German Medical Association

About: German Medical Association is a other organization based out in Berlin, Germany. It is known for research contribution in the topics: Population & Poison control. The organization has 54 authors who have published 83 publications receiving 2271 citations.

Overweight and obesity are associated with improved survival, functional outcome, and stroke recurrence after acute stroke or transient ischaemic attack: observations from the TEMPiS trial

Abstract: Aims The aim of the study was to evaluate the association of the body mass index (BMI) with mortality and with non-fatal functional outcome in patients with acute stroke or transient ischaemic attack (TIA). Obesity is an established risk factors in primary cardiovascular disease prevention including stroke. The impact of overweight in patients with stroke or TIA on secondary fatal and non-fatal functional outcomes is less well established. Methods and results Data from 4428 patients with acute stroke or transient ischaemic attack (TIA) from the Telemedical Project for Integrative Stroke Care (TEMPiS) were studied in this post hoc analysis. The body mass index was available in 1521 patients. Patients were categorized as underweight (BMI 3). Mortality risk was lower in overweight patients [hazard ratio (HR): 0.69, 95% confidence interval (CI): 0.56–0.86) and lowest in obese (HR: 0.50, 95% CI: 0.35–0.71) and very obese patients (HR: 0.36, 95% CI: 0.20–0.66] compared with normal BMI. Functional, non-fatal outcomes, and recurrent stroke followed the same inverse pattern: underweight patients had the worst outcomes but obese patients had better outcomes than patients with normal BMI (all P 30 kg/m2) than patients with normal weight (HR: 0.70; 95% CI: 0.50–0.98). Underweight patients had consistently the highest risks for all endpoints. Conclusion Overweight and obese patients with stroke or TIA have better survival and better combined outcomes of survival and non-fatal functional status than patients with the BMI <25 kg/m2.

Time experience and time judgment in major depression, mania and healthy subjects. A controlled study of 93 subjects

Abstract: Objective: Studies on the time sense of depressed patients have revealed inconsistent results. Manic patients have been almost neglected. Method: Patients with a major depressive episode (n = 32), or a manic episode (n = 30) (both Diagnostic and Statistical Manual of Mental Disorders-IV, Mini-International Neuropsychiatric Interview-confirmed), and 31 healthy controls were included. The subjective time experience was assessed by a visual analog scale (VAS), the objectively measurable time judgment abilities by the Chronotest, a computer program developed for this study, consisting of time estimation and time production tasks. Results: Controls reported a balanced, manic patients an enhanced, and depressive patients a slowed experience of time flow in the VAS (P < 0.001). In the time judgment tasks, however, both depressed and manic patients showed time overestimation for the longer time spans (P < 0.008). Conclusion: This largest study on time sense in manic patients confirmed results of a divergent alteration of time experience in depressive and in manic patients but revealed an uniform time overestimation by both patient groups in time judgment tasks.

The suicide prevention effect of lithium: more than 20 years of evidence—a narrative review

Abstract: The management and treatment of patients with suicidal behavior is one of the most challenging tasks for health-care professionals. Patients with affective disorders are at high risk for suicidal behavior, therefore, should be a target for prevention. Numerous international studies of lithium use have documented anti-suicidal effects since the 1970s. Despite the unambiguous evidence of lithium’s anti-suicidal effects and recommendations in national and international guidelines for its use in acute and maintenance therapy of affective disorders, the use of lithium is still underrepresented. The following article provides a comprehensive review of studies investigating the anti-suicidal effect of lithium in patients with affective disorders.

Heavy metals and trace elements in hair and urine of a sample of arab children with autistic spectrum disorder.

Abstract: General information: Autism is a severe developmental disorder which involves social withdrawal, communication deficits, and stereotypic/repetitive behavior. The pathophysiological etiologies which precipitate autism symptoms remain elusive and controversial in many cases, but both genetic and environmental factors (and their interactions) have been implicated. While autism is considered multicausal, environmental factors have received significant attention. International discussion has focused on neurotoxins such as mercury and lead, suggesting that these and other toxic metals contribute to the development of the disorder. An epidemiological study released in 2006 (Palmer et al.) linking Toxic Release Inventory (TRI) data on mercury to special education data in Texas reported a 61% increase in autism prevalence rates (or 17% adjusted) per 1000 pounds of mercury released into the environment (1). We attempted to further evaluate whether exposure to variable environmental contributes to the genesis of autistic spectrum disorder, and thus is a factor increasing the risk for developing autism symptoms in utero or in early childhood. Purpose: The purpose of this study is to examine possible environmental risk factors and sources of exposure to mercury and other heavy metals in children with autism spectrum disorder versus controls. Through laboratory diagnostics we are able to distinguish between present and past exposure (i.e. hair analysis measurements reflect past exposure), urinary excretion levels of unprovoked urine represent immediate exposure. By assessing a spectrum of trace elements and heavy metals in hair and urine of both autistic and control groups, we focused on the participants’ past and present exposure. Methodology: The participants were 25 Autistic Spectrum Disorder (ASD) children (22 boys and 3 girls) between the age of 3 and 9 years. They were either diagnosed previously by other psychiatrist, psychologist, and developmental pediatrician or suspected by their parents as being autistic. All children were attendants to the Child Psychiatric Clinic in Erfan Psychiatric Hospital in Jeddah, KSA. Samples were collected during the period of June 2006 to March 2008. A control group of 25 children without any psychiatric or medical disorders was age-matched and sex-matched. All parents signed informed consent forms. All autistic children were subjected to a full clinical child psychiatric sheet for the diagnosis of autism spectrum disorder and exclusion of other psychiatric disorders according to the Diagnostic and

The Revised Declaration of Geneva: A Modern-Day Physician's Pledge

Abstract: As the contemporary successor to the 2500-year-old Hippocratic Oath, the Declaration of Geneva, which was adopted by the World Medical Association (WMA) at its second General Assembly in 1948,1 outlines in concise terms the professional duties of physicians and affirms the ethical principles of the global medical profession. The current version of the Declaration, which had to this point been amended only minimally in the nearly 70 years since its adoption, addresses a number of key ethical parameters relating to the patientphysician relationship, medical confidentiality, respect for teachers and colleagues, and other issues. A newly revised version adopted by the WMA General Assembly on October 14, 2017, includes several important changes and additions (Supplement). It is standard practice for the WMA to circulate its policy papers for review every 10 years to reevaluate the accuracy, essentiality, and relevance of the documents. The Declaration of Geneva is no exception. In 2016 (10 years following the most recent editorial revision of the Declaration), the WMA established an international workgroup to assess the Declaration of Geneva’s content, structure, audience, and implementation and to determine whether any amendments were necessary. Given the crucial nature of this document, the assigned workgroup charted a generous timeline of nearly 2 years to allow ample opportunity to gather feedback and suggestions not only from member national medical associations, but also from external experts. The goal in doing so was to ensure that the revision was as transparent and collaborative an effort as possible. Chaired by the German Medical Association and composed of workgroup members of different cultural, religious, and racial backgrounds, the workgroup tasked with determining the need for a revision carefully considered the Declaration in light of modern developments in medicine and medical ethics, as well as in the context of other important WMA policies and respected international literature. The workgroup also based its recommendations on comments solicited from WMA members on several occasions (most recently in July and August 2017), as well as a 3-week public consultation carried out in May and June 2017, during which the draft version of the revised Declaration was published on the WMA website and distributed to an international network of experts and stakeholders for comment. Each comment received over the course of the revision process was carefully reviewed VIEWPOINT