During the last 50 years, patterns of administering medical services have been changing. The emergency room (ER) of the general hospital does not treat medical emergencies exclusively. Many cases of psychosocial emergency, often disguised as suicide attempts or drug-related situations, appear for help. In this paper attention was focused on the rejecting attitude of the ER personnel towards patients suffering from self-inflicted conditions such as suicide attempts, drug addiction and alcoholism. The interaction between personnel and those patients and, respectively, their relatives, is described and the reasons and circumstances of the rejecting attitude are discussed. The author proposes the subsequent suggestions for alleviating stress in the ER situation: (1) Regular rotation of ER personnel. (2) Transforming the psychiatric consultation into a teaching session. (3) Introduction of a formal training program to ER personnel which would lead to more understanding of the patients and relatives and generate a higher morale in the staff. (4) Providing timely and adequate information to relatives who are waiting outside the ER.
Incomplete Testicular Feminization Syndrome
Authors: Assael Marcel , Lancet Moshe , Shani Adi
Published: February 2010

A rare case of psychosis with testicular feminization of the incomplete type is described from the clinical, hormonal, genetic and psychiatric aspects. She had a definite beard, well-developed breasts, male escutcheon, large clitoris and fused labioscrotal folds. The urethral opening was hypospadiac and there was no vagina. Inguinal gonads proved later to be testes upon operation, with Sertoli cells, hyalinized tubules and prominent Leydig cells. Her chromosome make-up was 46/XY. After orchidectomy there was a surge of LH, and drop of estrogens. She was reared as a girl despite external masculine traits, and she behaved and appeared as a female. The significance of the expectations of the society, the educators and environmental influences is focused. The ‘lack of identity’ in her is considered of great importance as the psychopathogenic factor, which undoubtedly hinders the process of social adjustment.
Strukturale Interpretation einer sogenannten symptomatischen Schizophrenic
Authors: Peters U.H.
Published: February 2010

A short text spoken by a patient with a supposed symptomatic schizophrenia in lupus erythematodes is analyzed by means of a structural interpretation. While the text appears schizophrenic, it is only the confusion and intermingling of five quite distinct textual levels which create this impression. These five levels are presented in three distinctive modes of narrative. Deviation and periphrase: while psychopathologically these breaks in the narrative are deviations from the main thread of argument, stylistically they are periphrasic statements, all having identical structures. They are all related emotionally as well as thematically to the central subject of the text. Their informational quality is impaired by their density and their interlocked form. Narrative: the text contains three meaningful and well-arranged stories. In one case a multilevel narrative structure is employed. Each story represents a response to the initial question. Metalanguage: on a metatextual level, the patient repeatedly makes reference to her linguistic peculiarities. These statements coincide with objective evaluation. Delusions and misidentification of individuals and situations used in classical psycho-pathological diagnosis can be given a different meaning (in the sense used by Weinrich) if interpretation has deepened the knowledge of the text. In this case, the similarity to schizophrenic texts is only superficial. A more detailed analysis illustrates the difference from schizophrenia on every level.
Doppelsuizid und symbiontische Psychose
Authors: Lange Ehrig , Ficker Friedemann
Published: February 2010

Symbiontic psychoses (induced delusions) are marked by ‘solitude by twos’ – together in alienation to the environment. This special psychological situation is dangerous and the foundation to develop ‘suicides by twos’ (double suicides). The relations between the psychotic partners (domination–subordination) change over to relations of double suicide (instogator–participant). The presuicide syndrome of such double suicides is described with two cases, one at the psychopathological borderline to a symbiontic psychosis, the other on the culmination of it (delusion of influence and reference).
Beurteilung der Wirksamkeit therapeutischer Massnahmen beim Alkoholdelir
Authors: Athen D. , Bender W. , Meyendorf R.
Published: February 2010

30 patients with delirium tremens were given in a double-blind trial – beside the basic treatment with chlormethiazol (Distraneurin®) – aprotinin (Trasylol®) or placebo. Duration of the delirium and the amount of chlormethiazol used were the criteria for successful treatment. It was shown that the additional application of aprotinin did neither shorten significantly the duration of the delirium nor save the amount of chlormethiazol used. Methodologically, special attention was given to the question of duration of the delirium and of registering symptoms. A delirium-rating scale was devised and its analysis showed a good randomization of the items. One main question was as to what extent the individual items were good indicators of a delirium. An item intercorrelation showed that there were two clusters of symptoms: psychological and sympathetic nervous system symptoms. It could be shown that the items ‘consciousness, orientation, hallucinations and short-term memory’ were good indicators of the delirium, while items of the autonomous nervous system, as tremor of hands and body, facial muscular twitching and exteroceptive reflexes, were less indicative of delirium. The duration of the delirium seems to be the best criterion for the question as to whether a drug is effective or not in delirium tremens. There is a highly significant correlation between the degree of the severity of the delirium and its duration. Other significant predictors for the severity of the delirium were the maximal pulse rate and change in blood pressure. Age, duration of alcoholism and psychological or physical depravation showed no influence on the duration of the delirium.
Slow-Drip Dibenzepine Infusion in Depression
Authors: Saletu B. , Schneewind U. , Strobl G. , König P. , Grünberger J. , Matejcek M.
Published: February 2010

The efficacy of a new intensive antidepressive treatment procedure – 48 h slow drip infusion with 1,440 mg dibenzepine2 and subsequent oral treatment – was investigated in endomorphous (endogenous) depressed patients. In addition to evaluations of alterations in psychopathology by clinicians, time of onset and the extent of the therapeutic effect was determined by the patients themselves using the affect-polarity profile, and by EEG power-spectral density analysis. Clinical improvement started as early as in the 3rd hour of the dibenzepine infusion and was predominantly due to an anxiolytic/sedative drug effect. The thymoleptic effect started at the end of the infusion and increased with progressing oral treatment up to the 3rd week. Neurophysiological changes were ahead of the psychopathological ones, since a statistical decrease in dominant frequency of the EEG occurred 1 h after the start of dibenzepine infusion.
Season of Birth and Schneider-Oriented Diagnosis of Affective Disorder
Authors: Koehler Karl , Jacoby Chretien
Published: February 2010

Most earlier studies and all recent studies on national samples have shown that compared with live births in the control population, schizophrenic patients have a significant excess of birth rates in the winter or early months of the year. In contrast, only some of the early research efforts and only some of the national studies (in England and Wales as well as for certain decades in Sweden) have demonstrated that the same holds true for patients with affective psychosis. The present German study, carried out on affective disorder diagnosed in a strongly Kurt Schneider-oriented clinic, found (as did most Scandinavian research on national samples) that there was no significant overrepresentation of births in the winter or early months of the year for all types of affective disorder, neurotic as well as psychotic. Thus, the findings on Schneider-diagnosed affective disturbances were similar to those on Schneider-diagnosed schizophrenia reported elsewhere.
Untersuchungen zum weissen Blutbild von Manikern, endogen Depressiven, Schizophrenen und Neurotikern
Authors: Diebold K.
Published: February 2010

Manic, endogenous depressive, schizophrenic and neurotic patients, 80 (40 females, 40 males) in each diagnostic group, are compared with regard to the white blood count with one another and with normal controls. Significant differences of means were found (1) between some groups of patients concerning the total number of leucocytes (µM ≠ µS, µD), the number of neutrophil granulocytes (µM ≠ µS, µN), the number of eosinophil granulocytes (µM ≠ µS, µD; µN ≠ µS, µD) and the number of lymphocytes (µN ≠ µD), and (2) between all groups of patients and normal controls concerning the number of monocytes (µD, µN, µM, µS ≠ µK). The findings are discussed.
Der Begriff der Krise
Authors: Reiter L. , Strotzka H.
Published: February 2010

An analysis of the concept of crisis cannot ignore that it is often used in a highly suggestive way, nor should it neglect to look at its historical roots. The psychosocial crisis concept as it is used in psychiatry, psychotherapy, social work, etc. has two historic roots: one root lies in the medical-natural-sciences tradition; the other in the dramaturgical Le. healing tradition, and they both flow together in the concept as commonly used. At present, there are numerous crisis definitions each of which emphasizes a different aspect. Greater precision, models and operational definitions are indispensable for exact research. Crisis precipitation, disposition (crisis proneness) of the system, environment and reaction of the system are discussed as separate aspects of a crisis. Finally, the innovative and constructive role is stressed which the crisis concept plays in research and practice.
Krisenintervention bei Jugendlichen Ein soziales Modell in Wien
Authors: Friedrich M.H.
Published: February 2010

An institute for adolescents can meet the specific adolescent crises in all their manifold manifestations. The crisis intervention model in the form of a youth centre for information and counselling as described here has the task of giving information and advice anonymously and free of charge in a way appropriate for young people, while being non-bureaucratic and not under the direct influence of the civil authorities. The work methods of the Info-Centre in Vienna are described.
Teamarbeit in der Jugendfürsorge als Instrument der Krisenintervention
Authors: Berger E.
Published: February 2010

The changing emphasis in psychiatric care demands the use of new strategies and the development of sociopsychiatric institutions. The term ‘crisis intervention’ is suitable in this respect insofar as it also includes the aspects of prevention and follow-up care. An attempt at the development of a model for multiprofessional teamwork in juvenile social work is outlined under the aspect of sectorised sociopsychiatric care. The exhaustion of the basically available possibilities is at the moment limited due to structural difficulties.
Die Struktur der residualen Dimension
Authors: Pethö B.
Published: February 2010

The spectrum of residual dimension extends from psychopathological symptoms to anthropological characteristics. A controlled, personal 5-year follow-up analysis of schizo-affective (cycloid, as Leonhard has it) and hebephrenic patients was made to scan these two extremes. A clinical defect was found, but in the hebephrenic group. The cycloid patients differ from normal controls only in respect of the insufficiency syndrome and of the anthropological characteristics. As shown by the residual syndrome of the cycloid patients – in contradiction to the present knowledge – a complete restoration to health would not occur in this group. The anthropological characteristic closed hmitedness is virtually the amplification of the clinical defect of hebephrenics. However, the closing-up limitedness of cycloids is quasi another side of their insufficiency syndrome. The nosospecificity of the structure of residual syndrome in both groups requires further investigations.
Die Pathodynamik symbiontischer Psychosen
Authors: Ficker Friedemann
Published: February 2010

The definition and division of symbiontic psychoses (induced insanity, folie à deux, psychosis of association) and their significance for the genesis of delusional developments are referred to at the beginning of the paper. After a presentation of environmental reactions on delusion, personality traits and mutual dependence in the predominance-subordination relationship of the partners of delusional symbioses are pointed out. The isolation of this symbiosis against the environment and its influence on this loneliness by twos are demonstrated. Besides the described suppositions, the primary delusion is essential for the pathodynamics of symbiontic psychoses because the delusional structure of the primary delusion, its compositional elements and especially the delusional motif are decisive for the transformation of a symbiosis which is still stable into a pathological we-formation. 5 case histories illustrate the pathodynamics of symbiontic psychoses.
Zur Frage kongruenter Beziehungen zwischen Befindens-, physiologischen und psychopathologischen Daten im Verlauf endogen depressiver Phasen
Authors: Opgenoorth E. , Wytek R. , Gabriel E. , Presslich O. , Schuster P.
Published: February 2010

In a longitudinal study of depressed episodes, changes in patients’ state were examined by variables on the subjective-psychological, physiological and behavioral levels, respectively. Starting from the hypothesis of a systematic connection of these variables changes in patients’ condition were defined from merely one of the above-mentioned levels, i.e. the test-psychological criteria relating to the subjective-psychological level (‘Polaritäts-profi’). Results based on the rank analysis of covariance are presented which show the complex multivariate correlations between the three levels.
Cultural Influences on Delusion
Authors: Ahmed Haroon
Published: February 2010

The nature and content of delusions were studied among 51 schizophrenic patients. The most common delusions in order of frequency were delusions of persecution, religious, magic, ideas of reference, passivity feelings and grandeur. The beliefs of the head of the family, or his equivalent, did not contribute directly to the content. It was concluded that the general cultural beliefs, rather than the immediate environment, play a dominant role in determining the contents of delusion.
Aspects of Depression in a Jewish Minority Group
Authors: Fernando Suman J.M.
Published: February 2010

This paper reports some findings of a cross-cultural study of depression in which Jewish and Protestant East Londoners were measured on several parameters. In discussing the findings, differences on familial factors are attributed to the marginality of Jews and those on hostility to differences in levels of repressed anger. Tentative observations on the types of illness seen among the depressed patients suggests that one needs to be cautious in applying subdivisions of the illness cross-culturally.
Objektivierende Untersuchungen zur Diagnosenänderung im Krankheitsverlauf von Fällen mit der Anfangs- bzw. Enddiagnose „Schizophrenie”, „endogene Depression” oder „Psychopathie”
Authors: Diebold K. , Haueisen S.
Published: February 2010

One hundred and fifty-two cases of changes in diagnosis of ‘schizophrenia’, ‘endogenous depression’ and ‘psychopathia’ in the course of illness, are statistically analyzed in regard to tendency of changes of diagnosis, sex, symptomatics and syndromatics, age of onset and duration of cycles. The changes of diagnosis show a clear tendency in favour of the diagnosis of ‘schizophrenia’ as opposed to ‘psychopathia’. Among the cases with changed diagnoses, women are significantly over-represented. On the level of symptomatics, few significant changes of symptom frequencies can be found. More information can be obtained in the analysis on syndromatics: four out of six groups show significant changes in the intensity of syndromes; on the basis of similarities in syndrome profiles, derived from materials which are diagnostically homogeneous, the actual diagnostic components can be evaluated. The analysis of the age of onset shows significant differences of means corresponding to the expectations of the hypothetic diagnostic components. Regarding duration of cycles, significant differences of means between the groups are not to be found.
Zur Lithiumverteilung im Organismus nach Intoxikation
Authors: Kluge H. , Waldmann K.-D. , Greger J.
Published: February 2010

This paper describes the lithium distribution in the organs of two manic-depressive women who died following lithium intoxication. In both cases intoxication was observed during and after an acute phase of epidemic influenza accompanied by diarrhoea. The patients died from cerebral failure 5 and 7 days after receiving their last lithium dose. Death could not be prevented although NaCl infusions and haemodialyses were carried out. Only slight differences in lithium content were found when comparing extracerebral organs and serum. However, the brain accumulated considerable amounts of lithium ion. This reached toxic concentration in most of the brain areas of both patients. The highest values were found in the white matter, pointing to a lithium accumulation in lipid-enriched brain cells. The results were interpreted in connection with earlier findings of our group and other authors.
Über besondere Erscheinungsformen der Schizophrenie im späten Lebensalter
Authors: Sternberg E. , Konzewoi V.
Published: February 2010

Aside from typical forms of late schizophrenia which generally conform to the definition given by M. Bleuler, there also are psychoses appearing in old age which differ significantly from the atypical symptoms and consequently present certain diagnostic difficulties. This report contains descriptions of late manifestations in schizophrenic psychoses, which develop with a continuous or assault-like course with a prevalence of parnoial disorders. Paranoid delusions, in such cases, are characterized by aging traits (concrete and short-term delusions, exaggeration of the degree of superficial persecution and prejudice, and a limited number of people involved in the delusions). The development of such forms of late schizophrenia takes a slowly progressing course. The results of these studies, especially the psychopathological symptomatology, the genetic-constitutional background and the development and outcome of these psychoses are analyzed in detail. The data permit to consider such forms of psychose as atypical variants of late schizophrenia.
Schneider-Negative Schizophrenia and Schizo-Affective Illness
Authors: Koehler Karl , Brüske Irene , Jacoby Chretien
Published: February 2010

A slightly modified version of provisional research criteria for so-called ‘schizo-affective and related psychosis’, as recently published by the St. Louis Group, was used to investigate the case records of 116 Schneider-oriented first admissions of schizophrenics without first rank symptoms (Schneider-negative) who were hospitalized in a German center during the years 1962–1971. The sample contained 19.8% (23 cases) of research diagnosable schizo-affective illness as thus defined. ‘Full’ affective research criteria were satisfied by 13 of these schizo-affectives, and 10 were able to fulfill the ‘adjusted’ affective criteria assumed to be indicative of labile mixed mood states. The sample was then further analyzed in terms of ‘schizophreniform’ psychoses and ‘atypical schizophrenia’. The findings seem to support the view that a non-negligible segment (23.3%) of Schneider-negative schizophrenia actually may represent either research diagnosable schizo-affective or affective disorders or satisfy criteria for both diagnoses.