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Biomedical subjects

M Ehrhardt

Publications and source records attributed to M Ehrhardt.

At least 19 recordsLinked to original sources

[Effects of therapy goal oriented cognitive behavioural aftercare measures on therapy transfer following inpatient psychosomatic rehabilitation].

OBJECTIVE: After discharge from inpatient psychosomatic rehabilitation patients often face problems to transfer and stabilize the modifications they have achieved in the clinic. Using targeted outpatient aftercare interventions up to eight weeks after discharge from the inpatient programme we tried to support this transfer, thus enhancing treatment effectiveness. METHOD: The evaluation was carried out as a field experiment. Patients were matched into pairs and then allocated randomly to either a control or an experimental condition. The experimental group, which had participated in specific aftercare measures after inpatient therapy, was compared to the control group at "discharge from clinic" and "twelve weeks post-discharge" relative to a number of variables relevant in therapy outcome. RESULTS: Twelve weeks post-discharge patients who had participated in aftercare measures show significantly better progress relative to their physical and psychological complaints than patients in the control group. Also, they are more capable of coping with psychosocial demands of their everyday life. They experience better control of their symptoms and they are more successful in attaining the goals they have set for themselves for the time after discharge. CONCLUSIONS: The findings show that supplementing psychosomatic inpatient rehabilitation with specific aftercare measures will lead to better transfer and to increased effectiveness of psychosomatic rehabilitation. Also on account of our results, outpatient rehab aftercare programmes have in the meantime become a regular component of inpatient psychosomatic rehabilitation in Germany.

Adult↗

[Need for rehabilitation from the viewpoint of the general practitioner].

In Germany, the general practitioner plays an important role in the allocation process of rehabilitative measures. A survey concerning the questions of need, demand and effectiveness of medical rehabilitation measures as seen from the general practitioner's perspective in Hamburg, Schleswig-Holstein und Halle/Saale (n = 956) in 1999 shows that general practitioners have a rather positive attitude towards rehabilitation in general. With regard to the different measures within the rehabilitation system they show a differentiated opinion. As they see a large percentage of over- and underuse of rehabilitation they would appreciate that their information on the patient would be more intensively taken into account in the allocation process.

Attitude of Health Personnel↗

An adjuvant afterloading brachytherapy device for use after orbital exenteration in patients with orbital malignancies.

In cases of malignant diseases situated within the orbit and threaten to extend beyond it, removal of the orbit and periorbital contents may be indicated, followed by adjuvant chemotherapy or irradiation. An effective radiotherapy device for treatment of residual or suspicious cancer in the enucleated orbit consists of an external-beam radiation source (60Co) and an intraoperatively fitted mould as a guide for the flexible afterloading tubes using a 192Ir source. Considering the physical dose distribution and the local situation, this therapy permits a high dose with homogeneous dose distribution to the target area of the orbit but also allows significant dose reduction to adjunctive critical structures. Four patients with different orbital malignancies were treated by means of a combination of percutaneous radiotherapy with afterloading brachytherapy following orbital exenteration. The individual mould of the orbital cavity is modeled at the end of the operation. The technique of radiotherapy, dose distribution, and follow-up of the disease are demonstrated. Orbital malignancies with an extremely poor prognosis may profit from the application of this combined radiotherapy to avoid supraradical surgical intervention.

Adenocarcinoma↗

[Intracavitary afterloading-therapy of cervicofacial tumors--results and experiences to date].

Since 1984 we have used the intracavitary afterloading brachytherapy also in therapy of cervicofacial tumors. We report on 21 patients, 12 of them with therapy of recurrences and 9 with a primary therapy. The patients represent an inhomogeneous selected group. With recurrences also long tumor-free survival periods (till now 44, 52, 53 months) can be attained by means of contact therapy alone or in combination with percutaneous irradiation. Also after primary intensive irradiation curative radiation doses are applicable again as therapy of recurrences. Procedure can likewise be applied in primary therapy of cervicofacial tumors as a boost-irradiation in percutaneous radiotherapy. It should be reserved to limited tumor situations in compliance with irradiation of small volumes.

Brachytherapy↗

[The use of glass fiber endoscopy in afterloading contact therapy].

In afterloading contact therapy of cervico-facial tumors the control of position of the applicator has a special importance. Especially this applies the contact therapy in epipharynx. By means of a phantom of synthetic material the application can be simulated in epipharynx and the position of the applicator can be shown by means of computer-assisted tomography in all three planes. Estimation of distances by computer-assisted tomography allows correction in position and also control of corrected applicator position. Compared to it the glass fibre endoscopy requires longer working time and the topographical orientation is rendered more difficult with the technique being available in the same manner as post-rhinoscopic endo-photographic documentation of findings.

Brachytherapy↗