Search PubMed⌕ Search

Biomedical subjects

A Ochs

Publications and source records attributed to A Ochs.

42 records · Page 3Linked to original sources
PubMed1991

[Clinical value of ultrasonography and computerized tomography prior to abdominal interventions].

We studied the value of ultrasound and computed tomography in the preoperative diagnosis of abdominal diseases in 100 patients. Reference methods were the reports of surgery and pathology. A computed tomography or ultrasound diagnosis could be correct or false and was considered uncertain, if the main diagnosis was missed but computed tomography or ultrasound suspected pathology, which then could be clarified by other procedures. Overall, computed tomography was superior with 75 correct, 13 false and 12 uncertain diagnoses compared to ultrasound with 58 correct, 31 false and 11 uncertain diagnoses. Ultrasound often failed because obesity or gas impaired visibility. If only cases without technical problems of ultrasound were taken into account, diseases of liver, gallbladder, pancreas, kidney, the adrenal region and other abdominal masses were equally well diagnosed by ultrasound and computed tomography. As expected, the diagnostic value of both modalities was markedly reduced in diseases of the bile duct and the gastrointestinal tract. Because the study design required both, ultrasound and computed tomography, cases already clarified by ultrasound were not included. This fact might have further reduced the sensitivity of ultrasound in comparison to computed tomography. Furthermore, ultrasound was mostly one of the first diagnostic procedures performed right after the patient's admission with little information on anamnestic and clinical data. The information given prior to computed tomography was in general more detailed.

Adult↗
PubMed1988

Plasmablastic immunoglobulin-secreting lymphoma. Report of a case and a glimpse at the prognosis.

The case of a 57-year-old patient with a plasmablastic lymphoma is described. The primary diagnosis was an ordinary plasmacytoma, type IgG kappa. The final course of the disease involved almost all of the organs. The clinical aspect was determined by multiple skin infiltrations. The present report has in common with other published cases the fact that multiple secondary skin involvement of immunoglobulin-secreting tumors, regardless of their origin, have a very poor prognosis. In comparison, primary multiple cutaneous immunoglobulin-secreting tumors have a better prognosis.

Aged↗
PubMed1986

[Primary orthostatic hypotension].

We studied a 25-year-old man suffering from primary orthostatic hypotension whose blood pressure decreased to 65/45 mm Hg during orthostasis and to 95/70 mm Hg during ergometric exercise (50 and 100 watt), and whose heart rate responses were inadequate. Resting catecholamine levels were within the normal range and did not show any significant increase related to orthostasis or to ergometric exercise. Hypersensitivity was observed to low doses of intravenous noradrenaline and isoproterenol. Specific binding of 3H-Yohimbine to intact platelets revealed a normal number of alpha-2-adrenoreceptors in agreement with the adrenaline-induced platelet aggregation in vitro, which was, however, in contrast to hypersensitivity to noradrenaline. Specific 3H-Dihydroalprenolol binding to intact polymorphonuclear leucocytes revealed an increased beta-2-adrenoreceptor density in agreement with hypersensitivity to Isoproterenol. Prescription of Fludrocortison improved orthostatic hypotension.

Adult↗
PubMedDate not supplied

Prevention of infectious complications after transjugular intrahepatic portosystemic shunt in cirrhotic patients with a single dose of ceftriaxone.

BACKGROUND/AIMS: Patients with cirrhosis of the liver are prone to bacterial infections. Therapeutic interventions such as endoscopic sclerotherapy increase the risk of bacterial infections in these patients. Following insertion of a transjugular intrahepatic portosystemic shunt (TIPS), the incidence of severe bacterial infections was recently shown to be 20% after elective procedures. This finding suggests antibiotic prophylaxis with the TIPS procedure. Antibiotic prophylaxis using cefotiam or cefotaxime/ampicillin did not significantly reduce infectious complications. The aim of the present study was therefore to investigate the efficacy of two different doses of a long-acting cephalosporin in prevention of bacterial infection after TIPS. METHODOLOGY: Eighty-two patients with cirrhosis (age: 52 +/- 2 years) who underwent elective TIPS were randomized to receive a single i.v. dose of either 1 g or 2 g Ceftriaxone 1 hour before the intervention. Patients with evidence of or suspected infections and patients on antibiotic therapy within 7 days prior to TIPS were excluded. Body temperature was monitored t.i.d. for 1 week and white blood count (WBC) and C-reactive protein (CRP) were determined before TIPS and 1 day and 1 week after TIPS. RESULTS: Only 2 of 82 patients (2.6%) showed signs of infection following TIPS insertion: One of 40 patients receiving 1 g Ceftriaxone and 1 of 42 patients receiving 2 g Ceftriaxone prior to TIPS developed temperature > 38.5 degrees C. In the latter patient this was due to pneumonia. This patient received antibiotic treatment with imipenem for 10 days. Temperature in the other patient normalized within 12 hours and he did not require antibiotic treatment. No significant differences in temperature, WBC and CRP between the different doses of Ceftriaxone were observed. CONCLUSIONS: Prophylactic treatment with Ceftriaxone reduces the reported incidence of bacterial infections after TIPS in patients with cirrhosis of the liver. Prophylaxis with 1 g Ceftriaxone seems as efficacious as 2 g.

Antibiotic Prophylaxis↗
PubMedDate not supplied

Helicobacter pylori infection does not correlate with plasma ammonia concentration and hepatic encephalopathy in patients with cirrhosis.

BACKGROUND/AIMS: In patients with cirrhosis, infection of the stomach with Helicobacter pylori may increase ammonia production and, consequently, the incidence of hepatic encephalopathy. To test this hypothesis a retrospective analysis was performed in patients with a transjugular intrahepatic portosystemic shunt. These patients are regarded to be ideal candidates for such a study since they have a high bioavailability of gut-derived ammonia and many of them develop spontaneous hepatic encephalopathy. METHODOLOGY: In 132 patients (Child-Pugh class A: 24%, B: 49%, C: 27%) with stable transjugular intrahepatic portosystemic shunt function for more than 3 months (mean follow-up: 15.5 +/- 10.8 months) the diagnosis of H. pylori infection was established by a specific and sensitive immunoblot assay for IgG- and IgA-antibodies. During follow-up, hepatic encephalopathy was assessed by clinical examination and a structured questionnaire. Venous plasma ammonia concentration was measured at the time of antibody determination (end of study period). RESULTS: Eighty-four patients (64%) had negative and 48 patients (36%) had positive immunoblots for H. pylori. The groups were comparable with respect to age, gender, etiology of cirrhosis, Child-Pugh class, follow-up after transjugular intrahepatic portosystemic shunt, and shunt function. The ammonia concentrations of the patients without (group 1) and with antibodies against H. pylori (group 2) were 73 +/- 27 and 69 +/- 28 mumol/L (mean +/- SD), respectively. Hepatic encephalopathy occurred in 23 of 84 patients (27%) of group 1 and in 11 of 48 patients (23%) of group 2. CONCLUSIONS: A positive immunoblot for H. pylori antibodies neither correlates with plasma ammonia concentration nor with the incidence of hepatic encephalopathy in patients with cirrhosis of the liver and portosystemic shunt.

Adult↗