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Biomedical subjects

R Schröck

Publications and source records attributed to R Schröck.

At least 19 recordsLinked to original sources
PubMed1996

[Physical complaints, stress and quality of life of oncologic patients. Effects and patient assessment in inpatient rehabilitation].

AIM: To what extent do cancer patients use an inpatient aftercare programme and how is its effect been estimated by them? How is the progress of "general physical complaints", "psychosocial stress" and "satisfaction with life" in some cases over a period of up to eight months? PATIENTS AND METHODS: To 201 patients with breast or intestinal cancer respectively, who were going to be or had already been admitted to an inpatient aftercare, standardised and unstandardized questionnaire were presented to be filled out at 4 or 5 different dates before and during the programme as well as 3 and 6 months later. RESULTS: Many patients tried to take part in the aftercare programme actively. Even 6 months later 95.6% estimated it as being "successful" and 70% said that there had been a lasting positive effect after the treatment. The "general physical complaints" and "psychosocial stress" grew significantly less during the inpatient aftercare programme and "satisfaction with life" improved. After the treatment these effects were declining again. CONCLUSIONS: The results indicate that many patients, who participate in an inpatient aftercare programme, profit by it directly. As the positive effects partially get lost during the following months, the patients should be prepared more intensely for the time after dismission with its higher level of strain and should get an especially attentive ambulant care at home.

Adaptation, Psychological↗
PubMed1995

[Moral action in nursing].

What ought I to do? is the classic question of moral dilemmas. It is concerned with the field of action in which human beings meet and where moral decisions have to be made in the course of everyday nursing care. Only when nurses discuss their own actual experiences, can they learn to arrive at a competent appropriate rationale and justification for action. With growing self-confidence, the willingness to act increases. Ethics is one of the relevant fields of knowledge. The attempt to create a link between moral action in nursing and ethics, comes to grief when the "myth of life and death" and the "Hypocratic myth" move centre stage. These myths really belong to the medical, not nursing perspective. Several other medical tendencies for generalisation and some in nursing, create barriers to the development of appropriate models for nursing action. It would be bad advice for nursing to present itself as a reservoir of humanitarianism. An appeal to professional conscience is no guarantee that morally defensible decisions will be arrived at. Only continuous examination of their own actions against a framework of sound moral argument can make it more likely that action appropriate to the desired goal can take place.

Conflict, Psychological↗
PubMed1986

[Tumor-associated antigens and fibrin derivatives as reaction products of ovarian cancer].

The detection of tumour-associated antigens in blood, ascites fluid, and tissue by the use of monoclonal antibodies establishes new aspects for the course control of ovarian cancer therapy and the evaluation of tumour-associated fibrinolysis. Monoclonal antibodies to the cross-linking site of fibrin derivatives in an enzyme immunoassay (D-dimer-ELISA) allow to compare quantitative results of fibrinolysis products with different tumour markers and the clinical tumour situation. In a prospective follow-up-study in 102 patients with epithelial ovarian carcinoma Ca 125, D-dimer, TPA, Ca 19-9, and CEA were investigated as tumour markers. Specificity (control group 61 gynaecologic patients with benign diseases) and sensitivity were compared in sensitivity-specificity diagrams (receiver operating characteristic curves) for different clinical tumour situations (preoperative, S0-S3). Applying a limit value of normal range, indicated in parentheses, the specificity of Ca 125 (greater than 65 mu/ml) amounts to 100%, D-dimer (greater than 700 ng/ml) 100%, TPA (greater than 120 mu/ml) 90%, CEA (greater than 5 ng/ml) 96%, Ca 19-9 (greater than 37 mu/ml) 98%. In the same sequence, sensitivity values came to 91%, 82%, 65%, 8% and 19% in manifest tumour situations. Antigen-concentration levels and frequency of pathological values depend on the degree of tumour disease. The results of seroimmunodiagnostic methods correlate with the clinical tumour situation: In 11 of 12 cases clinical tumour progression or relapse were accompanied by increasing concentrations of Ca 125 and D-dimer. In 21 cases of second-look laparotomies, tumour marker values in the normal range were often found not to be conclusive for diagnosing a tumour-free situation. The predictive value for true negative results amounted to only 18%. Immunohistochemical investigations and plasma-ascites diffusion ratios of antigens indicate that enrichment occurs in ascites. Fibrin deposition often surrounds tumour plugs and is found in interstitional tissue, whereas Ca 125 is expressed mainly at tumour cell surface. The histochemical image reflects fibrin as a tumour surrounding antigen and Ca 125 as a tumour-originated antigen. Clinical relevant serodiagnostic methods for ovarian cancer are brought about by the monoclonal detection of the investigated antigens.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1986

[MR tomography of gynecologic diseases of the minor pelvis].

The results of MR examinations of 31 women with gynaecological diseases are described; all had CT and histological confirmation at operation. The extent and relationship of the lesions were well demonstrated by the three-dimensional sections of MR, in some cases better than on CT. Variations in the signals allowed better differentiation of myomas and ovarian carcinomas from normal tissue. Like CT, MR tomography was not reliable in showing the extent of infiltration into neighbouring structures.

Adult↗
PubMed1985

[Simultaneous determination of Ca 125 and D-dimer in plasma and ascites in ovarian cancer].

In 37 patients with ovarian carcinoma stages Ic to IV the values of preoperatively determined tumour markers and the values of the follow-ups were examined in a trial to observe the course of the disease. The following sensitivity was recorded: Ca 125 92%, D-dimer 100%, TPA 76%, CEA 29%, CA 19-9 15%. Ca 125, D-dimer and TPA are unsuitable as follow-ups. They are also detectable in ascites.

Adenocarcinoma, Mucinous↗
PubMed1985

Measurement of crosslinked fibrin derivatives in plasma and ascitic fluid with monoclonal antibodies against D dimer using EIA and latex test.

D dimer and related crosslinked fibrin derivatives were measured in plasma of normal subjects and in patients with various disorders. In 23 healthy, young females low plasma levels were found (mean 47 ng/ml). In 12 patients with deep vein thrombosis, moderately elevated levels (mean 593 ng/ml) were seen. Higher levels were found in 6 patients with pulmonary embolism (mean 3,337 ng/ml). The highest values occurred in 4 patients with severe intravascular coagulation (31,000 to 390,000 ng/ml). In 22 patients with ovarian cancer and in 21 patients with other gynecologic carcinoma, normal to highly elevated levels of D dimer like material were found. These values corresponded well to concentrations of tumor marker CA 125, measured in the same samples, and to tumor activities staged in these patients based on clinical examinations. Very high values of crosslinked fibrin derivatives (75,000-525,000 ng/ml) were determined in ascitic fluid of patients with ovarian cancer.

Adult↗
PubMed1984

Recent aspects of hemostasis, hematology and hemorheology in preeclampsia-eclampsia.

Because intravascular fibrin deposition is found in the glomerular capillaries of patients who have died of eclampsia, it was long assumed that a chronic form of intravascular clotting represents the decisive cause of the condition. Fibrin deposition is also typically observed in the uteroplacental bloodstream. The occurrence of high levels of soluble fibrin and fibrin(ogen) degradation products, which in severe cases can also include fibrin oligomers, in combination with thrombocytopenia and factor VIII consumption were interpreted as additional evidence for the significance of intravascular clotting in the pathogenesis of EPH gestosis. The hemolysis of the microangiopathologic type, which occurs in severe cases, was attributed to the resulting impairment in microcirculation. Doubts regarding this theory arose when it was noted that the course of EPH gestosis is not altered by the use of heparin, and that even in severe cases of eclampsia with hemolysis and thrombocytopenia the plasmatic clotting system is involved only to a small extent and probably only secondarily. More recent investigations have yielded the first evidence of reduced prostacyclin synthesis in maternal and fetal vessels in patients with EPH gestosis. Since prostacyclins lower arterial resistance yet at the same time are strong inhibitors of thrombocyte aggregation, this prostacyclin deficiency could account for the hypertension and the occurrence of platelet thrombi in the placental bloodstream associated with EPH gestosis. The observation of a reduction in the number of thrombocytes as a consequence of increased platelet breakdown, which precedes a rise in the level of fibrin(ogen) degradation products, also points to the significance of an abnormal interrelation between platelets and endothelium. In addition to the plasmatic and thrombocytic hypercoagulability and impaired prostacyclin synthesis, hemoconcentration with increased microvascular permeability is also observed. Early detection of disturbances of the vessel wall and vessel contents may provide a means of prophylaxis.

Adult↗