U Weiss

Heinrich-Heine-Universität Düsseldorf, Düsseldorf, North Rhine-Westphalia, Germany

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Publications (16)38.27 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Postoperative Durchgangssyndrome sind pyschische Störungen, die nach Operationen akut auftreten können und einen flukturierenden Verlauf haben. Der postoperative Verlauf ist oft deutlich protrahiert. Ziel dieser Untersuchung war es, zu analysieren, wie häufig Durchgangssyndrome bei gefäßchirurgischen Patienten auftreten, und ob sich Risikofaktoren für deren Entwicklung identifizieren lassen. Methoden: Die somatischen Befunde von Patienten, die elektiv arteriel operiert wurden, wurden erfaßt. Darüber hinaus wurden die Patienten präoperativ psychiatrisch untersucht. Intraoperativ wurden der Infusions- und Transfusionsbedarf, Blutgase und Blutdruckverhalten sowie Narkose- und Operationszeiten dokumentiert. Postoperativ wurden die Patienten täglich von Tag 1–7 psychiatrisch und chirurgisch untersucht. Ein Durchgangssyndrom wurde nach dem Diagnostischen und Statistischen Manual Psychischer Störungen DSM IV diagnostiziert und in leichte, mittlere und schwere Formen unterteilt. Ergebnisse: 54 Patienten gingen in die Studie ein. Davon entwickelten 21 (38,9%) ein Durchgangssyndrom (11 leicht, 2 mittelschwer, 8 schwer). Deutliche Unterschiede zeigten sich zwischen Patienten mit aortalen Operationen(n=27, 55,5% Durchgangssyndrom) und solchen mit nichtaortalen Eingriffen (n=27, 22,2% Durchgangssyndromen). Bestimmte Begleiterkrankungen (Hörstörung), nicht jedoch ein höheres Lebensalter erhöhten die Wahrscheinlichkeit eines postoperativen Durchgangssyndromes. Sowohl allgemein psychopathologisch auffällige Patienten als auch solche mit einer depressiveren Grundstimmung entwickelten häufiger Durchgangssyndrome als psychiatrisch unauffällige. Patienten, deren intraoperativer Verlauf kompliziert war, entwickelten häufiger ein Durchgangssyndrom. Dabei war die Schwere des Verlaufes nicht an der absoluten Operationszeit, dem Blutdruck oder den Blutgasen abzulesen. Aussagekräftiger waren ein intra- oder postoperativ erniedrigter Hämoglobinwert (Hb <10 g %), ein erhöhter intraoperativer Infusionsbedarf und eine intraoperative Acidose. Patienten mit Durchgangssyndromen entwicklten häufiger postoperative Komplikationen (8/21=38,1% vs 6/33=18,2%) und mußten länger intensivmedizinisch behandelt werden (2,7 vs 2, 1 Tage, nur aortale Eingriffe 3,2 vs 2,4 Tage). Schlußfolgerungen: Postoperative Durchgangssyndrome sind nach gefäßchirurgischen Operationen häufig. Vor allem Patienten mit aortalen Operationen, mit bestimmten Begleiterkrankungen, psychopathologischen Auffälligkeiten und solche mit einem komplizierten intraoperativen Verlauf sind gefährdet, eine derartige Komplikation zu entwickeln. Introduction: Postoperative delirium is a common psychic disturbance occurring acutely after various surgical procedures and typically presenting with a fluctuating course. These patients' recovery takes longer. In this study we analyze the incidence of postoperative delirium in patients undergoing vascular surgery and try to identify risk factors for its development. Methods: Patients undergoing elective arterial operations were included. Their medical history, the specific vascular diagnosis and operation performed, the medication and laboratory data were monitored. Additionally the patients were preoperatively interviewed by a psychiatrist. Intraoperatively the drugs, infusions, possible transfusions, blood gases and pressures were monitored, as were the times of surgery and anesthesia. Postoperatively patients were seen daily by the psychiatrist and the surgeon for at least 7 days. Postoperative delirium was diagnosed according to DSM IV criteria, and mild, moderate and severe delirium were distinguished. Results: Fifty-four patients entered the study. Twenty-one (38.9%) developed postoperative delirium (11 mild, 2 moderate, 8 severe). Patients with aortic operations developed delirium more frequently than those with non-aortic procedures(55.5 vs 22.2%, n=27 each). Some preexisting diseases (hearing disturbance) increased the probability of postoperative delirium, while age was not identified as a risk factor. General psychopathological and depressive disturbances increased the likelihood of postoperative delirium. Patients who had a severe intraoperative course developed postoperative delirium more frequently. This was not seen in the absolute time of surgery or anesthesia nor in the intraoperative development of blood pressure or intraarterial gases, which did not differ between patients with and without postoperative delirium. More reliable parameters were an increased intraoperative need for crystalloid volume, intra – or postoperatively decreased hemoglobin values (Hb <10 g/dl) and the development of acidosis that had to be treated. Patients with delirium had serious complications more often (8/21=38.1% vs 6/33=18.2%) and needed Intensive Care treatment longer (2.7 vs 2.1 days, only aortic surgery 3.2 vs 2.4 days). Conclusions: Postoperative delirium after vascular surgery is frequent. Patients undergoing aortic surgery, with specific concomittant medical disease, psychopathological disturbances and a severe intraoperative course, are at risk of developing postoperative delirium.
    Der Anaesthesist 04/2012; 49(5):427-433. · 0.85 Impact Factor
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    ABSTRACT: In einem vom BMG geförderten 2-jährigen Projekt wurde anhand von insgesamt 1042 Behandlungsfällen an 4 psychiatrischen Kliniken unterschiedlicher Struktur in Nordrhein-Westfalen die Voraussetzung für eine externe Qualitätssicherung mit Hilfe der Tracer-Diagnose Schizophrenie geschaffen und durchgeführt. Ziele waren die Evaluation eines Erhebungsinstrumentariums, die Entwicklung von Qualitätsindikatoren und der Aufbau eines Rückmeldesystems zur Optimierung des internen Qualitätsmanagements. Anhand der erhobenen Daten ist es auf wissenschaftlich-statistischer Basis gelungen, Qualitätsindikatoren und eine vergleichende Art der Rückmeldung zu entwickeln, die neben Ergebnisvariablen auch Struktur-, Patienten- und Prozessvariablen beinhaltet. Diese Qualitätsprofile bilden einen wesentlichen Ausgangspunkt für krankheitsspezifische Problemanalysen im Rahmen eines internen Qualitätsmanagements. Due to legal regulations, external quality assurance is mandatory in Germany. Supported by the German Health Ministry (BMG),we present the results of a multicenter study in four hospitals with different structures on 1042 inpatients with the trace diagnosis of schizophrenia (ICD 10). We defined disease-specific indicators of structure, process, and outcome quality, developed an assessment instrument, and implemented a feedback system for quality comparison. The resulting quality profiles are useful as a starting point for internal quality management.
    Der Nervenarzt 04/2012; 71(5):364-372. · 0.80 Impact Factor
  • Der Anaesthesist 06/2000; 49(5):427-33. · 0.85 Impact Factor
  • Der Anaesthesist 06/2000; 49(5):427-33. · 0.85 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Postoperative delirium is a common psychic disturbance occurring acutely after various surgical procedures and typically presenting with a fluctuating course. These patients' recovery takes longer. In this study we analyze the incidence of postoperative delirium in patients undergoing vascular surgery and try to identify risk factors for its development. Patients undergoing elective arterial operations were included. Their medical history, the specific vascular diagnosis and operation performed, the medication and laboratory data were monitored. Additionally the patients were preoperatively interviewed by a psychiatrist. Intraoperatively the drugs, infusions, possible transfusions, blood gases and pressures were monitored, as were the times of surgery and anesthesia. Postoperatively patients were seen daily by the psychiatrist and the surgeon for at least 7 days. Postoperative delirium was diagnosed according to DSM IV criteria, and mild, moderate and severe delirium were distinguished. Fifty-four patients entered the study. Twenty-one (38.9%) developed postoperative delirium (11 mild, 2 moderate, 8 severe). Patients with aortic operations developed delirium more frequently than those with non-aortic procedures(55.5 vs 22.2%, n = 27 each). Some preexisting diseases (hearing disturbance) increased the probability of postoperative delirium, while age was not identified as a risk factor. General psychopathological and depressive disturbances increased the likelihood of postoperative delirium. Patients who had a severe intraoperative course developed postoperative delirium more frequently. This was not seen in the absolute time of surgery or anesthesia nor in the intraoperative development of blood pressure or intraarterial gases, which did not differ between patients with and without postoperative delirium. More reliable parameters were an increased intraoperative need for crystalloid volume, intra- or postoperatively decreased hemoglobin values (Hb < 10 g/dl) and the development of acidosis that had to be treated. Patients with delirium had serious complications more often (8/21 = 38.1% vs 6/33 = 18.2%) and needed Intensive Care treatment longer (2.7 vs 2.1 days, only aortic surgery 3.2 vs 2.4 days). Postoperative delirium after vascular surgery is frequent. Patients undergoing aortic surgery, with specific concomitant medical disease, psychopathological disturbances and a severe intraoperative course, are at risk of developing postoperative delirium.
    Der Chirurg 02/2000; 71(2):215-21. · 0.52 Impact Factor
  • Chirurg. 01/2000; 71(2):0215-0221.
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    ABSTRACT: Introduction: Postoperative delirium is a common psychic disturbance occurring acutely after various surgical procedures and typically presenting with a fluctuating course. These patients' recovery takes longer. In this study we analyze the incidence of postoperative delirium in patients undergoing vascular surgery and try to identify risk factors for its development. Methods: Patients undergoing elective arterial operations were included. Their medical history, the specific vascular diagnosis and operation performed, the medication and laboratory data were monitored. Additionally the patients were preoperatively interviewed by a psychiatrist. Intraoperatively the drugs, infusions, possible transfusions, blood gases and pressures were monitored, as were the times of surgery and anesthesia. Postoperatively patients were seen daily by the psychiatrist and the surgeon for at least 7 days. Postoperative delirium was diagnosed according to DSM IV criteria, and mild, moderate and severe delirium were distinguished. Results: Fifty-four patients entered the study. Twenty-one (38.9 %) developed postoperative delirium (11 mild, 2 moderate, 8 severe). Patients with aortic operations developed delirium more frequently than those with non-aortic procedures(55.5 vs 22.2 %, n = 27 each). Some preexisting diseases (hearing disturbance) increased the probability of postoperative delirium, while age was not identified as a risk factor. General psychopathological and depressive disturbances increased the likelihood of postoperative delirium. Patients who had a severe intraoperative course developed postoperative delirium more frequently. This was not seen in the absolute time of surgery or anesthesia nor in the intraoperative development of blood pressure or intraarterial gases, which did not differ between patients with and without postoperative delirium. More reliable parameters were an increased intraoperative need for crystalloid volume, intra – or postoperatively decreased hemoglobin values (Hb Conclusions: Postoperative delirium after vascular surgery is frequent. Patients undergoing aortic surgery, with specific concomittant medical disease, psychopathological disturbances and a severe intraoperative course, are at risk of developing postoperative delirium.
    Der Chirurg 01/2000; 71(2):215-221. · 0.52 Impact Factor
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    ABSTRACT: Schizophrenic patients with positive and negative symptoms, as well as non-patient control subjects, were asked to recognize emotional stimuli of happy, sad, and neutral facial expressions. Dependent measures were the percentage of correct responses, and the incorrect use of an emotion category owing to false recognition. Schizophrenic patients with negative symptoms exhibited a generalized emotion-recognition deficit, and their use of emotion categories during false recognition was random. Schizophrenic patients with positive symptoms showed a deficit in their recognition of 'sad' emotion and were 'positively biased' to the category 'happy' as reflected by its most frequent usage during false recognition.
    Psychiatry Research 08/1999; 87(1):39-46. · 2.46 Impact Factor
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    ABSTRACT: Emotional processing abilities are difficult to measure psychometrically. Ultimately their quantification has to rely on 'subjective' judgment thereby leaving open the problem of response biases. Assessments of autonomic arousal similarly provide a mere unspecified measurement of a specific emotion. A standardized mood induction procedure capable of obtaining reliable happy and sad mood changes in healthy subjects was used to demonstrate the effectiveness of this procedure. We performed a two-part experiment using a rater-based analysis of facial expressions. This entailed analyzing the emotion portrayed in the faces. The faces of 24 healthy subjects were videotaped during the mood induction procedure of happiness and sadness, respectively. A group of 20 raters naive to the experimental task and conditions rated the facial expressions on six basic emotions. Results showed that ratings corresponded with the facial expressions, which were reflecting the mood of the task condition. Subjects' facial expressions together with self-ratings demonstrate the successful applicability of this standardized mood induction procedure for eliciting happy and sad mood.
    Psychiatry Research 06/1999; 86(2):175-84. · 2.46 Impact Factor
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    ABSTRACT: Conditioning processes have been proposed to play a role in the development of anxiety disorders. As yet, the neurobiologic correlates of emotional learning have not been fully understood in these patients. Accordingly, brain activity was studied in subcortical and cortical regions involved in the processing of negative affect during differential aversive classical conditioning. Twelve patients with social phobia and 12 healthy control subjects were presented with paired conditioned (CS; neutral facial expressions) and unconditioned stimuli (US; negative odor vs unmanipulated air). Functional magnetic resonance imaging (fMRI) was utilized to examine regional cerebral activity during habituation, acquisition,a nd extinction trials. Activity was measured with echo-planar-imaging (EPI), and signal intensity in individually defined anatomic regions were analyzed. Subjective ratings of emotional valence to the CS indicated that behavioral conditioning occurred in both groups. The presentation of CS associated with negative odor led to signal decreases in the amygdala and hippocampus of normal subjects, whereas an opposite increased activation in both regions was observed in patients. Regional differences were not found during habituation and extinction. Results suggest that conditioned aversive stimuli are processed in subcortical regions, with phobic patients differing from control subjects.
    Biological Psychiatry 05/1999; 45(7):863-71. · 9.25 Impact Factor
  • Biological Psychiatry 01/1999; 45(7). · 9.25 Impact Factor
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    ABSTRACT: Several studies have reported impaired emotion processing in schizophrenic patients. However, the corresponding functional cerebral correlates of such impairment have not been fully understood, leaving the neurobiological basis of their affective symptoms unknown. Functional magnetic resonance imaging (fMRI) was utilized to examine brain activity in subcortical and cortical regions of 13 medicated male schizophrenic patients and 13 matched healthy controls during happy and sad mood induction. Results show brain activity in the amygdala of normal controls during negative affect, which is in line with previous neuroimaging findings. Unlike controls, schizophrenic patients have not demonstrated amygdala activation during sadness despite matched ratings to normal controls indicating a similar negative affect. Recognizing that structural abnormalities exist in the amygdala of schizophrenic patients, our results provide new evidence of functional abnormalities in the limbic system.
    Schizophrenia Research 12/1998; 34(3):133-42. · 4.59 Impact Factor
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    ABSTRACT: Functional magnetic resonance imaging was used to determine the activation of the amygdala while seven social phobics and five healthy controls were exposed to slides of neutral faces as well as aversive odor stimuli. The amygdala was selectively activated in the social phobics during presentation of the face stimuli. The data show for the first time that the amygdala is active in human phobics when they are exposed to potentially fear-relevant stimuli. Further research is needed to determine the extent to which overactivation of the amygdala precedes or is a consequence of phobia.
    Neuroreport 05/1998; 9(6):1223-6. · 1.40 Impact Factor
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    ABSTRACT: The potential of functional magnetic resonance imaging (fMRI) for experimental studies of the brain and behavior is considerable given its superior time and spatial resolution, but few studies have attempted to validate them against established methods for measuring cerebral activation. In a previous study absolute regional cerebral blood flow was measured in 16 healthy individuals using quantitative H215O-PET during standardized happy and sad mood induction and during two non-emotional control conditions. During sad mood, blood flow increased in the left amygdala and these changes correlated with shifts towards a negative affect. In the present study blood oxygenation level dependent (BOLD) changes were measured with fMRI during the same experimentally controlled mood states and control tasks. Twelve right-handed normal subjects were examined with a T2*-weighted FLASH sequence. A significant increase in signal intensity was found during sad as well as happy mood induction in the left amygdala. This converging evidence supports the potential of fMRI for advancing the understanding of neural substrates for emotional experience in humans.
    Psychiatry Research 12/1997; · 2.46 Impact Factor
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    ABSTRACT: Nineteen chronic low back pain patients (aged 19-63) and 17 controls (aged 20-41) received electrical pain stimuli during manipulation of their carotid baroreceptors. The non-invasive mechanical manipulation of baroreceptors, using the PRES technique (Phase Related External Suction), simulates the end-effects of phasic blood pressure changes. This technique was developed to assess pain responses induced by changes in blood pressure without the typical shortcomings of pharmacological manipulation or lack of a control condition. During maximum baroreceptor activity, there was an unexpected increase in the amplitude of the somatosensory evoked potentials (SEPs) elicited by the electrical pain stimuli condition (N150-P260 peak-to-peak). In most other studies the opposite effect was found, with decreased pain responses during maximum baroreceptor activity. The chronic pain group reported greater pain during highest baroreceptor activation than did the controls. In addition, the chronic pain group showed lower diastolic blood pressure. To determine whether pain and baroreceptor responses observed in the chronic pain group depended on lower blood pressure levels, a second experiment with a non-clinical sample was performed. Results showed that lower tonic blood pressures are associated with greater baroreceptor activity amplifying pain, while higher blood pressure is associated with pain dampening during high baroreceptor activity. Data suggested that the differences in pain responses found in low back pain patients were associated with their lower tonic blood pressure levels. It is proposed that in general, lower blood pressures may be associated with greater pain during baroreceptor activation.
    International Journal of Psychophysiology 05/1997; 25(3):201-10. · 2.04 Impact Factor
  • F. Schneider, U. Weiss

Publication Stats

740 Citations
38.27 Total Impact Points

Institutions

  • 1997–2012
    • Heinrich-Heine-Universität Düsseldorf
      • Klinik und Poliklinik für Psychiatrie und Psychotherapie der HHU, Rheinische Kliniken Düsseldorf
      Düsseldorf, North Rhine-Westphalia, Germany