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  1. Article ; Online: Supportive Therapie, „best supportive care“ und Palliativmedizin.

    Retz, M / Bardenheuer, H J

    Der Urologe. Ausg. A

    2018  Volume 57, Issue 5, Page(s) 530–531

    Title translation Supportive therapy, best supportive care, and palliative medicine.
    MeSH term(s) Humans ; Neoplasms/therapy ; Palliative Care/standards ; Palliative Medicine ; Practice Guidelines as Topic ; Research
    Language German
    Publishing date 2018-05-09
    Publishing country Germany
    Document type Editorial
    ZDB-ID 204041-4
    ISSN 1433-0563 ; 0340-2592 ; 0375-4685
    ISSN (online) 1433-0563
    ISSN 0340-2592 ; 0375-4685
    DOI 10.1007/s00120-018-0640-4
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  2. Article ; Online: Ethische Fallberatung in der Intensivmedizin: Verantwortliches Handeln in kritischer Lebensphase.

    Bardenheuer, H J

    Der Anaesthesist

    2012  Volume 61, Issue 1, Page(s) 5

    Title translation Ethical case consultation in intensive care medicine: responsible actions in critical phases of life.
    MeSH term(s) Critical Care/ethics ; Ethics Consultation ; Humans ; Male
    Language German
    Publishing date 2012-01
    Publishing country Germany
    Document type Comment ; Journal Article
    ZDB-ID 260-4
    ISSN 1432-055X ; 0003-2417
    ISSN (online) 1432-055X
    ISSN 0003-2417
    DOI 10.1007/s00101-012-1984-6
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  3. Article ; Online: Alteration of drug-metabolizing enzyme activity in palliative care patients: Microdosed assessment of cytochrome P450 3A.

    Geist, Marcus / Bardenheuer, Hubert / Burhenne, Juergen / Mikus, Gerd

    Palliative medicine

    2019  Volume 33, Issue 7, Page(s) 850–855

    Abstract: Background: Cytochrome P450 3A is the most relevant drug-metabolizing enzyme in humans as it is involved in the elimination of 50% of marketed drugs. Nothing is known about the activity of cytochrome P450 3A in palliative care patients who have ... ...

    Abstract Background: Cytochrome P450 3A is the most relevant drug-metabolizing enzyme in humans as it is involved in the elimination of 50% of marketed drugs. Nothing is known about the activity of cytochrome P450 3A in palliative care patients who have complicated symptoms often associated with a terminal illness.
    Aim: In order to improve drug dosing in end-of-life care and to avoid drug interactions, cytochrome P450 3A activity was determined in patients of a palliative care unit under real-life clinical conditions.
    Design: As midazolam is an established marker substance for cytochrome P450 3A activity, this single-arm prospective trial was designed to obtain a 4-h pharmacokinetic profile of midazolam after oral administration of a 10-µg dose from each enrolled patient. Plasma concentrations of midazolam and its primary metabolite 1'-hydroxy-midazolam were quantified by mass spectrometry techniques. Cytochrome P450 3A activity was calculated as partial metabolic clearance from a limited sampling area under the curve. All other drugs taken by the participating patients were considered, as well as recent blood test results and patients' diagnoses. The trial was registered at German Clinical Trials Register ( www.drks.de ): DRKS00011753.
    Setting/participants: The trial was carried out at a university palliative care unit under real-life clinical conditions. Every patient admitted to the ward was screened for possible participation, independent of the individual performance status.
    Results: Partial metabolic clearance of midazolam in palliative care patients was 31.7 ± 32.1 L/h. This was a highly significant 40% reduction (
    Conclusion: Dosing of cytochrome P450 3A substrate drugs (e.g. macrolide antibiotics, benzodiazepines, calcium channel blockers) needs to be adjusted in palliative care patients; otherwise, escalation of debilitating symptoms due to drug interactions might occur.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Cytochrome P-450 CYP3A/administration & dosage ; Cytochrome P-450 CYP3A/metabolism ; Drug Interactions ; Female ; Humans ; Liver/enzymology ; Male ; Midazolam/administration & dosage ; Midazolam/blood ; Midazolam/pharmacokinetics ; Middle Aged ; Palliative Care ; Prospective Studies ; Terminal Care ; Young Adult
    Chemical Substances Cytochrome P-450 CYP3A (EC 1.14.14.1) ; Midazolam (R60L0SM5BC)
    Language English
    Publishing date 2019-04-26
    Publishing country England
    Document type Journal Article
    ZDB-ID 639247-7
    ISSN 1477-030X ; 0269-2163
    ISSN (online) 1477-030X
    ISSN 0269-2163
    DOI 10.1177/0269216319843629
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  4. Article ; Online: Die neue Regelung der Patientenverfügung - Hilfe für Arzt und Patient?

    Bardenheuer, H J

    Der Anaesthesist

    2010  Volume 59, Issue 2, Page(s) 109–110

    Title translation New regulation patient advance directives--help for the doctor and patient.
    MeSH term(s) Advance Directives/legislation & jurisprudence ; Euthanasia/legislation & jurisprudence ; Germany ; Legislation, Medical
    Language German
    Publishing date 2010-02
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 260-4
    ISSN 1432-055X ; 0003-2417
    ISSN (online) 1432-055X
    ISSN 0003-2417
    DOI 10.1007/s00101-010-1686-x
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  5. Article ; Online: Therapierefraktäre Schmerzen.

    Keßler, Jens / Geist, Marcus / Bardenheuer, Hubert

    Deutsche medizinische Wochenschrift (1946)

    2018  Volume 143, Issue 19, Page(s) 1372–1380

    Abstract: Pain therapy concepts should be based on a biopsychosocial model. A prerequisite for adequate pain therapy is the detailed medical history. The questions about the intensity of pain and especially about the quality of pain are crucial for the selection ... ...

    Title translation Treatment-Refractory Pain.
    Abstract Pain therapy concepts should be based on a biopsychosocial model. A prerequisite for adequate pain therapy is the detailed medical history. The questions about the intensity of pain and especially about the quality of pain are crucial for the selection of drug therapy. In addition to the questioning, targeted physical examination is essential. This should be repeated in case of therapy-refractory pain in the course. The transfer of clinically relevant knowledge about the emergence and the development of pain occurs in the new cross-sectional area ​​14 "pain medicine" and has been anchored in the licensing regulations. Treatment-refractory pain, despite adequate pharmacological therapy, may be the result of individual metabolism. For tumor-related pain, opioid rotation is a suitable symptom control procedure. To avoid treatment-refractory pain peaks, the medication for the need for basic medication should be adjusted in the dose. Non-drug treatment should be targeted for treatment-refractory pain to promote patient's ownership. Physiotherapeutic measures have the goal of increasing the self-efficacy of pain and regaining confidence in one's own bodily functions.
    MeSH term(s) Adult ; Aged ; Basal Metabolism/physiology ; Female ; Humans ; Male ; Medical History Taking ; Middle Aged ; Neoplasms/complications ; Pain, Intractable/drug therapy ; Pain, Intractable/etiology ; Pain, Intractable/psychology ; Pain, Intractable/therapy ; Physical Examination ; Physical Therapy Modalities ; Precision Medicine
    Language German
    Publishing date 2018-09-19
    Publishing country Germany
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 200446-x
    ISSN 1439-4413 ; 0012-0472
    ISSN (online) 1439-4413
    ISSN 0012-0472
    DOI 10.1055/a-0587-0274
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Characteristics of salivary cortisol and alpha-amylase as psychobiological study outcomes in palliative care research

    Warth, Marco / Stoffel, Martin / Koehler, Friederike / Bardenheuer, Hubert J. / Kessler, Jens / Ditzen, Beate

    BMC Palliative Care

    2022  

    Abstract: Background: Psychosocial interventions are rapidly emerging in palliative care. However, randomized trials often fail to provide evidence for their effectiveness with regard to patient-reported outcomes. Stress biomarkers could complement self-report ... ...

    Title translation Merkmale des Speichelcortisols und der Alpha-Amylase als psychobiologische Studienergebnisse in der Palliativpflegeforschung. (DeepL)
    Abstract Background: Psychosocial interventions are rapidly emerging in palliative care. However, randomized trials often fail to provide evidence for their effectiveness with regard to patient-reported outcomes. Stress biomarkers could complement self-report data, but little is known about their feasibility, acceptance, and interpretability. Methods: Therefore, we designed a randomized crossover trial in which 42 patients in a palliative care unit participated in both a brief mindfulness intervention (MI) and a resting state control condition (CC) on two consecutive afternoons. On each day, we collected four saliva samples in 20-min intervals using Salivettes (c) to determine salivary cortisol (sCort) and alpha-amylase (sAA) concentration levels. At all measurement points, self-rated well-being and stress as well as cardiovascular markers were assessed. Baseline measurements further included self-rated quality of life and clinician-rated functional status. Results: 78.6% of the patients provided the maximum number of 8 saliva samples and 62.2% reported no subjective difficulties with the sampling procedures. 66.6% (sCort) and 69.6% (sAA) of all possible samples were finally included in the analysis. Xerostomia and nausea were the main reasons for missing data. Higher sCort levels were associated with higher heart rate and lower quality of life, functional status, and heart rate variability. Corticosteroid and sedative medication as well as time since last meal were identified as potential confounders. Regarding reactivity to the MI, we found an overall decrease in sCort levels over time (b = -.03, p =.01), but this effect did not differ significantly between the study conditions (b =.03, p =.21). sAA levels were higher in men than in women. Trajectories over time did not significantly differ between the two conditions (b = -.02, p =.80) and associations with other stress and health-related constructs were weak. Conclusions: Findings indicate that sCort might serve as a psychobiological outcome in future palliative care trials. However, future research should refine the exact measurement and conceptualization strategies for sCort in palliative care research. High attrition rates should be expected in patients with xerostomia or nausea.
    Keywords Achtsamkeit ; Biological Markers ; Biologische Marker ; Hydrocortisone ; Hydrokortison ; Lebensqualität ; Mindfulness ; Palliative Care ; Palliative Versorgung ; Quality of Life ; Stress ; Stress Reactions ; Stressreaktionen ; Terminally Ill Patients ; Unheilbar Erkrankte
    Language English
    Document type Article
    ZDB-ID 2091556-1
    ISSN 1472-684X
    ISSN 1472-684X
    DOI 10.1186/s12904-022-01085-1
    Database PSYNDEX

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  7. Article ; Online: Palliativmedizin: Rolle des Anästhesisten in einem interdisziplinären Fachgebiet.

    Bardenheuer, H J

    Der Anaesthesist

    2009  Volume 58, Issue 3, Page(s) 217

    Title translation Role of the anaesthesiologist in an interdisciplinary field.
    MeSH term(s) Anesthesiology/history ; Anesthesiology/trends ; Germany ; History, 20th Century ; Humans ; Interdisciplinary Communication ; Palliative Care ; Physicians
    Language German
    Publishing date 2009-03
    Publishing country Germany
    Document type Historical Article ; Journal Article
    ZDB-ID 260-4
    ISSN 1432-055X ; 0003-2417
    ISSN (online) 1432-055X
    ISSN 0003-2417
    DOI 10.1007/s00101-009-1542-z
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  8. Article: Einführung zum Thema: Ethische Fallberatung in der Intensivmedizin. Verantwortliches Handeln in kritischer Lebensphase. Introduction to the topic: Ethical case consultation in intensive care medicine. Responsible actions in critical phases of life

    Bardenheuer, H. J.

    Der Anaesthesist

    2012  Volume 61, Issue 1, Page(s) 5

    Language German
    Document type Article
    ZDB-ID 260-4
    ISSN 0003-2417
    Database Current Contents Medicine

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  9. Article: Ethische Fallberatung in der Intensivmedizin. Verantwortliches Handeln in kritischer Lebensphase

    Bardenheuer, H. J.

    Anaesthesist

    2012  Volume 61, Issue 1, Page(s) 5

    Title translation Ethics consultations in intensive care medicine. Responsible actions in critical phases of life
    Keywords ethics consultation ; intensive care units ; decision making ; palliative care
    Subject code AN
    Language German
    Document type Article
    ZDB-ID 260-4
    ISSN 1432-055X ; 0003-2417
    ISSN (online) 1432-055X
    ISSN 0003-2417
    Database Ethics in Medicine (ETHMED)

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  10. Article ; Conference proceedings: Tranexamsäure bei Blutungskomplikationen in der Palliativmedizin – Eine Fallserie

    Seitz, V / Kessler, J / Bardenheuer, H

    Zeitschrift für Palliativmedizin

    2014  

    Abstract: Einleitung: Blutungen bei fortgeschrittenen Tumorerkrankungen stellen ein häufiges, für Patienten sowie Therapeuten sehr belastendes und nur wenig thematisiertes Symptom dar. Der Fibrinolysehemmer Tranexamsäure wird bei signifikanter Blutung sowohl in ... ...

    Event/congress 10. Kongress der Deutschen Gesellschaft für Palliativmedizin und 13. Deutscher Kongress für Versorgungsforschung, Düsseldorf, 2014
    Abstract Einleitung: Blutungen bei fortgeschrittenen Tumorerkrankungen stellen ein häufiges, für Patienten sowie Therapeuten sehr belastendes und nur wenig thematisiertes Symptom dar. Der Fibrinolysehemmer Tranexamsäure wird bei signifikanter Blutung sowohl in der Notfallmedizin als auch bei Blutungskomplikationen im perioperativen Setting seit Jahren erfolgreich eingesetzt. In der Palliativmedizin wird Tranexamsäure bislang jedoch kaum angewendet.
    Material und Methoden: In einem Zeitraum von 9 Monaten wurde bei 20 Patienten mit unterschiedlicher Art und Ätiologie von Blutungskomplikationen eine systemische (3x tgl. 0,5 – 1,0 g) und ggf. zusätzlich lokale Therapie mit Tranexamsäure durchgeführt. Dabei wurde die Verträglichkeit und Effektivität im klinischen Verlauf beobachtet (Reduktion der Blutung, Substitution von Blutprodukten, Vermeidung von hämostyptischer Bestrahlung, etc.).
    Ergebnisse: Durch die Gabe von Tranexamsäure nahmen die Rate an Blutungskomplikationen und der Bedarf an Blutprodukten ab. Interventionelle Therapien (Endoskopie, Radiatio, Embolisation) oder gar Operationen konnten somit vermieden werden. Es wurden keine Komplikationen im Sinne eines erhöhten Thrombo-Embolie-Risikos beobachtet. Selten wurde (v.a. bei oraler Einnahme) leichte Übelkeit verzeichnet. Bei schwerer Niereninsuffizienz wurde die Dosierung angepasst.
    Diskussion: Der Einsatz von Tranexamsäure in der Prophylaxe und Therapie von Blutungen stellt einen vielfältig applizierbaren, effektiven, nebenwirkungsarmen und preiswerten Therapieansatz dar. Die Gabe von Tranexamsäure sollte bei hämorrhagischer Diathese und/oder Blutungen zur Steigerung der Lebensqualität im palliativmedizinischen Alltag etabliert werden.
    Language German
    Publishing date 2014-05-16
    Publishing place Stuttgart ; New York
    Document type Article ; Conference proceedings
    ZDB-ID 2072361-1
    ISSN 1615-293X ; 1615-2921
    ISSN (online) 1615-293X
    ISSN 1615-2921
    DOI 10.1055/s-0034-1374295
    Database Thieme publisher's database

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