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  • 1
    Electronic Resource
    Electronic Resource
    Stationäre Behandlung depressiver Patienten Konzeptuelle Überlegungen und Ergebnisse eines Pilotprojekts zur Qualitätssicherung in Baden-Württemberg (1998)
    Springer
    Der Nervenarzt 69 (1998), S. 59-65 
    Details
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Qualitätssicherung ; Strukturqualität ; Prozeßqualität ; Ergebnisqualität ; Psychiatrie ; Depressive Störungen ; Key words Quality assurance ; Structure quality ; Process quality ; Outcome quality ; Psychiatry ; Depressive disorder
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Quality-assurance activities will become more important in psychiatry during the next few years. In relation to other medical disciplines, some special aspects concerning structure, process and outcome quality as well as practical realization and methodologic aspects must be considered. These specific issues were the focus of a study dealing with the treatment of depressed inpatients. The experiences and results as well as considerations concerning future quality-assurance projects are discussed.
    Notes: Zusammenfassung Qualitätssicherungsmaßnahmen werden in den nächsten Jahren in der Psychiatrie zunehmend an Bedeutung gewinnen. Gegenüber anderen medizinischen Teildisziplinen zeichnen sie sich im Bereich der Psychiatrie durch eine Reihe von Besonderheiten aus und zwar sowohl im Hinblick auf die Struktur-, Prozeß- als auch Ergebnisqualität. Gleiches gilt auch für die Durchführung von Qualitätssicherungsprojekten aufgrund von methodischen Überlegungen. Diese speziellen konzeptuellen sowie methodischen Aspekte wurden versucht, bei der Durchführung eines Pilotprojekts zur stationären Behandlung depressiver Patienten zu berücksichtigen. Über Erfahrungen, Ergebnisse sowie weiterführende Überlegungen wird berichtet.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001150050239
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  • 2
    Electronic Resource
    Electronic Resource
    Antineoplastic efficacy of melphalan andN-(2-chloroethyl)-N-nitrosocarbamoyl-ω-lysine, in combination with diazoxide or insulin in autochthonous mammary carcinoma of the Sprague-Dawley rat (1990)
    Springer
    Journal of cancer research and clinical oncology 116 (1990), S. 45-50 
    Details
    ISSN: 1432-1335
    Keywords: Antineoplastic efficacy ; Melphalan ; Diazoxide ; Insulin ; Mammary carcinoma ; Sprague-Dawley rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The anticancer activity of melphalan andN-(2-chloroethyl)-N-nitrosocarbamoyl-ω-lysine (CNC-ω-Lys), was compared in the autochthonous, methylnitrosourea-induced mammary carcinoma of the Sprague-Dawley rat. In addition, the influence on the therapeutic efficacy of the combination with diazoxide, causing a mild, reversible diabetes, and with insulin was investigated. The comparison of melphalan and CNC-ω-Lys clearly showed the superiority of melphalan. Both compounds displayed a significant tumour inhibition in their medium and the highest dosages in comparison to the untreated control. The combination with diazoxide resulted for almost all groups in an increased tumour inhibition. Only the lowest dose of CNC-ω-Lys + diazoxide did not reduce the tumour volume significantly versus the control group. The combination with insulin, however, resulted in a loss of tumour inhibition compared to the effect of the cytotoxic drug alone, although in these groups, too, a significant decrease of tumour volumes versus controls could be observed. Mortality was within tolerable limits (〈20%) through the treatment period for all experimental groups. Median lifespans were increased in all therapy groups, but no additional benefit could be observed in the combination treatment groups.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01612639
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  • 3
    Electronic Resource
    Electronic Resource
    Androgen-linked alkylating agents: biological activity in methylnitrosourea-induced rat mammary carcinoma (1990)
    Springer
    Journal of cancer research and clinical oncology 116 (1990), S. 538-549 
    Details
    ISSN: 1432-1335
    Keywords: Androgen-linked alkylating agents ; Methylnitrosourea ; Mammary carcinoma ; Anticancer activity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary This article gives a comprehensive survey on the anticancer activity of nitrosoureas linked to steroidal androgens in methylnitrosourea (MMU)-induced rat mammary carcinoma. cis-Androsterone, testosterone, 19-nortestosterone and 5-α-dihydrotestosterone were used as carrier hormones and were linked to various cytotoxic N-[N′-(2-chloroethyl)-N′-nitrosocarbamoyl] (CNC)-aminoacids and to N-(2-hydroxyethyl)-N′-(2-chloroethyl)-N′-nitrosourea hemisuccinate (HECNU-hemisuccinate). In the MNU-model used esters of dihydrotestosterone (DHT) invariably were more active and less toxic than those of testosterone, nortestosterone and cis-androsterone. Within the DHT esters of CNC-aminoacids those of CNC-glycine, CNC-methionine and CNC-alanine showed the highest antineoplastic activities and superiority compared with equimolar dosages of their unlinked mixtures. Additionally, CNC-alanine-DHT ester had the highest therapeutic ratio of all agents investigated. HECNU-hemisuccinate-DHT ester, on the other hand, achieved even higher antitumor activity at the optimal dose but had a narrower therapeutic ratio. No obvious correlation between antineoplastic efficacy and receptor binding affinity could be demonstrated, but, to be active, a conjugate apparently had to have some receptor binding affinity for both androgen and progesterone receptors. The results obtained indicate that linking antineoplastic agents to transport molecules with affinity to steroid receptors is a highly promising approach to obtain drugs with specific activity in steroid receptor containing tumors.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01637072
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  • 4
    Electronic Resource
    Electronic Resource
    Differential relationship of vitamin A and E levels in methylnitrosourea-induced Sprague-Dawley rats following prolonged feeding of fatty diets enriched with the vitamins (1990)
    Springer
    Journal of cancer research and clinical oncology 116 (1990), S. 470-474 
    Details
    ISSN: 1432-1335
    Keywords: Vitamins A, E ; Semisynthetic fatty diet ; Methylnitrosourea ; Mammary carcinoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Prolonged supplementation of vitamins A and E (2500 IU and 11.3 IU/rat daily) in 10.3% and 21.6% fatty diets administered to methylnitrosourea-induced Sprague-Dawley rats caused alterations in plasma and liver levels of both vitamins as well as of the total lipids. Liver vitamin A levels increased steadily (more than four-fold) until termination of the experiment, whereas plasma vitamin A levels only showed a minor increase at the end of the study in comparison to rats fed a standard diet. Liver vitamin E levels initially showed no difference from those of rats treated with a standard diet, and were decreased at the end of the experiment, whereas the respective plasma levels were increased throughout the study, only showing a decrease relative to initial values at termination of the experiment. Plasma total lipids increased with age and following supplementation of the vitamins in the high-fat diet, whereas liver total lipids were influenced less by aging than by the fat and vitamin contents of the respective diets. The observed alterations were, however, not related to significant chemopreventive activity of the vitamins A and E contained in high-fat diets.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01612996
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  • 5
    Electronic Resource
    Electronic Resource
    Psychosomatische Grundversorgung auf der Grundlage des PLISSIT-Modells Entwicklung und Evaluation einer Weiterbildungskonzeption (1999)
    Springer
    Der Nervenarzt 70 (1999), S. 54-63 
    Details
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Psychosomatische Grundversorgung ; Fortbildung ; Hausärzte ; Beratung ; Psychiatrie ; Psychosomatik ; Key words Education ; Training program ; General practioners ; Psychosomatic medicine ; Psychiatry ; Primary care ; Continuous medical education
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Deficits in current approaches of psychosomatic and psychiatric education for general practitioners are reviewed. A skill-based training was developed in line with the four step counceling approach of the „PLISSIT” approach: The GP helps in first step („permission”) the patient to accept his problem and assesses informations about causing and maintaining factors of his symptomatology. In the second step he should provide information about the disorder and reverse misunderstanding and passivity (Limited Information). The GP’s should develop preliminary strategies for change in the third step („coping strategies”, „symptom management”; „special suggestions”) and preparate the intensive phase of therapy as the last step. First results of the evaluation of the training program are presented demonstrate the effectiveness and acceptance of the education programm.
    Notes: Zusammenfassung Ausgehend von einer Analyse der Schwächen aktueller Ansätze der psychosomatischen Grundversorgung wird einerseits ein Ansatz vorgestellt, der störungsspezifisch im Rahmen eines Mehrebenenmodells pharmakologische und verbale Intervention aufeinander bezieht. Andererseits werden im Sinne eines zeitökonomisch abgestuften Vorgehens verschiedene Phasen durch das zugrundegelegte PLISSIT-Modell differenziert: In der Permission-Phase geht es um die Akzeptanzvermittlung und Problemanalyse hinsichtlich der vom Patienten geschilderten Beschwerden, in der Phase der „limited information” um die dialogische Erarbeitung eines Störungsmodells und den Aufbau einer aktiven Änderungsmotivation, in der Phase der „special suggestions” erfolgt eine konkrete Anleitung zur Selbstbeobachtung und -protokollierung des Problemverhaltens sowie die Vermittlung von Strategien zum Symptommanagement; in der letzten Phase der „intensive therapy” geht es um die Indikationsstellung und den Motivationsaufbau zur fachärztlichen bzw. fachpsychotherapeutischen Weiterbehandlung. Empirische Ergebnisse zur Evaluation des Weiterbildungskonzeptes an über 200 Teilnehmern werden referiert.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001150050400
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  • 6
    Electronic Resource
    Electronic Resource
    Das Konzept der “Evidence-based Medicine” in der Psychiatrie Ein Weg zu einer rationaleren Psychiatrie? (2000)
    Springer
    Der Nervenarzt 71 (2000), S. 173-180 
    Details
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Evidence-based Medicine ; Psychiatrie ; Qualitätssicherung ; Datenbanken ; Randomisierte kontrollierte Studien ; Key words Evidence-based medicine ; Psychiatry ; Evidence-based health care ; Quality control
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Many of the diagnostic and therapeutic procedures in psychiatry and psychotherapy are based on opinion rather than evidence. The concept of evidence-based medicine aims to bridge the gap between clinical research and clinical decision-making by integrating the best available external evidence with personal expertise. In this article, we demonstrate several examples of the non-evidence-based medicine paradigm. Then we show the usefulness and practicability of the new evidence-based medicine paradigm by using a clinical example. Finally, we discuss the consequences, chances, and limitations of this new model. We also examine the role of the individual clinician's viewpoint as well as the need of institutional re-engineering and the possible restructuring of the entire health care system towards evidence-based methods.
    Notes: Zusammenfassung In der Psychiatrie und Psychotherapie finden weiterhin viele Therapieverfahren Anwendung ohne dass ein empirischer Nachweis ihrer Wirksamkeit vorliegt. Die aus dem angloamerikanischen Sprachraum stammende “Evidence-based Medicine” bietet ein Konzept, medizinische Entscheidungen auf der Basis der besten zz. Verfügbaren externen Evidenz in Verbindung mit der individuellen klinischen Erfahrung zu treffen. In diesem Beitrag werden zunächst Beispiele einer “Non-evidence-based Psychiatry” aufgezeigt, ein klinisches Beispiel soll das Konzept einer “Evidence-based Psychiatry” vorstellen, am Ende schließlich steht die Betrachtung ihrer Anwendung, Grenzen und Möglichkeiten in der Praxis. Zum einen wird der Stellenwert dieser Methode für den klinisch tätigen Psychiater und Psychotherapeuten dargestellt. Zum anderen werden mögliche Konsequenzen diskutiert. Diese ergeben sich für Aufbereitung und Bereitstellung der Evidenz in Form von Datenbanken und systematischen Übersichtsarbeiten und in der Notwendigkeit von Umbauprozessen für die einzelne Institution wie auch für das Gesundheitssystem als Ganzes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001150050026
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    Paper (German National Licenses)
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