ABSTRACT
Retraction Note to: Anaesthesist 2018 https://doi.org/10.1007/s00101-018-0513-7 Die Schriftleitung von Der Anaesthesist zieht den Artikel [1] zurück. Die Autoren erhielten die Freigabe der Ethikkommission der Ärztekammer des Saarlandes in 2003. Das Design der Studie, die ab 2005 durchgeführt wurde, wurde jedoch von diesem Ethikvotum nicht vollumfänglich abgedeckt.
ABSTRACT
BACKGROUND: Agitation is a frequent reason for emergency physician calls in psychiatric emergencies in the German preclinical emergency medical system. Benzodiazepines have proven to be effective in treating acute agitation. Although lorazepam has beneficial clinical and pharmacological properties it is hardly used by emergency physicians. The sublingual administration of lorazepam has many advantages compared to intravenous administration. MATERIAL AND METHODS: In an interventional trial lasting 18 months the efficacy, tolerance and onset of effects of sublingual and intravenous lorazepam in patients with agitation states in emergency duties were compared. The randomization to the intervention groups was subject to a time criterion. The sublingual administration of lorazepam over a period of 9 months was followed by an intravenous administration over the same period of time. The psychometric scales used were: PANSS-EC, CGI, CGI-Change, agitation-calmness evaluation scale, visual analog scale and sedation scale. Response to the intervention was defined by a 40% reduction on the PANSS-EC scale. RESULTS: A total of 37 individuals participated in the study (sublingual: nâ¯= 22, intravenous: nâ¯= 15). Lorazepam was effective in treating acute agitation. The effectiveness and tolerance of sublingual and intravenous lorazepam administration seems to be comparable. CONCLUSION: Sublingual administration of lorazepam is effective for treating acute agitation in emergency medical services.
ABSTRACT
Frontotemporal dementia remains a diagnostic challenge. Especially the differential diagnosis between FTD and affective disorders is often difficult. Based on a case report, diagnostic efforts and differential diagnoses are described and revisited criteria for the behavioral FTD (bvFTD) from Rascowsky et al. are mentioned.
Subject(s)
Frontotemporal Dementia/diagnosis , Aged , Diagnosis, Differential , Electroencephalography , Frontotemporal Dementia/epidemiology , Humans , Magnetic Resonance Imaging , Male , Mood Disorders/etiology , Mood Disorders/psychology , Neuropsychological TestsABSTRACT
Many patients with borderline personality disorder (BPD) receive pharmacological treatment. On account of the few treatment guidelines and the often changing symptoms, different substances are used. The present article summarises treatment-practice and study results concerning the pharmacological treatment of BPD.
Subject(s)
Borderline Personality Disorder/drug therapy , Antidepressive Agents/therapeutic use , Antimanic Agents/therapeutic use , Antipsychotic Agents/therapeutic use , Benzodiazepines/therapeutic use , Borderline Personality Disorder/complications , Borderline Personality Disorder/psychology , Central Nervous System Stimulants/therapeutic use , Fatty Acids, Omega-3/therapeutic use , Humans , Mental Disorders/complications , Randomized Controlled Trials as TopicABSTRACT
A 38-year-old female suffered from adrenogenital syndrome with 21-hydroxylase deficiency requiring a corticosteroid substitution. The virilized patient claims to have discontinued treatment with corticosteroids since the age of 15. In the 12 months prior to admission, the patient experienced addisonian crises and repeated decompensation with depressive-suicidal symptoms. Due to the second suicide attempt within a short period, the patient underwent psychiatric treatment presenting an organic depressive syndrome. Under sufficient medication including corticosteroids, antidepressants, and mood stabilizing therapy, the psychopathologic findings improved impressively. Noncompliance after discharge led to a relapse and another suicide attempt, which remitted promptly after adequate therapy.
