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Biomedical subjects

M Vollrath

Publications and source records attributed to M Vollrath.

At least 19 recordsLinked to original sources
PubMed2004

[Laryngomalacia. Definition, diagnosis and therapy].

Laryngomalacia, a rarely mentioned clinical entity in the German literature, is reviewed in this article. The clinical picture, diagnostics and pathogenesis are presented. The prognosis is favorable. Usually the inspiratory stridor disappears after the second year of life in most of the children. However, 7-22% of those involved develop life threatening symptoms which require surgical intervention. We performed laser supraglottoplasty, the method of choice, on five children with severe laryngomalacia. Intraoperative pre and post surgical findings and the surgical procedure are documented. The abnormally enlarged cuneiform cartilages within the aryepiglottic folds were the striking morphological feature in all of our cases. Inspiratory collapse affected only these structures. After laser supraglottoplasty, all of our children were immediately free of symptoms. Because of this high success rate, which is also reflected in literature, we recommend children with severe symptoms to have early surgery, thus preventing troublesome months in expectation of a spontaneous recovery.

Airway Obstruction↗
PubMed2004

The alcohol-related accident risk in Germany: procedure, methods and results.

This paper presents the first reliable estimation of the alcohol-related accident risk in Germany by comparing a representative sample of accidents to a representative sample of trips not leading to a crash. The information about the trips was taken from the German Roadside Survey 1992-1994 (n=9087) conducted in Unterfranken, part of Bavaria. These data were weighted according to a representative study of driving in Germany (KONTIV 89). The accident study comprises a representative sample of accidents in Unterfranken in 1993 (n=1968). Relating accident risk to BAC, the global risk function indicates an exponential increase of accident risk for BACs above 0.05%. Controlling for correlating factors leads to an overall lower estimation with, however, the same structure, indicating that alcohol is consumed by drivers in circumstances which further increase the risk introduced by alcohol. Analyzing the attributable risk (AR) shows that about 12% of all accidents are attributable to alcohol. Over 96% of these happen with BACs of 0.05% and above. Thus, measures aimed at reducing the alcohol-related accident risk must focus on larger BACs, especially of 0.08% and above.

Accidents, Traffic↗
PubMed2002

[The transactional stress model for the animal keeper].

A health problem of an animal or a group of animals represents a potential stress situation for the animal keeper. In this article, the transactional stress model, which was developed in social psychology was applied on the animal keeper and shows, how he perceives the influence of animal care. If veterinary help is considered relevant, it may lead to an improved coping, which affects the health of the animal keeper and the animal as well. This viewpoint leads to a cycle, in which cause, success, coping and utility are closely linked together.

Animal Husbandry↗
PubMed2002

Predictors of coping strategy selection in paediatric patients.

AIM: To assess the prevalence of specific coping strategies and predictors of coping strategy selection in 179 patients (mean age = 10.2 y). The children were investigated one month after the occurrence of an accident (n = 105), diagnosis of cancer (n = 26) or diagnosis of diabetes mellitus type I (n = 48). RESULTS: Patients used a great variety of coping strategies. The most frequent strategies were cognitive avoidance, positive cognitive restructuring and avoidant actions. The strategies of seeking problem-focused support and emotion-focused support were rarely used. Diagnostic category, length of hospital stay, and gender were not associated with coping strategy use. Age, socioeconomic status and functional status of the patient were found to predict coping strategy selection. Younger children made less use of active coping, distraction and seeking support. Patients of lower socioeconomic status used religious coping strategies significantly more often, whereas patients with lower functional status used avoidance and support-seeking strategies more often. CONCLUSION: In this study it was found that paediatric patients used a wide variety of coping strategies, irrespective of diagnosis and gender. Age of the child and functional status were the most important predictors of coping strategy selection.

Accidents↗
PubMed2001

Personality and stress.

Recent years have witnessed an upsurge of interest in how personality affects the stress process. This paper reports on a broad spectrum of findings on the relationships between personality and stress, taking transactional stress theory as the point of departure. A first part outlines the different approaches stress research has taken within personality psychology as opposed to research based on transactional stress theory and discusses the debate between these two paradigms. The second part gives an overview of empirical findings, with a focus on the Big Five personality factors, in order to demonstrate that personality affects the stress process in every aspect. The discussion suggests that we address unresolved problems of transactional stress research in the framework of interactionist personality psychology. Special attention ought to be given to developing a better understanding of situational characteristics, stress-producing mechanisms, and the functions of situational choices and coping strategies for personality.

Adaptation, Psychological↗
PubMed2000

Detecting intoxicated drivers in Germany -- estimating the effectiveness of police tests.

The most important prerequisite for deterring people from driving while intoxicated is to persuade them of the likelihood of being detected by the police. Detection requires the police (1) to stop intoxicated drivers and (2) to detect the intoxication. The latter is not a simple task in Germany as the police is only allowed to obtain a breath sample when indications of an intoxication are present. The paper estimates the effectiveness of police tests in detecting intoxicated driving by comparing data from the German Roadside Survey and the Unterfranken Accident Study to a study of usual police routine and to official accident statistics. Both the German Roadside Survey and the Unterfranken Accident study were conducted in such a way that breath alcohol testing was carried out for nearly every driver, thus giving an estimate of the number of intoxicated trips and accidents in Germany. Comparing these numbers to the intoxicated trips and accidents detected by the police allows a detailed analysis of different components of detection. From those, suggestions are given for increasing the effectiveness of police work.

Accidents, Traffic↗
PubMed1999

[Surgery of acquired laryngotracheal stenoses in childhood. Experiences and results from 1988 to 1998. I: Laryngotracheal reconstruction].

Subglottic laryngotracheal stenosis represents the most severe intubation injury and is increasingly encountered in children due to long-term ventilation during intensive care treatment. Since more than 90% of these children have tracheostomies their physical, psychosocial and speech development can be greatly impaired. A tracheostomy in infants can also be a potentially life-threatening condition, making necessary resolution of the laryngotracheal stenosis and removal of the tracheostoma as soon as possible. During the past 10 years, we have treated 46 children with laryngotracheal problems, including 18 children with severe laryngotracheal stenosis. Ten children (3 with grade II stenosis and 7 with grade III stenosis) were treated by laryngotracheal reconstruction using an anterior rib cartilage graft as described by Cotton. One child with posterior glottic stenosis required a posterior laminotomy with a second rib cartilage graft. Differing from the original method, we stabilized the enlarged endotracheal lumen postoperatively with a Montgomery t-tube. This was kept in place for 10 months on average (shortest period, 6 months; longest period, 12 months). All 10 children could be decannulated, and the tracheostoma closed. Three of the children were operated in other institutions and had a different technique prior to our intervention. Two of our operations failed initially. However, both patients were treated successfully by a second intervention (which was the fourth operation for one of the patients). The reasons for our modification, the operative technique and tips for postoperative management, as well as possible pitfalls and complications, are discussed.

Cartilage↗
PubMed1999

[Surgery of acquired laryngotracheal stenoses in childhood. Experiences and results from 1988-1998. II: The cricotracheal resection].

Approximately 90% of infants and children with severe acquired laryngotracheal stenoses are tracheotomy dependent and therefore impaired in their physical and speech developments. In addition, tracheotomized infants can be endangered by the cannula due to the possible crusting of secretions or its dislocation. Thus, early repair of a stenosis is mandatory. Within the last 10 years, we successfully operated on 18 children with severe laryngotracheal stenoses. Ten children were treated with a modified Cotton technique. This paper reports our results of cricotracheal resection performed in 8 children since 1994 (age distribution: 7 months through age 15 years). Four children had Cotton grade II stenoses, three had grade III stenoses and one grade IV stenoses. In 3 patients a tracheotomy had been performed at another institution. Since their tracheostomas were too far caudal, they could not be included in the primary resection. All 8 children have been successfully decannulated. Five children without tracheotomies could be extubated uneventfully on the 5th postoperative day. All three primarily tracheotomized children needed further endotracheal stenting with T-tubes because of stomal and suprastomal collapse. Two of these latter children additionally required a tracheoplasty with rib cartilage grafts in order to stabilize the suprastomal trachea prior to decannulation. No patient experienced injuries to the recurrent laryngeal nerves or insufficiencies of the anastomosis. All children's voices were not impaired. This is the third report in literature of cricotracheal resections in infants and children, indicating that this effective, one-stage procedure is superior to laryngotracheal reconstruction with rib cartilage.

Adolescent↗
PubMed1998

Neuroticism, coping and change in MCMI-II clinical syndromes: test of a mediator model.

The aim of the study was to examine prospectively whether coping mediated the relation between Neuroticism and change in different clinical mental syndromes. Assessments were conducted with 154 former psychiatric outpatients six and seven years after their initial contact with an outpatient clinic. Dispositional coping mediated the relation between Neuroticism and change in four of the nine clinical scales of the Millon Clinical Multiaxial Inventory (MCMI-II) (Millon, 1987). High Neuroticism led to coping strategies of disengagement and the venting of emotions and to a lack of problem-focused coping, which in turn translated into a relative increase on the MCMI-II scales. The mediator model of coping was found to apply to the MCMI-II scales 'somatoform disorder', 'dysthymia', 'alcohol dependence' and 'thought disorder'. Results are discussed under the perspective of an integration of the positions of the transactional theory of stress and personality psychology.

Adaptation, Psychological↗
PubMed1998

Coping styles predict change in personality disorders.

The present follow-up study is the first to investigate whether dispositional coping styles prospectively influence change in the Millon Clinical Multiaxial Inventory (MCMI-II) personality disorders. The sample consisted of 155 psychiatric outpatients who where investigated twice--namely six and seven years after their admission to the clinic. Coping styles prospectively predicted change in most of the MCMI-II personality disorders, whereas sex and age did not affect the outcome. The use of problem-focused coping and the seeking of social support improved the patient levels on the MCMI-II personality disorder scores. Dysfunctional coping styles such as selfdistraction, disengagement, use of alcohol or drugs, and venting of emotions, however, aggravated the patient MCMI-II personality disorders. Furthermore, the effects of coping patterns tended to be specific for single personality disorders.

Adaptation, Psychological↗
PubMed1996

Differential effects of coping in mental disorders: a prospective study in psychiatric outpatients.

The present follow-up study investigated the differential effects of dispositional coping styles on change in nine clinical syndromes of the Axis I spectrum of the DSM-III-R. Subjects were 155 psychiatric outpatients who were examined 6 and 7 years after their enrollment in the study. Coping accounted for up to 9% of the variance of symptom change over 1 year. As hypothesized, the effects of different coping styles varied considerably across the clinical syndromes. Active goal-oriented coping improved symptoms of the anxiety and the dependency spectrum; seeking social support had beneficial effects on symptoms of the depressive spectrum. The effects of the coping styles distraction, use of alcohol and other drugs, and focusing on and venting of emotions were detrimental, but again in a specific way. The results suggest that the differentiation of outcome criteria for coping is important.

Adaptation, Psychological↗
PubMed1994

Coping and MCMI-II symptom scales.

The associations of the MCMI-II symptom scales with dispositional coping strategies were studied among 239 psychiatric outpatients. A similar core-pattern of emotion-focused coping was associated with all symptom scales except the bipolar scale. High scores on the MCMI-II symptom scales were associated with low use of adaptive emotion-focused coping (e.g., seeking social support) and high use of maladaptive emotion-focused coping (e.g., disengagement). Thought disorder, drug dependence, and delusional disorder also were associated with reduced use of problem-focused coping. The findings support the theoretical distinction between adaptive and maladaptive emotion-focused coping. The potential negative impacts of this coping pattern in terms of mental health and life adaptation are discussed.

Adaptation, Psychological↗
PubMed1993

The self-image of adolescent patients with eating disorders.

Forty German adolescent anorectic patients were assessed with regard to self-image components as measured by the Offer Self-Image Questionnaire (OSIQ). The profile of this group deviated negatively from the German standardization group of healthy subjects on measures of impulse control, emotional tone, body image, social relationships, sexual attitudes, and psychopathology. In addition, the OSIQ profile of this German sample was remarkably similar to the profiles of samples reported in two American studies. Finally, it was found that inpatient treatment served to improve the psychological condition of the patients with regard to certain but not all self-image components. Despite a trend of improvement, some of the scores did not fully normalize in this sample.

Adolescent↗
PubMed1993

Coping and illness behavior among young adults with panic.

The present study investigated illness behavior and coping strategies among young adults with panic (N = 21), with other anxiety disorders (N = 27), and without anxiety disorders (controls; N = 296). The sample represented a cross-section of 29- to 30-year-old adults from the canton of Zurich in Switzerland. Coping was defined as the ways in which subjects react to life stress. Illness behavior was defined as use of medical care and substance consumption. Subjects with panic differed significantly from subjects with other anxiety disorders and controls in their coping strategies by seeking social support, using cognitive avoidance, and using rumination more frequently. Cognitive avoidance and rumination, however, are ineffective and maladaptive ways of dealing with stress. With respect to illness behavior, we found fewer differences. Subjects with panic had more psychiatric consultations and more days off from work than controls, but otherwise, they did not use medical care excessively. Also, their consumption of psychoactive substances was minimal, with the exception of tranquilizers. There was no indication of excessive use of nonpsychiatric medical care. The possible implications of these findings for psychotherapy and diagnostics are discussed.

Adaptation, Psychological↗
PubMed1993

[Berlin follow-up study of eating disorders in adolescence. I. Inpatient follow-up].

Following an introductory comment regarding the purpose of this longitudinal study on eating disorders in adolescence, findings based on assessment of the illness course during inpatient treatment are presented. A multidimensional research design that included both self rating and rating by others demonstrates a clear reduction of symptoms in a number of different areas. This is evident in the 'semantic differential' self-evaluation with regard to body-image and personality, the patient's attitudes toward eating, specific characteristics of the eating disorder syndrome, the self-concept, various personality attributes, physical complaints, and the sense of well-being. The analogous assessments made by therapists and ward staff members also indicated definite improvement with regard to those symptoms that are specific to eating disorders.

Adolescent↗
PubMed1992

Binge eating and weight concerns among young adults. Results from the Zurich cohort study.

In the longitudinal cohort study of young adults from the Canton of Zurich in Switzerland, two groups of eating problems were defined: binge eating and weight concerns. Subjects with these conditions were interviewed at the ages of 27-28 and 29-30 years. The binge eaters, mostly women, differed both from subjects with weight concerns and from controls. They had more severe eating problems and more anxiety and depression. Follow-up as well as retrospective data suggest that eating problems are persistent for the binge eaters, and, to a lesser extent, also for subjects with weight concerns. Even so, professional treatment is rarely sought by subjects with eating problems. These findings encourage long-term studies on eating problems in community samples.

Adult↗