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Biomedical subjects

G S Barolin

Publications and source records attributed to G S Barolin.

At least 19 recordsLinked to original sources
PubMed2001

[Psychotherapy in senile dementia?!].

Psychotherapy for senile demented patients is feasible and should become a routine. However, it must be integrated psychotherapy that is not school-centred but patient-centered. Especially in the work with senile demented patients it must closely cooperate with all health professions that are in the field. These endeavours must be systematically coordinated. Analytic psychotherapy in the classical sense is not feasable. However, in old (and demented) patients sometimes a strong desire persists to tell out of the past. The therapist's task there is mainly listening and not interpreting. Children, animals, plush-animals, music and dance-therapy are not so well-known possibilities to find a psychotherapeutic approach to senile demented persons. The basic psychotherapy should be known to all health professions. Professional psychotherapy should be given more attention as to the psychotherapy of old people.

Aged↗
PubMed2001

[Expanded criteria for assessment of legal competence and testifying capacity in borderline cases of organic brain syndromes--an important field for cooperation between medicine and law].

The three well-known criteria for legal competence and testamentary capacity, that is: consideration, awareness and the ability to express oneself in writing and speaking, ought to be extended by three further dimensions, namely: motivation, long-term intentions, gestures. This demands increased specialised competence and increased time, but seems indispensable in order to meet the postulate of human ethics: to give the patient the optimum support for a sensible realisation of will. This equally applies to medical experts and jurists (especially notaries and lawyers). The related demand to give increased time and attention to a patient, often in the form of repeated observation over several days, with detailed written documentation, shows that it is not at all a weakening, which is supported, but rather a more precise formation of concept. In this sense, we expect to meet better the demand of the best possible "objectivity" in evaluation, rather than within a merely schematic, single, short-time assessment. We substantiate this with several examples, taken from various areas, namely: in isolated aphasic/agraphic disorders, testamentary capacity and even legal competence can be retained according to the above criteria (despite the inability to write and speak). In analogy, also "last minute" decisions of the incurably sick person must be taken into account. We also show, however, that an assertion of legal competence (unrestricted ability to reach a decision) based on merely formalistic guide-lines, without taking into account long-term intentions and motivation, might seriously harm a patient. There is the case of a post-apoplexy patient who demanded immediate discharge to return home. This patient proved fully aware in classical questions of reference, but, due to homesickness, post-apoplectic syndrome and senile stubbornness, failed to take into account her inability to walk and incontinence. A consolidated discharge, however, was very well possible several weeks later. At an earlier stage this would have led to disaster. There will always remain a zone in which it is not possible to reach clear expert decisions either pro or contra but by incorporating the criteria above quoted, it will be possible to considerably narrow this zone. This corresponds to an evaluation process, which cultivates both optimum objectivity and optimum fairness.

Adult↗
PubMed2000

[Treatment of the incurably ill].

Modern medicine has a) drastically prolonged the average lifetime, and b) dying from a relatively brief transition phase, has in many cases become a long-lasting process. This demands an increased orientation of medicine, away from the pure goal of "healing" to the task of a long-lasting accompaniment. This means geriatric rehabilitation and ultimately accompaniment for the dying. New ethical and juridical problems arise thereof for the doctor which will be discussed here. However, also society is challenged. We need systematic installment of rehabilitation activities into nursing homes, and a rehabilitation insurance.

Aged↗
PubMed1999

[What is the attitude of Mrs. and Mr. Austria regarding their health system?].

1451 questionnaires were used in a survey. With 87% the population showed great interest for health questions. 2 thirds satisfaction with the present health system combined with 1 third of pessimism, concerning the opinion that the health system in the present form cannot persist because of financial difficulties. Higher educational levels showed more critisism. 800 verbal statements demanded more time for medical conversation; more esthetics in hospitals; inclusion of dental and spectacle-supplies into the health system; more alternative medicine (with very different opinions what should be ment by it). Selection of special risk group, like smoking, adipositas and extreme-sports. Cures were charged very differently, from "regular cheating" to an importance of getting allocation for the cure more easily. In 3 panel discussions confirmation of the above-mentioned items and some additional new points could be obtained including the importance of rehabilitation in old age.

Adult↗
PubMed1999

Rehabilitation needs psychotherapy.

The rehabilitation patient by his permanent disablement comes into an important crisis which makes psychotherapy as reasonable and necessary as other human crisis situations do. Especially the more senior patient must be regarded within this rank. There is a broad rank of known psychotherapeutic methods which however we propose to classify in six groups with the following main factors: Verbal communication Sociodynamics Representational means The hypnoid Behaviouristic means Physical means as entrance to psychotherapy We recommend 'renaissance of conversation culture' and give further hints on conversion therapy. The hypnoid can by no means only act in functional disturbances, however, its action is directly somatotropic. We could show this in paralysed patients. Conversation with the uncurably ill needs special emphasis schooling, and mainly taking the caregivers into the conversation (systemic approach). We have with good success used a combination model, combining autogenic training with analytically orientated group psychotherapy.

Persons with Disabilities↗
PubMed1998

[Organ transplantation: humanitarian--legal--ethical].

Thorough examinations and discussions made clear: brain-death must be identical with the total death of the individual person. This must be the basis for legal organ transplantation. However--as men always tend to make bad things out of good--there exists criminal organ trade, including murder on order. Serious medicine as well as the serious patient must keep complete distance to these malpractices, even regarding that there are scarcity of organs for transplantation and long waiting lists. Different countries have different legistic regulations. Austria is envied by many others for its legal regulations.

Altruism↗
PubMed1998

[Neurorehabilitation: what it used to be, what it is, how will it be?].

Although neuro-rehabilitation has found its identity, it needs close relationship to general rehabilitation and the other disciplines. In particular, however, there is a close relationship to geriatric rehabilitation. Within the framework of a continuous, non-interrupted rehabilitation chain many goals have already been attained and some have been pinpointed as important future aims. My own contribution to this has been the follow-up rehabilitation service which should also be adopted in nursing homes for the elderly or the incapacitated. What is essential is the phase-specific utilisation of all measures, including integrated psychotherapy. Translation into organisational measures requires activities on many levels, including also the political level. This, however, involves the use of assessment instruments which are at present being introduced on the market with newly developed graduations. Medication and electronics have enabled us to achieve a few aims, and we expect that even more may be realised in the future.

Adult↗
PubMed1998

[Use of cerebrolysin in the treatment of ischemic stroke].

Comparative analysis was performed of results of the treatment of patients with ischemic stroke, including 140 ones treated by means of hemodilution method (control group) and 40 patients treated with cerebrolysin (test group). Barolin's scale of the neurorehabilitation was used for the analysis of the results. Statistically significant results of rehabilitation were better in the test group. Improvement of the parameters characterizing social contacts, working activity and behaviour was more pronounced than an improvement of motor functions. Cerebrolysin had accelerating effect on restoration of damaged functions, by creating more stable basis for rehabilitation.

Amino Acids↗
PubMed1998

["Integrated psychotherapy": a new clinical challenge].

Integrated psychotherapy according to Barolin wants to be embedded in the general health system and regards the whole "bio-psychosocial entity of man" using psychical means, which can take psychotropic as well as somatotropic effect. It should come out of an isolated ivory tower and seek coordination with each and everyone dealing with the "human entity": medical (like medication, physiotherapy, etc.), nursing, social work, administration, etc. Psychotherapeutic "schools" should serve as a solid base of learning. Practical use however should go beyond schools: patient-centered instead of school-centered. Integrated psychotherapy should reach all persons who need it, within their somatogenic and psychogenic problems, especially the physical ill, up to accompaniment of the dying, especially in rehabilitation, including social environment, old-age groups. For this it needs social integration accepting economic responsibility (in the sense of "social ethics") plus evaluation. Hence, theory and practice of integrated psychotherapy find themselves linked to a higher human-ethical postulate, with a marked communicative component.

Austria↗
PubMed1997

[Headache and psyche].

There exists no 'typical' psychogenic headache. But there is no headache without psychogenic component. Preponderance of psychogenesis is given as follows: We find it more in permanent undulating headache than in migraine. There are psychosomatic bridges via vasomotor functions and cervical spine. In the field of triggers, personal biographic psychodynamics, together with the actual situation, play a roll. There is a field of modifiers containing depressivity, expertise-situation and drug abuse. Such psychogenic action on different levels can best be perceived via a multifactorial headache concept. This should lead towards a multidimensional therapy orientated on target symptoms.

Cervical Vertebrae↗
PubMed1997

[Are there signs of hospitalism in the rehabilitation process?].

The term rehabilitation hospitalism refers to: retardation of rehabilitation progress behind (remaining) abilities. The main causes are: Associate depression (psychoreactive, somatogenic plus endogenic component; usually overlapping), Additional somatogenic factors (heart/circulation, pain, etc), Unfavourable conditions in the surroundings (rehabilitation organisation, family, etc.) Treatment (causal plus symptomatic): Medication, especially psychopharmaceutical, Physiotherapy, Psychotherapy plus organisation plus hygiene plus family therapy No "either/or" but "as well as".

Chronic Disease↗
PubMed1997

[Odontogenic (concomitant) etiology of headache].

A systematic follow-up showed that out of 785 headache patients 1/4 had odontogenic pathogenic factors with possible connections to the headache syndrome and were indicated to be operated. 158 could be systematically examined and (surprisingly enough) improvement of headache syndromes ranking at 2/3 was about equally frequent within the group of those who had undergone dental operation and those that had not wanted to do so. In sub-groups different responses to operation were observed: cephalaea (permanent headache), better than migraine (attack figured headache); etiology of wisdom-tooth better than other tooth-pathology; upper jaw better than lower jaw. Our results once more underlined the multifactorial etiology of headache, that is opposed to a monocausal oriented headache diagnosis (as the IHS-nomenclature tries to impose). Still it has considered to be relevant that a good diagnostic examination in the field of tooth-, jaw- and mouth medicine should be conducted in every headache patient, even in "typical" migraine patients. When indicated, operations should be done; however the patient properly informed that improvement is not obligatory. Same time all the other possible etiologies for headaches shall be regarded and if positive treated.

Headache↗
PubMed1997

[Rehabilitation group (team) in neuro-rehabilitation--self evaluation and patient satisfaction].

The bio-psychosocial entity man demands multidimensional therapeutical approach. Our institution could offer fluent transition from acute neurology to neuro-rehabilitation. Thus could easily be examined the coordination of the 3 main therapeutical activities: medication, physiotherapy and integrated psychotherapy. We demanded judgements by patients, doctors, physiotherapists, nursing persons, ergotherapeuts, music-therapeuts and logopeds. We ourself were astonished about the high judgement by patients which gave 91% very good to good action of therapy. Within differentiating evaluation of single methods we found very similar judgements within the different professional groups. Besides a good action on to the patients there was to be found a positive action to the team-spirit. There were wishes for more professional education, more communication and more time for the patients. We consider this a good sign for the working climate that has developed under these circumstances.

Aged↗
PubMed1997

[Medical teaching and humanistic-communicative aspects: two step-children of quality evaluation. An example of a compact teaching experiment with integrated final examination shows better results].

Evaluation of teaching regarding the humanitarian communicative aspect can not take place without controls. However, isolated controls without other evaluative measures are irrational instruments. This specially holds true for final exams. It seems important to use methods of evaluation which at the same time improve the quality and do not in the negative sense (like a final exam) knock out and disqualify (Tab. 2). We can give some examples out of daily routine which--alas--are very wide reaching. The humanitarian communicative factor, which is an integrative part of medicine very badly is strongly disregarded in favour of educating towards a mechanistic apparatschikway, namely in medical education, carrier, supervision of hospitals. We need strong good will for reformation! We do not only raise postulates here but can show an example of a teaching experiment, where students were put in small groups for intensive teaching with an integrated final exam. This was possible without more costs, but with more human engagement on the side of the teachers.

Altruism↗