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A comparative study of diabetics with autonomic neuropathy (N = 13) as against nonneuropathic diabetics (N = 16) and healthy control persons (N = 20) was carried out with respect 10 heart rate both at rest and under stress, frequency of cardiac arrhythmias in a 24-h ECG and accuracy of heartbeat and arrhythmia perception. In the subjects with diabetic autonomic neuropathy, the spontaneaus variability and stress-induced reactivity of the heart rate as weil as the number of tachycardic episodes were reduced, whereas the frequency of ventricular extrasystoles was somewhat increased. Impaired heartbeat perception and a complete Ioss of perception of arrhythmias as a consequence of neuropathic deafferentation could be demonstrated. Cardiac perception disordersalso playavital roJe in other clinical problems, e.g. silent myocardial infarction and Iack of awareness of hypoglycaemia in diabetes mellitus.
In panic disorder bodily sensations appear to play an important role as a trigger for anxiety. In our psychophysiological model of panic attacks we postulate the following vicious circle: individuals with panic attacks perceive even quite small increases in heart rate and interpret these changes as being catastrophic. This elicits anxiety and a further increase in heart rate. To evaluate this model we conducted a field study of 28 subjects with panic attacks and 20 healthy controls. A 24 hr ambulatory ECG was recorded and the subjects were instructed to report any cardiac perceptions during this period and to rate the anxiety elicited by these perceptions. The incidence of cardiac perceptions was about the same in both groups, but only subjects with panic attacks reported anxiety associated with such perceptions. Analysis of the ECGs revealed that in both groups heart rate accelerations preceded cardiac perceptions. Following cardiac perceptions, the healthy controls showed a heart rate deceleration, whereas the subjects with panic attacks had a further acceleration. This heart rate increase after cardiac perceptions was positively related to the level of anxiety elicited by the perceptions. These results provide clear evidence in support of the vicious circle model of panic attacks.
In Hessen wurde 1989 ein Modellversuch zum Einsatz neuer Technologien in der Berufsausbildung lernbehinderter Jugendlicher gestartet. Die Chancen Lernbehinderter für qualifizierte Arbeitsplätze im Bereich Metall der Fachrichtungen Drehen, Fräsen und Produktionstechnik sollen dadurch verbessert werden.
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The effects of 19 meals of different caloric content on slides on palatability and hypothetical duration of consumption were investigated in 7 patients with anorexia nervosa, 17 patients with bulimia nervosa at the beginning and after 8 weeks of hospital treatment. Nine healthy females served as controls. At the beginning of treatment, palatability of low caloric food was significantly higher and hypothetical duration of consumption of high caloric food was significantly longer in patients when compared to controls. After 8 weeks, in the patients palatability of low caloric food had decreased. Dislike for high caloric food remained stable in anorexics.
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