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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  EbM & Individualisierte Medizin; 12. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin; 20110324-20110326; Berlin; DOC11ebm58 /20110323/
    Publication Date: 2011-03-23
    Keywords: ddc: 610
    Language: German
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  • 2
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  29. Jahrestagung der Retinologischen Gesellschaft; 20160617-20160618; Berlin; DOC16rg10 /20160616/
    Publication Date: 2016-06-18
    Keywords: ddc: 610
    Language: German
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  • 3
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  10. Deutscher Kongress für Versorgungsforschung; 18. GAA-Jahrestagung; 20111020-20111022; Köln; DOC11dkvf099 /20111012/
    Publication Date: 2011-10-12
    Keywords: ddc: 610
    Language: German
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  • 4
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Prävention zwischen Evidenz und Eminenz; 15. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin; 20140313-20140315; Halle; DOC14ebmP1g /20140310/
    Publication Date: 2014-03-11
    Keywords: ddc: 610
    Language: German
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  • 5
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Mainz//2011; 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi); 20110926-20110929; Mainz; DOC11gmds577 /20110920/
    Publication Date: 2011-09-20
    Keywords: ddc: 610
    Language: English
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  • 6
    ISSN: 1433-8491
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A total of 232 (84%) first episodes of schizophrenia from our epidemiologically defined ABC sample (Age, Beginning and Course) were retrospectively assessed with regard to the onset and early course of the disorder. In a follow-up study a representative subgroup (n=133) was prospectively examined in five cross sections over 3 years from first admission on. Population-based incidence rates for 5-year age groups comprising a range of 〈10-〈60 years were calculated on the basis of two definitions of onset: first sign of disorder and first psychotic symptom. In 40% of adult patients who had been admitted with a first schizophrenic episode after age 20 years the prodromal phase, in 11% the psychotic prephase, began before that age. This demonstrates that schizophrenia often begins in an age period in which the social and cognitive development and brain maturation are still unfinished. Early-onset schizophrenias (〈-20 years) were compared with a medium-onset group (21〈35 years) and a late-onset group (35-〈60 years) with regard to age and type of onset, early symptom-related course, social development and social course. The number of schizophrenia-specific positive and negative syndromes in early-onset schizophrenia is comparable to that of higher age groups. However, neurotic syndromes, emotional disorders and conduct disorders are most frequent in younger patients, especially in young men. Paranoid syndromes seem to prevail in late-onset schizophrenia, whereas less differentiated positive syndromes, such as delusional mood, are more frequent in the youngest age group. An earlier onset of schizophrenia has more severe social consequences than onset in adults, because it interrupts the cognitive and social development at an earlier stage. The worse social course of schizophrenia in men compared with women cannot be related to a more severe symtomatology, but to the earlier age at onset and the impairment or stagnation of social ascent at an earlier stage of social and cognitive development. Social disability in the sense of an adaptation to the expectations of the social environment, as well as symtomatology during the further course of schizophrenia, show no major differences between the genders nor between the age groups.
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  • 7
    ISSN: 1432-1440
    Keywords: Thyroid disorders ; Subclinical hyperthyroidism ; Subclinical hypothyroidism ; Psychic symptoms ; Somatic symptoms
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The characteristic psychic and somatic features found in patients with overt hyper- or hypothyroidism are usually attributed to elevated or diminished levels, respectively, of thyroid hormones. This concept does not sufficiently explain our previous investigations in which the same symptoms, albeit attenuated, were also seen in patients suffering from so-called latent disturbances of thyroid function. This state of disorder, however, exhibits normal concentrations of peripheral thyroid hormones. Only the response of thyroid-stimulating hormone (TSH) to thyrotropin-releasing hormone (TRH) stimulation is in accordance with the behaviour of the overt thyroid dysfunction and enables its differentiation from the euthyroid state. In this context, we investigated the question as to whether pathologic signs in thyroid disorders are correlated to alterations of peripheral thyroid hormones or to changes in the hypothalamus pituitary axis. Therefore, we investigated two groups of ten patients each who suffered from latent hyper- or hypothyroidism, respectively, and ten euthyroid controls. All were matched from sex and age. Endocrine function was estimated by TRH testing, TT3, TT4 and thyroxine binding globuline (TBG). Psychologic testing was performed by questionnaires concerning subjective somatic symptoms, emotional disturbances, psychomotoric performance, cognitive impairment and personality. Patients with latent hyperthyroidism were more subject to somatic symptoms and affective complaints than were those who had latent hypothyroidism. As compared with controls, there were significant differences in exhaustion and pain in the limbs and heart. In terms of affective complaints, patients were more depressive, anxious, touchy and irritable; their personalities showed a higher degree of emotional lability, excitement and irritability. Many symptoms described in overt thyroid dysfunction could be found in latent metabolic disturbances. Therefore, we conclude that the alterations of health in thyroid disorders are more likely to be caused by hypothalamic pituitary impairment than by changes in peripheral hormone levels. The stronger symptoms occurring in overt thyroid dysfunction as compared with latent metabolic disturbances may reflect the degree of hypothalamic pituitary dysfunction.
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  • 8
    ISSN: 1432-1440
    Keywords: Subclinical thyroid disorders ; Sonography ; Epidemiology ; Goiter
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Subclinical thyroid disorders have received increasing attention in recent years due to refined laboratory methods and a stronger emphasis on the role of preventive medicine. We performed a screening for thyroid-stimulating hormone (TSH) on 6884 persons in a working population. In cases in which TSH was not within the normal range we also measured the levels of triiodothyronine (T3), thyroxine (T4), and thyroxine-binding globulin (TBG). All persons who did not present with exclusion criteria or other nonthyroidal illnesses (n = 59) and the controls (n = 39) were submitted to thyrotropin-releasing hormone (TRH)-testing. Additionally, sonography of the thyroid was performed on 120 persons (59 subjects with abnormal hormone levels and 61 controls) to determine thyroid size and rule out morphological abnormalities. Based on the TRH test and T3, T4, and TBG measurements we found a prevalence of 0.03% (2/6884) for overt hyperthyroidism, 0.33% (23/6884) for subclinical hyperthyroidism, 0.09% (6/6884) for subclinical hypothyroidism, and 0.015% (1/6884) for overt hypothyroidism in the healthy population. In subjects with overt or subclinical hyperthyroidism the prevalence of goiters (thyroid volume 〉 18 ml in women, 〉 25 ml in men) was 28%. Of this group 48% had structural abnormalities. All persons with goiters and/or structural abnormalities were over 35 years of age. Among the euthyroid, 20% had thyroid enlargement, and the same proportion presented with structural abnormalities. There were no differences between the two age groups. In the group with overt/subclinical hypothyroidism 47% presented with structural abnormalities of the thyroid; however, none presented with thyroid enlargement. Thyroid nodules were found only in older persons (〉 〉 35 years) with euthyroidism or hypothyroidism. These data confirm the relatively high prevalence of functional and morphological abnormalities of the thyroid. An early substitution with iodine is warranted to prevent functional and morphological disorders of the thyroid in older age. People with subclinical hyperthyroid disorders must avoid exposure to iodine, which can cause an exacerbation of the disease.
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  • 9
    ISSN: 1435-2451
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Anhand der postoperativen Ernährungstherapie von 1147 Patienten nach Magenresektion wegen Magen- und Zwölffingerdarmgeschwüren wurde die Häufigkeit der Komplikationen, welche in Abhängigkeit vom Eiweißhaushalt stehen, aufgezeigt. Es ergab sich unter Berücksichtigung der erheblichen Altersverschiebung, daß Patienten mit Aminosäuren-Infusionen trotz höheren Lebensalters nur eine geringe Zunahme der Komplikationsrate gegenüber mangelhaft ernährten jüngeren Patienten hatten. Statistisch gesicherte Unterschiede fanden sich hinsichtlich des Entlassungstermines und des Gewichtsverlustes. Auf die Schwierigkeiten, positive klinische Kriterien für die Effizienz einer postoperativen parenteralen Ernährung zu erhalten, wurde hingewiesen.
    Notes: Summary Based on the results of alimentary therapy after resection of the stomach for gastric and duodenal ulcer in 1147 patients, the frequency of complications connected with the protein metabolism is demonstrated. Considering the considerable differences in age it was seen that patients with amino-acid infusions showed only a slight increase in the rate of complications despite higher age compared with inadequately fed younger patients. There were statistically confirmed differences with regard to the time of discharge and loss of weight. The difficulties in obtaining positive clinical criteria of the efficacy of postoperative parenteral feeding are pointed out.
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