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Biomedical subjects

G Krüskemper

Publications and source records attributed to G Krüskemper.

At least 19 recordsLinked to original sources

[On quality of life after surgical therapy of oral cancer - a retrospective multi-center study: the connection between dedentition, denture, quality of life, and dysphagia, and the resulting rehabilitation schemes].

PURPOSE: The surgical treatment of oral cancer results in functional and aesthetical impairments. Patients' quality of life is considerably impaired by oral symptoms resulting from therapy of oral cancer. In many cases the inevitable resection of the tumor, as well as the adjuvant radiochemotherapy will cause the destruction of physiologically and anatomically important structures. One focus of research was the specific rehabilitation of dental loss by functional dentures. Another was the course of 19 impairments (comprehension of speech for unknown others, comprehension of speech for familiar others, eating/swallowing, mobility of the tongue, opening range of the mouth, mobility of lower jaw, mobility of neck, mobility of arms and shoulders, sense of taste, sense of smell, appearance, strength, appetite, respiration, pain, swelling, xerostomia, halitosis). METHODS: Commissioned by the German, Austrian and Swiss cooperative group on tumors of the maxillofacial region (DOSAK), data were collected in 3.894 questionnaires at 43 hospitals in Germany, Austria and Switzerland. The catalogue comprised 147 items in 9 chapters. At the end of the enquiry, 1.761 anonymous questionnaires were returned by 38 hospitals. 1.652 of these could be evaluated regarding the question. RESULTS: The sum score of the 19 impairments was highly increased immediately after the operation and recovered over the next 6 months, without, however, reaching the pre-surgery level. Of 1.652 patients, only 35% did not lose any teeth during therapy. 23% lost up to 5, 17% up to 10 teeth. A quarter of the patients lost more than 10 teeth. The more teeth were lost, the greater the decline of quality of life (p < or = 0.001), although this could be allayed by the functionality of the dentures (p < or = 0.001). There is a reciprocal dependence between the functionality of dental prosthetics and impairment by eating/swallowing (p < or = 0.001). CONCLUSIONS: Patients' quality of life after radical surgery of a carcinoma of the oral cavity depends not only on the functionality of dentures and the specificity of rehabilitation, but also from the initial findings, the extent and location of the resection, the chosen therapy, the general circumstances of the patient's life as well as their strategies of coping. These factors, however, unlike those of functionality of dental prosthesis and rehabilitation, are not modifiable.

Austria↗

Assessment of satisfaction with the communication process during consultation of cancer patients with potentially curable disease, cancer patients on palliative care, and HIV-positive patients.

The aim of this study was to evaluate the attitudes of cancer patients towards the medical interview and to determine their psychosocial satisfaction subsequent to the dialogue. The answers given by patients with curable cancer were compared to those given by cancer patients whose treatment intent was palliative and to the replies of patients infected with the human immunodeficiency virus (HIV), a nonmalignant but also incurable state. The subject population comprised a total of 139 patients. Patients had to complete a questionnaire with a total of 34 items. The answers to the questions were rated on a 5-point scale with response options ranging from 1 to 5 or consisting of true-false statements. Cancer patients, palliative and curative, and HIV-positive patients considered their physicians to be honest (x = 4.34, x = 4.58, and x = 4.30, respectively; p = 0.104), and they emphasized that he/she took enough time answering their questions (x = 4.00, x = 4.30 and x = 4391, respectively; p = 0.12). Cancer patients treated with potentially curable disease were more frequently afraid of being informed about additional diagnostic examinations and about the disclosure of results as compared to cancer patients on palliative care (p < 0.05 for both questions). Patients with HIV-infection considered themselves less informed about the treatment they received as compared to curative cancer patients (x = 3.73 and x = 4.28, respectively; p < 0.046). Only 8.0% of the tumor patients on palliative care, but 63.6% of the HIV-positive patients realized that their medication was given with the objective to relieve symptoms (p < 0.001). When asked about additional goals of treatment, 48% of the palliative cancer patients and 15.1% of the HIV-positive patients checked "cure" (p < 0.002). In conclusion, particularly patients with curable cancer were afraid of information they might receive during the medical interview. Cancer patients considered themselves better informed compared to patients with HIV-infection. This is in significant contrast with the actual, measurable knowledge about their disease in the latter group. It is indeed surprising that only a small minority of incurable cancer patients realized that the goal of the medical care they received was relief of symptoms, the principle objective of palliation.

Adult↗

[Instead of vacation at shoal resort, a stay in the hospital--aspects of illness during vacation].

Every summer, the number of hospitalizations for acute deterioration of a chronic disease increases in the Southern Northsea holiday region. These patients usually are holiday-makers coming to the region for recreation. This study analyzes the relationships among acute illness, reason for going on holiday, existing chronic disease, mode of transport/arrival, and consultation of general practitioner beforehand. A total of 62 holiday-makers from the region who had been hospitalized for internal illness were included in the study. 80.6% of them knew to be suffering from a chronic disease. In 41 patients, acute deterioration of their chronic condition within a few days after their arrival had resulted in admission to the hospital. Usually, their doctor had not advised against the intended holiday trip. The study findings indicate that chronically ill patients need individualized counselling about potential medical hazards associated with their chronic condition especially in light of the physical and emotional strains involved in an intended holiday. Also, mention should be made of the possibilities for participating in an organized health-resort programme.

Adolescent↗

[Psychosocial aspects of fecal incontinence].

Although fecal incontinence is one of the more frequent clinical symptoms of the gastrointestinal tract, its assessment is often neglected in clinical practice. The psychosocial aspects of the symptoms are also often overlooked: The number of undetected cases in comparison to those registered illustrates that not only patients but also physicians avoid this topic during clinical routine. Consequences of fecal incontinence for the quality of life of patients have rarely been investigated, but we could show that there are specific impacts of incontinence on family life, specifically with respect to sexuality, and on the job situation of those affected. Finally, it has been shown that in most cases continence can be achieved by management strategies deriving from psychological learning theory such as biofeedback training.

Adaptation, Psychological↗

[Effects on platelet functions].

Platelet adhesiveness was measured in a total of 589 healthy volunteers and patients. Patients suffered from heart failure, diabetes mellitus, myocardial infarction and deep vein thrombosis have a significant higher platelet adhesiveness as healthy volunteers. The effect of the socalled stressors on platelet adhesiveness was shown in vivo; the same values of platelet adhesiveness were seen as in patients. Therefore it can be concluded that stressors constitute a risk factor in patients with altered vessel walls.

Arterial Occlusive Diseases↗

[Psychological tests of patients with chronic rheumatoid arthritis(author's transl)].

27 women with rheumatoid arthritis had elevated depression and social introversion scores in the Minnesota multiple phasic personality inventory (MMPI) tests, whereas their somatic activity appeared reduced. Age of the patient at time of investigation apparently had no influence on the degree of psychological changes, but was reflected in an increased social introversion. Most important for the degree of psychological impairment was the height of the ARA index, which correlated positively with the neurotic triad as well as the psychasthenia scale in the MMPI. An elevation of the neurotic triad is common in many somatic disease. Patients with rheumatoid arthritis had an additional, introversion and depression, and decreased somatic activity.

Adjustment Disorders↗