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F Stiefel

Publications and source records attributed to F Stiefel.

69 records · Page 4Linked to original sources
PubMed1993

Preliminary results of a study assessing asthenia and related psychological and biological phenomena in patients with advanced cancer.

Asthenia is a very common symptom of patients with advanced cancer, but its investigation is hindered by a lack of suitable validated measuring instruments. The goal of the present study was to construct and validate a questionnaire for the study of asthenia in cancer patients, as well as to establish correlations with other symptoms and physiological and biochemical parameters. A group of 31 patients with advanced cancer and a control group of 30 healthy volunteers were examined. The proposed questionnaire, based on visual analogue scales, questions with categorical answers and on the hospital anxiety and depression scale was validated by comparing results of the patient and control groups, by the test/retest method and by comparison with the evaluation of an observer. Correlation with various physiological and biochemical parameters was performed. The questionnaire distinguished well among the patients and control groups. VAS of asthenia proved quite stable over a period of 5 days. Correlations of asthenia with lack of appetite, the hospital anxiety and depression scale, weight, heart rate and serum cortisol levels could be established. No significant correlation between asthenia and various serum markers of inflammation and cytokines, including C-reactive protein, tumour necrosis factor, interleukin-1, and interleukin-2 receptors, could be found. The proposed questionnaire for evaluation of asthenia could be validated in a patient sample of limited size and a simplified questionnaire based on visual analogue scales is being developed for further investigations.

Adult↗
PubMed1992

Acute confusional states in patients with advanced cancer.

In 39 of 100 cancer patients admitted to the palliative care unit at Edmonton General Hospital, the presence of delirium during their last week of life required psychotropic drug treatment. In 10 of the 39 delirious patients, symptoms were only controllable by sedation; this was achieved in 9 patients by a continuous subcutaneous infusion of midazolam. Although haloperidol is considered to be the treatment of choice in agitated, delirious cancer patients, our data suggest that palliative care treatment strategies for these patients may be different.

Adult↗
PubMed1991

[Counseling and liaison psychiatry--a concept for smaller general hospitals?].

Motivated by own experiences in consultation- and liaison-psychiatry in the USA and in internal medicine in Switzerland, the author describes history, present state and value of consultation- and liaison-psychiatry for patient care. Obstacles against implementation of consultation- and liaison-psychiatry in Switzerland are discussed.

Consultants↗
PubMed1991

Delirium in cancer patients.

Delirium is the second most common psychiatric diagnosis among hospitalized elderly cancer patients. A variety of factors are known to cause delirium in cancer patients, and the most frequently observed are outlined. History, presence of an altered mental state with identification of the cognitive impairment, and a close watch of mental function will help to differentiate delirium from a normal stress reaction, an adjustment disorder to cancer diagnosis, or early dementia. As in other medically ill patients, antipsychotic drugs are the cornerstone of treatment for delirium not manageable with environmental manipulation or causal therapy. Haloperidol is the most commonly prescribed drug for delirium in the cancer setting because of its low cardiovascular and anticholinergic effects. Cancer patients who are debilitated require a much lower starting dose than do the physically healthy.

Aged↗
PubMed1989

[Pain in tumor patients and indications for psychopharmaceutic agents].

Pain involves both somatic and psychological processes, and often requires in cancer patients a multidisciplinary management approach. Psychotropic medications can be helpful as part of adjuvant pharmacological treatment of pain and can be beneficial especially in cancer patients. Anxiety and depression, which may be associated with cancer, can influence the pain experience and can be managed symptomatically with psychotropic drugs. In addition, some psychotropic drugs have analgetic properties, or may be used to reduce some side effects of narcotics.

Anxiety↗
PubMed1989

[Suicide and cancer].

Epidemiological studies demonstrate that cancer patients are at increased risk of suicide. While affective illness and alcoholism are the most important determinants of suicide in the physically healthy population, vulnerability to suicide in cancer patients is influenced by a number of other factors including psychosocial and psychosomatic effects of advanced illness, pain, organic mental syndromes and preexisting psychopathology. Ways of influencing these risk factors are discussed, together with their use in preventive care and management of suicidal cancer patients.

Humans↗