995 resultados para Platzer, Hans-Wolfgang.
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Mode of access: Internet.
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Kirjallisuusarvostelu
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Objetivos: avaliar os resultados da embolização das artérias uterinas (EAU) como tratamento do leiomioma uterino. Métodos: foram estudadas 18 mulheres com diagnóstico ultra-sonográfico de leiomioma uterino submetidas à EAU com partículas de álcool polivinílico (PVA). O acesso arterial foi realizado por punção da artéria femoral e a progressão do cateter foi monitorada até atingir seletivamente as artérias uterinas. A avaliação dos resultados foi realizada pelo estudo ultra-sonográfico antes e três meses após o procedimento. Foi realizado controle clínico evolutivo para avaliação das características menstruais e do volume uterino. Resultados: houve insucesso técnico em três casos por dificuldade de cateterização das artérias uterinas. O sangramento e a dismenorréia foram controlados no intervalo de três meses em 86 e 60% das pacientes, respectivamente. A média dos volumes uterinos iniciais foi de 381 cm³ e após 3 meses foi de 263 cm³. Houve redução média de 27,4% no volume uterino três meses após o tratamento. Três pacientes tiveram insuficiência ovariana clínica e laboratorial (20% dos casos). Conclusões: a EAU representa alternativa terapêutica para o tratamento dos leiomiomas uterinos. Em virtude do risco de insuficiência ovariana esse procedimento é reservado para pacientes com mais de 45 anos de idade ou com prole completa.
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The Working Alliance Inventory-Short Revised (WAI-SR) is a recently refined measure of the therapeutic alliance that assesses three key aspects of the therapeutic alliance: (a) agreement on the tasks of therapy, (b) agreement on the goals of therapy and (c) development of an affective bond. The WAI-SR demonstrated good psychometric properties in an initial validation in psychotherapy outpatients in the USA. The generalizability of these findings is limited because in some countries a substantial portion of individual psychotherapy is delivered in inpatient settings. This study investigated and compared the psychometric properties of the WAI-SR in German outpatients (N = 88) and inpatients (N = 243). In both samples reliability (alpha > 0.80) and convergent validity with the Helping Alliance Questionnaire were good (r > 0.64). Confirmatory factor analysis showed acceptable to good model fit for the proposed Bond-Task-Goal model in both samples. Multi-group analysis demonstrated that the same constructs were measured across settings. Alliance ratings of outpatients and inpatients differed regarding the overlap of alliance components and the magnitude of the alliance ratings: The differentiation of the alliance components was poorer in inpatients and they reported lower alliances. Unique aspects of the alliance in inpatient treatment are discussed and a need for further research on the alliance in inpatient settings is pointed out. Overall, the WAI-SR can be recommended for alliance assessment in both settings.
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Radiocarbon-dated pollen, rhizopod, chironomid and total organic carbon (TOC) records from Nikolay Lake (73°20'N, 124°12'E) and a pollen record from a nearby peat sequence are used for a detailed environmental reconstruction of the Holocene in the Lena Delta area. Shrubby Alnus fruticosa and Betula exilis tundra existed during 10,300-4800 cal. yr BP and gradually disappeared after that time. Climate reconstructions based on the pollen and chironomid records suggest that the climate during ca. 10,300-9200 cal. yr BP was up to 2-3 °C warmer than the present day. Pollen-based reconstructions show that the climate was relatively warm during 9200-6000 cal. yr BP and rather unstable between ca. 5800-3700 cal. yr BP. Both the qualitative interpretation of pollen data and the results of quantitative reconstruction indicate that climate and vegetation became similar to modern-day conditions after ca. 3600 cal. yr BP. The chironomid-based temperature reconstruction suggests a relatively warm period between ca. 2300 and 1400 cal. yr BP, which corresponds to the slightly warmer climate conditions reconstructed from the pollen. Modern chironomid and rhizopod assemblages were established after ca. 1400 cal. yr BP.
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Based on field investigations in northern Russia and interpretation of offshore seismic data, we have made a preliminary reconstruction of the maximum ice-sheet extent in the Barents and Kara Sea region during the Early/Middle Weichselian and the Late Weichselian. Our investigations indicate that the Barents and Kara ice sheets attained their maximum Weichselian positions in northern Russia prior to 50 000 yr BP, whereas the northeastern flank of the Scandinavian Ice Sheet advanced to a maximum position shortly after 17000 calendar years ago. During the Late Weichselian (25 000-10000 yr BP), much of the Russian Arctic remained ice-free. According to our reconstruction, the extent of the ice sheets in the Barents and Kara Sea region during the Late Weichselian glacial maximum was less than half that of the maximum model which, up to now, has been widely used as a boundary condition for testing and refining General Circulation Models (GCMs). Preliminary numerical-modelling experiments predict Late Weichselian ice sheets which are larger than the ice extent implied for the Kara Sea region from dated geological evidence, suggesting very low precipitation.