Universitatsklinikums Ulm

Schönau am Königssee, Germany

Universitatsklinikums Ulm

Schönau am Königssee, Germany
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Himmel R.,Universitatsklinikums Ulm | Zwonitzer A.,Universitatsklinikums Ulm | Thurn L.,Universitatsklinikums Ulm | Fegert J.M.,Universitatsklinikums Ulm | Ziegenhain U.,Universitatsklinikums Ulm
Nervenheilkunde | Year: 2017

Children are severely ar risk by witnessing domestic violence. In particular women and children who flee to a women's refuge, often have long-lasting and massive experiences of violence. Although it can be assumed that these women and children are burdened psychologically particularly high, in Germany there are no systematic-rule studies whose results could help to better supply the women and children with (specific) support services from existing support systems to handle their experiences of violence. The present pilot study investigated children and their mothers in five women's refuges concerning their psychological distress. The children were asked about behavioral problems, symptoms of attachment disorders and traumatic experiences. The mothers were asked about psychological distress in particular for depression symptoms. The results pointed out that the majority of children and their mothers suffered from high psychological distress.

Objectives: Many adolescents show dysfunctional behaviors such as suicidality and nonsuicidal self-injury (NSSI). School staff are often insufficiently educated in how to deal with such behavior. Objective of the present study was to evaluate a workshop aiming to improve knowledge and skills on how to deal with NSSI and suicidality in students. Material and methods: In total, 16 two-day workshops were offered and attended by 257 persons. During pre-, post- and follow-up (FU)- assessments, confidence in own skills, attitudes towards-, perceived knowledge and actual knowledge on NSSI and suicidality were gathered. Behavioral changes (FU) and satisfaction with the workshop were assessed as well. Results: Taken together, school staff were very satisfied with the workshop. Confidence, perceived and actual knowledge improved strongly from pre to post and remained stable until follow-up (large effect size). Behavioral changes were registered at FU. Conclusions/Clinical relevance: Improved knowledge and skills of school staff on NSSI and suicidality might help to improve dealing with affected adolescents. © Schattauer 2017.

Children of incarcerated parents are a highrisk sample. They often grow up in a multiple problem environment and are exposed to miscellaneous risk factors. They are showing an increased lifetime prevalence of psychiatric disorders. The probability of getting arrested is also higher than in a control sample. A study revealed that approximately one third of incarcerated women and men have children up to the age of 18 in southern Germany. Nevertheless, there are only some isolated and not area wide intervention programs for children with an incarcerated parent. Since 2011 there is a specialized intervention program in the federal state of Baden-Württemberg, which involves systematic support opportunities for families affected by the incarceration of a parent. The goal of the project is especially the support of their children. The scientific evaluation was made by the clinic for child and adolescent psychiatry/psychotherapy at the university of Ulm. The results are the first attempt for an systematic review about the psychological situation of children of incarcerated parents in Germany. The results show that these children are at high risk concerning attachment difficulties and behaviour problems. The comparison of the results before and after the treatment of the parent-child-project showed some little improvements. © Schattauer 2017.

Henn K.,Universitatsklinikums Ulm | Himmel R.,Universitatsklinikums Ulm | Fegert J.M.,Universitatsklinikums Ulm | Ziegenhain U.,Universitatsklinikums Ulm
Nervenheilkunde | Year: 2017

As a result of the UN Convention on the Rights of Persons With Disabilities' ratification, the right of children with special needs to attend general school in form of an inclu - sive education is realized more frequently. So far, schools do not have enough personal and structural resources to meet the different challenges of the new students with disabilities. Therefore so called "Schulbegleiter" (school assistants) financed by the local social and youth welfare systems are employed. School assistants can be qualified pedagogics as well as paraprofessionals and volunteers. Until now only few systematic training courses for school assistants exist. This article gives an overview of current research. Additionally the authors' developed and tested curriculum for a training for school assistants is presented. © Schattauer 2017.

Establishment of organ site-specific cancer centers by the German Cancer Society (GCS) is part of the basic politically driven reform of oncology care in Germany. Since 2007 an increasing number of prostate cancer centers have been guided toward certification by the OnkoZert GmbH of the GCS. Currently 68 centers are certified and together with ongoing certification proceedings will amount to 81 prostate cancer centers, which cover about one fourth of cases of primary prostate cancer. Urology is of particular importance in the management of these centers. For the most part, urologists belonging to a clinical unit are the initiators of the certification process, thus ensuring that uro-oncology is firmly entrenched in the specialty with involvement of outpatient service providers. Fears that authority will be lost are unfounded as long as responsibility for this task is taken seriously and active use is made of the possibilities for creativity. A similarly important function is fulfilled by the testicular cancer centers that offer second opinion services, which were initiated by urology conjointly with German Cancer Aid to pursue the goal of quality assurance for this tumor entity and therefore likewise secure the position of this tumor in the realm of urologists. By applying such strategic approaches, urologists will succeed in sustainably safeguarding their future importance in a very competitive environment and in counteracting the encroachments of other specialties by exhibiting clear orientation. © 2011 Springer-Verlag.

Bruck S.,Universitatsklinikums Ulm | Skrabal C.,Universitatsklinikums Ulm | Trager K.,Universitatsklinikums Ulm | Reinelt H.,Universitatsklinikums Ulm
Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie | Year: 2014

Protamine is a protein mainly used to reverse anticoagulant effects of heparin during cardiac or vascular surgery with extracorporeal circulation. Adverse events after protamine administration are rare but if they occur they can be catastrophic. Based on a case report with an elective cardiac surgery patient with known allergy to fish, we discuss the related events and risk factors for an adverse reaction after protamine. The patient management and its outcome are presented.

Korper S.,Universitatsklinikums Ulm | Hochsmann B.,Universitatsklinikums Ulm | Schrezenmeier H.,Universitatsklinikums Ulm
LaboratoriumsMedizin | Year: 2015

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare benign clonal disorder of hematopoiesis. Its etiologic basis is the clonal dominance of a PIGA-mutated hematopoietic progenitor that gives rise to GPI-deficient blood cells that are unable to express complement inhibitors like CD55 or CD59. These cells are prone to complement-induced hemolysis. In classic hemolytic PNH, granulocyte clone sizes can be up to 90% or more. Much progress has been made during the last years in understanding the interrelations of complement-dependent hemolysis; its consequences like thrombosis, renal failure or pulmonal hypertension; and possible treatment strategies. To gain clinical relevance, the PNH clone has to make a relevant contribution to blood cell generation; however, a minimal clone size as a threshold for the occurrence of symptoms such as thrombosis, dyspnea, chest or abdominal pain cannot be given. Such symptoms can be seen in a relevant proportion of patients with clone size smaller than 10%. The driver for the clonal dominance of the PIGA-mutated hematopoiesis is still not clear. Recently, data about coexisting mutations in cancer genes have been published and new mechanisms for autoimmunity have been presented. The success of eculizumab in the treatment of PNH patients has stimulated the development of a variety of new strategies for complement inhibition. This review will focus on the most important findings in pathophysiology, clinical course and treatments during the last years. © 2015 by De Gruyter.

Illness behaviour involves cultural, situational and personal predispositions. World Wide Web search statistics provided by internet applications like Google Insights for Search have the potential to facilitate our research on the distribution of mental disorders, our understanding of both sociocultural imprintings and trends in psychophenomenology and could make a remarkable contribution to medical research and public health. © Georg Thieme Verlag KG Stuttgart - New York.

Schmid M.,University Hospital Freiburg | Hummler H.,Universitatsklinikums Ulm
Padiatrische Praxis | Year: 2011

In Germany about 700000 children are born every year. Most of them are healthy and do not need resuscitation immediately after birth. Nevertheless birth is one of the most dangerous situations in life, for both the mother as well as for the newborn infant. To ensure the highest level of care for both the mother and the infant, pregnant women at risk for complications should be transferred to perinatal centers according to german national regulations and current clinical guidelines. However, perinatal complications cannot always be anticipated and may occur unexpectedly during the course of an uneventful pregnancy or during delivery. In this case, the obstetric team has the responsibility for the care of the newborn infant until the neonatologist is available to take over. Therefore, obstetricians, midwifes, anaesthesiologists or any other health care personel should be familiar with the principles of resuscitation of the newborn after birth. Wherever babies are born, there should be one person who is able to take care on the newborn infant and who is able to perform a complete resuscitation according to the ILCOR guidelines, if needed. Our objective is to present the ILCOR guidelines and to provide practical advice for the management of the sick neonate immediately after birth. The main steps of support are easily provided with some basic knowledge and practical training. This training is now offered at various places in Germany in the context of curricula based on the ERC or AAP/AHA course systems. Using the skills taught in these courses the number of infants dying or suffering from permanent sequelae of birth asphyxia or other complications may be reduced significantly.

Schmid M.,Kinder und Jugendpsychiatrische Klinik der Universitaren Psychiatrischen Kliniken Basel | Goldbeck L.,Universitatsklinikums Ulm
Praxis der Kinderpsychologie und Kinderpsychiatrie | Year: 2010

Complex Posttraumatic Stress Disorder and Developmental Trauma Disorder are discussed as new diagnostic entities representing the broad spectrum of trauma-related symptoms of children and adolescents. However, the psychotherapy of severe and complex trauma during adolescence is challenging because trauma-associated symptoms like attachment problems, the expectation of self-inefficacy and dissociation may complicate therapeutic work and limit treatment outcome. Therefore it is necessary to develop evidence-based treatment approaches for these mental disorders. Trauma-focused cognitive-behavioral therapy has been successfully evaluated for the treatment of posttraumatic stress disorder. Actual treatment approaches combine strategies from Dialectal Behavioral Therapy (DBT) with cognitive behavioral techniques of trauma therapy for the treatment of complex trauma disorder. This article gives a practical overview about cognitive-behavioral treatment approaches and discusses problems of their implementation in the clinical routine of child and adolescent psychiatrists/psychotherapists. © Vandenhoeck & Ruprecht GmbH & Co. KG, Göttingen 2010.

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