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Biomedical subjects

G Vogel

Publications and source records attributed to G Vogel.

At least 181 records · Page 10Linked to original sources
PubMed1995

A comparative trial of a low molecular weight heparin (enoxaparin) versus standard heparin for the prophylaxis of postoperative deep vein thrombosis in general surgery.

BACKGROUND: Various studies have been performed in general surgery patients comparing low molecular weight heparin (LMWH) with standard heparin (SH) for the prevention of postoperative deep vein thrombosis (DVT), revealing contradicting results. Therefore, we have compared the efficacy and safety of a LMWH for the prevention of DVT after major general surgery. PATIENTS AND METHODS: Patients received either 20 mg LMWH (enoxaparin) once daily, or 5,000 IU SH TID, starting preoperatively in a prospective, randomized, double-blind international multicenter trial. DVT was diagnosed using fibrinogen I 125 leg scanning. Major and minor bleeding were assessed clinically. RESULTS: A total of 718 patients were randomized to LMWH, and 709 patients to SH. DVT was detected in 58 LMWH-treated patients (8.1%, 95% confidence interval [CI] 6.2% to 10.3%) and in 45 patients allocated to SH (6.3%, 95% CI 4.7% to 8.4%, P > 0.05). Major bleeding complications occurred in 11 LMWH-treated patients (1.5%, 95% CI 0.8% to 2.7%) and in 18 patients to whom standard heparin was administered (2.5%, 95% CI 1.5% to 3.9%, P > 0.05). Four LMWH-treated patients (0.6%) required reoperation for bleeding as compared to 13 patients in the SH group (1.8%, P = 0.03). CONCLUSION: This LMWH appeared as effective and safe as SH. In view of its more convenient way of administration, this LMWH might be preferred for thromboprophylaxis.

Aged↗
PubMed1995

Zolpidem in the treatment of transient insomnia: a double-blind, randomized comparison with placebo.

Transient insomnia may be induced by stress, sleep in unfamiliar surroundings, jet lag and other factors. Zolpidem, a novel imidazopyridine hypnotic, has been shown to have hypnotic properties in most patients without significantly affecting next-day performance. Using the first-night effect in a sleep laboratory as a model of transient insomnia, this placebo-controlled, double-blind, parallel-group study evaluated the efficacy and safety of zolpidem in 462 normal volunteers. Zolpidem was tested at doses of 5, 7.5, 10, 15 and 20 mg, and statistical analysis of 7.5 mg and 10 mg was compared with placebo (unbalanced randomization). Compared with placebo, the 7.5 mg and 10 mg doses of zolpidem decreased sleep latency and increased sleep duration and maintenance (i.e. reduced number of awakenings). Zolpidem (7.5 mg or 10 mg) had no significant effect on next-day psychomotor performance. No statistically significant differences in the overall side-effect profiles were found between 7.5-mg and 10-mg zolpidem dose groups and placebo. This study demonstrates that zolpidem at 7.5 mg and 10 mg is effective in the treatment of transient insomnia.

Adult↗
PubMed1995

Multicenter evaluation of a new capillary blood prothrombin time monitoring system.

The analytical performance of the new capillary blood prothrombin time monitoring system CoaguChek was examined in a multicenter evaluation at six hospitals. The coefficients of variation of the INR obtained in the CoaguChek imprecision study were approximately 7% in the control plasma provided (within-run and day-to-day) and 4% in blood (within-run). The prothrombin times were ascertained in capillary blood (CoaguChek PT Test) and citrated venous plasma (Hepato Quick, Thromborel S) from 359 patients under oral anticoagulation therapy with phenprocoumon, acenocoumarin or warfarin. The agreement with the test results obtained with the comparison methods was acceptable versus Hepato Quick assay (n = 359; y = 1.23 x -0.49, r = 0.888) and good versus Thromborel S method (n = 359; y = 1.09 x -0.28, r = 0.895). A simplified assessment of all test results (n = 795) in a nine-field comparison table showed a concordance with the comparison methods of more than 80 (Hepato Quick: 81%, Thromborel S: 83%). The concordance between Hepato-Quick and Thromborel S was slightly higher (88%). Its good analytical performance and convenient handling recommend the CoaguChek system as a suitable system for decentralized prothrombin time testing.

Blood Chemical Analysis↗
PubMed1995

[Parent counseling--a multi-perspective approach].

There is a consultation concept being presented within the scope of parental consultation at consultation offices which emphasizes the necessity of the synopsis of five different perspectives. Besides general developmental psychological understanding about the child's development and the accompanying capabilities of parents there is the subject of individual characteristics of children with which they are born, for instance brain-organic handicaps and differences in temperaments. Furthermore, the personality of the parents as result of their life history as well as the actual life situation and the life circumstances of the family with the resulting future perspectives are being included into the synopsis. Finally as the 5th perspective there are conceptions about the interaction processes between these different influencing factors to be added. Contributions of various authors with regard to the five perspectives are being examined and relations to the model of personality and development of the Integrative Therapy being made as well as conclusions for the parental consultation being drawn.

Child↗
PubMed1995

Treatment of coronary heart disease by diet and exercise.

Management of risk factors by diet and exercise in patients with coronary heart disease in two controlled studies, resulted in significant modification of atherogenic lipoproteins, myocardial perfusion, and physical work capacity. Moreover, within 1 year there were significantly more regression and less progression of coronary atherosclerosis in the study group compared to usual care control patients. Follow-up for 6 years showed erosion of dietary discipline, unfavorable changes in lipoprotein levels, and subsequent progression of coronary lesions in many patients. It is concluded that the course of coronary heart disease can be favorably modified by intensive dietary counseling and supervised exercise, but that maintenance of positive results remain a challenge for physicians and patients alike.

Arteriosclerosis↗
PubMed1994

[Partial portal vein and mesenteric vein thrombosis in familial protein S deficiency].

Protein S, a vitamin-K dependent glycoprotein is a cofactor of protein-C system, which acts as an inhibitor of the plasmatic coagulation. Protein-S congenital deficiency results in recurrent venous thromboses, atypical locations in portal and mesenteric veins are possible. In our patient the partial thrombosis of the portal vein was diagnosed by computed tomography and angiography. Small bowel ischaemia due to mesenteric vein thrombosis required segmental resection. Post-operatively the patient was heparinized and later phenprocoumon was applied to a long-term therapy.

Adult↗
PubMed1993

The detection, purification, structural characterization, and metabolism of diphosphoinositol pentakisphosphate(s) and bisdiphosphoinositol tetrakisphosphate(s).

A new class of inositol phosphates containing energy-rich pyrophosphoryl residues has been characterized. D/L-1-Diphosphoinositol pentakisphosphate(s) and D/L-bis-(1,4)-diphosphoinositol tetrakisphosphate(s) are present as soluble ionic species in the cytosol of amoebae (Dictyostelium discoideum) at concentrations in the range of 0.05-0.25 mM. These compounds are rapidly metabolized in intact cells and can be synthesized in cell lysates from myo-inositol hexakisphosphate in the presence of ATP. Their phosphomonoester groups have predicted C-O-P bond energies of between 3.3 and 4 kcal mol-1; however, the bond energies of the P-O-P links in their diphosphate moieties are 6.6 kcal mol-1 and hence similar to the equivalent bonds in ADP, indicating a potential role for these compounds as phosphate donors in phosphotransferase reactions. Compounds with similar chromatographic properties are found in a variety of mammalian cell types.

Animals↗
PubMed1993

Sexual dimorphism in the human face assessed by euclidean distance matrix analysis.

The form of any object can be viewed as a combination of size and shape. A recently proposed method (euclidean distance matrix analysis) can differentiate between size and shape differences. It has been applied to analyse the sexual dimorphism in facial form in a sample of 108 healthy young adults (57 men, 51 women). The face was wider and longer in men than in women. A global shape difference was demonstrated, the male face being more rectangular and the female face more square. Gender variations involved especially the lower third of the face and, in particular, the position of the pogonion relative to the other structures.

Adult↗
PubMed1992

The effect of storage in liquid nitrogen on the isolation of oral yeasts in human saliva.

Stimulated whole saliva samples were collected from a group of 127 6-yr-old schoolchildren. Each sample was divided into three parts. The first two, one of which contained added glycerol, were immediately frozen in liquid nitrogen and stored at -196 degrees C for 2 months. The third part was transferred to the laboratory and plated on selective medium for yeasts. Colony counts of the frozen and non-frozen samples were then compared. Statistical analysis showed a highly significant correlation between the counts for frozen and unfrozen samples. A high (40.1%) prevalence of yeast carriers was found, and Candida albicans was the most frequently recovered yeast.

Candida↗
PubMed1992

Clinical uses and advantages of low doses of benzodiazepine hypnotics.

The most common adverse effects associated with the use of benzodiazepine hypnotics are residual daytime effects (daytime sedation and daytime performance decrements), anterograde amnesia, and rebound insomnia. Studies show that these adverse effects are related to dose. Hence, benzodiazepine hypnotics should be used in low doses so as to minimize or prevent these common adverse effects. It is now generally accepted that benzodiazepines should not be administered long-term for the treatment of chronic "idiopathic" insomnia. Two noncontinuous sleep disturbances, insomnia in the elderly and transient insomnia in young and middle-aged adults, are probably the most acceptable indications for the use of benzodiazepines. Low doses of short- and intermediate-acting benzodiazepines (triazolam and temazepam) are efficacious in the treatment of insomnia in the elderly, and preliminary evidence suggests that they are efficacious in the treatment of transient insomnia in young and middle-aged adults.

Adult↗
PubMed1991

Treatment of coronary heart disease with diet and exercise--problems of compliance.

The effects of low fat diet and intensive physical exercise were examined in a randomized prospective study in patients with angiographically documented coronary heart disease. In addition to supervised regular physical exercise, patients of the intervention group (n = 18) were subjected to intensive dietary counselling with the aim of a low fat, low cholesterol diet to be maintained for at least 12 months. The control group (n = 27) received relevant advise only and usual care by private physicians. In the intervention group there was significant lowering of plasma triglycerides (202 +/- 82/141 +/- 74 mg/dl) and body weight (78.2 +/- 9.5/73.7 +/- 10.4 kg) while total and LDL cholesterol did not change significantly. There was a tendency for a rise of HDL-cholesterol (35.6 +/- 9.0/40.4 +/- 14.8 mg/dl, p = 0.07). According to 24-hour diet protocols there was a significant lowering of energy intake (2.298 +/- 697/1.602 +/- 758 kcal/day), of fat intake (111.7 +/- 44.4/52.0 +/- 23.9 g/day) and of intake of dietary cholesterol (402.8 +/- 186/161.3 +/- 100.3 mg/day) as well as of saturated fatty acids (42.5 +/- 20.4/14.3 +/- 8.1 g/day). Fatty acid composition of adipose tissue was not correlated with the patients' 24-hour dietary protocols. In the control group there were no changes of plasma lipids, body weight or diet composition according to 24-hour protocols after 1 year compared to data at the beginning of the study. There was, however, a marked correlation of adipose tissue composition and dietary information given by the patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗
PubMed1990

Predictive value of fibrin monomers in postoperative deep vein thrombosis.

Intravascular activation of the coagulation system produces disseminated intravascular coagulation or deep vein thrombosis and is characterized by the occurrence of circulating soluble fibrin monomer complexes (FM) in plasma. In order to evaluate the prognostic and diagnostic value of this parameter in 156 patients with fractures of the femur, neck of the femur, tibia, and fibula, and with knee-joint or elective hip surgery, soluble fibrin monomer complexes (FM) were determined using the FM Test from Boehringer Mannheim/Diagnostica STAGO (erythrocyte agglutination test according to Largo). Plasma samples were taken prior to and on the 1st, 2nd, 3rd, 5th, 7th, and 9th postoperative day. Diagnosis of DVT was carried out by 125-I-labelled fibrinogen test in parallel. Positive results were checked by phlebography on the 7th or 9th postoperative day. Positive FM results were obtained in only 26% of patients without DVT. In 34 of 36 patients (94%) with postoperative DVT confirmed by phlebography, on the other hand, elevated FM levels were detected 2-4 days before the 125-I-labelled fibrinogen test gave positive results. The predictive value calculated on the basis of elevated FM levels is 63-73%. These results show that the FM Test allows early detection of a prethrombotic state in the development of postoperative DVT.

Blood Coagulation Tests↗
PubMed1990

[Early and late results after local streptokinase administration in massive lung embolism].

In a total number of 44 patients with acute massive lung embolism 42 patients survived the acute phase. The treatment was carried out by thrombolysis with streptokinase. The application was performed as near to the thrombus as possible, in several patients after preceding balloon dilatation or also as multiphase treatment using urokinase. We altogether obtained favourable early results concerning the recanalisation got as well as also with regard to the clinical state and the subjective condition, particularly for patients with single acute occurrence and a latency period of less than 72 hours up to the beginning of the treatment. In follow-up examinations of 17 patients after more than 9 months (on an average after 32 months) without exception a good and further on ameliorated condition, respectively, was stated. Under long-term anticoagulation with phenprocoumon no recidivation embolisms appeared. Ergooxytensiometric investigations had as result a clear to extreme hypoxia on exertion as limiting factor for 12 out of 17 patients. Apart from this the majority of the patients a hyperdynamic regulatation of the circulation was to be observed. Therefore the ergooxytensiometry is recommended for the judgment of the result of the treatment as to the demandable exercise tolerance.

Adult↗
PubMed1990

Development of a double antibody radioimmunoassay for quantitation of 1 alpha,25-dihydroxyvitamin D.

A sensitive radioimmunoassay (RIA) for 1 alpha,25-dihydroxyvitamin D [1 alpha,25(OH)2-D] with a double antibody (DAB) separation technique to separate free from bound antigen has been developed. The hormone was extracted from 1 ml serum or plasma by Extrelut columns and normal phase high performance liquid chromatography and quantitated in the DAB-RIA. The detection limit of the assay was 3.75 ng/l. The intraassay variation coefficients were 15.9% and 10.5% for samples with 1 alpha,25(OH)2D3 concentrations of 54 ng/l and 130 ng/l, respectively. The interassay variation coefficients were 18.0% and 16.7% for these two concentrations. Mean (and SD) values for 1,25(OH)2D in serum of 40 healthy subjects and 38 patients with chronic renal failure who did not receive 1,25(OH)2D3 were 62.8 ng/ml (22.2) and 12.4 ng/ml (9.8), respectively. The mean value for 7 patients with primary hyperparathyroidism was 66.5 ng/ml (35.8) before surgery. These results compared well with those of an established charcoal-based RIA. Compared to charcoal-based RIAs, the DAB-RIA is faster and requires less laborious assay procedures.

Adult↗
PubMed1990

Rebound insomnia: its determinants and significance.

Rebound insomnia is a sleep disturbance that occurs on discontinuation of benzodiazepine hypnotic drugs. It has been reported in both patients and healthy normal subjects and is characterized by increased wakefulness above the person's baseline levels. This article reviews that available information regarding determinants, possible mechanisms, and clinical significance of rebound insomnia. It is concluded that rebound insomnia is a disturbance of one or two nights' duration that primarily follows discontinuation of short- to intermediate-acting benzodiazepines. It occurs at high doses of a given drug, beyond which no additional hypnotic efficacy is evident. There seem to be clear individual differences in the experience of rebound insomnia, but no prospective studies have established which differences predict rebound. It is likely to be avoided by initiating treatment with the lowest effective dose and tapering the dose upon discontinuation.

Anti-Anxiety Agents↗