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Biomedical subjects

H Csef

Publications and source records attributed to H Csef.

At least 19 recordsLinked to original sources
PubMed2006

[Psychosocial stress as a risk- and prognostic factor in coronary artery disease and myocardial infarction].

Cardiovascular diseases (CVD) challenge patients and social systems alike. Epidemiologic and economic data underscores demands for additional knowledge and therapeutic options. As recent data shows, psychosocial stress is underestimated as a risk- and prognostic factor in CVD. Cardiac mortality rises sharply whithin a small time-frame after a catastrophic event. But even common daily hassles, anxiety, depression or personality traits can impair cardiac health. Social networks are thought of being cardio-protective. However, if not perceived as supportive, social networks may influence cardiac health negatively. Therefore new approaches emerge against one of the most relevant disease of our time.

Anxiety↗
PubMed2005

[Stress and myocardial infarction].

Most people throughout the world die from the consequences of cardiovascular disease. Stress and psychosocial burdens have, in the past, been underestimated with regard to the importance of their impact on the development and course of such diseases. In the INTERHEART study, psychosocial burdens occupy third place among the risk factors for developing acute myocardial infarction. The relevance of these factors is underscored by more recent studies, also with regard to the prognosis in already manifest CAH. The causes of mental stresses may be intrapsychic problems (e.g. depression). The roots may, however, also be found in the private sphere or at the workplace. On the basis of specific history-taking, relevant risk constellations can be identified for a comparatively low expenditure of time. Specific therapeutic approaches aimed at reducing and coping with stress may, in future, help prevent diseases of the heart and lower the risk of contracting a myocardial infarction.

Clinical Trials as Topic↗
PubMed2002

Paroxetine for the treatment of interferon-alpha-induced depression in chronic hepatitis C.

BACKGROUND: Psychiatric side-effects may require dose reduction or premature discontinuation of interferon therapy in chronic hepatitis C. New strategies are needed in order to prevent the premature termination of interferon therapy. AIM: To evaluate prospectively the efficacy and tolerability of antidepressant therapy (paroxetine, a selective serotonin reuptake inhibitor) in patients with chronic hepatitis C treated with interferon-alpha who have developed interferon-induced major depression. METHODS: A sub-group of 14 individuals from 121 consecutively treated hepatitis C patients developed substance-induced major depression without suicidal ideation during interferon-alpha treatment. The individuals in this sub-group received paroxetine after the occurrence of depression (20 mg daily until termination of interferon therapy). Diagnostic scores for depression (and anger-hostility) were obtained in a repeated measures design (Hospital Anxiety and Depression Scale and Symptom Checklist 90 Items Revised). RESULTS: Eleven of the 14 patients (78.6%) with interferon-induced major depression were able to complete interferon-alpha therapy as scheduled under concomitant paroxetine treatment (three dropouts: insufficient improvement of depression, occurrence of epileptic seizures, paroxetine-induced nausea/dizziness). Within 4 weeks after the start of paroxetine medication, depression scores declined significantly in all patients. CONCLUSIONS: Our data suggest that concomitant therapy with paroxetine is an effective way to treat interferon-induced depression in patients with chronic hepatitis C.

Adolescent↗
PubMed2001

[Depression in cancer patients. Early recognition--adequate treatment].

During or following chemotherapy, cancer patients frequently suffer from depression, asthenia and lassitude, which may have an unfavorable effect on the course of the disease. Psychotherapeutic interventions and psychopharmaceuticals can significantly ameliorate these symptoms and thus improve the patient's quality of life. Over the long term, the general practitioner has a key diagnostic and therapeutic function. While monitoring the further course of the patient, he can recognize the signs of depression and call in specialist help.

Ambulatory Care↗
PubMed2001

[Chronic fatigue].

Explore the source record for details and available documents.

Diagnosis, Differential↗
PubMed2001

Compliance with therapy in patients with chronic hepatitis C: associations with psychiatric symptoms, interpersonal problems, and mode of acquisition.

Tolerance of interferon-a therapy for hepatitis C is often poor and medication is expensive. Compliance with diagnostic procedures and, even more important, with medical treatment is obviously critical to minimize the rate of dropouts and to maximize cost efficiency. Moreover, a good concordance with scheduled follow-ups is important for early recognition and treatment of interferon-associated side effects. Therefore, we investigated psychiatric symptoms, interpersonal problems, different modes of acquisition, and sociodemographic factors in HCV-infected patients as possible predictor variables of good versus poor compliance. In a longitudinal study, 74 patients with chronic hepatitis C (CHC) who fulfilled the criteria for treatment with interferon (IFN)-alpha-2b with or without ribavirin were investigated prospectively to identify those at risk for poor compliance during IFN medication. To assess predictive factors, we used both IIP-C (Inventory of Interpersonal Problems) and SCL-90-R (Symptom Check List 90 Items Revised) as psychometric instruments. Sociodemographic and somatic variables as well as compliance during IFN therapy were also evaluated. Poor compliance before or during medication was demonstrated by 23% (N = 17) of HCV patients. Sociodemographic factors and mode of acquisition, particularly former intravenous drug (IVD) abuse were not significantly linked with compliance. Logistic regression analysis demonstrated that the subgroup of patients with compliance problems was best identified by both pretherapeutic psychiatric symptoms and interpersonal problems. Predictive value was best and significant for anger-hostility (P = 0.009), intrusive (P = 0.014), depression (P = 0.015), and phobic anxiety (P = 0.049). Adopting this statistical prediction model, sensitivity was 47.1%, but specificity reached 98.3%. In total, 86.5% of cases were classified correctly. In situations of unclear indication for IFN therapy, psychological variables assessment of before the beginning of treatment may represent an additional decision-making factor.

Adolescent↗
PubMed1999

[Psychotherapy: the earlier, the better. Postponing therapy harms the patient and health insurance].

Psychotherapeutic measures produce good results providing they are initiated in good time, and the treatment is appropriate to the problem and given by a competent therapist. There are, however, numerous difficulties that can result in the psychogenic disorders becoming chronic. The poor public acceptance of psychotherapy is based on fear and the negative perception of this form of treatment. It would appear to be of great importance to improve the image of psychotherapy to avoid chronicity.

Cost Savings↗
PubMed1998

[Attitude towards physician-assisted suicide among German doctors. A representative survey of the medical district association of Würzburg].

BACKGROUND AND OBJECTIVE: The widespread legalization of "physician assisted suicide" (PAS) in The Netherlands and comparable tendencies in other European countries have given rise to discussions of this topic in Germany. This questionnaire was undertaken because of the dearth of previous informative studies in Germany. SUBJECTS AND METHODS: Among all registered practicing doctors in the medical district of Würzburg (n = 1821) a randomly selected group of 150 (males and females) was asked to participate in a personal interview-enquiry about active and passive euthanasia. 93 (62%, 32% women, 61% men) agreed: 44.1% were doctors working in a hospital, 45.2% worked in their own practice, the others worked elsewhere or (3) were retired. All specialties and medical activities were represented. About 40% were general practitioners or worked in internal medicine. RESULTS: 81.7% of the group were against active PAS. All rejected it for non-moribund patients. CONCLUSIONS: The results of this study differ from similar enquiries in other countries in demonstrating a relatively strong rejection of active assistance in patient-suicide. Those German specialists who would most likely be confronted with this problem (e.g. neurologists, intensivists, anaesthetists, oncologists) tended towards a greater readiness to agree to physician-assisted suicide. A dialogue between doctors in different specialties is an urgent requirement and should be intensively pursued.

Attitude of Health Personnel↗
PubMed1998

[The non-specific environmental syndromes MCS (Multiple Chemical Sensitivity), IEI (Idiopathic Environmental Intolerance) and SBS (Sick Building Syndrome)].

This review starts with a clinical description of the most common unspecific environmental diseases, such as Multiple Chemical Sensitivities (MCS), Idiopathic Environmental Intolerances (IEI) and Sick Building Syndrome (SBS). These syndromes are very controversial discussed between scientific medicine and "clinical ecology". In addition, they have fundamental similarities to Chronic Fatigue Syndrome (CFS) and Fibromyalgia. Finally the spectrum of therapeutic approaches is discussed.

Desensitization, Immunologic↗
PubMed1998

[Active euthanasia or better palliative therapy?].

The Dutch Supreme Court ruled that in exceptional instances, physician-assisted suicide might be justifiable for patients with unbearable mental suffering but no physical illness. A recent report shows that explicit requests for physician-assisted suicide are not uncommon in psychiatric practice in the Netherlands. Some of those requests were granted and their medical background was described. Psychiatric consultation for medical patients who request physician-assisted suicide is relatively rare. Therefore is seems to be necessary to establish better palliative care for the terminally ill. When psychiatrists help their patients to commit suicide there is a danger of abuse and "slippery slope".

English Abstract↗
PubMed1996

[Recent psychosomatic contributions to the pathogenesis and therapy of irritable colon (irritable bowel syndrome)].

Epidemiological studies indicate that irritable bowel syndrome represents the most frequent somatoforme disorder. Current pathogenetic concepts as well as newer results in pathophysiology, neurobiology and psychoendocrinology are described. As an example of the "brain-gut-link", the role of cholecystokinin (CCK) is discussed. The positive results of psychotherapeutic intervention studies are described in more detail. An intensified cooperation between the gastroenterologist and the psychotherapist is recommended.

Cholecystokinin↗