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F Dressler

Publications and source records attributed to F Dressler.

At least 19 recordsLinked to original sources
PubMed1999

[In Process Citation]

OBJECTIVE: The purpose of this study was to evaluate the effects of opioid addiction on pregnancy, perinatal period, and the long-term development of mother and child. MATERIAL AND METHODS: Records of 44 opioid-dependent women and their children were analyzed. Thirty-three patients were enrolled in methadone maintenance treatment (MMT) programs or received codeine. RESULTS: Problems during pregnancy were premature rupture of membranes (n = 8), premature labor (n = 21), premature delivery (n = 9), abruption placentae (n = 2), cesarean section (n = 10), and fetal growth retardation (n = 15). Whereas MMT improved fetal growth, no influence was seen on other problems during pregnancy. Thirty newborns had significant withdrawal symptoms. One child became HIV-positive and two children required treatment for suspected congenital syphilis. One child died of sudden infant death syndrome. CONCLUSIONS: The major goal has to be the avoidance of an unwanted pregnancy. Does it still happen, the patient needs special support. If an opioid-dependent woman presents herself the first time, an anamnesis concerning drugs in addition to a general anamnesis should be arisen.

Journal Article↗
PubMed1998

[Neonatal hearing screening with the Echosensor automated device for otoacoustic emissions. A comparative study].

Following the recommendations of the United States National Institutes of Health Consensus Conference in 1993, otoacoustic emissions (OAE) are now used internationally for hearing screening. The use of recording systems as well as the interpretation of results requires specially trained personnel although measurements are easier to perform than other recording methods available. To date, no objective method for general hearing screening, has been introduced in Germany, for neonates or children at risk, even though it would be desirable to detect and rehabilitate children with congenital hearing loss as early as possible (incidence, 1-6 per 1000). The Echosensor provides the means for carrying out OAE recordings within a short period of time and includes an automatic evaluation of results. Recordings can also be made by trained personnel. As a comparison test, audiologically trained staff recorded otoacoustic emissions in 111 new-born children in order to compare the results of the Echosensor with the results of a conventional OAE measurements device (the ILO88). The aim of this pilot study was to determine the reliability and validity of the recordings in comparison with available standards in brainstem audiometry. Our study showed that the results of the Echosensor corresponded well with the ILO88 results. Consequently, an OAE measuring method is now available is also provides high sensitivity and specificity and is easy to use. Our findings show that the Echosensor can meet the demands of systematic hearing screening in Germany.

Acoustic Impedance Tests↗
PubMed1998

[Overview of the current status of measurable parameters of cartilage metabolism in various body fluids].

The human cartilage and bone is characterized by a remodeling during the life, well balanced by neosynthesis and degradation of matrix components. In different joint diseases, it becomes imbalanced and the destruction of the cartilage supersedes the repair. In tissue processes in disease and in normal turnover of the matrix, these molecules are fragmented and released into surrounding fluids, in the synovial fluid, and then in the blood and the urine, where they can be detected. The quantitative measurement in the synovial fluid is more specific than in the other body fluids. The research process in recent years has suggested that these molecular markers of cartilage and bone matrix metabolism can be used to determine diagnosis, the disease severity rather than its presence or absence, the prognosis, and the response to therapy. They should help to identify the disease mechanism in different joint diseases not only on the tissue but also on the molecular level. The specific cartilage matrix markers promise to become useful tools in the future in clinical use. The research in this area is still in the early stages, with most results dated from the end of the 1980s and the 1990s.

Aggrecans↗
PubMed1998

Juvenile rheumatoid arthritis and spondyloarthropathies.

This paper reviews the current literature on the clinical aspects of juvenile rheumatoid arthritis (JRA) and the juvenile spondyloarthropathies. The classification of the juvenile arthritides remains controversial. A sibling pair registry established a role for genetic influences on the onset and course types of JRA. Even in the absence of steroid treatment, children with JRA demonstrated decreased bone mineral density and an impairment of linear growth. Magnetic resonance imaging was found to be helpful in detecting subtalar or sacroiliac involvement. Studies were published on the use of azathioprine, cyclosporine, and cyclopyhosphamide in the treatment of severe JRA. The lack of severe liver toxicity was shown in patients having received high total doses of methotrexate. An international agreement was reached on defining improvement in JRA. Several studies found an improved long-term outcome in patients with JRA or the juvenile spondyloarthropathies.

Arthritis, Juvenile↗
PubMed1998

[Endoscopic appendectomy in gynecology].

From 1987 to 1997 we treated 406 patients with appendicitis. 392 patients were treated by endoscopic appendectomy, 14 patients underwent laparotomy for appendectomy. Among these 406 patients we found 4 patients with primary pelvic inflammatory disease, 18 patients with endometriosis, 15 pregnant patients and 13 patients older than 60 year's. The difficulties during the laparoscopic operation were unimportant and we could keep them under control by laparoscopic. 13 patients developed severe complications during the postoperative period. For this reason we do not perform a prophylactic appendectomy during gynaecological laparoscopies. We present in this paper our results and indications for the endoscopic appendectomy.

Adolescent↗
PubMed1997

Valve replacement in the small aortic annulus: prospective randomized trial of St. Jude with Medtronic Hall.

OBJECTIVE: The ideal prosthesis for aortic valve replacement in patients with small annuli remains controversial and has yet to be identified. The purpose of this report is to compare the St. Jude (SJ) Medical and Medtronic Hall (MH) valves for aortic valve replacement in the small aortic root. METHODS: From 1986 to 1994 we prospectively randomized 456 patients to receive either the SJ or the MH valve. From this population, 80 patients (SJ, 42 patients; MH 38 patients) had a 19 or 21 mm aortic prosthesis inserted without annulus enlarging procedure. RESULTS: Follow-up was complete in all 80 patients for 270 patient years (mean 40.5 months). Analysis showed that the SJ and MH groups were similar with respect to age, gender, body surface area, valve area, NYHA class, ventricular function, prosthesis size, frequency of revascularization, bypass and global ischemic time. There were two operative deaths (1 SJ, 1 MH). Clinical performance and Dobutamine stress transesophageal doppler echocardiography could not demonstrate a significant advantage of one prosthesis over the other in this population. The change in aortic valve gradient, and left ventricular mass index measured preoperatively and within 12 months postoperatively were not different in both cohorts. CONCLUSION: The study could not detect a difference in the performance of the SJ and MH heart valves for aortic valve replacement in patients with small aortic annuli.

Adult↗
PubMed1996

[Effect of surgical laparoscopy on prognosis of early and limited ovarian malignancies].

9375 laparoscopies were performed at our clinic between 1987 and 1993. In this patient group the incidence of early or localised stages of ovarial malignomas FIGO I and II is 0.9 per cent. 81 laparoscopies were performed on patients suffering from localised stages of ovarial malignomas. 32% (n = 26) of these laparoscopised patients suffering from ovarial malignomas were subjected to extended diagnostic-surgical laparoscopy. These 26 localised stages of ovarial malignomas on which tumour-aggressive laparoscopy had been performed, were followed up and the relevant literature studied and processed. In 23 of the patients thus subjected to tumour-aggressive laparoscopic surgery we did not observe any deterioration of the prognosis during the treatment period (1-8 years). Problematic postoperative courses were seen in 3 patients; the reasons for this are discussed in the present paper. Measures resulting in opening of the tumours during diagnostic-surgical laparoscopy are neither accidental nor unforeseen incidents, but are rather part of an overall surgical strategy. If safety techniques are adopted-as described in this paper-diagnostic-surgical laparoscopy can be performed even during localised stages of ovarial malignomas without any presently recognisable adverse effect on patient prognosis.

Adult↗
PubMed1995

[Risk of recurrence and rate of intrauterine pregnancy after endoscopic therapy of extrauterine pregnancies. 10 years experiences with the treatment of 709 extrauterine pregnancies].

709 ectopic pregnancies were observed from 1983-1992 in the Department of Gynaecology of the Neukölln Hospital, Berlin, Germany, 585 out of which underwent laparoscopic treatment. 169 of 372 patients treated from 1986-1991 still wished to conceive, and we found intrauterine pregnancies in 60% (102 patients) and recurrent ectopic pregnancies in 27% (46 patients). In 9% (11 patients) of these the recurrence occurred following a delivery. A long term follow-up of patients from 1986-1988 was carried out in 1989 and 1993. Compared to 1989, the data of 1993 show a remarkable increase in recurrences and a merely slight increase in intrauterine pregnancies. For representative results the duration of follow-up should be 5 years or longer. 37 cases were operated on while preserving the organ, on a solitary tube or on both tubes. This group with an intrauterine pregnancy rate of 33-47% and a recurrence rate of 49% is discussed later. The risk of recurrence is increased after organ-preserving treatment of a second tubal pregnancy and after severe pelvic inflammatory disease. The process of deciding between maintaining the organ versus salpingectomy, is also discussed.

Fallopian Tubes↗
PubMed1995

[The clinical picture of endoscopically treated extrauterine pregnancy. Postoperative follow-up of 677 endoscopically operated extrauterine pregnancies 1983-1993].

677 ectopic pregnancies were treated by laparoscopy from 1983-1993. Complications in 26 cases led to a second laparoscopic intervention; these complications are analysed to access the advantages and risks of this new procedure. The postoperative HCG blood levels were observed and salpingectomy vs. organ-preserving techniques compared. 30 cases of postoperative HCG-increases and 19 cases with operative treatment of residual trophoblast are also analysed. Endoscopic salpingectomy of tubal pregnancies is a safe procedure with a very low complication rate. Organ-preserving treatment of tubal pregnancies via laparoscopy has a critical complication range of 7-9%. This should be considered for the choice of the operating procedure and the patient should be informed of the risks and their frequency.

Adult↗
PubMed1994

Detection of Borrelia burgdorferi DNA by polymerase chain reaction in synovial fluid from patients with Lyme arthritis.

BACKGROUND: Borrelia burgdorferi is difficult to detect in synovial fluid, which limits our understanding of the pathogenesis of Lyme arthritis, particularly when arthritis persists despite antibiotic therapy. METHODS: Using the polymerase chain reaction (PCR), we attempted to detect B. burgdorferi DNA in joint-fluid samples obtained over a 17-year period. The samples were tested in two separate laboratories with four sets of primers and probes, three of which target plasmid DNA that encodes outer-surface protein A (OspA). RESULTS: B. burgdorferi DNA was detected in 75 of 88 patients with Lyme arthritis (85 percent) and in none of 64 control patients. Each of the three OspA primer-probe sets was sensitive, and the results were moderately concordant in the two laboratories (kappa = 0.54 to 0.73). Of 73 patients with Lyme arthritis that was untreated or treated with only short courses of oral antibiotics, 70 (96 percent) had positive PCR results. In contrast, of 19 patients who received either parenteral antibiotics or long courses of oral antibiotics (> or = 1 month), only 7 (37 percent) had positive tests (P < 0.001). None of these seven patients had received more than two months of oral antibiotic treatment or more than three weeks of intravenous antibiotic treatment. Of 10 patients with chronic arthritis (continuous joint inflammation for one year or more) despite multiple courses of antibiotics, 7 had consistently negative tests in samples obtained three months to two years after treatment. CONCLUSIONS: PCR testing can detect B. burgdorferi DNA in synovial fluid. This test may be able to show whether Lyme arthritis that persists after antibiotic treatment is due to persistence of the spirochete.

Adolescent↗
PubMed1994

Antibody responses to the three genomic groups of Borrelia burgdorferi in European Lyme borreliosis.

The antibody responses to the three genomic groups of Borrelia burgdorferi (B. burgdorferi sensu stricto, Borrelia garinii, and Borrelia afzelii) were determined in 97 German patients with various manifestations of Lyme borreliosis. The geometric mean antibody titers in each patient group, determined by ELISA, were similar with each antigen preparation. By Western blotting, however, patients with meningopolyneuritis tended to respond to more spirochetal polypeptides of B. garinii, the group 2 strain, whereas those with arthritis recognized more antigens of B. afzelii, the group 3 strain (P < .03), as did those with acrodermatitis. Only 1 patient each with erythema migrans, arthritis, or acrodermatitis had weak reactivity with outer surface protein A (OspA), and none responded to OspB. It is concluded that differences among the three groups of B. burgdorferi may result in variations in the antibody response in European Lyme borreliosis.

Antibodies, Bacterial↗
PubMed1993

Western blotting in the serodiagnosis of Lyme disease.

There are currently no accepted criteria for positive Western blots in Lyme disease. In a retrospective analysis of 225 case and control subjects, the best discriminatory ability of test criteria was obtained by requiring at least 2 of the 8 most common IgM bands in early disease (18, 21, 28, 37, 41, 45, 58, and 93 kDa) and by requiring at least 5 of the 10 most frequent IgG bands after the first weeks of infection (18, 21, 28, 30, 39, 41, 45, 58, 66, and 93 kDa). When these definitions were tested in a prospective study of all 237 patients seen in a diagnostic Lyme disease clinic during a 1-year period and in 74 patients with erythema migrans or summer flu-like illnesses, the IgM blot in early disease had a sensitivity of 32% and a specificity of 100%; the IgG blot after the first weeks of infection had a sensitivity of 83% and a specificity of 95%. Among patients with indeterminate IgG responses by ELISA, 6 of 9 patients with active Lyme disease had positive blots compared with 2 of 34 patients with other illnesses (P < .001). Thus, Western blotting can be used to increase the specificity of serologic testing in Lyme disease.

Antibodies, Bacterial↗
PubMed1993

Infectious diseases affecting the musculoskeletal system in children and adolescents.

Many infectious organisms can lead to musculoskeletal symptoms in children. This article reviews recent studies on rheumatic fever, invasive group A streptococcal infections, septic infections of bones and soft tissues, reactive arthritides caused by viruses, fungi or bacteria, and Lyme disease. The search for etiologic organisms in chronic arthritis continues. Although Koch's postulates are not fulfilled in most cases of infectious arthropathies, progress has been made in diagnosing and treating these diseases.

Adolescent↗