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Wagner T, Kamel W, Stier R, Persigehl T, Datta R, Bruns C, Stippel D, Thomas M. [Differential diagnosis of chronic abdominal pain-Incidental finding of a conspicuous liver lesion in a 15-year-old girl with abdominal pain]. Chirurgie (Heidelb) 2024; 95:235-237. [PMID: 38165449 PMCID: PMC10879336 DOI: 10.1007/s00104-023-02009-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/17/2023] [Indexed: 01/03/2024]
Affiliation(s)
- Tristan Wagner
- Klinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Universitätsklinikum Köln, Köln, Deutschland
| | - Wasim Kamel
- Klinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Universitätsklinikum Köln, Köln, Deutschland.
| | - Raphael Stier
- Klinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Universitätsklinikum Köln, Köln, Deutschland
| | - Thorsten Persigehl
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Köln, Köln, Deutschland
| | - Rabi Datta
- Klinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Universitätsklinikum Köln, Köln, Deutschland
| | - Christiane Bruns
- Klinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Universitätsklinikum Köln, Köln, Deutschland
| | - Dirk Stippel
- Klinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Universitätsklinikum Köln, Köln, Deutschland
| | - Michael Thomas
- Klinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Universitätsklinikum Köln, Köln, Deutschland
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2
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Chon SH, Brunner S, Müller DT, Lorenz F, Stier R, Streller L, Eckhoff J, Straatman J, Babic B, Schiffmann LM, Schröder W, Schmidt T, Bruns CJ, Fuchs HF. Time to endoscopic vacuum therapy-lessons learned after > 150 robotic-assisted minimally invasive esophagectomies (RAMIE) at a German high-volume center. Surg Endosc 2023; 37:741-748. [PMID: 36344896 PMCID: PMC9640783 DOI: 10.1007/s00464-022-09754-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 10/29/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE OF THE STUDY In esophageal surgery, anastomotic leak (AL) remains one of the most severe and critical adverse events after oncological esophagectomy. Endoscopic vacuum therapy (EVT) can be used to treat AL; however, in the current literature, treatment outcomes and reports on how to use this novel technique are scarce. The aim of this study was to evaluate the outcomes of patients with an AL after IL RAMIE and to determine whether using EVT as an treatment option is safe and feasible. MATERIAL AND METHODS This study includes all patients who developed an Esophagectomy Complications Consensus Group (ECCG) type II AL after IL RAMIE at our center between April 2017 and December 2021. The analysis focuses on time to EVT, duration of EVT, and follow up treatments for these patients. RESULTS A total of 157 patients underwent an IL RAMIE at our hospital. 21 patients of these (13.4%) developed an ECCG type II AL. One patient died of unrelated Covid-19 pneumonia and was excluded from the study cohort. The mean duration of EVT was 12 days (range 4-28 days), with a mean of two sponge changes (range 0-5 changes). AL was diagnosed at a mean of 8 days post-surgery (range 2-16 days). Closure of the AL with EVT was successful in 15 out of 20 patients (75%). Placement of a SEMS (Self-expandlable metallic stent) after EVT was performed in four patients due to persisting AL. Overall success rate of anastomotic sealing independently of the treatment modality was achieved in 19 out of 20 Patients (95%). No severe EVT-related adverse events occurred. CONCLUSION This study shows that EVT can be a safe and effective endoscopic treatment option for ECCG type II AL.
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Affiliation(s)
- Seung-Hun Chon
- Interdisciplinary Endoscopy Unit, Department of General, Visceral, Cancer, and Transplant Surgery, University Hospital of Cologne, Kerpener Street 62, 50937, Cologne, Germany.
- Interdisciplinary Endoscopy Unit, Department of Gastroenterology and Hepatology, University Hospital of Cologne, Kerpener Street 62, 50937, Cologne, Germany.
| | - Stefanie Brunner
- Interdisciplinary Endoscopy Unit, Department of General, Visceral, Cancer, and Transplant Surgery, University Hospital of Cologne, Kerpener Street 62, 50937, Cologne, Germany
- Interdisciplinary Endoscopy Unit, Department of Gastroenterology and Hepatology, University Hospital of Cologne, Kerpener Street 62, 50937, Cologne, Germany
| | - Dolores T Müller
- Interdisciplinary Endoscopy Unit, Department of General, Visceral, Cancer, and Transplant Surgery, University Hospital of Cologne, Kerpener Street 62, 50937, Cologne, Germany
| | - Florian Lorenz
- Interdisciplinary Endoscopy Unit, Department of Gastroenterology and Hepatology, University Hospital of Cologne, Kerpener Street 62, 50937, Cologne, Germany
| | - Raphael Stier
- Interdisciplinary Endoscopy Unit, Department of General, Visceral, Cancer, and Transplant Surgery, University Hospital of Cologne, Kerpener Street 62, 50937, Cologne, Germany
| | - Lea Streller
- Interdisciplinary Endoscopy Unit, Department of Gastroenterology and Hepatology, University Hospital of Cologne, Kerpener Street 62, 50937, Cologne, Germany
| | - Jennifer Eckhoff
- Interdisciplinary Endoscopy Unit, Department of General, Visceral, Cancer, and Transplant Surgery, University Hospital of Cologne, Kerpener Street 62, 50937, Cologne, Germany
| | - Jennifer Straatman
- Interdisciplinary Endoscopy Unit, Department of General, Visceral, Cancer, and Transplant Surgery, University Hospital of Cologne, Kerpener Street 62, 50937, Cologne, Germany
| | - Benjamin Babic
- Interdisciplinary Endoscopy Unit, Department of General, Visceral, Cancer, and Transplant Surgery, University Hospital of Cologne, Kerpener Street 62, 50937, Cologne, Germany
| | - Lars M Schiffmann
- Interdisciplinary Endoscopy Unit, Department of General, Visceral, Cancer, and Transplant Surgery, University Hospital of Cologne, Kerpener Street 62, 50937, Cologne, Germany
| | - Wolfgang Schröder
- Interdisciplinary Endoscopy Unit, Department of General, Visceral, Cancer, and Transplant Surgery, University Hospital of Cologne, Kerpener Street 62, 50937, Cologne, Germany
| | - Thomas Schmidt
- Interdisciplinary Endoscopy Unit, Department of General, Visceral, Cancer, and Transplant Surgery, University Hospital of Cologne, Kerpener Street 62, 50937, Cologne, Germany
| | - Christiane J Bruns
- Interdisciplinary Endoscopy Unit, Department of General, Visceral, Cancer, and Transplant Surgery, University Hospital of Cologne, Kerpener Street 62, 50937, Cologne, Germany
| | - Hans F Fuchs
- Interdisciplinary Endoscopy Unit, Department of General, Visceral, Cancer, and Transplant Surgery, University Hospital of Cologne, Kerpener Street 62, 50937, Cologne, Germany
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Müller D, Stier R, Straatman J, Babic B, Schiffmann L, Eckhoff J, Schmidt T, Bruns C, Fuchs HF. [ICG lymph node mapping in cancer surgery of the upper gastrointestinal tract]. Chirurgie (Heidelb) 2022; 93:925-933. [PMID: 35925142 DOI: 10.1007/s00104-022-01659-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/06/2022] [Indexed: 06/15/2023]
Abstract
The importance of the assessment of the N‑status in gastric carcinoma, tumors of the gastroesophageal junction and esophageal cancer is undisputed; however, there is currently no internationally validated method for lymph node mapping in esophageal and gastric cancer. Near-infrared fluorescence imaging (NIR) is an innovative technique from the field of vibrational spectroscopy, which in combination with the fluorescent dye indocyanine green (ICG) enables intraoperative real-time visualization of anatomical structures. The ICG currently has four fields of application in oncological surgery: intraoperative real-time angiography for visualization of perfusion, lymphography for visualization of lymphatic vessels, visualization of solid tumors, and (sentinel) lymph node mapping. For imaging of the lymph drainage area and therefore the consecutive lymph nodes, peritumoral injection of ICG must be performed. Several studies have demonstrated the feasibility of peritumoral injection of ICG administered 15 min to 3 days preoperatively with subsequent intraoperative visualization of the lymph nodes. So far prospective randomized studies on the validation of the method are still lacking. In contrast, the use of ICG for lymph node mapping and visualization of sentinel lymph nodes in gastric cancer has been performed in large cohorts as well as in prospective randomized settings. Up to now, multicenter studies for ICG-guided lymph node mapping during oncological surgery of the upper gastrointestinal tract are lacking. Artificial intelligence methods can help to evaluate these techniques in an automated manner in the future as well as to support intraoperative decision making and therefore to improve the quality of oncological surgery.
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Affiliation(s)
- Dolores Müller
- Klinik und Poliklinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Uniklinik Köln (AöR), Kerpener Str. 62, 50937, Köln, Deutschland
| | - Raphael Stier
- Klinik und Poliklinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Uniklinik Köln (AöR), Kerpener Str. 62, 50937, Köln, Deutschland
| | - Jennifer Straatman
- Klinik und Poliklinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Uniklinik Köln (AöR), Kerpener Str. 62, 50937, Köln, Deutschland
| | - Benjamin Babic
- Klinik und Poliklinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Uniklinik Köln (AöR), Kerpener Str. 62, 50937, Köln, Deutschland
| | - Lars Schiffmann
- Klinik und Poliklinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Uniklinik Köln (AöR), Kerpener Str. 62, 50937, Köln, Deutschland
| | - Jennifer Eckhoff
- Klinik und Poliklinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Uniklinik Köln (AöR), Kerpener Str. 62, 50937, Köln, Deutschland
| | - Thomas Schmidt
- Klinik und Poliklinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Uniklinik Köln (AöR), Kerpener Str. 62, 50937, Köln, Deutschland
| | - Christiane Bruns
- Klinik und Poliklinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Uniklinik Köln (AöR), Kerpener Str. 62, 50937, Köln, Deutschland
| | - Hans F Fuchs
- Klinik und Poliklinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Uniklinik Köln (AöR), Kerpener Str. 62, 50937, Köln, Deutschland.
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Stier C, Koschker AC, Kim M, Stier R, Chiappetta S, Stein J. Fast-track rescue weight reduction therapy to achieve rapid technical operability for emergency bariatric surgery in patients with life-threatening inoperable severe obesity – A proof of concept study. Clin Nutr ESPEN 2022; 50:238-246. [PMID: 35871930 DOI: 10.1016/j.clnesp.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 05/14/2022] [Accepted: 05/17/2022] [Indexed: 10/18/2022]
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Lay S, Stier R, Schneider A, Budick T, Greinert A, Rosenecker J. Heiserkeit, Husten und Atemnot unter dem Weihnachtsbaum. Monatsschr Kinderheilkd 2021. [DOI: 10.1007/s00112-021-01316-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Stier C, Balonov I, Stier R, Chiappetta S, Fuss CT, Dayyeh BA. Endoscopic Management of Clinically Severe Obesity: Primary and Secondary Therapeutic Procedures. Curr Obes Rep 2020; 9:339-347. [PMID: 32495297 DOI: 10.1007/s13679-020-00385-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE OF REVIEW In the treatment of epidemic obesity and metabolic disorders, conservative approaches often fail to achieve the treatment goal in patients with very high BMI. To date, bariatric surgery accomplishes the most sustainable results in patients with morbid obesity. This leads to a treatment gap for lower and middle classes of obesity defined by BMI. Primary endoscopic procedures, which are less invasive than surgery, may be able to sufficiently fill this gap. Furthermore, secondary endoscopic procedures have developed into an essential addition regarding complication management of bariatric surgeries. The purpose of this review was to point out the latest developments in the field of bariatric endoscopy, including both primary and secondary procedures. RECENT FINDINGS Innovative devices and their possible applications will be discussed. These include various endoscopic suturing techniques as well as newly developed implants for the upper gastrointestinal tract to counteract the obesity epidemic. The growing understanding of the pathophysiology of obesity and the role of the gastrointestinal tract allows for the development of more effective endoscopic procedures regarding obesity treatment.
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Affiliation(s)
- Christine Stier
- Department of Surgical Endoscopy, Sana Hospitals Germany, Obesity Center NRW, Huerth, Germany.
- Department of General, Visceral and Transplant Surgery, RWTH University Aachen, University of Aachen, Aachen, Germany.
| | - Ilja Balonov
- University Hospital Wuerzburg, Wuerzburg, Germany
| | - Raphael Stier
- Department of General, Visceral, Tumor and Transplant Surgery, University Hospital of Cologne, Cologne, Germany
| | - Sonja Chiappetta
- Department of Obesity and Metabolic Surgery, Ospedale Evangelico Betania, Naples, Italy
| | - Carnina Teresa Fuss
- Department of Internal Medicine I, Endocrinology and Diabetes Unit, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Barham Abu Dayyeh
- Department of Gastroenterology, Mayo Clinic Rochester, Rochester, MA, USA
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Stier C, Koschker AC, Stier R, Sosnierz A, Chiappetta S. Are We Missing Treatment Standards for Thromboprophylaxis of the Obese and Super-Obese Patient Population? A Prospective Systematic Cohort Study. Obes Surg 2020; 30:1704-1711. [PMID: 31974866 DOI: 10.1007/s11695-020-04383-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Venous thromboembolism (VTE) is the most frequent 30-day complication in patients with morbid obesity undergoing bariatric surgery. Therefore, there is a need for optimized low molecular weight heparin (LMWH) thromboprophylaxis dosing strategies in order to avoid VTE-associated morbidity and mortality in this patient population. OBJECTIVE The primary goal was to evaluate if a pre-specified enoxaparin dosing regimen in patients undergoing bariatric surgery reaches anti-factor Xa (aFXa) levels in the defined target range (0.2-0.4 U/ml). Second, we aimed to identify biometric and laboratory parameters that might influence the aFXa value. METHODS A prospective database of 236 patients with obesity who received thromboprophylaxis with enoxaparin was established. These patients were divided into two weight-adjusted groups (group 1 < 150 kg, group 2 ≥ 150 kg). Enoxaparin was administered twice daily; dosing was determined by weight (group 1, 2 × 40 mg/day; group 2, 2 × 60 mg/day). In both groups, the peak aFXa serum level was evaluated 3 days after initiating the thromboprophylaxis. RESULTS In group 1 (body mass index (BMI) 42.94 ± 6.84 kg/m2, weight of 121.7 ± 17.49 kg), seventy-one of the included 124 patients (57.25%) reached the aFXa target range of 0.2 to 0.4 U/m. In group 2 (BMI 63.21 ± 10.05 kg/m2, weight of 191.66 ± 33.37 kg), 68 of 112 (60.71%) patients scored prophylactic aFXa range. Multiple regression of the biometric and laboratory parameters showed significance for weight, waist-to-hip ratio, glomerular filtration rate (GFR), creatinine, and HbA1c exclusively in group 1. There was no case of VTE within 3 months after surgery and no case of severe perioperative bleeding in those patients who underwent surgery. CONCLUSIONS Measurement of the aFXa level helps to define the real prophylactic thromboprophylaxis status in patients with obesity, especially in those with a weight above 150 kg. In patients at risk, the measurement of aFXa should be considered in routine clinical practice.
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Affiliation(s)
- Christine Stier
- Sana Obesity Center of Nordrhein-Westfalen, Hürth, Nordrhein-Westfalen, Germany.
| | | | | | | | - Sonja Chiappetta
- Department of Obesity and Metabolic Surgery, Ospedale Evangelico Betania, Naples, Italy
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Stier R, Jehn P, Johannsen H, Müller C, Gellrich NC, Spalthoff S. Reality or wishful thinking: do bicycle helmets prevent facial injuries? Int J Oral Maxillofac Surg 2019; 48:1235-1240. [DOI: 10.1016/j.ijom.2019.02.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 02/21/2019] [Accepted: 02/26/2019] [Indexed: 10/27/2022]
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Müller C, Gösling T, Mameghani A, Stier R, Klein M, Hüfner T, Krettek C. Osteoporosebedingte Wirbelkörperfrakturen. Orthopäde 2010; 39:417-24. [DOI: 10.1007/s00132-009-1576-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Abstract
Standardized assessment of a family's characteristics (conflict management, cohesion, etc.) is not used routinely, although these variables may play an important role in the course of psychological disorders in children. The present study investigated differences within the features of families of children with hyperkinetic and emotional disorders. Families of 20 boys diagnosed with Attention Deficit Hyperkinetic Disorder and 20 boys with Emotional Disorder (ages 6-12 years) by giving the Mannheim Parents Interview and the teacher's form of the Conners scale were included for evaluation and compared with a matched, healthy control group of 20 boys. Parents were asked to complete a form assessing the family's characteristics ("Familienklima-Testsystem"), including Cohesion, Expressiveness, Conflict Tendency, Individual Independence, Achievement Orientation, Intellectual-Cultural Orientation, Active-Recreational Orientation, Moral-Religious Emphasis, and Organization. Comparison of groups was made by the Kruskal-Wallis test and Mann-Whitney U test. There are significantly more conflicts in families whose children belong to the two disorder groups. Compared with a matched healthy control group, there is low Expressiveness, Independence, and Cultural and Active-Recreational Orientation in the Emotional Disorder group and a significant lack of Organization and Cohesion in the Attention Deficit Hyperkinetic Disorder group. Altogether there seems to be a significant association of Attention Deficit Hyperkinetic Disorder symptoms with the family's Cohesion and Organization. One implication is that therapists focus their efforts not only on the children with disorders but also on their families.
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Affiliation(s)
- H Niederhofer
- Department of Child and Adolescent Psychiatry, University Hospital of Psychiatry, Innsbruck, Austria
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Stier R, Gerdes N, Bührlen B, Haaf HG, Jäckel WH. [Reconditioning in groups: an effective programme for the rehabilitation of patients with low back pain?]. Rehabilitation (Stuttg) 2001; 40:321-31. [PMID: 11742422 DOI: 10.1055/s-2001-18965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
The article reports on a study in which elements of a group-oriented reconditioning programme for patients with low back pain were incorporated into the routine of an in-patient orthopaedic rehabilitation clinic. The specific elements of the new programme consisted of stable group structures during the whole stay of 3 to 4 weeks, and of 3 to 7 hrs. walks in hilly ground three times a week. The effects of this programme were tested against a standard programme with a mix of passive and active elements using a controlled study design. 92 persons participated in an experimental group and 81 persons in a control group with no significant differences found between the two groups at admission. Effects were measured by means of a physicians' questionnaire and a multidimensional patients' questionnaire (IRES) answered at admission, at discharge, and at six- and twelve-month follow-up. The results of a two-factorial analysis of variance with repeated measures showed that the interaction between group and time on the summary score of the IRES was not significant, although the experimental group showed somewhat better effects at all times of measurement. The discussion focuses on the reasons for this result, among which the unexpectedly good effects in the control group are named, as well as certain difficulties with the implementation of a strongly activity-oriented programme into the course of a "normal" rehabilitation clinic.
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Affiliation(s)
- R Stier
- Hochrhein-Institut für Rehabilitationsforschung, Bad Säckingen
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12
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Stier R. The economics of patient satisfaction. Healthc Forum J 1987; 30:19-21, 23, 25 passim. [PMID: 10283412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Struwe FE, Reinwein H, Stier R. [Coumarin embryopathy]. Radiologe 1984; 24:68-71. [PMID: 6709881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Anticoagulant therapy using coumarin derivatives (vitamin K antagonists) during early pregnancy may result in a characteristic embryopathy appearing as a phaenocopy of chondrodysplasia punctata (Conradi-Hünermann's disease). This has been suggested in advance by observations made in newborns of mothers who had been treated previously with warfarin or acenocoumon. Similar observations made in a newborn after the mother's treatment with phencoumon in early pregnancy are described in this paper. Coumarin embryopathy is proposed as a common term.
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Keller KM, Stier R, Böhm N. [Mucoviscidosis--uncommon morphologic findings in a systemic disease]. Med Welt 1983; 34:1344-8. [PMID: 6656571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Stier R, Schultz-Brauns B, Riedesser P, Zeisel HJ. [Psychological aspects of the preparation and performance of endoscopies in children and adolescents]. Klin Padiatr 1983; 195:342-6. [PMID: 6632713 DOI: 10.1055/s-2008-1034394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Individual observations lead to the realisation that during endoscopy children may develop such a degree of seemingly unexplainable anxiety that the performance of the examination is considerably prejudiced. We therefore examined 39 children systematically, evaluating them according to fearsome products of their imagination on the one hand and real or warranted anxiety on the other. Adjusted to age the children were tested using drawings, projectional tests and role-playing in addition to interviewing, sometimes of their parents as well. The most prominent expressions of anxiety in conjunction with endoscopy were fear of suffocation; fear of damage to internal organs and, in girls, fear of lesions to a "baby inside". In adolescents problems with prudery became evident. On the basis of our experience we developed a systematic model of psychological preparation for endoscopic examinations.
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Dailey F, Stier R, Featherstone L. Incomplete cross reactivity between the mites dermatophagoides farinae and D. pteronyssinus. J Allergy Clin Immunol 1982. [DOI: 10.1016/s0091-6749(62)80421-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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17
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Scharner E, Stier R. [Drying experiments with Salmonella-containing raw sausages]. Z Gesamte Hyg 1968; 14:701-4. [PMID: 4896930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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