Elevated impulsivity and impaired decision-making cognition in heavy users of MDMA ("Ecstasy").

Rationale: In animal studies, the common club drug 3,4-methylendioxymethamphetamine (MDMA, "Ecstasy") consistently caused a prolonged loss of presynaptic serotonergic neurons, and evidence suggests that MDMA consumption may also affect the human serotonergic system. Serotonin (5-HT) has been implicated in the regulation of impulsivity and such executive functions as decision-making cognition. In fact, MDMA users have shown elevated impulsivity in two studies, but little is known about decision making in drug-free MDMA consumers.

Influence of atypical neuroleptics on executive functioning in patients with schizophrenia: a randomized, double-blind comparison of olanzapine vs. clozapine.

Accepted clinical evidence suggests superior efficacy of novel antipsychotics in the treatment of cognitive symptoms in schizophrenia. Whether this constitutes a primary drug effect or a secondary effect due to easing extrapyramidal side-effects or improving positive symptoms when converting from a first- to a second-generation neuroleptic is still open to debate. Long-term efficacy as well as differential drug effects on cognitive performance are also poorly documented.

Semantic integration in healthcare networks.

A seamless support of information flow for increasingly distributed healthcare processes requires to integrate heterogeneous IT systems into a comprehensive distributed information system. Different standards contribute to ease this integration. In a research project focussing on the development of a reference architecture for inter-institutional health information systems, we identified and categorised concurring integration standards by distinguishing between technical and semantic integration on the one hand, and data and functional integration on the other hand.

Improving pathway compliance and clinician performance by using information technology.

To deliver patient-specific advice at the time and place of a consultation, to improve clinician performance and compliance by using computer-based decision support, and to integrate such IT solutions with the clinical workflow are important strategies for the implementation of clinical pathways. User acceptance plays a critical role: additional effort has to be balanced with enough benefit for the users. Experiences from routine use of an online surgical pathway at Marburg University Medical Center show that it is possible to successfully address this issue by seamlessly integrating patient-specific pat documentation tasks which have to be done anyway and by substantially reusing entered data to accelerate routine tasks (e.

Sensorimotor gating and habituation of the startle response in schizophrenic patients randomly treated with amisulpride or olanzapine.

Background: Schizophrenic patients exhibit impairments in prepulse inhibition (PPI) and habituation of the acoustic startle response (ASR). Recent studies suggested that PPI deficits and habituation deficits are normalized after antipsychotic treatment. Despite clear evidence of gating and habituation mechanisms in animal models, it is still unknown which neurotransmitter systems are involved in schizophrenic patients.

Interventions in the initial prodromal states of psychosis in Germany: concept and recruitment.

Background: The Early Detection and Intervention Programme of the German Research Network on Schizophrenia (GRNS) investigates the initial prodromal phase of psychosis in a multidimensional approach. Two intervention strategies are being studied by two large-scale multicentre projects.

Aims: To present the concept of the intervention studies, and to provide an interim report of the recruitment procedure.

Attenuation of the prepulse inhibition of the acoustic startle response within and between sessions.

Prepulse inhibition (PPI) and habituation of the acoustic startle response (ASR) are widely used biological markers in the study of psychiatric disorders and have been shown to be homologous across species. Previous studies in humans suggested that PPI is a stable and reliable measure between test sessions, but that PPI decreases within sessions. The purpose of this study was to explore the short- and long-term decrease in PPI as a potential confound in the measurement and interpretation of PPI.

Relation between cerebrospinal fluid, gray matter and white matter changes in families with schizophrenia.

Background: Gray matter reduction and ventricular enlargement belong to the best replicated findings in schizophrenia. Brain morphologic changes were also found in non-schizophrenic family members (FM). The intention of this study was to examine whether non-psychotic first-degree relatives reveal similar morphologic changes as schizophrenic patients and how state of genetic loading contribute to these abnormalities.

Pathogenesis of human metapneumovirus lung infection in BALB/c mice and cotton rats.

Human metapneumovirus (hMPV) is a newly described member of the Paramyxoviridae family causing acute respiratory tract infections, especially in young children. We studied the pathogenesis of this viral infection in two experimental small animal models (BALB/c mice and cotton rats). Significant viral replication in the lungs of both animals was found following an intranasal challenge of 10(8) 50% tissue culture infectious doses (TCID50) and persisted for <2 and <3 weeks in the case of cotton rats and mice, respectively.

Two-phase seed dispersal: linking the effects of frugivorous birds and seed-caching rodents.

Frugivorous birds disperse the seeds of many fruit-bearing plants, but the fate of seeds after defecation or regurgitation is often unknown. Some rodents gather and scatter hoard seeds, and some of these may be overlooked, germinate, and establish plants. We show that these two disparate modes of seed dispersal are linked in some plants.

Remitting form of hemicrania continua: two new cases exhibiting one unusual autonomic feature.

Hemicrania continua (HC) is an uncommon, primary headache disorder characterized by a continuous, strictly unilateral headache of moderate intensity with superimposed exacerbations of more severe pain and accompanying autonomic features. Whereas in the majority of HC patients the headache is continuous and without pain-free intervals, we report two new cases of the rare remitting form of HC. One patient described unusual olfactory sensation during episodes of exacerbation, which we classify as an olfactory aura.

Relationship between mirtazapine dose, plasma concentration, response, and side effects in clinical practice.

Objective: The aim of this study was to evaluate the benefit of mirtazapine plasma concentration monitoring in a typical clinical setting.

Methods: The relationship between mirtazapine plasma concentration, dose, response, and side effects was studied in 65 inpatients presenting with a depressive episode according to ICD-10. Plasma concentrations, the 17-item Hamilton Depression Rating (HAMD), and the UKU side effect rating were performed weekly.

Protein sequence tags: a novel solution for comparative proteomics.

Comparative proteome profiling using stable isotope peptide labelling and mass spectrometry has emerged as a promising strategy. Here, we show the broad potential of our proprietary protein sequence tag (PST) technology. A special feature of PST is its ability to detect a wide variety of proteins including the pharmaceutically relevant membrane and nuclear proteins.

A randomized, double-blind, placebo-controlled study of the efficacy and safety of tolperisone in spasticity following cerebral stroke.

To study the efficacy and safety of tolperisone - a centrally acting muscle relaxant with membrane stabilizing activity - in the treatment of stroke-related spasticity. This was a randomized, double-blind, placebo-controlled, multicenter study with parallel groups. Treatment lasted 12 weeks and was started with a titration period of variable length (dose range 300-900 mg tolperisone daily).

Demand-driven evolution of IT systems in healthcare--a case study for improving interdisciplinary processes.

Objectives: To analyze and to optimize interdisciplinary clinical processes, to introduce an IT-supported model for demand-driven system evolution in healthcare, and to demonstrate the feasibility of the approach for a clinical example and to present an evaluation.

Methods: System evolution and change management are viewed as two sides of the same coin, thus formal methods for process analysis and IT system evolution were embedded into a goal-oriented change management model. Based on a process model, a Failure Mode and Effects Analysis (FMEA) and a computer simulation were performed.

Psychotherapy in a day clinic: results of a 1.5 year follow-up.

Objective: In a prospective, naturalistic 1.5 year follow-up study of N= 114 consecutively admitted day clinic patients efficacy of the program and predictors of outcome are evaluated.

Methods: Patients had severe neurotic disturbances and personality disorders.

Pathways of trihalomethane uptake in swimming pools.

Chlorination of pool water leads to the formation of numerous disinfection by-products (DBPs), chloroform usually being most abundant. Bathers and pool guardians take up various amounts of DBPs by different pathways. Identification of different uptake paths is important in order to develop a technical strategy for swimming pool water treatment and to develop focussed technical solutions to minimize THM uptake.

Randomized double blind comparison of olanzapine vs. clozapine on subjective well-being and clinical outcome in patients with schizophrenia.

Objective: This randomized double-blind multicenter trial evaluated the effects of olanzapine vs. clozapine on subjective well-being, quality of life (QOL) and clinical outcome.

Method: The primary objective was to demonstrate non-inferiority of olanzapine, mean dosage 16.

Shape changes in prefrontal, but not parieto-occipital regions: brains of schizophrenic patients come closer to a circle in coronal and sagittal view.

There is some evidence for prefrontal (PF) lobe changes in schizophrenia while the parieto-occipital (PO) region seems to be unaffected. This magnetic resonance imaging (MRI) study was performed to examine shape differences as part of the spectrum of structural abnormalities in schizophrenia. The measurements were done on families affected with schizophrenia to identify the influence of genetic and environmental factors on these changes.

Evaluation and outcome of behavioural changes in the rehabilitation of cancer patients: a review.

The global increase in the number of newly diagnosed cancers has led in most affected countries to increased numbers of cancer survivors, who have specific needs for physical and psychosocial rehabilitation. In spite of recent progress, little is known about the specific rehabilitation measures that could increase the quality of life for cancer survivors. We reviewed published interventions that focussed on changing known risk factors for cancer recurrence and improving physical well-being; those we selected were exercise, smoking, alcohol consumption, diet and the use of sun screens.

Multiple promoters are a common feature of mitochondrial genes in Arabidopsis.

Mitochondrial genes in the plant Arabidopsis thaliana are transcribed by two phage-type RNA polymerases encoded in the nucleus. Little is known about cis-elements that are recognized by these enzymes and mediate the transcription of the Arabidopsis mitochondrial genome. Here, 30 transcription initiation sites of 12 mitochondrial genes and gene clusters have been determined using 5'-RACE and ribonuclease protection analysis of primary transcripts labelled in vitro by guanylyltransferase.

Cognitive improvement in schizophrenic patients does not require a serotonergic mechanism: randomized controlled trial of olanzapine vs amisulpride.

Combined serotonin-2A (5-HT(2A)) and dopamine-2 (D2) receptor blockade has been proposed as a candidate mechanism by which second-generation antipsychotics (SGAs) improve both cognition and negative symptoms in schizophrenic patients, in contrast to antipsychotics of the first generation. The SGA amisulpride, however, only binds to D2/D3 receptors, which makes it an interesting tool to test this assumption. In a randomized controlled trial, 52 schizophrenic patients were allocated to treatment with either olanzapine (10-20 mg/day) or amisulpride (400-800 mg/day).

[Incidence of rigor during treatment with flupentixol decanoate in comparison to risperidone].

Study Objective: We investigated as to whether dosedependent extrapyramidal tolerance of Flupentixol decanoate is inferior to that of Risperidone.

Method: 143 Risperidone and 177 Flupentixol decanoate treated patients were consecutively entered into this non - randomized open study and assessed with the Simpson-Angus-Scale regarding presence of rigor. Treatment comparisons of rigor frequency was done by Kaplan-Meier analysis.

Neuroimaging and 5-HT2C receptor polymorphism: a HMPAO-SPECT study in healthy male probands using mCPP-challenge of the 5-HT2C receptor.

Background: The human 5-HT (2C) receptor gene has been localized on the X chromosome and is expressed in two genetic variants. Whereas previous investigations have suggested that the 5-HT (2C) receptor gene polymorphism is critically involved in the pathogenesis of affective and eating disorders, as yet the functional consequences being associated with the rare serine variant of the 5-HT (2C) receptor in humans are unclear.

Methods: We explored by HMPAO-SPECT if a challenge with the serotonin agonist mCPP, that interacts mainly with the 5-HT (2C) receptor, provokes different patterns of regional cerebral bloodflow (rCBF) as a function of the genetic variant of the receptor.