PubMed Health⌕ Search

Biomedical subjects

V Köllner

Publications and source records attributed to V Köllner.

18 recordsLinked to original sources
PubMed2005

[Indications for the surgical therapy of obesity with magenband operation (gastric banding)].

Morbid obesity is an increasing problem in most of the industrial countries. Conservative treatment strategies are often not very effective. Because of the enormous costs and concomitant diseases of obesity, effective therapeutic strategies are mandatory. Gastric banding is a surgical method to reduce weight in the long run when patients are morbidly obese. A silicone band is used to create a small pouch in the upper part of the stomach leading to early satiety after ingestion only small amounts of food. The benefit of this method is the laparoscopic technique and the reversibility, because the band is easy to remove. In the long run a significant reduction of weight and an amelioration or even prevention of diseases resulting from obesity can be achieved. To assure treatment quality, it makes sense to administer this therapy in an interdisciplinary setting that integrates psychosomatic diagnostics and therapies, too. This paper reviews indications, contraindications as well as pre- and postoperative necessarily care of gastric banding.

Gastroscopes↗
PubMed2005

[Physical complaints in dysphonic patients].

BACKGROUND: In previous studies, patients with benign organic and functional voice disorders were shown to suffer from physical complaints. The present study focuses on a specific nosologic classification of these disorders in the sense of diagnosing a somatoform illness. PATIENTS AND METHODS: Eighty patients (50 women, 30 men) aged 44+/-11 years (18-60), suffering from various voice disorders (functional: n=18 women, n=13 men; organic: n=32 women, n=17 men), were examined after informed consent. Physical complaints were assessed using the Giessen Complaint Questionnaire GBB-24. Age and gender matched normal controls were taken from the literature. Data were analyzed using the non parametric two-by-two four-field-test. RESULTS: The individual diagnosis of dysphonic women showed pathologic values in all subscales except limb complaints. The individual diagnosis of men showed pathologic values in the limb complaints subscale (P<0.05). When comparing functional and organic disorders, no significant difference (P>0.05) was found in neither of the gender groups. DISCUSSION AND CONCLUSIONS: Depending on gender and type of voice disorder, dysphonic patients suffer from different physical complaints. Both patients with functional and organic disorders are affected. Therefore, it does not seem justified to classify functional voice disorders as somatoform disorders.

Adolescent↗
PubMed2004

[Anorexia nervosa. Implications for emergency medical services].

We discuss emergency medical service implications of eating disorders using the case of CPR in a 30-year-old female with severe anorexia nervosa and offer a literature review of potential lethal complications. Despite therapeutical advances, anorexia nervosa is still an illness with considerably high mortality. Potential severe complications of this illness can have life-threatening implications. Emergency medical service decisions have a prognostic impact on the further course of the illness. Whether patients should be treated against their own volition is of particular importance.

Adult↗
PubMed2004

[Voice handicap in patients with organic and functional dysphonia].

BACKGROUND: The goal of this study was to assess and compare voice handicap in patients with benign organic and functional dysphonia. PATIENTS AND METHODS: Voice handicap was assessed using a German version of the Voice Handicap Index. A total of 108 German speaking patients, 64 women and 44 men aged 45.3+/-15.1 years with benign organic ( n=69) or functional ( n=39) voice disorders completed the questionnaire immediately after clinical examination and without knowing their individual diagnosis. Fifty individuals without voice complaints and normal voice status, 28 women and 22 men aged 47.1+/-15.5 years, served as controls. RESULTS: Significant differences ( P<0.001) were found between all dysphonic patients and the control group. When comparing dysphonic patients according to their gender and diagnosis group (organic or functional) no significant differences were detected. CONCLUSION: It can no longer be assumed that patients with functional voice disorders over emphasize their disease. The data obtained in this study prove that there are no gender specific differences in the way a voice disorder is experienced. There are also no differences in the way patients with a different language background experience their voice handicap.

Adult↗
PubMed2004

[Psychooncology. New aspects for urology].

Cancer and psychiatric symptoms commonly co-occur. The frequency is about 50%, and those most important for urology are depression, anxiety, and probably post-traumatic stress disorder. There is a strong relationship between psychological distress and cancer pain. This review provides information on diagnostic and therapeutic strategies for psychiatric diseases, which are important for oncology patients in urology. Special advice is given for the doctor-patient relationship and communication.

Anxiety↗
PubMed2004

[Urology and Psychosomatics. A historical summary].

The investigation and description of psychosomatic interrelationships has a long tradition in the field of urology. At the beginning of last century, psychosomatic theories and therapies involving urologic questions were developed, some of which are still part of current therapeutic strategies. Numerous studies accentuated the need for a psychosomatic diagnostics and therapy of urologic diseases. The appreciation of psychosomatic urology is growing, a fact which is reflected in current urological teaching curricula.

Female↗
PubMed2004

Pain perception in patients undergoing bone marrow puncture--a pilot study.

The objective of this study was to establish the relationship between the perception of pain, anxiety, and depressive tendency in performance of bone marrow puncture. 93 consecutive patients (62% men, 38% women) from a hematological oncology outpatient department ages 20 to 85 years (M age = 53.7, SD = 15.1) were questioned. On average, the patients had undergone 2.5 (+/- 2.6) punctures. The underlying disease was leukemia in 49%, malignant lymphoma in 41%, another malignant disease in 2%, and there was a benign condition in 8%. Depression and general anxiety were measured using the Hospital Depression and Anxiety Scale (HADS-D). Fear of puncture and perception of pain were registered with visual analog scales. Patients with increased scores of anxiety or depressive tendency on the HADS-D suffered significantly more severely from fear of puncture and pain than patients with normal scores. However, the puncture-related fear in the group as a whole correlated markedly more closely with the intensity and tolerability of pain than did general fear and depressive tendency. This finding must be considered when planning psychological interventions in this group of patients.

Adult↗
PubMed2002

[Consultation or liaison psychotherapy service--what difference does it make for an outpatient pain clinic?].

OBJECTIVES: Even if the effectiveness of psychotherapy emphasising a cognitive behavioral approach is clearly shown by randomised controlled trials, it is difficult to motivate chronic pain patients to use this type of treatment. We compared the effectiveness of consultation and liaison models of co-operation between an outpatient pain clinic and a psychosomatic department in creating motivation to psychotherapy. METHODS: In a retrospective design we collected data of all patients seen in the pain clinic during two periods of 6 months before ( N=165) and after ( N=277) changing from a consultation to a liaison model. Clinical data were documented by the MASK system (Hildebrandt u. Pfingsten 1993). Depression was screened using a depression scale (vgl. Zerssen 1973), somatic complaints by listing of complaints (vgl. Zerssen u. Koeller 1976) and two short screening questionnaires. RESULTS: In the liaison model diagnostic sessions with the consulting psychotherapist were significantly more often recommended by physicians from anaesthesia departments (25.6% vs 13.9%; p<0.01) and accepted by patients (63.3 vs 30.4%; p<0.01). In both systems 80% of the patients accepted the suggested psychotherapy. After changing to the liaison type of co-operation, there was a significant decrease in the prescription of opioid and benzodiazepine drugs. CONCLUSIONS: The liaison model of co-operation was significantly more effective to enhance physician's and patient's motivation for a psychosomatic approach to pain treatment. Psychotherapy is better accepted by patients suffering from chronic pain if it is offered in a multidisciplinary context and in the familiar surroundings of the pain clinic.

Adolescent↗
PubMed2001

[Interdisciplinary management of chronic tinnitus (II)].

Tinnitus is defined as the perception of sound in the absence of any appropriate external stimulation. It is a common, bothersome and hard-to-evaluate symptom and in most cases it cannot be objectified. Its incidence in Germany and the western world is about 10%. About 1-2% of the population are severely disturbed by tinnitus and it may disrupt everyday activities and sleep. Recent theoretical developments favour a neurophysiological approach as an explanation for tinnitus in addition to a psychoacoustic model based on peripheral lesion in the cochlea or auditory nerve. In the neurophysiological model, the processing of the tinnitus signal plays a dominant role in its detection, perception and evaluation. Therefore, attention and other psychological factors become important in the understanding and treatment of tinnitus. Many treatments of chronic tinnitus have been proposed and implemented. Today, cognitive-behavioural treatment is regarded as an important part of an integrative therapy which may be compiled of counselling, relaxation therapy, instrumental (hearing aid, tinnitus masker, tinnitus instrument, tinnitus noiser) and pharmacological tools (lidocaine, neurotransmitters). In well-controlled studies the empirical support for other therapeutical approaches such as acupuncture is weak. This work gives a review of the current knowledge of the etiology, pathogenesis, epidemiology, the interdisciplinary diagnostic approach and treatment of tinnitus and especially focuses on insurance and medico-legal aspects.

Chronic Disease↗
PubMed2001

Quality of life of patients with laryngeal carcinoma: a post-treatment study.

This study was designed to determine the quality of life of patients successfully treated for laryngeal cancer. A questionnaire was mailed to 233 patients. A total of 124 responses were suitable for analysis. The questionnaire consisted of three components: sociodemographic data, European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (QLQ - C 30, version 2.0), and EORTC QLQ, Head and Neck Module (H & N 35). The assessment included five treatment groups: chordectomy, partial laryngectomy, irradiation as primary therapy, laryngectomy, laryngectomy and radiotherapy. The evaluation for the functional scales of the EORTC QLQ - C 30 resulted in a higher quality of life of patients with maintained larynx in comparison to laryngectomised patients. In the symptom scales, patients after laryngectomy and/or radiotherapy suffered more from fatigue, pains and appetite loss. Laryngectomees stated more financial difficulties. The evaluation of the ENT-specific EORTC module showed that patients after laryngectomy had more symptoms. Typical symptoms after radiotherapy were a dry mouth, sticky saliva and coughing. Noticeably, no differences existed among the several groups with regard to voice production. The EORTC QLQ- H & N 35 does not appear to be sensitive enough to assess this parameter.

Adult↗
PubMed1997

Tolerability of internal low-energy shock strengths currently needed for endocardial atrial cardioversion.

There seems to be no relation between shock strength and patient's tolerability using energy levels currently needed for low-energy internal atrial cardioversion. Every patient felt that the second delivered shock, independent of the amount of energy, was more uncomfortable than the first one, which indicates that psychological conditioning may also play an important role in determining discomfort.

Atrial Fibrillation↗
PubMed1995

[Education in Psychosomatic medicine and psychotherapy in the German Federal Republic].

The institutionalization of the subject of psychosomatic medicine and psychotherapy at German universities has been implicated by the Approbationsordnung of 1970. Since then, this topic is a compulsory subject for medical students. This allowed the creation of a nearly complete covering supply of the teaching demands by various teaching organization forms, as interview groups and students' Balint groups. A study questioning 158 medical students at the Medical Faculty of the University of Bonn showed how this topic was assessed and accepted. The ambition of the students was to have an instruction focusing on more practical aspects and a more powerful consideration of psychosomatic aspects in the curriculum of the medical faculty. Finally, a short overview will be given on the postgraduate training of physicians as well as on the implications of psychosomatics in general health care. Also several aspects to the subtitle psychosomatics and psychotherapy as well as to the title psychotherapy in general medicine are given.

Attitude↗
PubMed1991

[Enoximone in postoperative "low-output syndrome"--comparison with dobutamine].

Low output syndrome sometimes complicates early postoperative states following cardiac surgery. A comparative study of hemodynamic responses to enoximone and dobutamine was carried out in two groups of 20 patients each, during a 22-24 hour postoperative observation period. Enoximone, 1 mg/kg i.v. total dose, was given in the first 20 minutes. The infusion was then reduced to 2-10 micrograms.kg-1.min-1 for the next 22-24 hours. Dobutamine was administered in a dose of 4-7 micrograms.kg-1.min-1 over the same period. After 15 minutes of therapy with enoximone cardiac index increased by 42% (initial value 2.31 +/- 0.34 l/min/m2), after 30 minutes by 50%, after 120 minutes by 65% and after 24 hours by 91% from the initial value. At the same time the pulmonary capillary wedge pressure decreased from the initial value of 15.21 +/- 1.65 mmHg by 20%, 25%, 26% and by 43% (22 hours). After dobutamine cardiac index increased from 2.23 +/- 0.6 l/min/m2 by 30% (15 minutes), 47% (30 minutes), 57% (2 hours) and by 85% (22 hours). The pulmonary capillary wedge pressure decreased from 15.70 +/- 3.14 mmHg by 13% (15 minutes), 17% (30 minutes), 22% (2 hours) and by 43% (22 hours). The enoximone group showed a diminution of systolic arterial pressure of 14% in the first 120 minutes, with a return to initial values after 22 hours. Dobutamine produced an increase in systolic arterial pressure of 23% after 2 hours, maintaining increased values of approximately 20% during the observation period. Heart rate increase slightly in both groups in a similar way.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

Comparison of dobutamine and enoximone for low output states following cardiac surgery.

Low output syndrome sometimes complicates early postoperative states following cardiac surgery. A comparative study of haemodynamic responses to enoximone and dobutamine was carried out in two groups of 20 patients each, during a 24-hour postoperative observation period. Parameters in addition to routine measurements were determined using a pulmonary artery catheter. Enoximone, 1 mg/kg i.v. in total, was given in the first 20 minutes. The infusion was then reduced to 3-20 micrograms/kg/minute for the next 24 hours. Dobutamine was administered in a continuous dose of 5-7 micrograms/kg/minute over the same period. After 15 minutes' therapy with enoximone, cardiac index increased from 2.31 +/- 0.34 litres/minute/m2 to 3.30 +/- 0.38 litres/minute/m2; after 120 minutes to 3.83 +/- 0.60 litres/minute/m2 and after 24 hours to 4.34 +/- 0.50 litres/minute/m2. Pulmonary capillary wedge pressure at the same intervals decreased from 15.21 +/- 1.65 mm Hg initially to 12.11 +/- 2.83, 11.2 +/- 4.50 and 8.77 +/- 2.98 mm Hg. After dobutamine, cardiac index rose from 2.33 +/- 0.60 litres/minute/m2 to 2.90 +/- 0.81 (15 minutes), 3.52 +/- 0.74 (120 minutes) and 4.12 +/- 1.07 litres/minute/m2 (24 hours). The pulmonary wedge pressure values decreased in this group, from 15.20 +/- 3.14 mm Hg at the beginning to 13.74 +/- 3.02 (15 minutes), 12.17 +/- 5.25 (120 minutes) and 9.81 +/- 4.23 mm Hg (24 hours). The enoximone group showed a diminution of systolic arterial pressure of 14% in the first 120 minutes, with a return to initial values after 24 hours.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗