[Possibilities in psychiatric-psychotherapeutic and family practice treatment of borderline patients]. / Möglichkeiten der psychiatrisch-psychotherapeutischen und hausärztlichen Behandlung von Borderline-Patienten.

In this article it is shown that, in spite of the diagnostic heterogeneity and in spite of differing concepts for treatment, basic principles for treatment may be assessed that have proven effective in daily therapeutic routine. It is decisive to consider typical difficulties in which therapists of borderline patients may get involved. Treatment is primarily based on psychotherapy. After a short review of different therapeutic concepts for borderline derangements, fundamental psychotherapeutic principles are illustrated. According to target symptoms, psychotropic drugs may be indicated as an adjunct. The use of various drugs is discussed. Ambulatory and clinical options for treatment and their indications are summarized, and treatment of borderline patients by their family doctor is stressed in particular.

[General medicine criteria for the determination of dental care needs of geriatric patients]. / Allgemeinmedizinische Kriterien zur Erfassung des zahnärztlichen Behandlungsbedarfs geriatrischer Patienten.

Recently it has been shown that there is a high prevalence of treatable dental conditions in elderly subjects in Switzerland. The purpose of the present prospective study was to assess the value of an oral screening examination intended to help the primary care physician to determine which patients should be referred to a dental service for specialized treatment. Of 219 patients aged over 65 referred consecutively to a geriatric hospital, 58.4% were objectively in need of dental treatment according to the data obtained by a dentist. In a multiple logistic analysis, 4 oral screening criteria (presence of residual teeth of the patient's own, no prosthetic replacement of an edentulous arch, subjective dental treatment requirement, subjective chewing impairment) were found to predict the objectively assessed dental need with a sensitivity of 93.0% and a specificity of 82.4%. Among the patients with objective dental treatment requirement not predicted by the screening examination, 3 had ulcerations of the oral mucosa. An intraoral soft-tissue examination should therefore be included in the screening examination. In conclusion, simple oral screening may serve to identify patients needing dental care with a high degree of diagnostic accuracy. This enables the primary care physicians to screen for oral and dental problems and to refer patients in the same way as for other special treatment problems.

Dental treatment needs in an elderly population referred to a geriatric hospital in Switzerland.

Of 219 elderly patients admitted consecutively to a geriatric hospital in Switzerland, 59.4% were edentulous. A high proportion of the dentate patients exhibited tooth loss patterns requiring free-end partial dentures in the maxilla (36.0%) or the mandible (69.7%). Of the remaining teeth, 29.3% were decayed, and 45.1% had severe periodontitis. Virtually all (97.8%) dentate and 31.5% of the edentulous subjects were judged to need some kind of dental treatment. In contrast, the subjective need for dental treatment was low in dentate (30.4%) and edentulous (13.1%) subjects. Prosthesis hygiene was poor in 73.8% of the 191 denture wearers whether they needed assistance with oral hygiene or not. The objectively-assessed need for a new prosthesis in edentulous patients was determined by income, marital status, and patient mobility, whereas the need for a prosthesis alteration was related to cognitive function. These findings should help to plan future dental prophylactic and therapeutic services in geriatric hospitals.

[The time requirements for the dental treatment of independent and handicapped geriatric patients. An epidemiological study]. / Zeitbedarf für die zahnmedizinische Behandlung bei selbständigen und behinderten geriatrischen Patienten. Eine epidemiologische Untersuchung.

To plan a dental care program for geriatric patients, the dental treatment needs of 219 elderly patients consecutively admitted to a geriatric hospital were quantitatively assessed. Of 89 patients with residual teeth, 97.8% were assessed as needing dental treatment of a mean projected duration of about 312 min per patient. Of the 130 edentulous patients, 30.8% needed dental treatment of a mean projected duration of about 194 min per patient. Patients exhibiting high (greater than 60 min) dental treatment needs were more frequently impaired in activities of daily living than patients with low (less than or equal to 60 min) dental treatment needs (e.g. impaired transfer function 60.2% vs. 28.0%). There was no difference in the oral hygiene or in the cleanliness of removable dentures between patients needing and not needing help in activities of daily living. In conclusion, the present results show a high amount of dental treatment needed in elderly patients. For the planning of an effective dental care program, special attention has to be paid to the interdisciplinary treatment of patients with limitations in activities of daily living. Furthermore, the improvement of the oral hygiene status is of paramount importance in most elderly patients.

[Tolerance and pharmacologic effectiveness of antiglaucoma eyedrops]. / Verträglichkeit und pharmakologische Wirksamkeit von antiglaukomatösen Augentropfen.

The beta-blocking agent carteolol hydrochloride differs slightly from other beta-blockers by its intrinsic sympathomimetic activity. Its effect on intraocular pressure and heart rate was tested in a comparison with timolol maleate, as was subjective tolerance of it, in 28 eyes (14 subjects) with either ocular hypertension or simple chronic open-angle glaucoma. The two drugs had a similar effect on intraocular pressure; both were well tolerated subjectively. Carteolol lowered heart rate more in patients with higher heart rates, while timolol lowered it more in patients with lower heart rates.