Self-regulation following prostatectomy: phase-specific self-efficacy beliefs for pelvic-floor exercise.

OBJECTIVE: Beliefs in one's ability to perform a task or behaviour successfully are described as self-efficacy beliefs (Bandura, 1977). Since individuals have to deal with differing demands during a behaviour-change process, they form phase-specific self-efficacy beliefs directed at these respective challenges. The present study, based on the Health Action Process Approach (Schwarzer, 2001), examines the theoretical differentiation, relative importance, and differential effects of four phase-specific self-efficacy beliefs, including task self-efficacy, preactional self-efficacy, maintenance self-efficacy, and recovery self-efficacy. DESIGN: In a prospective longitudinal study, 112 prostatectomy-patients received questionnaires at 2 days, 2 weeks, 1 month, and 6 months post-surgery. METHODS: Participants provided data on phase-specific self-efficacies as well as phase indicators of health-behaviour change, that is, intentions, planning, and pelvic-floor exercise. Hierarchical regression analyses were conducted to test the study hypotheses. RESULTS: Task self-efficacy was not uniquely associated with intentions. Preactional self-efficacy was related to action planning. Maintenance self-efficacy did not predict behaviour. Recovery self-efficacy was associated with re-uptake of pelvic-floor exercise after relapses only. CONCLUSION: Findings underline the importance of differentiating between task self-efficacy and preactional self-efficacy during early phases of behaviour change as well as of considering the occurrence of relapses as a moderator of potential effects of recovery self-efficacy on the maintenance of behaviour change. Advanced knowledge on distinct, phase-specific self-efficacy beliefs may facilitate the design of effective tailored interventions for behaviour change.

Effects of intranasal hypocretin-1 (orexin A) on sleep in narcolepsy with cataplexy.

BACKGROUND: The neuropeptides hypocretin-1 and -2 (hcrt-1 and -2, also known as orexin A and B) are crucially involved in the regulation of sleep/wake states. On the one hand, the sleep-wake disorder narcolepsy can be caused by an hcrt-1 deficiency. On the other, intracerebral administration of hcrt-1 produces an increase in wakefulness at the expense of REM sleep in normal and narcoleptic animals. In humans intranasal administration has been shown to effectively deliver neuropeptides directly to the central nervous system. We hypothesised that the intranasal application of hcrt-1 increases wakefulness and reduces REM sleep in the natural human hcrt-1 deficiency narcolepsy with cataplexy. METHODS: In this double-blind, random-order crossover, placebo-controlled, within-subject design study we administered human recombinant hcrt-1 (435 nmol) intranasally to eight subjects with narcolepsy with cataplexy before night sleep, followed by standard polysomnography. RESULTS: Although intranasal administration of hcrt-1 had no statistically significant effect on nocturnal wakefulness, we found that it reduced REM sleep quantity, particularly during the second half of the recording. Furthermore, intranasal hcrt-1 had a clear REM sleep stabilising effect and led to significantly reduced direct wake to REM transitions. CONCLUSION: In this pilot study we found, first, evidence that the intranasal administration of hcrt-1 has functional effects on sleep in narcolepsy with cataplexy. Our results may encourage the use of the intranasal approach in further studies on hypocretinergic sleep regulation and might also contribute to the future development of a causal treatment for narcolepsy with cataplexy.

Development and factorial validation of a short version of the narcissism inventory (NI-20).

BACKGROUND: Narcissism is seen as a normal but heterogeneously formed personality variable, ranging from 'grandiosity-exhibitionism' to 'vulnerability-sensitivity'. This article reports the development and factorial validation of a short version of a narcissism inventory. SAMPLING AND METHODS: The sample includes data of 4,509 consecutive psychosomatic inpatients. The overall sample was divided in 2 equally sized randomized subsamples. One sample (n = 2,262) was used for exploratory factor analysis (principal component analysis). The other sample (n = 2,265) was used for confirmatory tests of the model fit of the newly built NI-20 version, and to analyze the model fit separately for men and women using structural equation modeling with AMOS software. RESULTS: The short version (NI-20) consists of 20 items, with items representing almost all of the original 18 subscales and 4 second-order dimensions. The NI-20 possesses properties similar to the NI-90, with a considerable gain in test economy. The 4-factor structure of the NI-20 was confirmed, and reaches good fit indices. CONCLUSIONS: The NI-20 is an economical instrument with acceptable psychometric characteristics that reflects the heterogeneous aspects of narcissism. A methodological limitation is that the interactions between sociodemographic variables were not included as potential predictors.

[Anosmics are more poorly able to taste than normal persons]. / Anosmiker schmecken schlechter als Gesunde.

INTRODUCTION: The senses of smell and taste interact closely during eating and drinking and can sensitize each other. The conditioning olfactory priming disappears with permanent anosmia, so one can suppose that has effects on taste sensibility. METHODS: The thresholds of taste recognition were measured for sweet, salty, sour, and bitter by using the 3-drops-method according to Henkin in 39 anosmics and were compared with those of 39 normal subjects of the same age and gender. RESULTS: Anosmics had a poorer, i. e. higher recognition threshold for all taste qualities than normal persons. The median recognition threshold of bitter was 8 times, of salty four times, and of sour twice higher. The median recognition thresholds of sweet were equal. The gustatory recognition thresholds of the young and older anosmics didn't differ significantly. The recognition thresholds of young and older normal subjects were not different except sour. The duration and the cause of anosmia had no influence on the recognition thresholds. CONCLUSION: Anosmics actually taste all four taste qualities more poorly. That olfacto-gustatory decline should be considered for insurance reports. Anosmics should be advised to spice their meals gustatorily for coping strategy.

[Olfactory and gustatory disorders--causes, diagnosis and treatment]. / Riech- und Schmeckstörungen. So reparieren Sie die Sinne lhres Patienten.

Olfactory and gustatory disorders are by no means uncommon, and may be associated with an appreciable impairment of the patient's quality of life. In many cases, diagnosis and treatment is not easy, and necessitates interdisciplinary cooperation between the general practitioner, internist, ENT specialist, neurologist and psychiatrist. Many of the non-evidence-based treatments still applied in hospitals and the physician's office should, for reasons of quality control and to avoid polypragmasy possibly associated with undesirable side effects, be employed with reservations. With reference to the guidelines issued by the working group Olfactologie/Gustologie der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Hals-Chirurgie (Olfactology/Gustology of the German Society of ENT Medicine, Head and Neck Surgery), a review of the causes, diagnosis and treatment of olfactory and gustatory disorders [3,4] is presented.

[Prolactinoma of the sphenoid sinus. Case report and literature review]. / Prolaktinom der Keilbeinhöhle. Kasuistik und Literaturübersicht.

In this case study, we report on a patient complaining of headache who, after CT and MRI, was found to have a neoplasia of the left sphenoid sinus. After a transnasal biopsy and histological examination, a prolactinoma was diagnosed. Based on this case, we discuss important aspects of tumor biology, diagnostic procedures, histology as well as differential diagnosis. Prolactinoma has to be considered as a differential diagnose in all sphenoid sinus neoplasias with close contact to the pituitary gland.

Development of enzyme-linked immunosorbent assays using recombinant borrelial antigens for serodiagnosis of Borrelia burgdorferi infection.

To improve IgG antibody detection in the serodiagnosis of Borrelia burgdorferi infection, indirect enzyme-linked immunosorbent assays (ELISAs) were developed utilizing purified recombinant antigens of B. burgdorferi sensu lato: the chromosomally encoded proteins p100 of strain PKo (B. afzelii) and p4li (internal flagellin fragments) derived from strains PKo, PBi (B. garinii), and B31 (B. burgdorferi sensu stricto). In Western blot analysis, these proteins have proved to be highly specific and sensitive for IgG antibody detection, especially in late manifestations of Lyme borreliosis. Sera from 464 forest workers, a high-risk group for infections with B. burgdorferi, were investigated and the results compared with those obtained by a commercial ELISA using an octyl-beta-D-glucopyranoside (OGP) extract from B. afzelii (PKo) cells as the antigenic substrate. Sera derived from 200 blood donors served for determination of the 95% specific cut-off level. The number of positive test results using OGP-ELISA (23.9%) was only slightly higher than that using p100-ELISA (19.8%); corresponding results were observed in 84.7% of all sera (14.2% positive, 70.5% negative). The frequency and interassay correspondence of positive results increased with the age of the forest workers, as most markedly demonstrated by p100 and OGP assays (P < 0.0001). Using the p41i-ELISAs, generally no significant strain-dependent differences in sensitivity were found (PKo, 13.8%; PBi, 14.2%; B31, 12.9%). Compared with the p100-ELISA, the p41i-assays showed significantly lower detection rates for IgG antibodies (P < 0.03) and a reduced capacity for quantitative discrimination between seropositive individuals and negative controls (P < 0.0007). At a 95% specificity, the IgG antibody detection rate could be increased to 23.1% when the p100-ELISA was evaluated in combination with the assays using p41i/PBi and P41i/B31. Due to its high sensitivity, the specific recombinant p100-ELISA might be a suitable test for detection of late immune responses to B. burgdorferi, thus being especially useful for epidemiological investigations.

[Cystectomy or transurethral resection in the treatment of bladder carcinoma]. / Zur Frage der Zystektomie oder transurethralen Resektion (TUR) in der Behandlung des Harnblasenkarzinoms.

136 patients with carcinoma of the bladder were followed up after cystectomy and ileal conduit (n = 50), and TUR with post-operative irradiation (n = 86) with betatron (n = 35) or telecobalt (n = 51). The 3-year survival rate after cystectomy was 40% for all stages, the early mortality rate was around 14%. The complication rate was 16%. In the second half the survival rate was improved to 69.2% and the early mortality rate was lowered to 7.9%. After TUR and irradiation the 3-year survival rate was 48% for all stages, whereby 41% of the survivors or 20% of all patients had no further recurrence of tumours. Understaging with questionable removal in the healthy person and high persistence and recurrence are the methodic limits to TUR; a high early mortality rate and secondary late complications are the burden of cystectomy, besides psychological factors. Indications and results are discussed on the basis of the literature and an individual approach is recommended.

[Correlation of the immune profile with local immunocyte infiltration in urinary bladder tumours (author's transl)]. / Zur Korrelation des Immunprofils mit der lokalen Immunozyteninfiltration bei Harnblasentumoren.

In 40 patients with urinary bladder tumours we compared the results of the immune profile, obtained by means of cutaneous tests with dinitrochlorobenzene (DNCB), and the infiltration of immunocompetent cells in the histological pattern after transurethral tumour resection. It was noted that the more the tumour had infiltrated, the less was it possible to immunize with DNCB or to achieve an immunocyte infiltration in the tumour. According to the classification of the WHO there was a positive reaction in 56-67% and a correlating immunocyte infiltration in 50-73%.

[Radioactive substances (32P and 89Sr) in the treatment of pain in bone metastases]. / Radioaktive Substanzen (32P und 89Sr) in der Schmerzbehandlung bei Knochenmetastasen.

In the urological department of the Wilhelminenspital altogether 22 patients with incurable bone pains in metastasizing carcinoma were treated with radioisotopes between 1976 and 1980. 32P and 89Sr were used in a dosage of 3 times 3 mCi and once 1 mCi. A reaction to the therapy could be proved in 46%, in 23% the success could be estimated as very good. Clinic and therapy were discussed with the help of own cases and literature.

[The prognostic significance of the immune status (DNCB-test) in patients with carcinoma of the bladder, checked by observation of the course of disease (author's transl)]. / Die prognostische Bedeutung des Immunstatus (DNCB-Test), kontrolliert durch Verlaufsbeobachtungen beim Harnblasenkarzinom.

On the basis of three years of observation of 48 patients with histologically verified carcinoma of the bladder, a correlation was established between the immune profile (DNCB-test) and the clinical stage. Whereas in early stages of the tumour no correlation could be found between the results of the skin test and the subsequent development of the disease, in invasive advanced carcinoma the prognostic aspect was more favourable when the results of the DNCB-test was positive. The indication for radical cystectomy can be supported by the results of the DNCB-test in addition to staging and grading. Infiltrative growth and negative DNCB-test are indications for cystectomy, whereas a positive immune status seems to justify a observant attitude and endoscopic controls.

[Ureteric reimplantation in passage disturbances of the pelvic ureter (author's transl)]. / Die Ureterreimplantation bei Passagestörungen des pelvinen Harnleiters. Ein Erfahrungsbericht (1966 bis 1976).

Between 1966 and 1976 106 ureter reimplantations were performed in 94 patients. Subsequent checks in 48 patients with 53 reimplants showed good results in 39 cases (73.5%). In 5 cases the results were moderately good (9.4%) and in 9 cases (16.9%) poor. Since there was found insufficient correlation between infection and reflux direct reimplantation and/or plastic surgery of the flaps is recommended for the reconstruction operation.

Capillary viscometer for use with crosslinking polymer melts.

A capillary viscometer is described which adapts a conventional capillary rheometer for use with crosslinking polymers. Illustrative data obtained with the viscometer using diallyl phthalate resin are included.