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Biomedical subjects

B Hagen

Publications and source records attributed to B Hagen.

90 records · Page 5Linked to original sources
PubMed1982

Corticotropin releasing factor (CRF)-stimulation test in normal controls and patients with disturbances of the hypothalamo-pituitary-adrenal axis.

Intravenous application of 100 micrograms synthetic ovine corticotropin releasing factor (CRF) led to stimulation of ACTH-secretion in nine normal controls, with a maximum 30 min after CRF. Cortisol, corticosterone, cortisone and 11-deoxycortisol increased with a maximum at 60 min after CRF, whereas no rise was seen in aldosterone, 11-deoxycorticosterone, 17-alpha-hydroxyprogesterone, progesterone, DHEA-S and testosterone. The specificity of CRF-stimulation was also shown by unchanged TSH, LH, FSH, hGH, prolactin and thyroid hormone levels, als well as unchanged insulin and gastrin levels. No serious side-effects were observed during the test period and afterwards. CRF-tests were performed in ten patients with disturbances of the hypothalamo pituitary adrenal axis (HPAA). Preliminary findings show hyperresponsiveness of ACTH in all situations of ACTH-hypersecretion (two patients with Cushing's disease, one patient with Nelson's syndrome, and one with Addison's disease). In contrast, one patient with successful microadenomectomy showed no response of ACTH to CRF, whereas in another patient with a macroadenoma ACTH and cortisol-levels still increased postoperatively. Divergent patterns in ACTH-responsiveness to CRF were seen in four patients with secondary adrenal insufficiency, allowing the localization of the defect. These data point to the possible importance of the "CRF-test" as a differential diagnostic tool and prognostic factor in diseases of the HPAA.

Adrenal Cortex Hormones↗
PubMed1982

[Translumbar aortography by catheter technique. Methods, indications and value (author's transl)].

400 examinations performed during the last three years by TLA (only catheter technique) were subjected to critical analysis and studied particularly in respect to the rate of complications. We observed 13 complications (3,25%) of moderate severity, including 3 large hematomas (documented by CT), 3 paravasations and 7 dissections, but no fatal complications. Two (0,5%) of these complications had clinical evidence. The advantages of the catheter technique of TLA are described. Injections through rigid metal cannula should be avoided because of the high incidence of complications (mainly the increased risk of dissection). Downstream injection resulted in excellent visualization of peripheral occluding vascular disease. Upstream injection should be preferred to demonstrate the major abdominal arteries as well as supraceliac collateral circulation in the case of high Leriche syndrome. The low or intermediate puncture of the aorta is preferable to facilitate caudad direction of the catheter and to diminish the risk of damaging other vessels or puncturing an organ.

Aortic Dissection↗
PubMed1982

[Contrast media and pain in peripheral arteriography. Randomized, intra-individual double-blind trial: ioglicinate, ioglicinate-lidocaine, ioxaglate].

The intravasal application of contrast media (CM) can induce pain and heat. We assessed these local side effects by an intraindividual comparison in 60 patients with occlusive arterial disease. A dolorimeter and calorimeter (graduated scales) were employed to register and differentiate the subjective sensations experienced by the patient, while objective reactions (peripheral motoric reactions, circulatory parameters) were recorded by the trial list at the same time. Ioxaglate, an ionic dimer, was distinctly superior to Ioglicinate, an ionic CM. However, the differences were less marked in the comparison with a Ioglicinate-Lidocaine-mixture. Emphasis is given to the fact osmolality is the most important parameter in the generation of pain. Potential points at which the intraarterially administered local anaesthetic could attack are discussed. The clinical conclusions include consideration of the cost-effectivity ratios of the tested CM's and a discussion of whether or not modern standards still justify general anaesthesia for peripheral angiography.

Angiography↗
PubMed1982

[Iopamidol, a new non-ionic roentgen contrast medium. Results of angiographic studies in more than 300 patients, with special reference to pain reactions].

Iopamidol, a new non-ionic, monomeric contrast medium with low osmolality has been well established in our angiographic routine procedures according to the favourable results obtained in more than 300 controlled trials. The general tolerance (demonstrated by the rate of systemic adverse reactions) of the lower concentrated solution (300 mg iodine/ml) is a little bit better than that of the higher concentrated one (370 mg iodine/ml). We could demonstrate a significant difference between the two preparations regarding to local side effects such as pain and heat sensations. The results of 100 intraindividual double blind studies (only peripheral angiography) specially referring to local side effects showed the high significant decrease of pain and heat sensations after application of Iopamidol as compared to the results gained by the ionic Ioxitalamate and Ioglicinate. There was no remarkable difference between Iopamidol and Ioxaglate which is a dimeric but equally low osmolar substance. The role of osmolality in the generation of side effects is pointed out. In consequence the advantages of using contrast media of reduced osmolality particularly in peripheral angiography must be emphasized.

Angiography↗
PubMed1980

[Computed tomographic demonstration of retroperitoneal haematoma following translumbar aortography (author's transl)].

26 patients were prospectively studied by computed tomography to evaluate the amount and localization of retroperitoneal hemorrhage following translumbar aortography (TLA). The topographic relations of the needle passage to the surrounding organs and soft tissues were demonstrated in 2 patients undergoing a typical high and low TLA. The computerized quantitative evaluation of the size of hemorrhage (differential calculation) showed values between 5 and 200 ml. The mean value was 20 ml. Bleeding of the muscle was observed more often (53%) than aortal or periaortic hemorrhage (37%).

Aged↗
PubMedDate not supplied

Self-expandable macroporous nitinol stents for transfemoral exclusion of aortic aneurysms in dogs: preliminary results.

This experimental study evaluated the feasibility of excluding artificially created aortic aneurysms in dogs with transfemorally inserted nitinol stents, serving as intraluminal bypass. Infrarenal aortic aneurysms were created in eleven dogs (28-35 kg) by end-to-end anastomosis of sacciform conduits. Single and double wire-knitted, macroporous, superelastic, self-expanding nitinol stents without any additional wrapping or in-between fabrics served as endovascular grafts. The pore size of the double-knitted stents was less than 0.7 mm2. Angiography following stent placement showed immediate exclusion of the aneurysms for the double-knitted stents. For the single-knitted stents (2 cases), partial exclusion was achieved only after considerable delay. CT studies in the dogs with the double-knitted stents revealed patency of the grafts after 3 to 5 weeks with the aneurysms totally thrombosed. So far gross pathology of 1 dog at 24 h and 1 at 12 months revealed patency of the stents. At 12 months histopathology showed a neointima covering the inner stent surface with the aneurysm filled by an organized thrombus. It is concluded, that an "open" stent with a tight meshwork appears to be a suitable device to instantly exclude artificial aneurysms of the canine aorta.

Alloys↗
PubMedDate not supplied

Iliac and femoropopliteal vascular occlusive disease treated with flexible tantalum stents.

Two hundred patients were treated with tantalum stents, 2 in the aortoiliac bifurcation, 114 in the iliac, and 84 in the femoropopliteal arteries. The indications for stenting were technically unsuccessful percutaneous transluminal angioplasty (PTA) due to arterial recoil, dissection (156 patients), or acute occlusions (15 patients). Long iliac artery occlusions (29 patients) were indications for primary stenting. Life-table analysis revealed a 3-year patency rate of 95% for stented iliac arteries, and a 1-year patency rate of 80% for stented femoropopliteal arteries. Restenosis of the stented femoropopliteal lumen was particularly frequent in stents placed for restenosis following prior PTA (7 of 12 patients), in stents placed into the distal superficial femoral and popliteal arteries (14 of 24 patients), and in stents positioned over a longer than 4-cm artery segment (9 of 16 patients). For the aortic bifurcation and iliac arteries, arterial stenting has proved to be a valuable adjunct to PTA; for femoropopliteal arteries, stenting should be restricted to acute arterial occlusions or severe residual stenosis following PTA.

Adult↗
PubMedDate not supplied

Nursing resource requirement and support services.

How can medical-surgical and critical care units reduce their nursing care hours per patient day (HPPD)? When nurse executives understand the impact of professional, nonprofessional, and technological support services on HPPD they can work toward further cost reduction without adversely affecting the quality of patient care.

Health Resources↗
PubMedDate not supplied

The relationship between length of stay and required nursing care hours.

The average length of stay (LOS) of patients in hospitals has declined rapidly since the introduction of the prospective payment system. It has been argued by nurses that reduced LOS is associated with increased nursing resource consumption, but there has been little empirical evidence to support the argument. The authors offer evidence of a relationship between LOS and hours per patient day in eleven clinical specialty areas. These findings have major implications for budgeting and the delivery of nursing care services.

Hospital Units↗
PubMedDate not supplied

Impact of research on pediatric pain assessment and outcomes.

PURPOSE: Pediatric nurses from varied practice and educational backgrounds learned about research by doing a ward-based study. The aim of the study was to determine if regular assessment of children's pain would improve their pain management and postoperative progress. METHOD: Children, ages 5 to 17 years (n = 36), measured their pain every 4 hours postoperatively using the Wong-Baker Faces Pain Rating Scale. Outcomes regarding amount of analgesic given, subjective pain reports, time and progress of ambulation, and length of hospital stay were compared with data from a retrospective chart-review of a control group (n = 50). FINDINGS: No statistically significant differences in these variables were found. An important clinical finding was that despite all children having prescribed PRN analgesic orders, one quarter of the children received no pain relief intervention. Also, one quarter of the children stated that their pain control was only partially effective. CONCLUSIONS: Study results reinforce findings reported in the literature regarding ineffective pain management in children, and highlight a need for improved nursing practice. Clinical significance was achieved in terms of staff learning of the research process, increased awareness of pediatric pain management practices, improved ward morale, and inter-agency sharing of resources.

Adolescent↗