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Biomedical subjects

M Langenbach

Publications and source records attributed to M Langenbach.

16 recordsLinked to original sources
PubMed2006

Emotional stress and subjective body experience of heart transplantation candidates.

We studied subjective complaints, psychological symptoms, and subjective appraisal of their body of 54 heart transplantation candidates at the time of admission to the waiting list using standardized psychological tests (GBB24, SCL-90-R, FBeK). The results of GBB24 and SCL90-R indicated high scores of strain before transplantation. In the FbeK, patients assessed their own body as worse than the normal population on all scales. Male patients displayed significantly higher scores of strain than women, but there was no difference in assessing their own bodies. The considerable scores of strain indicate the need for psychosomatic and psychotherapeutic interventions in a significant subgroup of patients.

Anxiety↗
PubMed2004

[Predictors and mechanisms of tinnitus distress - a longitudinal analysis].

BACKGROUND: The available cross-sectional and retrospective evidence does not provide a clear answer to the question whether the multiple psychological problems and disturbances found in patients with chronic decompensated tinnitus are cause or consequence of the tinnitus. The present research took a longitudinal approach to examine this question. METHOD: Psychopathological symptoms, personality, socio-demographical variables and otological features were assessed in 48 patients which had suffered from tinnitus for a period of no longer than 4 weeks. Six months after first assessment 92 % of the original sample (n = 44) were re-examined. 34 of these patients displayed chronic tinnitus. Univariate and multiple regression analyses were conducted in order to identify variables at first assessment which predicted tinnitus distress at second assessment for the 34 patients with chronic tinnitus. RESULTS: Tinnitus attributed sleep disturbance, anxiousness, and life satisfaction, each assessed at first investigation, independently predicted tinnitus distress at second assessment six months later. These three variables together predicted 56 % of the variance of tinnitus distress at second assessment. CONCLUSIONS: Our results support the model that the symptom tinnitus may develop on the basis of an enhanced psychophysiological tension and become a condensational core of preexisting psychological distress as a facilitatory process. Our results suggest that early psychotherapeutic interventions in patients at risk may prevent decompensation.

Adaptation, Psychological↗
PubMed2003

[Eating disorders: anorexia nervosa, bulimia, binge eating].

We present an overview of three different eating disorders which seem to have an increasing prevalence, especially among young women between 12 and 20 years of age. Anorexia and bulimia nervosa are "threshold disorders" which usually become manifest for the first time during the transition from childhood to early adult life. Eating disorders are chronic disorders and often take a course of 6 or more years. Remission, improvements and symptom change can be expected even after many years of the disorder. Psychiatric comorbidity which occurs in more than 50% of eating disordered patients is of prime importance for prognosis. Depression, anxiety disorders, obsessive-compulsive disorders, and personality disorders are most common. There is a variety of complex in- and outpatient treatments with different components which have to be chosen according to the individual case.

Adolescent↗
PubMed2003

[Patients' subjective experiences after liver transplantation].

AIM: To study prospectively a cohort of patients in the first year after liver transplantation (LTx) with respect to their subjective experiences and their clinical condition. METHODS: Sixteen non-selected, consecutive patients (9 male) of the Clinic of Visceral Surgery of Cologne University were interviewed between 4 and 12 months after orthotopic LTx by narrative interviews. The interviews were audiotaped and transcribed according to standard international rules. We analysed the content of the interviews according to Grounded Theory and performed an ideal type analysis based on case comparison. RESULTS: Nine patients (56.25 %) had a mental disorder according to ICD-10. Patients' subjective experiences of the transplantation could be grouped into five ideal types: the successful, the grateful, the help-seeking, the vulnerable, and the special patient. These ideal types were found to be of a dimensional pattern when re-assessed at single-case level, i. e. individual patients fulfilled criteria of these ideal types to different degrees. CONCLUSIONS: Our patients perceive LTx predominantly as successful therapy for terminal liver disease. They use different coping strategies to come to terms with the considerable impact of transplantation. Each strategy implies specific risk profiles which have to be kept in mind when dealing clinically with LTx patients.

Adult↗
PubMed1999

Observation levels in acute psychiatric admissions.

It was our objective to compare the influence of patients' variables and circumstances of admission on the use of observation levels in acute psychiatric admissions in a British mental health unit. We performed a prospective case note survey of all acute psychiatric admissions during 28 consecutive days in June and July 1991 within a large teaching hospital and a traditional psychiatric hospital in Nottingham, England. We compared, the demographic characteristics of 88 consecutive admissions, admission procedures, clinical data, initial observation levels and changes in observation levels. As for the results, most patients were admitted outside of regular working hours (weekends or after 5 p.m.). Most patients were placed on intermediate (close) observation. The most important factor associated with the choice of observation level was the legal status of the patient (chi2 = 14.79, df = 2, p < 0.001, Fisher's exact test p < 0.0001). There were significantly fewer incidents (chi2 = 7.72, df= 2, p < 0.05, Fisher's exact test p < 0.01) on the highest (special) category of observation. The observation policy of the unit was not followed consistently. The number of factors contributing to the choice of observation levels reflects the complexity of the task facing the staff. Special observation is an effective method of managing acutely disturbed patients. The time of admission of most patients implies that more trained staff should be provided outside of regular hours. Clinical staff should be regularly trained in the use of observation procedures. It should be a regular topic in clinical audit.

Adult↗
PubMed1998

Assaults on staff.

Explore the source record for details and available documents.

Crisis Intervention↗
PubMed1994

Curriculum issues related to nurse turnover.

The problem of turnover rates among registered nurses has implications for nursing curriculum and for continuing education programs. After a brief presentation of turnover issues, curriculum implications will be discussed under three broad areas: (a) content about turnover included in nursing management textbooks; (b) nursing curriculum issues that influence the survivability of graduates of schools of nursing and thereby affect turnover rates; and (c) continuing education needs of registered nurses. This paper is not a summary of solutions for turnover. The problem of turnover is complex and poorly understood. The curricular issues provide challenges to traditional nursing education that would increase the likelihood of the development of "hardy" nurse graduates who have survival skills for the practice environment.

Curriculum↗
PubMed1989

The value of different neuro-imaging methods in the diagnosis of a congenital, spinal, epidural meningeal cyst.

Congenital, spinal, epidural cysts are rare causes of transverse or radicular spinal lesions. Usually these cysts are located in the thoracal region, are oblong-shaped, and extend over several segments dorsally to the cord. Frequently, they cause no symptoms for years. They are fairly accessible to diagnostics by modern neuro-imaging methods. We report on a 15 year old girl with paraparesis, which showed a slow progression over two years, short-term remissions, and finally impairment of bladder function. Myelogram, computer-assisted tomography and nuclear magnetic resonance tomography showed a large space-occupying mass from D8 to L1 epidural and dorsal of the myelon. Operation disclosed an epidural cyst from D10 to L2. Histologically, the removed material was classified as a meningeal cyst. Post-operatively the girl's condition improved under intensive physio-therapy. For the diagnosis of this spinal dysrhapic disorder CT scanning after intrathecal application of contrast medium and magnetic resonance imaging were most valuable.

Adolescent↗
PubMed1987

The leakage of serum proteins across the blood-nerve barrier in hereditary and inflammatory neuropathies. An immunohistochemical and morphometric study.

The leakage of eight different serum proteins and immunoglobulins across the blood-nerve barrier (BNB) was studied by means of the peroxidase-antiperoxidase method in hereditary and inflammatory neuropathies and graded semiquantitatively with respect to endoneurial staining intensity and distribution. These data were compared with the degree of alterations of the myelinated nerve fibre population evaluated by morphometric analysis. Our series of 18 human sural nerve biopsies included seven hereditary neuropathies (three HMSN I, two HMSN II, two tomaculous neuropathies), nine inflammatory neuropathies (seven polyneuritis, two hypertrophic neuritis) and two normal controls. In HMSN II and in tomaculous neuropathy there was no enhanced endoneurial staining for serum proteins despite of a severe nerve fibre loss, whereas in HMSN I a rise of serum proteins of small and moderate molecular size like albumin and IgG was demonstrated in the endoneurial space indicating an impaired BNB function. Qualitative changes of the BNB with leakage also of high molecular weight proteins were observed in polyneuritis and hypertrophic neuritis, irrespective of the degree of nerve fibre changes. Our results show that fibre loss and alteration of the BNB are not correlated. The unselective leakage of serum proteins through the BNB appears to be a characteristic change in inflammatory neuropathies leading to proteinous edema. With regard to the subperineurial accentuation of the endoneurial edema it will be discussed that the vascular diffusion barrier is more fragile than the perineurial diffusion barrier.

Adolescent↗
PubMed1987

Oklahoma pharmacists' explanations of professional satisfaction and dissatisfaction.

This study examined whether the theoretical constructs of role conflict and incomplete professionalization serve as valid explanations of pharmacists' professional satisfaction or dissatisfaction. A sample of registered pharmacists in Oklahoma responded to a mail-out questionnaire containing indicies designed to measure job satisfaction and professional satisfaction. The questionnaire also included a satisfaction inventory of 17 facets considered to characterize pharmacy as a profession. From the questionnaire respondents, samples of pharmacists demonstrating extreme professional satisfaction and extreme dissatisfaction were randomly selected for telephone interviews. This study found pharmacists' professional satisfaction to be significantly less than satisfaction with their job. The study results would indicate that incomplete professionalization and internalized career goals rather than role conflicts are significantly related to pharmacist professional satisfaction.

Conflict, Psychological↗