Title: MD, Dr.med. (Munich), PhD (London)
Present position:
Doctor in training, Department of Neurology at the University of Ulm, Germany (since January 2005)
Institution where degree(s) were taken:
1987-1994
Medical School, Ludwig-Maximilians-University, Munich, Germany
1989-1993
Thesis (MD) in Neurosciences, Institute of Surgical Research, Ludwig-Maximilians-University, Munich, Germany (“summa cum laude”)
1996-2000
PhD in Neurology and Medicine, King's College Hospital, London, UK
Previous research done in Haydom area (Title of thesis):
1. Hospital-based frequency of neurological diseases in a rural African hospital: a prospective study of 800 cases
2. Causes of seizures in patients admitted to a rural African Hospital
3. Hospital-based pattern of epilepsy in a rural African Hospital, including experience of 26 months of patients follow-up in the same context
4. Establishment of a new classification system for epilepsies appropriate for resource poor countries
5. Evaluation of injuries in African patients with epilepsy
6. Socio-cultural attitude towards patients with epilepsy in a rural African area
7. Malaria symptoms with emphasis on neurology in children in a holo-endemic area in Eastern Africa: establishment of a scoring system
Current research or planned research in the Haydom area or related to Haydom:
A. Projects in Northern Tanzania (Haydom, Manyara Region and Loliondo, Maasailand, Arusha Region); the below projects are in the phase of data analysis and writing up
1. Hospital-based frequency of neurological diseases in a rural African hospital: a prospective study of 800 cases (finished)
2. Causes of reduction in consciousness level in patients admitted to a rural African Hospital (ongoing)
3. Causes of acute confusion in patients admitted to a rural African Hospital (ongoing)
4. Causes of seizures in patients admitted to a rural African Hospital (finished)
5. Backache in patients admitted to a rural African Hospital (ongoing)
6. Head trauma in patients admitted to a rural African Hospital (ongoing)
7. Hospital-based pattern of epilepsy in a rural African Hospital, including experience of 26 months of patients follow-up in the same context (finished)
8. Establishment of a new classification system for epilepsies appropriate for resource poor countries (finished)
9. Evaluation of injuries in African patients with epilepsy (finished)
10. Socio-cultural attitude towards patients with epilepsy in a rural African area (finished)
11. Hospital-based pattern of febrile convulsions in a rural African Hospital (finished)
12. Hospital-based pattern of meningitis in a rural African hospital (finished)
13. Autonomic dysfunction in African diabetic patients (finished)
14. Establishment of normal values for autonomic function testing in a rural African setting (finished)
15. Community-based prevalence of epilepsy, febrile convulsions, headache, backache, parkinsonism and restless legs in a rural area in Northern Tanzania (finished)
16. Community-based prevalence of epilepsy and febrile convulsions in Masai people (finished)
17. Malaria symptoms with emphasis on neurology in children in a holo-endemic area in Eastern Africa: establishment of a scoring system (finished)
18. Neurological signs/symptoms in HIV/AIDS in a low endemic area in rural Africa (in preparation)
19. Neurocysticercosis in patients with epilepsy in Northern Tanzania (finished)
20. Evaluation of compliance of people with epilepsy in the Epilepsy Clinic of Haydom Lutheran Hospital (in preparation)
21. Confirmation of clinical diagnosis of people with epilepsy by means of EEG (in preparation)
B. Projects in Southern Tanzania (Mahenge, Morogoro Region) (the below projects will start in February 2005, the preparatory phase has been finished)
1. Epilepsy prevalence in a high endemic area for onchocerciasis in Southern Tanzania (ongoing)
2. Epilepsy syndrome reminiscent of the Nakalanga syndrome in a high endemic area for onchocerciasis in Southern Tanzania: clinical description and potential causes (ongoing)
3. Exploration of a potential causal relationship between epilepsy and onchocerciasis in a high endemic area for onchocerca volvolus in Southern Tanzania (ongoing)
4. The effect of the introduction of Ivermectin with regards to the prevalence of epilepsy (ongoing)
5. The prevalence of febrile seizures in an area where the prevalence of epilepsy is unusually high: comparison with two other regions in Tanzania (ongoing)
Contact information:
e-mail: drawinkler@yahoo.com.au
Postal address: Hormayrstrasse 3
80997 München, Germany
Publications:
A. Research papers (chronologically)
1. Staub F, Winkler A, Peters J, Kempski O, Baethmann A. Swelling, acidosis, and irreversible damage of glial cells from exposure to arachidonic acid in vitro. Journal of Cerebral Blood Flow and Metabolism 1994; 14: 1030-1039.
2. Staub F, Winkler A, Peters J, Kempski O, Baetmann A. Mechanisms of glial swelling by arachidonic acid. Acta Neurochirurgica Suppl 1994; 60: 20-23.
3. Staub F, Winkler A, Peters J, Goerke U, Kempski O, Baethmann A. Clearance and metabolism of arachidonic acid by C6 glioma cells and astrocytes. Neurochemical Research 1995; 20: 1449-1456.
4. Staub F, Winkler A, Haberstock J, Plesnila N, Peters J, Chang RC, Kempski O, Baethmann A. Swelling, intracellular acidosis and damage of glial cells. Acta Neurochirurgica Suppl 1996; 66: 56-62.
5. Weng G, Markus M, Markus A, Winkler A, Borasio GD. P 21 ras supports the survival of chick embryonic motor neurones. NeuroReport 1996, 7: 1077-1081.
6. Markus M, Kahle PJ, Winkler AS, Horstmann S, Anneser JMH, Borasio GD.Survival-promoting activity of inhibitors of cyclin-dependent kinases on primary neurons correlates with inhibition of c-jun kinase-1. Neurobiology of Disease 1997; 4: 122-133.
7. Bereznai B, Winkler A, Borasio GD, Gasser T. A novel SOD1 mutation in an Austrian family with amyotrophic lateral sclerosis. Neuromuscular Disorders 1997; 7:113-116.
8. Winkler AS, Marsden J, Chaudhuri KR, Hambley H, Watkins PJ. Erythropoietin depletion and anaemia in diabetes. Diabetic Medicine 1999; 16: 813-819.
9. Winkler AS, Watkins PJ. Long term treatment of the anaemia in type 1 diabetes mellitus with erythropoietin. Diabetic Medicine 2000; 17: 250-251.
10. Winkler AS, Baethmann A, Peters J, Kempski O, Staub F. Mechanisms of arachidonic acid induced glial swelling. Brain Research 2000; 76: 419-423.
11. Winkler AS, Ejskjaer N, Edmonds M, Watkins PJ. Dissociated sensory loss in diabetic autonomic neuropathy. Diabetic Medicine 2000; 17: 457-462.
12. Winkler AS, Landau S, Chaudhuri KR, Watkins PJ. Erythropoietin treatment of postural hypotension in anaemic type 1 diabetic patients with autonomic neuropathy: a case study of four patients. Diabetes Care 2001; 24: 1121-1123.
13. Bosman DR, Winkler AS, Marsden JT, Macdougalll IC, Watkins PJ. Anemia with erythropoietin deficiency occurs early in diabetic nephropathy. Diabetes Care 2001; 24: 495-499.
14. Winkler AS, Marsden J, Parton M, Watkins PJ, Chaudhuri KR. Erythropoietin deficiency and anaemia in multiple system atrophy: Movement Disorders 2001; 16: 233-239.
15. Winkler AS, Landau S, Chaudhuri KR. Serum prolactin levels in Parkinson's disease and multiple system atrophy. Clinical AutonomicResearch 2002: 12; 399-403.
16. Winkler AS, Hu M, Dean A, Gregson N, Chaudhuri KR. Phenotypic and neuropathological heterogeneity of anti-Hu antibody related paraneoplastic syndrome presenting with progressive dysautonomia: Report of two cases Clinical Autonomic Research 2002; 11:115-118.
17. Winkler AS, Marsden J, Deacon A, Wilson S, Chandler G, Macdougall IC, Peters TJ. Serum erythropoietin levels are inappropriately low in the acute neuropsychiatric porphyrias. Clinica Chimica Acta 2002: 317; 97-100.
18. Winkler AS, Reuter I, Harwood G, Chaudhuri KR. The frequency and significance of “striatal toe” in parkinsonism. Parkinsonism and Related Disorders 2002: 9; 97-101.
19. Winkler AS, Landau S, Watkins PJ, Chaudhuri KR. Observations on haematological and cardiovascular effects of erythropoietin treatment in multiple system atrophy with sympathetic failure: a case report. Clinical Autonomic Research 2002: 12; 203-206.
20. Winkler AS, Macdougall IC, Peters TJ. Erythropoietin treatment in the neuropsychiatric porphyrias. Clinica Chimica Acta 2003; 338:61-66.
21. Winkler AS, Marsden J, Cleare T, Peters T, Wessely S. Autonomic function and serum erythropoietin levels in chronic fatigue syndrome. Journal of Psychosomatic Research 2004; 56: 179-183.
22. Winkler AS, Peters TJ, Elwes RDC. Refractory seizures in patients with neuropsychiatric porphyrias: report of three cases. Journal of Neurology Neurosurgery and Psychiatry 2005;76:380-383.
23. Mosser P, Schmutzhard E, Winkler AS. The pattern of seizures in rural Tanzania. Journal of the Neurological Sciences (in print).
24. Winkler AS, Schaffert M, Schmutzhard E. Epilepsy in resource poor countries – suggestion of an adjusted classification. Epilepsia (in print)
B. Bookchapters
1. Winkler A, Staub F, Kempski O, Baethmann A. Glial swelling and glial acidosis induced by arachidonic acid. In: Grote J, Witzleb, eds. Funktions-analyse biologischer Systeme 21. Stuttgart: Fischer Verlag 1993.
2. F. Staub, A. Winkler, J. Peters, O. Kempski, A. Baethmann. Swelling and damage of glial cells by arachidonic acid. In: Tomita M et al., eds. Microcirculatory Stasis in the Brain. Amsterdam: Elsevier 1993; pp 311-318.
3. F. Staub, A. Winkler, J. Peters, O. Kempski, A. Baethmann. Mechanisms of glial swelling by arachidonic acid. In: Ito U et al., eds. Acta Neurochirurgica. Brain Edema IX. Wien: Springer 1994; pp 20-23.
4. F. Staub, A. Winkler, J. Peters, O. Kempski, A. Baethmann. Cytotoxic glial swelling by arachidonic acid. In: Bauer BL and Klinger M, eds. Advances in Neurosurgery. Berlin: Springer 1994; pp 165-169.
5. F. Staub, A. Winkler, J. Peters, O. Kempski, A. Baethmann. Glial swelling and damage by arachidonic acid. In: Hartmann A et al., eds. Cerebral Ischemia and Basic Mechanisms. Berlin: Springer 1994; pp 230-234.
6. Winkler AS. Dysphagie. In: Maydell M and Voltz R, eds. Palliativmedizin: Neurologie und Psychiatrie. Deutsche Gesellschaft für Palliativmedizin 1996; pp 66-69.
7. Winkler AS, Chaudhuri KR. Psychiatric aspects of Parkinsonism. In: Vyas JN, Ahuja N, eds. Textbook of Postgraduate Psychiatry. New Delhi: Jaypee Brothers 1998; pp 479-484.
8. Winkler AS, Howlett WP, Borasio GD. Neurological disorders. In: Palliative Care in the Developing World: Principles & Practice 2004
C. Awards and grants
Hoechst Award of the Japanese Society for Microcirculation 1993.
Swelling and damage of glial cells by arachidonic acid. (MD thesis)
Grant from the British Heart Foundation 1996, supporting work related to erythropoietin in autonomic neuropathy (Ph.D thesis).
Grant from the Savoy Epilepsy Foundation Canada 2003, supporting work related to the epilepsy project in Africa.
Grant from the Savoy Epilepsy Foundation Canada 2004, supporting work related to the epilepsy project in Africa.
Planned publications are in relation to the above research projects.
Work dissemination/professional presentations:
- Seminar on epilepsy at Haydom Lutheran Hospital March 2003
- Webpage with regular updates on my work in Haydom Lutheran Hospital as well as the scientific projects www.epilepsie-berlin.de link Tansania (German)
- Article on the epilepsy project at Haydom on the webpage of the Haydom Lutheran Hospital www.haydom.no.
- Invited guest speaker at the first “German Symposium on Neurology of Resource Poor Countries”, Charité, Berlin, Germany, June 2005
- Invited guest speaker at the symposium of the “Austrian Society for Tropical Medicine and Parasitology”, Vienna, Austria November 2005. Invitation, draft abstract, abstract
- Invited guest speaker at the first symposium of the “Internationales Netzwerk zur Entwicklungszusammenarbeit im Bereich psychische Gesundheit”, Munich December 2005. Subject : Epilepsie in Tansania - Erfahrungen während eines dreijährigen Aufenthaltes
- Invited guest speaker at the symposium ”Mental Health in Developing Countries”, Munich, December 2005
Dr.Med.Univ. (MA) Students’ Research Projects Dr. Andrea-Sylvia Winkler
Blocher, Joachim. Neurocysticercosis in the catchment area of Haydom Lutheran Hospital. [Thesis Dr.Med.Univ/MA]. Medical University of Innsbrück, Innsbruck, Austria, 2007.
Haeggblom, Sara Amanda. Autonomic dysfunction in diabetic patients at Haydom Lutheran Hospital. [Thesis Dr.Med.Univ/MA]. Medical University of Innsbrück, Innsbruck, Austria, 2006. (#102 Amanda pdf)
Kerschbaumsteiner, Kerstin. Community-based prevalences of selected neurological diseases in a rural Tanzanian community. Epidemiology and characteristics of epilepsy. [Thesis Dr.Med.Univ/MA]. Medical University of Innsbruck, Innsbruck, Austria; 2005.
Mayer, Michael. Sociocultural attitude towards patients with epilepsy in the catchment area of Haydom Lutheran Hospital. [Thesis Dr.Med.Univ/MA]. University of Innsbrück, Innsbruck, Austria, 2005. (#127 Michael Mayer pdf)
Meindl, Michael. Epidemiology of febrile fits in the catchment area of Haydom Lutheran Hospital. [Thesis Dr.Med.Univ/MA]. University of Innsbrück, Innsbruck, Austria, 2006. (#128 Meindl pdf)
Mosser, Philipp. Hospital-based prevalence of neurological diseases in rural Tanzania. [Thesis Dr.Med.Univ/MA]. Department of Neurology, University of Innsbruck, Innsbruck, Austria; 2004.
Schaffert, Matthias Björn. A clinic for people with epilepsy in rural Tanzania - Patients' characteristics, a classification system, pattern of injuries and a 25 month follow-up. [Thesis Dr.Med.Univ./MA]. Medizinischen Universität Innsbruck, Innsbruck, Austria; 2005.
Stelzhammer, Brigitte. Community-based prevalences of headache and backache in a rural Tanzanian community – epidemiology and characteristics. [Thesis Dr. Med.Univ./MA] Medical University of Innsbruck, Innsbruck, Austria; 2005.