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Biomedical subjects

E Zillessen

Publications and source records attributed to E Zillessen.

At least 19 recordsLinked to original sources
PubMed2002

[Ambulant rehabilitation of patients with gastrointestinal and metabolic diseases].

For the following reasons it has, despite plausible different opinions, seldom been possible realize ambulant rehabilitation offers:For historical reasons gut rehabilitation centers lie outside of conurbations. A model of gastrointestinal-oncologic rehabilitation supports developing an entirely new concept for ambulant treatments, instead of merely copying the presently in-patient rehabilitation therapy. In the exemplary thoughts of the GRVS, which were already presented five years ago, quantitative factors have not been taken into consideration satisfactorily. Considering this the following three diagnosis groups become relevant - diabetes m. - obesity - gastrointestinal cancer. The needed ambulant rehabilitation concepts are to be connected to the long-term ambulant treatment, available close to the patient's home city.

Ambulatory Care↗
PubMed1999

[Determination of subjective burden from chronic inflammatory bowel disease and its psychosocial consequences. Results from a study of 200 patients].

Somatic symptoms of chronic organic diseases do not sufficiently explain the degree to which the individual's daily life is impaired. Quality of life questionnaires are increasingly used to measure long term effects of therapy and rehabilitation. The present study is concerned with determining factors associated with the quality of life of patients suffering from inflammatory bowel disease (IBS). We investigated 200 consecutive inpatients with IBS (Crohn's disease 119, ulcerative colitis 81; 142 males, females; mean age 36.8 years) of the Niederrhein Clinic, a centre for gastroenterologic diseases and metabolic disorders. We assessed sociodemographic data of the last three years, the results of all recent clinical examinations (pattern and extension of inflammatory lesions) CDAI and CAI to determine the activity of the disease, expert ratings of disease severity as well as impact on family, partnership, social environment and leisure activities, psychometric data concerning anxiety (STAI), depression (Paranoid-Depressivitätsskala), and coping (FKV). The subjective impairment was measured by structured interviews. The inflammatory activity of IBS and the intensity of symptoms correlated only insignificantly with the subjective impairment. Depression (as measured by the Paranoid-Depressivitätsskala) and a depressive style of coping (FKV) revealed to be the best predictors for subjective impairment. For patients with a mild to moderate degree of IBS quality of life does not significantly depend on the degree and severity of disease. A depressive coping style seems to be a crucial target of rehabilitation and psychotherapy in IBS.

Adaptation, Psychological↗
PubMed1996

[Effect of elevated head position in bed in therapy of gastroesophageal reflux].

In a randomized multicentric trial the effect of sleeping with the bed-head raised was studied in inpatients with reflux symptoms. All patients underwent an endoscopic and pH-metric examination. As a result from the diagnostic procedures three groups were formed: group 1 - refluxlike dyspepsia (endoscopic and pH-metric examination normal), group 2 - reflux disease without esophagitis (endoscopy normal, pH-metric examination abnormal), group 3 - refluxesophagitis (endoscopy abnormal). All patients were randomly assigned to either sleeping with horizontal bed-head or having the bed-head raised (15 cm). Furthermore, the patients in group 3 were put on treatment with omeprazole (20 mg twice a day) those in group 2 were treated with a procinetic drug (cisapride 30 mg). The patients in group 1 had no drug therapy. However, antacids were allowed in all patients. For a two-week-period reflux symptoms and use of antacids were registered. No difference was seen in the symptom-score or use of antacids. Also sub-group analysis (sex, age, body-mass-index, severity of esophagitis and nocturnal reflux) did not reveal any impact of sleeping with the bed-head raised on reflux symptoms or use of antacids.

Adult↗
PubMed1996

[Gastroenterologic and hepatologic rehabilitation today--on changes in indications and contents].

The rehabilitation in gastrointestinal diseases has experienced the introduction of new concepts. Regional health resorts (i.e., mineral springs, climate or mud baths) do not play a role anymore. Today, rehabilitation cliniques are teaching and training centers for chronic patients with multiprofessional teams. The need for rehabilitation cannot be derived from the diagnosis alone or the duration of the illness but from the severity of the symptoms and/or additional psychosocial problems. The order of the application of different techniques during medical rehabilitation differs from patient to patient and necessitates a definition of the rehabilitation goal. Chronic inflammatory bowel disease, chronic pancreatitis, and chronic liver diseases are explained as an example. "Rehabilitation of gastrointestinal or metabolic diseases' is often better described with a model of progression than with the traditional model of disablement. Therefore, a network of clinical and ambulant rehabilitation as well as an entanglement of institutions providing hospital care and after-care is required.

Aftercare↗
PubMed1986

[Candidiasis of the esophagus. Prospective study of incidence, type of complaints and predisposing factors].

Clinical findings, symptoms and predisposing factors were studied in 43 patients with oesophageal candidiasis, 40 patients with peptic oesophagitis and 40 normal controls. Oesophageal candidiasis was confirmed cytologically. 2.4% of patients who had undergone gastroscopy had oesophageal candidiasis; only three of them had simultaneous candidiasis of the oral cavity. Cardiac failure, oesophageal varices, hiatus hernia and gastric ulcer were common associated disorders. 42% of patients with candidal oesophagitis were symptom-free. Most common symptoms were vomiting, retrosternal and epigastric pain. Peptic oesophagitis was more frequently associated with symptoms. Predisposing factors were present in 88% of cases of oesophageal candidiasis: alcoholism, hepatic cirrhosis, diabetes mellitus, malignant tumours and other wasting diseases. 18 patients had had treatment with cimetidine; they included all 13 patients whose candidiasis was first detected at check endoscopy.

Candidiasis↗
PubMed1984

[Postoperative cholangiography using the T-drain canal].

Postoperative cholangiography using the T-drain canal (PCST) with flexible fibre endoscopes was done in five patients. Cases were palliative papillary drainage in malignant occlusion, passage of the intact papilla, expulsion of concrement through the cut papilla, bougienage of inflammatory bile duct stenosis with lavage removal of stone, and an endoscopic selective peripheral bile duct drainage. In one female bile duct stone wedging after endoscopic sphincterotomy of the papilla during chemical litholysis had occurred previously. For removal of residual concrements PCST competes with catheter extraction, chemolitholysis, dilatation of the papilla and endoscopic sphincterotomy. Thus far, complications are not serious. In cases of good cooperation between surgeon and endoscopist PCST could develop into a routine method.

Aged↗
PubMed1984

Dissolution of biliary duct stones without papillotomy in a patient with Billroth II resection and Crohn's disease.

A patient with a Billroth II resection and Crohn's disease subsequently developed obstructive jaundice and biliary sepsis. Three hepatic duct stones were demonstrated by ERC. After overcoming the obstruction by means of temporary retrograde internal drainage, perfusion of glyceryl-1-monooctanoate-carnosine and bile-acid-EDTA solution (2) was combined with sucralfate instillation into the blind loop via a duodenal tube. During successful treatment of the cholangiolithiasis, no deterioration of Crohn's disease was seen. Secondary effects such as abdominal pain or diarrhoea, were treated symptomatically.

Aged↗