[A new hysteroscope and its practical use in gynecology].
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Diagnosis↗
Biomedical subjects
A Freund
Publications and source records attributed to A Freund.
[Pediatric characteristics of adult respiratory distress syndrome: a meta-analysis].
A meta-analysis of the literature is carried out in order to present the current knowledge of ARDS in childhood (0-15 years). This might be helpful for planning controlled studies on new therapeutic measures (e.g. surfactant replacement, antioxidants, extracorporeal gas exchange). By means of Medline all available publications were taken into account referring to minimal criteria defined before. There were 4 studies (50 patients) and 48 individual case-reports (48 patients). Most often ARDS was caused by infection (21 resp. 30%), aspiration (12 resp. 23%) and trauma (10 resp. 23%). Therapeutically high respiration pressures and toxic oxygen tensions were applied generally (average maximum PEEP: 14.7 resp. 15.8 cm H2O; average maximum PIP: 59.6 resp. 61.9 cm H2O; FiO2 > 0.5 for an average of 10.1 resp. 10.4 days). The most frequent complications were barotrauma (43.8 resp. 78%), infection (60.4%) and multiorgan failure (66.7%). Mortality rate was 31.3 resp. 52%. So also in childhood almost every second case is fatal. Especially multiorgan failure as well as high levels of FiO2 and PEEP indicate bad prognosis at an early stage. Therefore it is necessary and justified to perform clinical trials on therapeutic agents successfully tested in animal studies before.
Adolescent↗
[Tuberculous meningitis in a 13-month-old boy: a case report].
We present the case of a 13-month old Turkish boy of Kurdish origin with tuberculous meningitis. Fever of unknown origin and neurologic symptoms (loss of ability of walking and free sitting, cerebral seizures, central paresis of the VII. cranial nerve, coma) led to the diagnosis. Cranial CT demonstrated hydrocephalus and enhancement of the basal meninges after contrast injection; the chest x-ray showed an infiltrate in the right upper lobe of the lung and the cerebrospinal fluid (CSF) mild pleocytosis with elevated protein and reduced glucose concentrations. Diagnosis was confirmed by detection of Mycobacterium tuberculosis in the CSF by polymerase chain reaction (PCR). Immediately, surgical and level-controlled tuberculostatic treatment was initiated. The patient recovered completely.
Antitubercular Agents↗
Short-term efficacy of back injury intervention project for patient care providers at one hospital.
A one-year Back Injury Prevention Program was initiated at a 440-bed acute care hospital in 1996 in response to concerns over high incidence and severity of back injuries among nursing staff and others. The program included an ergonomic evaluation of patient handling, pilot testing and purchase of new equipment, a train-the-trainer program, and training of 374 nurses and other patient handling staff (approximately one-half of the nursing staff). An impact evaluation, measured by comparing self-reported knowledge, work practices, and back pain among a subset of trainees and controls revealed an increase in knowledge of risk factors, a marginal increase in the use of mechanical devices to transfer patients, and a significant decrease in repositioning of patients in bed among trained versus control subjects (p = .017). Over the course of the program, the number of back injuries was 30% below the average of the prior 3 years, with the number of reported injuries in the final quarter (immediately following the training program) approximately one-seventh of the three prior quarters. It is concluded that back injury training may increase knowledge of risk factors and controls and may impact behaviors over which individuals have control (e.g., how often they move patients). However, training effectiveness is limited when engineering controls such as patient transfer devices are unavailable.
Back Injuries↗
Subjective symptoms, blood glucose estimation, and blood glucose concentrations in adolescents with diabetes.
Twenty-five adolescent campers with insulin-dependent diabetes mellitus (IDDM) completed a Symptom Rating Checklist and estimated their blood glucose (BG) immediately before having their BG assessed four times daily for 11 days. Consistent relationships between BG and symptoms were not identified when the data were analyzed for the group as a whole. However, when each camper's data were analyzed separately, 23 of the 25 adolescents had at least one significant glycemia-symptom (G-S) correlation. Each camper seemed to have a unique G-S pattern; only one symptom (hungry) was significantly related to BG for more than half of the youngsters studied. Almost all of the significant G-S correlations were indicative of low rather than high BG. However, when asked, few campers were able to accurately identify which symptoms were reliably associated with low or high BG. In this study, different measures of BG estimation error led to different results. The percent of estimates +/- 20% of the actual BG value (55% in this study) was strongly influenced by the actual BG reading because higher BG values have larger accuracy ranges than lower BG concentrations. When estimated BG was simply subtracted from actual BG, under- and overestimates canceled each other out, resulting in an unusually small estimated error (5 mg/dl in this investigation). The absolute difference score ignores the direction of estimation error, but may more accurately reflect patients' average estimation error (68 mg/dl in this study). When actual and estimated BG values were correlated for the group as a whole, the patients appeared to be highly accurate at estimating BG (r = .93, P less than .0001).(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗