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Biomedical subjects

E Witt

Publications and source records attributed to E Witt.

At least 73 records · Page 4Linked to original sources
PubMed1989

Long-term results after childhood condylar fractures. A computer-tomographic study.

A computer-tomographic study of the remodelling process of the TMJ was made of 12 patients who had suffered condylar fractures during their growth period. The most interesting results were exhibited by patients with low fractures of the condyle and medial luxation of the small fragment. The remodelled condyles consisted of 2 parts, a medial part, probably the remainder of the small fragment and a lateral part, probably callus formation. In some patients a flattening of the fossa characterized by thickening of the roof was clearly observed. The case presentation additionally included one patient with post-traumatic ankylosis and one patient presenting a bifid condyle.

Adolescent↗
PubMed1985

[Heart transplantation in cardiomyopathy].

Within the spectrum of presently accepted candidates for heart transplantation, end-stage heart failure in dilated cardiomyopathy has become the principle indication. Although several indicators of poor prognosis have been specified, the decision for heart transplantation is primarily made on clinical grounds. Expected long-term survival after transplantation is 60 to 80% at one year and more than 50% at five years. Since July, 1983, 50 patients underwent orthotopic heart transplantation, 38 of whom had been suffering from dilated cardiomyopathy. Ages ranged from nine to 54 years with a mean of 40 years. At present, 38 patients are alive, 34 are discharged from hospital, 14 have returned to work or school. Physical capacity and cardiac function are normal. There was no difference between the cardiomyopathy patients and the coronary artery disease patients with respect to rate and severity of rejection episodes, infection and long-term findings. Heart transplantation is considered a promising routine treatment for end-stage heart failure in particular in younger patients with dilated cardiomyopathy.

Adolescent↗
PubMed1983

[Long-term effect of a new delayed-action nitroglycerin compared to isosorbide dinitrate. Double-blind hemodynamic study].

Nitroglycerin bound to cellulose (Nitroglin) was investigated in patients with coronary heart disease as to the oral long-term effects in a dosage of 10 mg (n = 10) and 20 mg (n = 10) in comparison with 40 mg sustained release isosorbide dinitrate (n = 10) and placebo (n = 10). Haemodynamics were evaluated in a randomised double blind protocol. All true medications showed comparable maximal effects on right heart atrial pressure, pulmonary artery and pulmonary capillary pressure taking place with certainty between the first and fourth hour. Differences were seen for the duration of action: 10 mg cellulose bound nitroglycerin showed a sustained action until the end of the sixth hour, 20 mg until the eighth hour. The 20 mg dosage was aequipotent to the action of 40 mg of sustained action isosorbide dinitrate. However, the high dosage of 20 mg cellulose bound nitroglycerin cannot be recommended universally as diminutions of cardiac output by 30-40% may occur. Cellulose bound nitroglycerin is an oral long-term nitrate with therapeutic relevance besides the sustained action isosorbide dinitrate.

Adult↗
PubMed1981

[Risks of treatment with beta-blocking agents in acute myocardial infarction (author's transl)].

Haemodynamic investigations were performed in 40 patients with acute myocardial infarction before and after intravenous application of 6 mg propranolol. Cardiac index was significantly decreased caused by reduction of cardiac frequency and stroke volume. Pulmonary capillary pressure increased significantly. As a consequence pulmonary and peripheral vascular resistance increased. Arterial blood pressure remained largely unaffected. Propranolol showed a haemodynamically beneficial decrease of left ventricular stroke work without signs of negative cardiodepression at a cardiac index of more than 3.0 l/min . m2. At a cardiac index of less than 3.0 l/min . m2 a haemodynamically detrimental lowering of cardiac index to ranges of insufficiency of 2.0 l/min . m2 on average occurred. Thus cardiac index is an important factor for the decision of use of beta-blocking agents in acute myocardial infarction. Indiscriminate use of beta-blocking substances should not be accepted.

Adult↗
PubMed1981

[Long-term prognosis of cardiac pulmonary edema].

A retrospective determination of survival time over a total control phase of eight years was done in 53 patients who had been admitted to an internal intensive care unit in 1970 because of cardial pulmonary edema. The hospital survival rate amounted to 55%. 27% of the patients were still alive six months after discharge; after a year there were only 20%. Three of the 53 patients reached the 8th control year. The most unfavorable short- and long-term prognosis by far was evidenced by pulmonary edema resulting from an acute myocardial infarction with a hospital lethality of 80%; none of these patients survived longer than two years (n = 19). Irrespective of the nature of the basic disease, comparable rates were found for those types of pulmonary edema connected with a higher grade insufficiency of the right heart and corresponding increase of the central venous pressure over 20 cm water column (n = 13). In contrast, the pulmonary edema in consequence of a cor hypertonicum had a fairly good prognosis, because the 50% survival rate amounted to four years in this group (n = 21). All attempts to quantify the life prognosis in cases of pulmonary edema possess only speculative significance for the interests of the individual case. Nevertheless, they are indispensable for the correct choice of therapeutic procedure in medical borderline situations.

Aged↗
PubMed1981

[The treatment of acute myocardial infarctions with beta-receptor-blockers. II. Hemodynamic effects of propranolol with and without combination therapy with nitroglycerin (author's transl)].

In 20 infarct patients, whose age varies from 43 to 78 years (m 59.6), continuous hemodynamic measurements were made to determine the cardiovascular effects of propranolol without and during a simultaneous infusion treatment with nitroglycerin. In cases of compensated ventricular function and pulmonary wedged pressures of 15 mm Hg or less (N = 10), a mean intravenous propranolol dose of 6.1 +/- 1.3 mg led to a significant reduction of the LVSWI and a simultaneous increase of the PCP by 31% of the control value (P less than or equal to 0.005). A simultaneously performed infusion treatment with nitroglycerin at a mean dose of 3.0 +/- 1.6 mg/h resulted in totally cutting off the propranolol-induced PCP increase, whereas a decrease of the heart rate and the LVSWI due to a beta-receptor-blockade remained completely unchanged. In the case of pre-existing congestion insufficiency of the left ventricle (N = 10) and of a pulmonary wedged pressure of above 15 mm Hg, the administration of a mean dose of propranolol of 5.8 +/- 1.1 mg for protection of the myocardium resulted in a partly disquieting decrease of the volume of cardiac output (P less than or equal to 0.005) which was 28% of the control value for the CI an 12% for the SVI. Correspondingly the left ventricular stroke work decreased to 18%. Nitroglycerin has a reducing influence on these changes, but not down to the initial level. In cases of sufficient ventricular function, propranolol has a favorable influence on the myocardial O2-metabolism via its depressor effect on heart rate and contractility. By means of nitroglycerin, an increase of the pulmonary wedged pressure occurring under this condition can be inhibited. However, in the case of a pre-existing congestion insufficiency, propranolol can lead to a partly disquieting depression of the circulation, which, apart from the hemodynamic risks, makes a rather unfavorable influence on the myocardial O2-metabolism seem likely.

Adult↗
PubMed1981

[Treatment of acute myocardial infarction with betareceptor blocking agents. I. Hemodynamic effects of Propranolol in combination with digitalis (author's transl)].

In the acute stage of transmural myocardial infarction, 22 patients ranging in age from 34 to 76 (mean 61.6) were given propranolol- because of its alleged myocardium-protecting properties - intravenously at a dosage of 0.03 to 0.1 mg/kg body weight under conditions of continuous hemodynamic control. Subsequently, the influence of digoxin, administered i. v. at a dosage of 0.01 my/kg body weight, on the negative-inotropic propranolol effects was examined. A hemodynamic comparison was made of the effects of propranolol before and after digitalis administration. In patients with compensated cardiac function (group 1, 16 patients), the propranolol-induced drop in the left ventricular stroke-work-index and rise in the left-ventricular filling pressure was completely compensated again by digitalis. The frequency-decreasing propranolol effect was nor influenced by digitalis. In patients with cardiac decompensation (group 2, 6 patients) digitalis only led to a renewed compensation of the left-ventricular stroke-work-index, the rise of the left-ventricular filling pressure remained unaffected. It follows from that, in cases of myocardial infarction without cardial decompensation, propranolol requires concomitant digitalisation. In cases of already existent myocardial insufficiency, propranolol can produce an unfavorable increase of the decompensation signs.

Acute Disease↗
PubMed1980

[Age structure, lethality and expenditure of an internist intensive care ward. Prospective studies (author's transl)].

The total mortality for 1977 of 706 prospectively examined patients with an average age of 68 in an intensive care ward was 15%. 42% of the patients were 70 years old with a lethality of 19%, which was not essentially higher than the 51 to 70 year-old patients with 16%. In 139 patients with a recent myocardial infarction the lethality was 20%. Infarct patients over 70 years old died in 27%, between 51 and 70 years old in 17% and under 51 years of age in 7% of cases. Resuscitation measures were essential in 93 cases and led to a lasting success in 25%.

Age Factors↗