ABSTRACT Increases in serum triglycerides, cholesterol and pre-β- and β-lipoproteins have been considered as significant pathogenic factors regarding the possible thrombotic side-effect of treatment with oral contraceptives of the combined type containing synthetic oestrogen. With the purpose of investigating the influence of natural oestrogen (oestradiol-17β + oestriol/norethisterone acetate) versus synthetic oestrogen (ethinyloestradiol/norethisterone acetate) on serum lipids and lipoproteins in young women compared to independent and individual controls, as controlled double-blind investigation was performed in 33 women in a total material and 18 women in a selected group. The significant changes were as follows: quantitative increases in serum triglycerides ( P < 0.001) and β-lipoproteins ( P < 0.01) during treatment with synthetic oestrogen, while in contrast no such change was observed in subjects on natural oestrogen, which was found to decrease serum cholesterol ( P < 0.05), phospholipids ( P < 0.05) and α-lipoprotein ( P < 0.05). Quantitative estimation of serum lipoproteins was found to be more valuable than the relative estimation by electrophoresis. It is concluded that oral contraceptives containing natural oestrogens induce less significant and, qualitatively, more benign changes in serum lipids and lipoproteins than preparations containing synthetic oestrogen do.
Within paediatric disciplines and in particular in child and adolescent psychiatry very little work is available regarding the quality of life (QoL) of patients. After using literature search and interviews for identifying the relevant QoL domains, a set of self report questionnaires (for the parents: proxy rating) was developed (C-version: children 10 to 14 years, A-version: adolescents 14 to 18 years, P-version: parental proxy rating about child/adolescent). It was aimed at an almost identical wording within each questionnaire version in regard to the different QoL domains. The questionnaires should not primarily address symptomatology (like e.g. the Child Behaviour Checklist by Achenbach and Edelbrock 1983). After a pilot phase ensuring adequacy and appropriateness of the forms, the questionnaires were field tested in a consecutive series of nearly 700 patients which were referred to the Cologne university department of child and adolescent psychiatry for diagnosis and treatment between 1996 and 2000. The intended structure of the questionnaire system with symptom and functioning scales concerning the domains: "physical performance, fatigue, anxiety, depression, peer group, school, family, beliefs, general QoL" and some further single questions was confirmed by psychometric testing (validity and reliability). Interscale correlations were in general moderate, exhibiting the expected pattern. Analyses of variances using the method of "known groups comparisons" showed e.g. age, sex, and diagnosis related effects hinting towards clinically meaningful differences. The questionnaire forms were well accepted and understood by patients and parents and the wording of the addressed topics was reported to be adequate. Further work will include the psychopathological findings and will focus on specific subgroups of patients (e.g. different diagnoses) as well as on the longitudinal observation of special patient groups, e.g. patients with eating disorders. It can be concluded that the new QoL instruments were successfully employed in a consecutive series of patients and showed very sufficient psychometric properties.
Abstract. An investigation has been carried out to assess the accuracy by which the diurnal urinary excretion of oestriol (dU‐oestriol) in pregnant women can be estimated from urine specimens collected in periods less than 24 hours. Night urines (9 h) are not recommended as a substitute for diurnal urines (24 h). Even correlation of the oestriol output from the night urines with the output of creatininium gives day by day variations which are significantly greater than the corresponding variations of the diurnal urines. in cases where the collection of a correct diurnal urine specimen (24 h) is difficult to obtain and it is important to get a quick answer it is recommended to use a single voided urine specimen and to calculate the diurnal excretion of oestriol by means of the creatininium output.
Nach Literaturrecherche und Interviews zur Identifizierung und Festlegung der fur die von Kindern und Jugendlichen mit psychischen Storungen relevanten Bereiche wurde ein Fragebogensystem (LKJ: Kinder- und Jugendpsychiatrie) auf der Basis des Selbsturteils (bzw. des Fremdurteils fur die Elternversion) in drei Versionen entwickelt (K-Version: Kinder 10 bis 14 Jahre, J-Version: Jugendliche 14 bis 18 Jahre, E-Version: Elternurteil uber Kind/Jugendlichen). In den drei Versionen wurden die abgefragten Bereiche der moglichst deckungsgleich abgebildet. Das Fragebogensystem wurde komplementar zur primar nicht gewunschten Erfassung von Symptomen und Psychopathologie konzipiert (wie z.B. durch die Child-Behavior-Checklist von Achenbach u. Edelbrock 1983). Nach einer Pilotphase wurden die Fragebogen innerhalb einer konsekutiven Inanspruchnahmepopulation der Klinik fur Psychiatrie und Psychotherapie des Kindes und Jugendalters der Universitat zu Koln eingesetzt. Von ca. 700 Familien liegen jetzt Daten vor. Die angenommene Struktur mit Symptom- und Funktionsskalen aus den Bereichen: korperliche Funktion, Fatigue, Angste, Depressivitat, Gleichaltrigengruppe, Schulbereich, Familie, Glauben, allgemeine Lebensqualitat und einigen Einzelfragen konnte durch psychometrische Testung (Validitat und Reliabilitat) bestatigt werden. Die Korrelationen zwischen den Skalen waren in der Regel masig ausgepragt und zeigten die erwarteten Muster. Erste Varianzanalysen erbrachten z.B. alters-, geschlechts- und diagnosebezogene Effekte als Hinweise auf klinisch bedeutsame Unterschiede. Die Fragebogen wurden von Patienten und Eltern gut aufgenommen und die Formulierung der Fragen wurde als angemessen und verstandlich beurteilt. Im weiteren wird die Einbeziehung psychopathologischer Daten, die Identifikation von spezifischen Untergruppen von Patienten (z.B. unterschiedliche Diagnosen) sowie die Verlaufsbeobachtung spezieller Patientengruppen (z.B. Patientinnen mit Esstorungen) im Vordergrund stehen. Zusammenfassend kann festgestellt werden, das die hier dargestellten Langversionen des Lebensqualitatsfragebogens bei einer konsekutiven Inanspruchnahmepopulation kinder- und jugendpsychiatrischer Patienten erfolgreich eingesetzt werden konnten und die vorliegenden Analysen sehr zufriedenstellende psychometrische Kennwerte ergaben.
Within paediatric disciplines and in particular in child and adolescent psychiatry very little work is available regarding the quality of life (QoL) of patients. After using literature search and interviews for identifying the relevant domains, a set of self report questionnaires (for the parents: proxy rating) was developed (C-version: children 10 to 14 years, A-version: adolescents 14 to 18 years, P-version: parental proxy rating about child/adolescent). It was aimed at an almost identical wording within each questionnaire version in regard to the different domains. The questionnaires should not primarily address symptomatology (like e.g. the Child Behaviour Checklist by Achenbach and Edelbrock 1983). After a pilot phase ensuring adequacy and appropriateness of the forms, the questionnaires were field tested in a consecutive series of nearly 700 patients which were referred to the Cologne university department of child and adolescent psychiatry for diagnosis and treatment between 1996 and 2000. The intended structure of the questionnaire system with symptom and functioning scales concerning the domains: physical performance, fatigue, anxiety, depression, peer group, school, family, beliefs, general QoL and some further single questions was confirmed by psychometric testing (validity and reliability). Interscale correlations were in general moderate, exhibiting the expected pattern. Analyses of variances using the method of known groups comparisons showed e.g. age, sex, and diagnosis related effects hinting towards clinically meaningful differences. The questionnaire forms were well accepted and understood by patients and parents and the wording of the addressed topics was reported to be adequate. Further work will include the psychopathological findings and will focus on specific subgroups of patients (e.g. different diagnoses) as well as on the longitudinal observation of special patient groups, e.g. patients with eating disorders. It can be concluded that the new instruments were successfully employed in a consecutive series of patients and showed very sufficient psychometric properties.
The aim of the present study was to determine the effect of intensive acupuncture on severe tinnitus. The structure of the study was a randomized, double-blind, clinical investigation with open therapeutic surveillance and included 54 patients. All were subjected to 25 treatment sessions over a period of two months, each treatment lasting 30 minutes. Fifty-two patients completed the study. The variables used for self-registration were based on the Visual Analogue Scale, where annoyance, loudness and awareness of the tinnitus were assessed. These were recorded twice daily over a four month period starting one month before the first treatment and ending one month after the last treatment. Questionnaires, interviews and audiometry were carried out repeatedly. No statistically significant differences were found between the acupuncture group and the placebo group.
