Search PubMed⌕ Search

Biomedical subjects

J Kugler

Publications and source records attributed to J Kugler.

At least 55 records · Page 3Linked to original sources
PubMed1997

Effects of pain-incompatible imagery on tolerance of pain, heart rate, and skin resistance.

Imagery is an important component in strategies for coping with pain. In this study, we examined, whether imagery influences tolerance for pain and whether subjects, trained in pain-incompatible imagery differ in heart rate and skin resistance from these in a control group during a pain-induction session. 39 subjects were randomly assigned to two groups: imagery and control. Both groups had two pain-induction sessions. At intake into the study (t1). Pain Tolerance and Psychophysiological Reaction to Pain were assessed using a pressure algometer. After the first session, the experimental group received 1 hr. of training in pain-incompatible imagery. Seven days later, the session was repeated (t2). The results showed that Pain Tolerance was significantly increased in the group who used pain-incompatible imagery. One might follow the notion that increased Pain Tolerance is associated with increased Psychophysiological Pain Reaction, but results suggest the contrary. Subjects trained in pain-incompatible imagery had lower heart rates during the second pain induction than the control group. Groups did not differ with regard to skin resistance. It can be stated that besides information, cues on coping with pain may be helpful in clinical practice.

Adaptation, Psychological↗
PubMed1997

Effects of nondirective suggestions on pain tolerance, pain threshold and pain intensity perception.

In this experiment, we followed the issue whether nondirective suggestions have an effect on pain threshold, pain tolerance, and perception of pain intensity. 48 healthy subjects consented to take part. At intake into the study (t1), pain threshold and pain tolerance were assessed in all subjects using a pressure algometer. Perception of maximum pain intensity perception was rated on a scale of 0 to 25. Seven days later, the session was repeated (t2). Subjects were randomly assigned to one of two groups. One group received nondirective suggestions as pretreatment. Subjects listened to a tape of 20 min. which consisted of general information about pain theory. In this context, suggestions for coping with pain were placed. The other group served as a control and received no pretreatment. Analysis showed that pain tolerance was significantly prolonged in the group who received nondirective suggestions, while pain threshold and perception of maximum pain intensity did not differ across groups. This study demonstrates that nondirective suggestions are effective in prolonging pain tolerance. It can be stated that, beside information, cues on coping with pain may be helpful in clinical practice.

Adaptation, Psychological↗
PubMed1997

[Psychological concept of pain therapy. 1. Relaxation therapy, imagery methods, hypnotherapy and psychoanalysis].

In this article, the contribution of the psychotherapy schools to psychological pain therapy shall be explained. In the first part, relaxation methods, imaginative techniques hypnotherapy, and psychoanalysis as well as their importance for psychological pain therapy are presented. Research findings for autogenic training, progressive muscle relaxation and meditative methods are shown as example for relaxation methods. Imagery is shortly explained and associated to hypnotherapeutic methods. In hypnotherapy, research results, the pattern of a session and hypnotherapeutic strategies for pain reduction are demonstrated. In the explanation of psychoanalysis, the aims and explanation principles of analytic methods for the psychogenic pain development are shown.

Humans↗
PubMed1996

Excavation of caries lesions induces transient decrease of total salivary immunoglobulin A concentration.

Salivary immunoglobulin A (IgA) secreted by salivary glands is the predominant humoral factor of the local immune system in the oral cavity. Epidemiological studies emphasize the importance of salivary IgA in the protection from infections and caries. This study investigated how excavation of caries lesions affects total salivary IgA concentration. Fifteen patients were assigned to two sessions: the first session consisted of the excavation of a caries lesion. Thirty min before, during, directly after, and 30 min after the excavation, patients were asked for saliva samples. One wk later, a control session was performed on the same patients at the same time of the day, consisting of a dental inspection without any drilling. Marked, transient decreases were observed in concentration and secretion rate of total salivary immunoglobulin A during and immediately after caries excavation. Thirty min after caries excavation, immunoglobulin A concentrations returned to baseline. No differences were found between sessions with regard to saliva flow and cortisol concentration. It was concluded that transient decreases of total salivary immunoglobulin A concentrations are induced by excavation of caries lesions.

Adult↗
PubMed1996

Competition stress in soccer coaches increases salivary. Immunoglobin A and salivary cortisol concentrations.

The effect of acute psychological stress on salivary immunoglobulin A (sIgA) and salivary cortisol concentrations was studied in professional soccer coaches (n = 17) before, during, and after a match of their team. Saliva samples were collected at five time points (2 hours before the match, at the beginning of the match, during half time break, at the end of the match and one hour after the match) and analysed for sIgA and salivary cortisol together with the subjective rating of perceived psychophysiological arousal. In addition, control subjects (n = 8) were tested under resting conditions with identical procedures. Results show that soccer coaches rated themselves as more excited and tense during the match compared to time points before and after the match of their team. Furthermore, coaches revealed pronounced, transient increases in sIgA and salivary cortisol concentrations compared to control subjects. These data indicate, that acute psychological stress activates non-specific humoral immune functions.

Adult↗
PubMed1996

[Assessing the risk of HIV infection in the clinic and daily environment by medical students].

The potential risks of obtaining an HIV infection during the clinical routine becomes recently more and more a subject for discussion. The assessment of HIV transmission in the hospital by medical students seems to be important, because medical students are doing practical nursing training, medical clerkships and courses in the hospital, are in a developing process to their later social role as a physician and because of their age, they belong to the group with the highest statistical risk of getting HIV infected. The following study analysed the view of medical students to get HIV infected in typical clinical routine situations and non-clinical situations. 316 medical student in the first year (average age: 22 years, female = 171, male = 145) estimated the risk of getting HIV infected for 18 different clinical and non-clinical situations. The survey was done in 1991 and 1993. It becomes obvious, that medical students still have gaps in their knowledge about HIV transmission. Over 10% of them estimated non-clinical situations like mosquito- and animal-bites or clinical situations like changing dirty linen or physical examination as situations with a high risk of getting HIV infected. The study shows, that medical students need more informations and counselling about HIV related aspects for their later work as a physician.

Adolescent↗
PubMed1996

[Instead of vacation at shoal resort, a stay in the hospital--aspects of illness during vacation].

Every summer, the number of hospitalizations for acute deterioration of a chronic disease increases in the Southern Northsea holiday region. These patients usually are holiday-makers coming to the region for recreation. This study analyzes the relationships among acute illness, reason for going on holiday, existing chronic disease, mode of transport/arrival, and consultation of general practitioner beforehand. A total of 62 holiday-makers from the region who had been hospitalized for internal illness were included in the study. 80.6% of them knew to be suffering from a chronic disease. In 41 patients, acute deterioration of their chronic condition within a few days after their arrival had resulted in admission to the hospital. Usually, their doctor had not advised against the intended holiday trip. The study findings indicate that chronically ill patients need individualized counselling about potential medical hazards associated with their chronic condition especially in light of the physical and emotional strains involved in an intended holiday. Also, mention should be made of the possibilities for participating in an organized health-resort programme.

Adolescent↗
PubMed1995

Underestimation of sensorimotor task-induced blood-pressure changes by posttask sphygmomanometry.

For assessment of cardiovascular effects of sensorimotor work, blood pressure is commonly measured by arm sphygmomanometry. A technique introduced by Penaz makes it feasible to monitor blood pressure noninvasively and continuously from the finger artery which measures give high correlations with intraarterial measurement. This study compared blood-pressure changes induced by a standard sensorimotor task using sphygmomanometry and the Penaz-method. It was investigated whether sphygmomanometrically recorded blood pressure can be used to estimate task-induced blood-pressure changes and whether inflating the cuff to different maximum pressures induces blood-pressure changes. 46 normotensive individuals were randomly assigned to the discomfort group (maximum arm-cuff pressure of 280 mmHg) or to the control group (maximum arm-cuff pressure of 160 mmHg). The experiment consisted of six tasks of 4 min. each. Results indicated that sphygmomanometries under-estimated task-induced blood-pressure changes and that phasic systolic and diastolic blood-pressure elevations during the task were leveled off shortly after the end of the task. Effects of 'cuff-inflation hypertension' were not found. The Penaz-method appears to be more appropriate than sphygmomanometry if dynamic aspects of blood pressure are of interest.

Adult↗
PubMed1995

Randomized, surgical adjuvant clinical trial of recombinant interferon alfa-2a in selected patients with malignant melanoma.

PURPOSE: We conducted a randomized prospective trial in selected patients with fully resected high-risk stage I and II malignant melanoma. PATIENTS AND METHODS: Interferon alfa-2a (IFN-alpha 2a) 20 x 10(6) U/m2 was administered three times each week for 12 weeks by the intramuscular route. Both the treatment group (n = 131) and the control group (n = 131) were evenly balanced with regard to relevant prognostic discriminants. RESULTS: The median disease-free survival (DFS) time was 2.4 years for the IFN-alpha 2a group and 2.0 years for the observation group (log-rank P = 0.19). The median survival times were 6.6 years for IFN-alpha 2a and 5.0 years for observation (log-rank P = .40). For stage I patients (n = 102), there was no apparent therapeutic advantage from IFN-alpha 2a therapy. The DFS for stage II patients was a median of 10.8 months in the control group versus 17 months in the treatment group. The overall survival time was 4.1 years for the treatment group versus 2.7 years for the control group. The differences in DFS for stage II patient were significant in a Cox model. These results must be interpreted cautiously because of subset analysis. A severe flu-like toxicity occurred in 44% of patients, 13% lost at least 10% of their baseline weight, and 45% experienced a worsening of Eastern Cooperative Oncology Group (ECOG) performance score. CONCLUSION: Our findings indicate trends that suggest a possible benefit for selected patients with high-risk malignant melanoma. The results will require further study in a larger patient population for confirmation.

Adult↗
PubMed1994

Emotional adjustment and perceived locus of control in heart transplant patients.

Orthotopic heart transplantation has been established as a routine clinical operation. In this study, we were interested in: (a) how patients cope emotionally with the situation pre- and postsurgically, especially with regard to anxiety and depression; and (b) whether the patient's perceived locus of control is related to emotional adjustment before and after heart transplantation. Twenty patients who were on the waiting list for heart transplantation with highest priority provided complete psychological questionnaires presurgically and 20 days after surgery when intensive care was no longer required. During the waiting period, patients rated high on depression, state and trait anxiety in comparison with healthy references while ratings on perceived locus of control scales were within the norm ranges. After surgery, heart transplant patients experienced significantly less state/trait anxiety and depression reaching levels which were no longer statistically different from health references. While postsurgical ratings of anxiety (state and trait) and depression were not significantly correlated with presurgical ratings, both were closely related to ratings of locus of control. Belief in powerful others was positively correlated with pre- and postsurgical anxiety and depression. Chance control orientation was related only to presurgical emotional disturbances. It can be concluded that emotional adjustment after heart transplantation is more likely to be predicted by presurgical ratings of locus of control than by presurgical emotional adjustment.

Adaptation, Psychological↗
PubMed1994

Effects of rehabilitation exercise programmes on anxiety and depression in coronary patients: a meta-analysis.

In coronary patients, emotional disturbances in the sense of increased anxiety and depression have often been documented. Over the last years, there has been a growing interest in the effects of exercise on emotion. This meta-analysis, based on 13 to 15 studies on psychological effects of exercise programmes in coronary patients, showed a positive effect size both for anxiety (dmean = .3137) and depression (dmean = .4569). Nevertheless, these effect sizes have to be evaluated as less than medium by convention and in comparison to the effect size of psychotherapeutic interventions. The effect sizes on anxiety or depression were not related to methodological characteristics of the included studies, like duration of the exercise programme, time chosen for follow-up, publication year or use of control groups. But there was a significantly negative correlation between sample size and effect size. This might indicate a potential publication bias in the sense that significant rather than non-significant results may be published on small subject samples. We concluded that exercise programmes should not be considered the only treatment for emotional disturbances in coronary patients, but that they can be psychologically beneficial as an additional treatment component.

Anxiety↗
PubMed1994

[Ketamine--anticonvulsive and proconvulsive actions].

Animal experimentation has revealed that ketamine has anticonvulsive properties. Changes in the EEG have also been reported in animals; these have been designated non-convulsive generalized electrographic seizures because of their similarities to epileptiform potentials, even though there are no recognizable signs of seizures. The cataleptic condition of the cats in which these changes were observed led to the conclusion that ketamine could cause petit mal seizures, which took the course of petit mal status. Ketamine was therefore also seen as a dangerous anaesthetic agent predisposing to convulsions, the use of which could lead to status epilepticus and irreversible brain damage. These conflicts of opinion should be resolved, as they are based on various misconceptions. (1) The terminology used for epilepsy by specialized clinicians is not always correctly applied in the context of animal experimentation. (2) The activation of epileptiform potentials in the EEG of animals cannot be interpreted as a reliable sign of epileptogenic efficiency in humans. (3) Too little regard is paid to the different actions of anaesthetic agents in various sites of the brain, at different doses and with different routes of administration. (4) The statistical significance and biological relevance of the study results are inadequate because the numbers of observations are too small. Epileptologists regret the insufficiency of animal models as paradigma for the study of efficiency of antiepileptic drugs in humans. The degree by which extensor spasms in the front paw of Gerbils of rats induced by pentylentetrazol or electric current are reduced after application of an anticonvulsive drug is no reliable measure of its anticonvulsive effect in humans.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Rise in systolic blood pressure during sphygmomanometry depends on the maximum inflation pressure of the arm cuff.

OBJECTIVE: Sphygmomanometric recordings of blood pressure are a standard technique in clinical practice. We investigated whether arm-cuff inflation can induce short-term blood pressure changes ('cuff-inflation hypertension'), limiting the generalizability of recordings. METHODS: Progress in biomedical methodology makes it feasible to monitor blood pressure continuously and non-invasively at the finger artery (the Peñaz method). Seventy-two normotensive subjects were randomly assigned either to a series of sphygmomanometric recordings in which a maximum cuff pressure of 300 mmHg was applied, to a series in which the maximum cuff pressure was 175 mmHg or to a control group in whom no sphygmomanometric recordings were made. RESULTS: The subjects exposed to arm-cuff inflations perceived the cuff inflation pressure, but their perception could not differentiate between the two maximum cuff pressures. Furthermore, increases in systolic blood pressure during the inflation period were recorded when a maximum cuff pressure of 300 mmHg was applied. The effects on diastolic blood pressure were not significant. CONCLUSIONS: The maximum arm-cuff pressure during sphygmomanometry should be not too far above the pressure needed to occlude the brachial artery. A high maximum arm-cuff pressure increases the chances of inducing 'cuff-inflation hypertension'.

Adult↗
PubMed1993

Influence of the earth's magnetic field on resting and activated EEG mapping in normal subjects.

We found in a former investigation that by measuring sleep parameters, the REM latency is shortened in the E-W position of sleepers compared with the N-S position. This paper reports on a further neurological observation in humans concerning the influence of the earth's magnetic field: there are statistically significant differences in the EEG of normal subjects, depending on whether the subjects sit facing the N-S or E-W direction. The difference is especially pronounced in the alpha-power.

Adult↗