[S3 guidelines on diagnostics and therapy of bipolar disorders: development process and essential recommendations]. / S3-Leitlinie zur Diagnostik und Therapie bipolarer Störungen: Entwicklungsprozess und wesentliche Empfehlungen.

Bipolar disorders are severe psychiatric disorders with extensive individual and health economic consequences. Starting in 2007 the first German evidence and consensus based guideline for diagnostics and treatment of bipolar disorders was developed which holds the potential of increasing confidence of therapists, patients and relatives in the decision-making process and improving healthcare service experiences of patients and relatives. Apart from recommendations for diagnostics and treatment the guidelines provide those for trialogue action, knowledge transfer and self-help and for strategies for healthcare provision of this complex disorder. In the present article the methodology and essential recommendations are outlined and complemented in specific topics by corresponding articles in this special issue. Due to restrictions of the length of this presentation there is the need to refer to the comprehensive version of the guidelines at several points also regarding a detailed discussion of the limitations.

[Guideline on bipolar disorders and the importance of trialogue: chances and risks]. / Leitlinie Bipolare Störungen und die Bedeutung des Trialogs : Chancen und Risiken.

The term trialogue means the best possible equally contributing cooperation between affected patients and therapists as well as the self-evident inclusion of relatives. This is true for therapy, antistigma efforts by the planning of care, in associations such as the German Society for Bipolar Disorders and by assimilation of guidelines. Trialogue has a history and in its current version many levels and a hopeful vision of characteristics of understanding and treatment. This idea is presented here and relationships with characteristics of understanding and therapy of bipolar disorders will be made. Finally the recommendations of guidelines on trialogue will be presented and essential headings will be discussed under the aspect of trialogue: where and how are basic ideas and core demands of associations of affected persons and relatives considered? How is the process of trialogue to be assessed for the assimilation of guidelines? What are the chances and risks for the implementation? How can trialogue support the implementation?

LIF Studies of the Ã1A' States of BiOH and BiOD.

Electronic spectra of the recently discovered BiOH and BiOD radicals have been studied by means of laser-induced fluorescence measurements in the 400-1000 nm range. Laser excitation spectra observed in the range 430-450 nm are attributed to transitions from the &Xtilde;1A' ground state to the theoretically predicted Ã1A' state. Fluorescence spectra from the Ã1A',nu'3 = 0, 1 levels consist of short nu"3 progressions to the lower states &Xtilde;1A', &Xtilde;3A', and ã1A'. Laser excitation spectra in the range 580-620 nm contain bands with both DeltaKa = 0 and DeltaKa = +/-1 subbands. They are attributed to hybrid bands of the Ã1A' <-- &Xtilde;3A' transition. Analyses of the spectra have yielded vibronic energy levels of the &Xtilde;1A', &Xtilde;3A', ã1A', and Ã1A' states of both isotopes and effective rotational constants A - 1/2(B + C) and DK for some levels. The radiative lifetime of the Ã1A',000 state was found to be 0.92 +/- 0.03 µs. Copyright 1998 Academic Press.

Gas Phase LIF Study of the b1Sigma+(b0(+)) left and right arrow X3Sigma-(X10(+), X21) Transition of NI.

First gas phase spectra of the nitrogen monoiodide radical NI are reported. The b1Sigma+(b0(+)) left and right arrow X3Sigma-(X10(+), X21) transition of NI has been studied by laser-induced fluorescence measurements. Ground state NI radicals were generated in a fast-flow system by reaction of microwave-discharged nitrogen with iodine vapor. Vibrational levels v = 0, 1, and 2 of the b1Sigma+ state were excited with a pulsed dye laser. Rotational and vibrational constants of the X3Sigma- and b1Sigma+ states were deduced from analysis of high-resolution excitation spectra. Time-resolved measurements of the fluorescence decay and measurements of relative line and band intensities allowed determination of the radiative lifetime of the b state, of band transition probabilities, and of the ratio of transition moments µ0/µ1 for the b0(+) --> X10(+) and b0(+) --> X21 subtransitions. Comparison of calculated and experimental line intensities and FC factors shows that treatment of the X3Sigma- state in terms of a Hund's case (a) formalism is preferable to use of a case (c) formalism. Copyright 1998 Academic Press.

LIF Study of the b1Sigma+(b0(+)) left and right arrow X3Sigma-(X10(+),X21) Transitions of SbH and SbD.

The b1Sigma+(b0(+)) left and right arrow X3Sigma-(X10(+),X21) transitions of SbH and SbD have been studied by laser-induced fluorescence measurements. Ground state SbH(SbD) radicals were generated in a fast-flow system by reaction of microwave-discharged hydrogen (deuterium) with antimony vapor. Vibrational levels v = 0 and 1 of the b1Sigma+ state were excited with a pulsed dye laser. In addition to five electric dipole branches SR, QP, QR, QQ, and OP, weak magnetic dipole branches PQ were observed in the 0-0 bands of the b1Sigma+ <-- X3Sigma- transitions. Rotational and vibrational constants of the X3Sigma- and b1Sigma+ states were deduced from high-resolution excitation spectra. Time-resolved measurements of the fluorescence decay and measurements of relative line and band intensities allowed determination of the radiative lifetime of the b1Sigma+ state of SbH (tau = 173 +/- 3 µs) and of the electric and magnetic dipole transition moments µ0 = +/-0.036 D, µ1 = -/+0.058 D, |M| = 1.62 Bohr magnetons. Copyright 1998 Academic Press.

Risk factors in carcinoma in situ of the urinary bladder. Dutch South East Cooperative Urological Group.

OBJECTIVES: In this article we describe the long-term follow-up of patients with carcinoma in situ (CIS) of the urinary bladder and examine whether the extent of CIS, the presence of associated papillary tumors, or the response to treatment influence the course of the disease. METHODS: Fifty-two patients with CIS of the bladder, treated in a randomized prospective study, are described. In 23 patients with concomitant papillary tumors all macroscopically visible lesions were completely resected transurethrally (TUR). CIS was histologically confirmed in all patients by biopsy, 29 of whom had primary CIS. The patients were treated with intravesical mitomycin, bacille Calmette-Guérin (BCG)-RIVM or BCG-Tice and followed regularly by urine cytology, cystoscopy, and biopsy. RESULTS: Complete response was achieved in 65% of the patients. Of these responders, 24% later had a recurrence of CIS or a superficial tumor and 18% had progressive disease (PD). In the nonresponding patients, progression occurred in 67%. In the whole group, PD was seen in 35% of the patients, and radical cystectomy was performed in 21%. The disease-related death rate was 13%. The risk for recurrence or PD was not higher in patients with more extensive CIS, defined as three or more positive biopsy results or when CIS was associated with papillary tumors compared to patients with one or two biopsy specimens positive for CIS or CIS alone. Nonresponding patients showed a significantly higher progression rate and cystectomy rate than responding patients (P = 0.0012 and 0.008, respectively). CONCLUSIONS: CIS of the bladder is a malignancy with a poor prognosis, especially in patients not responding after intravesical treatment. Early detection and adjuvant intravesical treatment after TUR of concomitant papillary tumors are required. In patients not responding after intravesical treatment, radical surgery is necessary before progression occurs. The number of biopsies positive for CIS, not the presence of concomitant superficial tumors, was an indicator for progression or recurrence.