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Meyer K.,Universitatspoliklinik For Endokrinologie
Therapeutische Umschau | Year: 2013

Duration and severity of obesity is a riskfactor for developing left ven triculardysfunction, manifest cardiac damageand heart failure. To fulfill the increasedenergy demand with excessive bodyweight, the organism responds byphysiologic adaptation mechanismsuch as an increased blood volume, andstructural and functional cardiac adaptations.These adaptations result in anincreased stroke volume and cardiacoutput at rest and during exercise. Inearly stages of obesity an increased cardiacload is resulting in ventricular remodellingand diastolic dysfunction. Asobesity becomes chronic a progressiveimpairment of diastolic and systolicfunction ensues, and finally a developmentof left heart failure. Therefore,already in early stages of cardiac overloadand left ventricular dysfunction asufficient and sustainable weight reductionshould be targeted avoiding animpairment of diastolic and systolicfunction and development of heartfailure in time. © 2013 Verlag Hans Huber, Hogrefe AG, Bern. Source

Laederach K.,Universitatspoliklinik For Endokrinologie
Therapeutische Umschau | Year: 2013

Morbid obesity is by many seen as oneof the biggest challenges to publichealth in the 21st Century. The WorldHealth Organization (WHO) describesit as the "epidemic of the 21st Century".It is entitled as a major cause of noncommunicablechronic diseases andpremature deaths. Here, the trend isstill increasing: Overweight and obesitydo not only pose a serious healthproblem in industrialized nations, butincreasingly also in developing countries.According to WHO the cost estimatesof this epidemic is approximatedto several billion dollars per year. Alsofor the cost the tendency is still rising. © 2013 Verlag Hans Huber, Hogrefe AG, Bern. Source

Wiesmann-Fiscalini S.,Universitatspoliklinik For Endokrinologie
Therapeutische Umschau | Year: 2013

Mindful awareness of one's body has shown itself to be an effective therapeutic tool in the treatment of obesity and problematic eating habits. The introduction of non-judgemental attention in regards to one's sensory experience, emotions and thought processes offers clients inner flexibility as well as more choice in responding to habitual (eating) patterns. © 2013 Verlag Hans Huber, Hogrefe AG, Bern. Source

Kurmann S.,Bern University of Applied Sciences | Kurmann S.,Universitatspoliklinik For Endokrinologie | Boinay-Merkle F.,Bern University of Applied Sciences | Hahn S.,Bern University of Applied Sciences
Aktuelle Ernahrungsmedizin | Year: 2012

Objective: Malnutrition in clinical practice remains undiagnosed and untreated in over 50 % of the cases. It increases in-hospital complications and mortality, length of hospital stay and moreover, it decreases quality of life of those affected. This literature review investigates barriers and facilitators to implementing evidence concerning nutritional screening in clinical practice. Methods: Systematic literature search on the databases PubMed, CINAHL and Cochrane. Evaluation of the selected literature and discussion in reference to the general literature on implementing evidence into clinical practice. Results: Six studies were included in this literature review. They revealed that barriers and facilitators to nutritional screening were mostly related to organizational issues like manpower or mentoring and education in nutritional screening. Task sharing issues are of utmost importance regarding this topic of high multidisciplinary. Conclusion: There are very few studies on barriers and facilitators of nutritional screening and systematic research is lacking almost completely. Implementing nutritional screening on all inpatients is demanded by the World Health Organization, the Public Health Council of Europe and the Swiss Federal Nutrition Committee. However, implementing this recommendation in clinical practice seems challenging. Therefore, further studies of barriers and facilitators to nutritional screening are of high necessity. © Georg Thieme Verlag KG Stuttgart · New York. Source

Sahli R.,Universitatspoliklinik For Endokrinologie | Christ E.,Universitatspoliklinik For Endokrinologie
Internistische Praxis | Year: 2011

Thyroid nodules are a very common clinical finding with an age-related increase in prevalence. The clinical detection of thyroid nodules is outnumbered by the ultrasonographic assessment of thyroid nodules. The clinical challenge is to exclude the rarely occurring thyroid cancer and clinical or subclinical hyperthyroidism. Ultrasonography is the first imaging study in all patients with palpable nodules, their size and TSH determine further diagnostic evaluations. Fine-needle aspiration (cytology) is recommended in euthyroid patients of nodules measuring more than 1 cm in diameter. Nodules more than 4 cm in diameter have to be removed surgically without preceding cytological examination. Without risk factors thyroid nodules are followed by clinical examination and ultrasonography initially after 6-12 months, in case of symptoms or rapid growth a follow-up assessment should be done earlier. Source

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