Universitatsklinik Ulm

Neu-Ulm, Germany

Universitatsklinik Ulm

Neu-Ulm, Germany

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Ferreira J.J.,University of Lisbon | Rosser A.,University of Cardiff | Craufurd D.,University of Manchester | Squitieri F.,IRCSS Neuromed | And 2 more authors.
Movement Disorders | Year: 2015

Background: It has been suggested that treatment with ethyl-eicosapentaenoic acid (EPA) may improve motor function in patients with Huntington's disease (HD) with cytosine-adenine-guanine repeat numbers of <45. Methods: This multicenter, randomized, double-blind, placebo-controlled 6-month trial compared the effects of ethyl-EPA versus placebo on 290 subjects with mild-to-moderate HD. The primary endpoint was the change from baseline to 6 months in the Total Motor Score 4 (TMS-4) component of the Unified Huntington's Disease Rating Scale (UHDRS). Secondary endpoints included change from baseline in UHDRS subscores and Clinical Global Impression (CGI). Results: No significant differences in TMS-4 scores were noted between treatment groups. Similarly, there were no significant differences between groups on any of the UHDRS subscores or CGI scores. Conclusion: Ethyl-EPA was not beneficial in patients with HD during 6 months of placebo-controlled evaluation. © 2015 International Parkinson and Movement Disorder Society.

Rohde G.,Ruhr University Bochum | Straube E.,Friedrich - Schiller University of Jena | Essig A.,Universitatsklinik Ulm | Reinhold P.,Institute For Molekulare Pathogenese | Sachse K.,Institute For Molekulare Pathogenese
Deutsches Arzteblatt | Year: 2010

Background: Zoonoses were already a subject of intense interest even before the SARS and avian influenza epidemics arose. For many years, chlamydiae have been hypothesized to be important zoonotic pathogens, because of their wide distribution and their infectious cycle. This article provides an overview of the current state of knowledge on this subject. Methods: The authors present a selective review of the literature as well as their own findings. Results: The scientific knowledge of the distribution and infectious cycle of chlamydiae is still inadequate. The laboratory diagnosis of chlamydial zoonoses remains unsatisfactory in both human and vet erinary medicine, as there are no commercially available sensitive and species-specific tests. Acute chlamydial infections are usually treated with macrolides, tetracyclines, or quinolones. Persistent varieties are not covered by standard therapy. Conclusions: There is a considerable need for research on chlamydial infections, especially with regard to the diagnosis and treatment of persistent varieties.

Plener P.L.,Universitatsklinik Ulm | Fegert J.M.,Universitatsklinik Ulm | Kolch M.G.,Universitatsklinik Ulm | Kolch M.G.,Vivantes Netzwerk fur Gesundheit GmbH
Zeitschrift fur Kinder- und Jugendpsychiatrie und Psychotherapie | Year: 2012

Depending on symptom severity, psychopharmacological treatment can be a valuable option in the treatment of depressive disorders in childhood and adolescence. This review provides recommendations for clinical treatment, focusing on suicidality and treatment-resistant patients. The quality of studies regarding the psychopharmacological therapy of depressive disorders in childhood and adolescence has improved since the «black box» warning of the FDA concerning the occurrence of suicidality under treatment with selective serotonin reuptake inhibitors (SSRIs). In Germany, there is proof for a trend toward a more evidence-based psychopharmacological treatment approach within recent years. © 2012 Verlag Hans Huber, Hogrefe AG.

Thermann P.,Klinik fur Innere Medizin IV | Dollinger M.M.,Universitatsklinik Ulm
Zeitschrift fur Gastroenterologie | Year: 2016

Sarcoidosis is a rare systemic disease characterized by noncaseating granulomas in affected organs. With > 90 % of all cases lung involvement is the most frequent site of manifestation of sarcoidosis, nevertheless multiple other organs can be affected. Extrapulmonary manifestations are lymph nodes, skin, nervous system, heart, eyes, bone marrow, spleen or gastrointestinal tract including liver and pancreas. Involvement of the gastrointestinal tract is rare, it can affect the whole intestine and is most frequently found in the stomach. Despite its infrequent manifestation, gastrointestinal sarcoidosis can have a significant clinical impact depending on the organ involved, so that early diagnosis is warranted. Medical treatment mainly consists of immunosuppressive therapy, most frequently with corticosteroids being the first treatment of choice. Dosage and duration of therapy is not well established yet. In the literature very limited data are available on this topic with randomized trials missing completely. The aim of this paper is to give a summary of the available data to this date. © Georg Thieme Verlag KG.

Barrech A.,Universitatsklinik Ulm | Baumert J.,Helmholtz Center for Environmental Research | Emeny R.T.,Helmholtz Center for Environmental Research | Gundel H.,Universitatsklinik Ulm | And 2 more authors.
Scandinavian Journal of Work, Environment and Health | Year: 2016

Objective This study aimed to examine prospectively the influence of exposure to job insecurity during working life on subjective well-being (SWB) after retirement, an association which has not been studied to date. Method Data were derived from the prospective population-based MONICA/KORA study conducted in southern Germany. Participants were recruited and data were collected during three independent surveys between 1984-1995 (T1) and followed up in 2009 (T2). The study sample consisted of 1801 employed participants (1146 male/ 655 female) aged 41-72 years at T1 and ≥65 years at T2, without missing data. Self-administered questionnaires and clinical examinations were used to assess job insecurity and risk factors at T1 and SWB at T2. Mean follow-up was 19.6 years. Logistic regression analyses were performed to determine the association of job insecurity with SWB after retirement. We accounted for an extensive set of sociodemographic, lifestyle-, health- and work-related risk factors. Results At T1, 39.5% of the participants reported job insecurity, which was associated with a 1.40-fold [95% confidence interval (95% CI) 1.08-1.82] risk of low SWB at T2 in models adjusted for sociodemographic and lifestyle- and health-related conditions at T1. Additional adjustment for a set of work-related risk factors at T1 had little effect on this association. Conclusions Exposure to job insecurity at midlife was associated with low SWB in retirement, even after controlling for an extensive set of risk factors. This shows that the negative effects of unstable working conditions might persist well into retirement, long after cessation of employment. © Scandinavian Journal of Work, Environment & Health.

Plener P.L.,Universitatsklinik Ulm | Straub J.,Universitatsklinik Ulm | Fegert J.M.,Universitatsklinik Ulm | Keller F.,Universitatsklinik Ulm
Nervenheilkunde | Year: 2015

Recent data from the nationwide German KiGGS survey show a stable level of psychiatric and behavioural symptoms in a community sample. Nevertheless, rates of psychopharmacological treatment in childhood and adolescence are increasing. This study analyses the prevalence of ICD-10 chapter F diagnoses, from German hospitals in children up to the age of 15 in the years 2003 to 2012. There was a significant increase in most diagnostic groups with the exception of organic (F0), schizophrenic (F2), personality and behavioral disorders (F6) and mental retardation (F7), showing stable or even decreasing rates of hospital treatments in a 10 year time frame. © Schattauer 2015

On average approximately 50 % of patients treated on European intensive care units (ICU) suffer from an infection. Also on German ICUs, an increase in the prevalence of multidrug-resistant bacteria as well as the consumption of antibiotics have been noted. The treatment of infections caused by multidrug-resistant bacteria is a significant challenge as they lead to prolonged hospital stays, higher mortality and higher logistic and financial expenditure for hospitals. Further aspects are the sluggish development of new antibiotic drugs by the pharmaceutical industry and frequent problems with the delivery of established antibiotics. In meeting this challenge, the S3 guideline strategies to enhance rational use of antibiotics in hospitals were published by the Association of the Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, AWMF) in 2013. In this article we describe several important aspects of an antibiotic stewardship (ABS) program in a German teaching hospital with specific examples from the ICU of the Department of Anesthesiology in the University Clinic in Ulm, Germany. © 2016 Springer-Verlag Berlin Heidelberg

Laszlo R.,Universitatsklinik Ulm | Steinacker J.M.,Universitatsklinik Ulm
Herz | Year: 2016

A training-induced increase in vagal tone, left atrial enlargement and high atrial volume load due to exercise can theoretically favor induction and continuation of atrial fibrillation (AF) in (endurance) athletes. However, there is currently no evidence for a higher occurrence of AF in young endurance athletes in comparison to an age-matched normal population. The correlate of long-term endurance training results in proarrhythmogenic atrial remodeling in a rat model. The results of some studies also suggest that there may be atrial remodeling in humans, which might be an explanation for the comparatively higher incidence of AF in veteran athletes, whereby the relative risk might have been overestimated due to methodological problems, e.g. due to insufficient consideration of “new” AF risk factors. To date, there are no indications for an increased risk of AF due to normal physical activity: on the contrary, moderate physical activity seems to decrease the risk for AF. For an individual evaluation of sports participation of patients with AF, the overall cardiac situation, atrioventricular conduction during exercise, a possible oral anticoagulation as well as the sport and training intensity practiced are important. Well-adapted training for patients with AF has to be considered as safe and effective in terms of the overall positive effects of physical activity in patients with cardiovascular problems, for example due to a positive influence on cardiovascular risk factors. © 2015, Urban & Vogel.

Barrech A.,Universitatsklinik Ulm
Public Health Forum | Year: 2014

The structural changes and economic crises of the past decades have led to an increase in job insecurity among employees worldwide (OECD, 1997; Eurofound, 2012). Current research suggests that job insecurity is a work-related stressor which can have detrimental effects on psychological, as well as somatic health (Greenhalgh and Rosenblatt, 2010). To date, there is a lack of studies on preventive approaches, especially in work-settings. With regards to the individual and societal implications of job insecurity, the validation of appropriate interventions is called for.

Up to one-third of all schizophrenic patients suffer from auditory verbal hallucinations (AVH) that are resistant to antipsychotics. The use of repetitive transcranial magnetic stimulation (rTMS) is a therapeutic option that may disrupt or attenuate treatment resistant (TR) AVHs. This article reviews the available literature on the use of rTMS to treat AVHs, particularly focusing on randomised controlled trials, which have introduced new definitions (refractory AVHs), and techniques (active comparator strategies and imaging-guided rTMS). A number of meta-analyses are considered, which support a range of positive effect sizes for AVH attenuation in response to rTMS. Larger maintenance and follow-up studies with clearer clinical definitions of TR AVH are required. The underlying mechanism of action of rTMS on language networks needs further clarification and future trials should focus on methods for assessing AVH changes, time courses of response, and the development of response markers. © Georg Thieme Verlag KG Stuttgart · New York.

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