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Biomedical subjects

F Loew

Publications and source records attributed to F Loew.

At least 37 records · Page 2Linked to original sources

Acute spinal intradural extramedullary hematoma: a nonsurgical approach for spinal cord decompression.

The authors present the case of a 60-year old man with a spontaneous spinal intradural hematoma in the thoracic and lumbar region, which was caused by anticoagulant therapy and led to a severe progressive transverse lesion. After substitution of coagulation factors, a small catheter was inserted into the subarachnoid space via a lumbar puncture. By alternating irrigation and suction removal of the blood clot, restoration of the cerebrospinal fluid passage was possible along with a marked improvement in the neurological deficits. At 8 months' follow-up, the patient had completely recovered from the severe paraparesis and bladder dysfunction.

Catheterization↗

[Review: arterial hypertension and advanced age].

In elderly and very old patients, arterial hypertension is a major cardiovascular risk factor. However, its management is still controversial. In this review paper, the effects of old age on cardiovascular homeostasis are discussed. Because of less efficient baroreflexes, increased blood pressure variability, postural hypotension, impaired renal and electrolytes regulation, elderly patients are more prone to side effects of treatment. Special attention should be paid to the blood pressure measurements: in this respect, ambulatory non invasive blood pressure profiles can be particularly helpful for the diagnosis and the control of hypertension. A practical approach acknowledging specific aspects of old age and recent advances in antihypertensive therapy is proposed.

Aged↗

The intraarterial route of drug delivery in the chemotherapy of malignant brain tumours.

This review is based on literature data and own experiences in 79 patients with malignant brain tumours using intraarterial delivery of cytostatic agents as adjuvant therapy. A survey is given of the pharmacological rationale of this therapeutic approach, of the drugs which have been used and of the related experimental and clinical experiences. Advantages and limitations are discussed and clinical conclusion drawn. Experience so far suggests that in anaplastic astrocytomas and oligodendrogliomas intraarterial ACNU might be as effective as intravenous BCNU against the tumours but causes less systemic side-effects.

Antineoplastic Agents↗

Indications for extra-intracranial bypass surgery. New orientation after the Toronto Bypass Study based on angiographic and non-invasive ultrasound flow measurements.

UNLABELLED: Angiographic and flow measurement results in 18 cases, who underwent extra-intracranial bypass surgery, are presented. The method was the Mavis ultrasound technique. MAIN RESULT: Patients with unilateral internal carotid artery (ICA) occlusion and additional contralateral ICA stenosis or occlusion had a permanent cerebral blood flow (CBF) increase as a consequence of the anastomosis. On the contrary, patients without contralateral flow impairment or with good spontaneous extra-intracranial anastomosis did not have a real CBF improvement but only a temporary flow increase on the anastomotic side with comparable flow decrease in the contralateral ICA. The so-called Toronto Bypass Study was designed to evaluate the effectiveness of extra-intracranial bypass surgery for stroke prevention but it did not prove its effectiveness in this regard. Intentionally it did not put or answer the question of possible haemodynamic benefit for special subgroups of patients with cerebrovascular occlusive disease. Our results suggest such a haemodynamic benefit, and in consequence an indication for bypass treatment may be given in cases with ICA occlusion and additional contralateral flow impairment and without sufficient spontaneous collateralization. The question of a stroke preventing effect in this special subgroup should be answered by another controlled study. But this will be almost impossible to realize because--as a consequence of the Toronto study--at least in our country almost no further patients are transferred to the neurosurgeon for possible bypass surgery.

Arterial Occlusive Diseases↗

Comparison of midazolam and oxazepam as hypnotics in elderly hospitalized patients. A double-blind clinical trial.

The efficacy and safety of 15 mg midazolam versus 15 mg oxazepam were compared in a double-blind clinical trial in 61 aged hospitalized patients (mean age 82.5, range 69 to 96), suffering from moderate to severe insomnia. The study covered 8 nights, i.e., 1 placebo night followed by 5 treatment nights and 2 further placebo nights. Both drugs were equally effective with respect to total sleep time, number of nocturnal awakenings, quality of sleep, condition on awakening, patients' assessment and dreams. However, sleep latency was significantly shorter in the midazolam group, which was also rated significantly more favorably by the medical staff. Side effects were mild and similar in both groups. No rebound or carry-over effects were noted. Midazolam can be considered an effective and safe sleep inducer in aged patients.

Aged↗

Intracarotid infusion of ACNU and BCNU as adjuvant therapy of malignant gliomas. Clinical aspects and critical considerations.

Thirty patients with malignant gliomas were treated by operation, radiotherapy and additional intracarotid infusions of ACNU and BCNU. Positive results were obtained in the treatment of oligodendrogliomas and astrocytomas grade III and IV. On the contrary, the results in cases of glioblastoma multiforme were disappointing: neither survival time nor quality of life had been significantly improved. The protective effect of phenobarbitone against systemic toxicity by ACNU was not always confirmed in this study. Based on literature reports and our own experience the indications, technical aspects, unexpected complications and results of this therapeutic approach are discussed.

Astrocytoma↗