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Biomedical subjects

M Bassler

Publications and source records attributed to M Bassler.

At least 19 recordsLinked to original sources
PubMed2002

[Evaluation of therapeutic success by patients with anxiety disorders after inpatient psychotherapy].

OBJECTIVE: To identify factors influencing the subjective assessment of patients regarding the outcome of in-patient psychotherapy for anxiety disorders. METHODS: A total of 231 patients were tested at admission, discharge and 1-year follow-up in a multi-center study. Subjective outcome assessment was measured with the revised German version of the Helping Alliance Questionnaire. The use of the term "outcome satisfaction" is discussed. RESULTS: Patient outcome assessment did not correlate with age, sex, or education, or with duration or severity of illness or duration of treatment. Outcome assessment was closely connected with therapy success. Reaching a low symptom level ("clinical significance") had a higher impact than a high pre-post-difference ("statistical significance"). CONCLUSIONS: Anxiety patients give a generally positive assessment of their therapy outcome, which is most determined by symptom-related treatment success. The differentiation of "clinical" and "statistical significance" of success is of importance for the patient's subjective view of the therapy outcome.

Adolescent↗
PubMed2001

Treating onychomycosis.

Onychomycosis accounts for one third of fungal skin infections. Because only about one half of nail dystrophies are caused by fungus, the diagnosis should be confirmed by potassium hydroxide preparation, culture or histology before treatment is started. Newer, more effective antifungal agents have made treating onychomycosis easier. Terbinafine and itraconazole are the therapeutic agents of choice. Although the U.S. Food and Drug Administration has not labeled fluconazole for the treatment of onychomycosis, early efficacy data are promising. Continuous oral terbinafine therapy is most effective against dermatophytes, which are responsible for the majority of onychomycosis cases. Intermittent pulse dosing with itraconazole is as safe and effective as short-term continuous therapy but more economical and convenient. With careful monitoring, patients treated with the newer antifungal agents have a good chance of achieving relief from onychomycosis and its complications.

Adult↗
PubMed2001

[A consecutive study of patients with irritable bowel disease in two tertiary referral centers].

OBJECTIVES: We investigated the nature of illness behavior and the meaning of emotional deficiencies during childhood in patients with irritable bowel diseases (IBS). DATA: A consecutive study in two tertiary referral centers was conducted with 48 patients suffering from irritable bowel diseases (IBS) and 91 patients with inflammatory bowel disease (IBD). METHODS: The diagnosis of IBS was made by following the Manning criteria, a positive diagnosis of IBD was established through physical, endoscopic and radiologic examinations and was confirmed histologically. Psychological data were obtained by structured psychiatric interviews and psychological self-report measures (GBB). RESULTS: We found that the rate of physician visits given in the course of the disease, is increased for those having irritable bowel disease (IBS). These patients are dissatisfied with the physicians and prone to psychophysiological complaint. In the daily routine and in occupation they are more impaired than those with inflammatory disease. This finding emphasizes in particular that patients with irritable bowel diseases (IBS) have experienced emotional deficiencies in childhood as an after effect of loss, divorce of the parents etc. CONCLUSIONS: Implications for doctor-patient relationship and the necessity for epidemiological studies in Germany are discussed.

Adult↗
PubMed2000

Doppler splitting of In-flight auger decay of dissociating oxygen molecules: the localization of delocalized core holes

By exploiting the core-excitation-induced dissociation of O2, we find that the Auger emission exhibits a Doppler-like energy shift. We show this to be a manifestation of localization of the core hole and propose that the problem of core-hole localization versus delocalization in core-hole spectroscopies may be resolved by considering the nature of the measurement.

Journal Article↗
PubMed1999

[State of empirical research in psychotherapy].

At present nearly 1200 psychotherapeutic treatments are offered on the market with all of them claiming to be helpful and effective. However many of them are not able to even fulfil minimal standards of scientifically substantiated evidence for effectiveness. Modern psychotherapy research has disclosed perspectives to adequately explore the complicated course of therapeutic process. The same way efforts for standardized judgement criteria of empirical studies offer the chance for meaningful evaluating the scientific quality of therapy studies. As shown by several meta-analyses the scientifically substantiated psychotherapy proved to be very effective in the treatment of mental disorders.

Germany↗
PubMed1997

[The randomization problem in psychotherapy studies].

In a research project comparing inpatient and outpatient psychotherapeutic treatment for patients suffering from anxiety disorders, 132 subjects were allocated to both treatments by means of randomisation. Because of the patients' voluntary agreement or refusal of the proposed treatment, the subsamples are markedly affected in their homogeneity. It seems that more disturbed patients agreed to inpatient psychotherapy, whereas less disturbed patients refused that form of treatment. Bias toward or against a given form of treatment turned out to be the most potent predictor in multivariate analysis. The influence of this distortion of the samples is discussed with regard to the generalisation of the results. Proposed countermeasures have their shortcomings, and in the end it seems that randomisation should be avoided in psychotherapeutic research.

Adult↗
PubMed1996

[Evaluation of the therapeutic process in inpatient psychotherapy with the Repertory Grid technique].

With a sample of 155 patients undergoing psychoanalytic inpatient psychotherapy, the clinical relevance of nomethetic measures derived from Repertory Grids (Role Construct Repertory Test; Kelly 1955) shall be demonstrated. Results lead to the conclusion that valuable findings concerning the psychotherapeutic process can be obtained from the grid without necessarily recurring to the framework of Personal Construct Psychology. In general, cognitive differentiation seems to diminish as therapy goes on. Successful patients start to deal with their parental imagines earlier in the therapeutic process than less successful ones. Moreover, they adapt the construction of their Self to the one of their Ideal Self, just as they construe the treating therapist increasingly similar to their Ideal Self. This points to the eminence of the therapeutic relationship for successful therapy outcome. Finally, the paper presents some possibilities to demonstrate transference processes within the scope of inpatient psychotherapy by means of grid measures. All in all, we consider the repertory grid technique as a promising tool for the evaluation of therapeutic processes, but it requires considerable expenditure to fit into clinical routine.

Adolescent↗
PubMed1995

[Psychodynamics and psychotherapy of anxiety disorders].

Three main concepts in the development of anxiety are important in psychoanalysis: 1. the conflict model assuming that anxiety is initiated by the Ego in dangerous situations, when usual coping strategies fail, 2. the structural model that essentially describes that with general weakness of the adaptive Ego-functions even common conflicts cannot be mastered adequately and, therefore, anxiety as an affect arises quickly, and 3. the ethological model assuming that anxiety is closely connected with ethologically founded needs of binding: with threat of loss of binding, the child reacts anxiously, mobilising care impulses of the parents and, thus, counteracting this threat. It is essential for the psychotherapy of anxiety disorders whether the patient exhibits an Ego-structural weakness requiring an active strengthening of the coping abilities of the Ego, or whether a more conflictual genesis of his anxiety should be assumed-in this case, the disclosure of the frequently unconscious background of the conflicts promises to be successful. Altogether, a more active and encouraging attitude of the therapist is preferable for the psychotherapeutic treatment of anxiety disorders to motivate the patient to directly confront himself with his anxiety symptoms.

Adaptation, Psychological↗
PubMed1995

[Prognostic factors for the success of psychoanalytically founded inpatient psychotherapy].

In the scope of our study for evaluation of the differential effect of inpatient psychotherapy we investigated by retrospective analysis of data at admission and 6. week of treatment, which factors were prognostic relevant for therapy success. We defined therapy-success as an equally weighted combination of patients' assessment of satisfaction with treatment success, which was evaluated by the Helping Relationship Questionnaire of Luborsky (1984), and the therapists' assessment of symptomatic and ego-structural improvement of the patients. For the variables, which were related to the patients or therapists, especially the therapists' judgement of the ego-structural disturbance of the patients (r = -.43, N = 218, p < 0.1) and motivation for psychotherapy (r = .27, N = 70, p < .01) exhibited relevant prognostic potency. The variables concerning the therapeutic relationship however gained increased prognostic value first after six weeks of treatment duration.

Adolescent↗
PubMed1995

[Which factors modify the duration of inpatient psychotherapy?].

The indication for differential duration of inpatient psychotherapy is a difficult question to answer, especially when the possible outcome-success of more severely disturbed patients (e.g. with borderline-personality disorder) is considered. Our own results showed no relevant correlation between the degree of patients' disturbance and treatment duration, neither any relevant correlation between treatment duration and therapists' evaluation of symptomatic or ego-structural improvement. The only marked effect on treatment duration was found for the patients' evaluation of their therapeutic relationship: the better they judged this relationship, the more their therapists tended to elongate inpatient psychotherapy. This finding supports a paradigm, which has been already well confirmed for outpatient psychotherapy: the specific importance of the therapeutic relationship for the therapeutic process even within the scope of inpatient psychotherapy. Another finding of our study indicates that more severely disturbed patients probably need a modified setting of inpatient psychotherapy: favorably a focus oriented interval treatment with short duration periods and alternating focus if necessary.

Adult↗
PubMed1994

[The Repertory Grid as a research instrument in inpatient psychotherapy. Possibilities of semantic construct analysis in patients with psychogenic pain].

The Repertory Grid Technique provides a differential analysis of individual constructs ("hypotheses"), by which we structure the perception of our environment. In our study we investigated 35 psychogenic chronic pain patients at beginning and end of inpatient psychotherapy, whether semantic changes occurred in their construct system. We analysed these semantic changes using a categorial system, which was developed by Landfield (1971). This categorial system consists of 22 different categories, at which a rating system (by use of a manual) evaluates the appropriate semantic attachment of constructs of an individual repertory grid to these categories. Our study shows that contrary to our expectation psychogenic pain patients comparatively often described themselves with constructs, which expressed direct social interactions or emotions. However, this finding must be interpreted with some reservation, as our patient group probably is not representative for most of the chronic pain patients, which usually are hardly to motivate for inpatient (respectively outpatient) psychotherapy. Finally we investigated the semantic changes of the construct system during the course of inpatient psychotherapy--here we assume that the conceptualization of own theory guided categories will provide more clinically relevant or perspective results compared to the original category system of Landfield.

Adult↗
PubMed1994

[Inpatient psychotherapy of anxiety disorders--a comparison of therapeutic effectiveness in patients with generalized anxiety disorder, agoraphobia and panic disorder].

We investigated the effect of psychoanalytically oriented inpatient psychotherapy on three essential forms of anxiety disorders (classified according ICD-10): 1. generalized anxiety disorder (n = 23), agoraphobia (n = 38) and panic disorder (n = 24). Examinations with psychometric test instruments were performed at beginning of inpatient psychotherapy, at dismissal and 6 weeks after dismissal. At the end of inpatient psychotherapy we judged four clinically relevant criteria of therapy success: at the one side the therapist's judgement of symptomatic and structural improvement of the patients, at the other side the patients' judgement of anxiety and depression diminuation. The results demonstrate that summing up these four success criteria 1.) 40.0% of the patients with anxiety disorders improved, 21.2% failed; 2.) 61.4% of the patients with agoraphobia improved, 6.3% failed and 3.) 52.5% of the patients with panic disorder improved, 6.5% failed. An additional analysis of these results showed that the patients with generalized anxiety disorder were significantly (p < 0.01) more disturbed (according clinical assessment) compared to the other two diagnostic groups. About 60% of these patients exhibited increased anxiety symptoms during the course of inpatients psychotherapy, nevertheless relative to the other success criteria these patients achieved satisfactory outcome results. In the paper the consequences of these findings are discussed especially for inpatient psychotherapy of severely disturbed patients with anxiety disorders.

Adult↗
PubMed1985

In vitro combination-effect of temocillin with ticarcillin and aminoglycosides on gram-negative and gram-positive bacteria.

The in vitro efficacy of temocillin in combination with ticarcillin and with gentamicin, tobramycin, amikacin and netilmicin against 80 Gram-negative and 20 Gram-positive bacterial strains was compared by use of the checkerboard agar dilution technique. No synergistic or additive effect was seen on the Gram-positive strains. Great variations occurred between the different bacterial species, and the temocillin-ticarcillin combination had only little effect against the Pseudomonas strains tested. On average, only 12% of all strains tested were inhibited synergistically by temocillin-gentamicin combinations, and only 7 to 10% by combinations of temocillin with the other aminoglycosides. However, 25% of Gram-negative strains were inhibited synergistically and 40% of Gram-negative strains were inhibited additively by the combination of temocillin-gentamicin.

Aminoglycosides↗
PubMed1985

[Comparative antibacterial activity of piperacillin against Pseudomonas aeruginosa, Escherichia coli and Streptococcus faecalis in cultures and human serum].

The in vitro activity of piperacillin at 1/4, 1 and 4 X MHK against 5 strains each of Pseudomonas aeruginosa, Escherichia coli and Streptococcus faecalis was compared in Mueller-Hinton-bouillon and human serum. Serum without piperacillin was bacteriostatic against P. aeruginosa for 8 hrs., against E. coli for 24 hrs. Subinhibitory piperacillin concentrations were bacteriostatic against E. coli, but had no effect against P. aeruginosa and S. faecalis. Bactericidal activity against E. coli was achieved at 1 X MHK against P. aeruginosa and S. faecalis at 4 X MHK. Except for P. aeruginosa in concentrations of 1/4 and 1 X MHK the piperacillin activity in bouillon and serum was almost identical.

Animals↗
PubMed1984

Penetration of cefotaxime into heart valves, subcutaneous and muscle tissue of patients undergoing open-heart surgery.

Twenty-nine adult patients undergoing open-heart surgery were given 2 g cefotaxime as 5 min intravenous bolus injection preoperatively. Within 6 h cefotaxime serum concentrations declined from 81.0 to 6.3 mg/l. Subcutaneous tissue and muscle concentrations varied between 0.3 and 8.7 micrograms/g, heart valve concentrations varied between 2.2 and 13.0 micrograms/g. Cefotaxime concentrations in heart valves are high enough to inhibit most Gram-negative organisms causing postoperative wound infections and endocarditis.

Cardiac Surgical Procedures↗
PubMed1984

Penetration of cefotetan into serum, myometrium, endometrium and salpinges.

24 patients received an intravenous 5-min bolus injection of 2 g cefotetan at various times prior to abdominal or vaginal hysterectomy. Cefotetan concentrations in salpinges were significantly higher than in myometrium and endometrium. Tissue concentrations of 16 micrograms/g could be attained for at least 5 h. At this concentration, 90% of most aerobic and anaerobic bacteria causing genital tract infections are inhibited.

Cefotetan↗