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  • 1
    ISSN: 1432-1238
    Keywords: Heart rate variability (HRV) ; Intoxication ; Tricyclic antidepressants (TCA) ; Clozapine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective Since intoxication with tricyclic antidepressants is common, a supplementary screening method for differentiation between therapeutic and supratherapeutic ranges would be a valuable diagnositc tool, particularly in delirious and unconscious patients Setting 109 patients treated with amitriptyline, 8 patients treated with doxepin, 10 patients treated with clozapine, and 72 normal control subjects matched for age and sex were tested for heart rate variability while resting. Results Considering time and frequency derived measures, which are rather independent of heart rate, the patients showed significantly decreased heart rate variability parameters (p〈0.0001), as compared with the normal subjects. Of the patients presenting delirious symptoms 6 showed coefficients of variation more than 4 standard deviations below the mean control value. Conclusions As heart rate variability can be easily calculated, this measurement is suggested as a useful tool to quickly exclude or support the diagnosis of chronic intoxication with tricyclic antidepressants or clozapine.
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  • 2
    ISSN: 1619-1560
    Keywords: heart rate analysis ; heart rate variability (HRV) ; alcohol dependence ; cardiovascular autonomic dysfunction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Standardized heart rate analyses were performed in 60 drug-free patients with alcohol dependence, who were admitted consecutively to a psychiatric department, and in 60 healthy normal matched subjects. The procedure included time and frequency derived measurements of heart rate variability (HRV). The investigations were carried out 3 weeks after admission and treatment on a closed ward to avoid autonomic hyperexcitability during withdrawal or relapse. The patients showed a significantly increased heart rate (p〈0.05), a significant reduction in the coefficient of variation while resting (p〈0.01) and a significant decrease of the high frequency power of spectral analysis (p〈0.01) compared with the normal subjects. Cardiovascular autonomic dysfunction was found in 12 of the patients, but in only one of the normal subjects (p〈0.01). The results indicated moderate parasympathetic (vagal) alteration in alcohol-dependent patients treated in a psychiatric department. This may have implications for psychotherapeutic or psychopharmacological treatment strategies and prognosis in such patients with alcohol dependence.
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  • 3
    ISSN: 1573-7373
    Keywords: Astrocytoma ; csf cytology ; spinal cord tumor ; tumor anaplasy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 43-year-old man died from the complications of astrocytoma metastasis. He first noticed symptoms of a lumbar disc prolapse in 1979. In 1987 a pilocytic astrocytoma (grade I) of the spinal cauda was removed. In 1989 a tumor recidivation at the same site was partially removed. Histology showed a grade II astrocytoma. Two months later the patient developed symptoms of increased intracerebral pressure. CSF cytology showed polymorphic giant tumor cells with hyperchromatic nuclei and a glioblastoma of the cerebral ventricles was diagnosed. The patient died from cardiovascular complications. The post-mortem investigation revealed an astrocytoma of the conus medullaris with an anaplastic ventral area (grade IV). This area was inaccessible to the biopsy. It is believed that tumor metastases from anaplastic parts spread along the spinal cord and brainstem and finally invaded the brain and cerebral ventricles.
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  • 4
    ISSN: 1432-1238
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
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  • 5
    ISSN: 1432-1246
    Keywords: Neurotoxicity ; Organic solvents ; Spray painters
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A multidisciplinary cross-sectional study was performed to examine the chronic neurotoxicity of organic solvents. Participating in the study were 105 persons employed as spray painters and having long-term solvent exposure (10–44 years) and a control group consisting of 58 construction workers, electricians, and plumbers without occupational contact to solvents. Samples were matched for age, preexposure intelligence level, occupation, and socioeconomic status. After controlling for potentially non occupational confounding factors (neuropsychiatric diseases, metabolic disorders, high blood pressure, alcohol intake) 83 spray painters and 42 controls were entered finally into the study. The evaluation included work history, self-rating questionnaire, neurologic investigation, psychiatric analysis using the Present State Examination (PSE), psychological testing, and computerized axial tomography (CAT) of the brain. Physical and neurologic examinations demonstrated no case of overt disorders of the central or peripheral nervous system. An important result of the psychiatric analysis was that the syndromes “special features of depression” and “loss of interest and concentration” occurred significantly more frequently among spray painters than among controls. Further analyses demonstrated an association with chronic exposure over 30 years and repeated acute neurotoxic effects during solvent exposures. Neither psychological nor performance tests demonstrated any statistically significant differences in the performance sets after adjustment according to premorbid intelligence level; this finding supports the presumption of only a low grade of mental dysfunction. Correlation analyses indicated a relationship between subjective health complaints and long-term solvent exposure; however, the effect of age cannot be completely ruled out. Visual evaluation of CAT scans of the brain demonstrated significantly higher values for spray painters on the Cella media index, a measure of the inner liquor system of the brain. None of the other CAT parameters of inner or external brain atrophy showed significant differences. The rate of diffuse cerebral atrophy was not increased in spray painters. No statistical relationship between the solvent exposure index and CAT parameters was found by correlation analysis. In summary, the results do not support the hypothesis of an increased risk of solvent-induced encephalopathy among spray painters. It is not possible to establish a typical picture of central nervous system dysfunction due to chronic solvent exposure. Differences in the frequency of PSE symptoms “special features of depression” and “loss of interest and concentration” could be considered solvent related only if long-term (on average 30-year) exposure in combination with repeated acute neurotic effects had occurred. Cerebral atrophy beyond that of normal aging was not found in long-term exposed spray painters.
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  • 6
    ISSN: 1432-2072
    Keywords: Cutaneous microcirculation ; Laser Doppler flowmetry ; Inspiratory gasp response ; Amitriptyline ; Fluoxetine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cutaneous microcirculation was investigated in 30 major depressed inpatients receiving either 150 mg amitriptyline (n=15) or 30 mg fluoxetine (n=15) as monotherapy, and in 15 normal control subjects matched for age and sex. The laser Doppler flux (LDF) was recorded while resting and under the condition of a sudden deep breath (“inspiratory gasp response”). In normal subjects this autonomic function test caused a marked decrement of LDF signal, which rapidly returned to the baseline value. In both groups of drug treated patients the decrements of LDF signal after a sudden deep breath did not differ from those found in the normal control subjects. However, in the amitriptyline-treated patients the return of LDF-signal to the baseline values was significantly delayed (P=0.0007), while patients treated with fluoxetine showed the same behaviour as normal subjects. With a discriminant analysis using the results of the inspiratory gasp responses, 100% of the amitriptyline treated patients were correctly classified. Since both groups of depressed patients revealed comparable depression scores, the differences found are probably due to the side effects of amitriptyline. Possible clinical implications of these findings are discussed.
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  • 7
    ISSN: 0165-0327
    Keywords: Heart rate analysis ; Heart rate variability ; Melancholic depression ; Panic disorder ; Reactive depression
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Medicine , Psychology
    Type of Medium: Electronic Resource
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