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Biomedical subjects

K Ernst

Publications and source records attributed to K Ernst.

At least 19 recordsLinked to original sources
PubMed1992

[How can one achieve compliance?--On the after-care of psychiatric patients after clinic discharge].

For 384 of 558 hospitalized psychiatric patients who were discharged within six months and for whom it was possible to plan aftercare, compliance was controlled by a phone call three months after discharge at the institution or practice to which the patient had been directed. Eighty percent of the ambulatory patients complied (schizophrenic patients: 84%). After three months 70 percent of the compliers still were in treatment. The hospital's arranging an appointment for the patient had the strongest influence on compliance. The success of this strategy is confirmed by the literature.

Aftercare↗
PubMed1992

[The status of Italian psychiatric reform: the example of Lombardy in comparison with Switzerland].

In Italy, the worldwide reduction in numbers of psychiatric beds since the fifties had led already by 1971 to a much lower per capita rate of beds than in most European countries. In Northern Italy the psychiatric reform of 1979 speeded up the ongoing reduction of beds, ameliorated conditions for hospitalized patients and built up ambulatory care. A comparison with three Swiss cantons shows that, in Lombardy, the largest and economically most developed Italian Region, the rate of patient contacts with outpatient services has probably reached or surpassed the level found in Switzerland. Contacts by home visits are much more frequent than in Switzerland. The number of psychiatric beds per 1,000 inhabitants is 0.7 in Lombardy and thus has been reduced to one third the Swiss bed-ratio. Comparisons of Italian with Dutch and Danish psychiatric register data show that the Italian psychiatric service as a whole reaches a considerably smaller segment of the severely disordered patients. The Region of Lombardy has recently been trying to increase the psychiatric bed-ratio by agreements with private hospitals. The shortage of beds is not compensated by the ambulatory services and is leading to increasing stress for the families of the severely disordered.

Bed Occupancy↗
PubMed1991

High phosphate diet-induced primary hyperparathyroidism: an animal model.

Primary hyperparathyroidism (PHPT) is increasing in incidence and detection, primarily because of the aging of our population and the widespread use of automated serum calcium determination. As a result, a substantial number of "early" cases or "biochemical" PHPT are being detected. The indications for parathyroidectomy in such early cases of PHPT are currently under debate, primarily because of economic issues. These factors underscore the importance of research into the basic mechanisms and natural history of PHPT. We investigated an animal model of diet-induced PHPT that retains two crucial aspects of PHPT: elevation of endogenously produced parathyroid hormone (PTH), accompanied by gross and microscopic changes in the native parathyroid glands. Female Long-Evans rats were divided into six groups of 15 each and fed a control diet (Ca/P of 1:2) or a high-phosphate diet (Ca/P of 1:7) for 1-, 2-, or 3-month intervals. Compared with the control animals, serum PTH levels were elevated at all three time intervals in the experimental group, whereas serum calcium levels were decreased at all time intervals. Serum creatine levels were also elevated at all time intervals, whereas serum phosphorus levels did not change. Parathyroid histopathologic studies demonstrated no change at 1 month, whereas nine of 15 experimental animals showed mild hyperplasia at 2 months and 13 of 14 showed mild to moderate hyperplasia with gland enlargement at 3 months compared with control animals. Histopathologic examination of the kidneys showed no change at 1 month but focal parenchymal inflammation with calcium deposition at 2 and 3 months in the experimental groups. In conclusion, the high-phosphate diet successfully induced the earliest changes of PHPT: elevated PTH levels and parathyroid hyperplasia. However, because renal function was mildly compromised early on, some element of early secondary (renal) hyperparathyroidism may have supervened quickly. Because this model is simple, it may be useful to investigate this complex syndrome further, as well as its natural history and the complications it produces in other organs such as the kidneys.

Animals↗
PubMed1991

Radiotherapy of primary human melanomas--experiences and suggestions.

We treated 60 invasive primary human melanomas by soft X-rays. In 23 additional cases radiotherapy was applied after total excision of a primary melanoma. Only in two cases was a tumor observed in the field of irradiation during the follow-up period: a recurrence of a primary melanoma and a skin metastasis. Radioresistance cannot be unequivocally assumed in either case. Since deeply situated in-transit metastases cannot be destroyed by soft X-rays in spite of our good results we regard radiotherapy of invasive primary melanomas as a second choice treatment to be administered if impaired general health, excessive tumor growth in certain localisations or refusal of the patient do not allow a major operation. Nodular parts of primary melanomas should be excised before radiotherapy to obtain material for histopathological confirmation of the diagnosis and to determine the thickness of the tumor. X-rays of lower hardness can subsequently be applied.

Adolescent↗
PubMed1990

[Cryosurgical treatment of precancerous cheilitis abrasiva].

Between 1984 and 1988, 44 patients suffering from cheilitis abrasiva praecancerosa were treated with cryosurgery using a nitrous oxide cryoprobe. A single treatment proved sufficient in 35 patients (80%). 9 patients (20%) developed a recurrent lesion 4 to 28 months after cryosurgery. All recurrences appeared within the first year. On account of the recidivity of the disease, we recommend a careful follow-up of the patients. On the other hand, cryosurgery has the advantage that it can be applied in elderly persons as well as in patients with concomitant internal diseases. In pracancerous lesions, the common drawbacks of a surgical therapy such as diminution of the lower lip and impairment of the superficial sensitivity can be avoided with the help of this technique. Invasive carcinomas of the lower lip, however, should not be treated with cryosurgery.

Aged↗
PubMed1986

Sustained antidepressive effect of repeated partial sleep deprivation.

In a naturalistic clinical trial we administered three partial sleep deprivations (PSD) within one week to a diagnostically heterogeneous sample of 30 depressed patients and applied serially three dexamethasone suppression tests (DST). We observed that this PSD treatment induced sustained clinical improvement independently from nosological attribution. Abnormal DST results prior to PSD treatment failed to predict clinical course, and normalized after beneficial response.

Adult↗
PubMed1985

[Relation between the frequency of complaints by neurotic patients and their solving personal problems].

The relationship between the frequency of neurotic complaints and the way in which subjects coped with problems was studied in 97 patients with neuroses and in 26 patients who had undergone a successful kidney transplantation. Although the frequency of complaints correlated with the severity of psychological problems, the individual nature of coping with problems and of complaints in both groups was different. Characteristic of the neurotic patients was a tendency toward overcoming problems in a passive manner.

Adaptation, Psychological↗