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Biomedical subjects

G Weisz

Publications and source records attributed to G Weisz.

At least 37 records · Page 2Linked to original sources

[Treatment of the diabetic foot by hyperbaric oxygen].

Diabetic foot wounds are consequences of the neuropathy and the small and large vessel disease that complicate diabetes. At the cellular level, the result is hypoxia which impairs wound healing. Hyperbaric oxygenation (HBO) may be a useful adjuvant to wound care. It leads to enhanced oxygenation of the affected tissues, has an antiseptic effect, reduces edema, and accelerates collagen production and angiogenesis, thus enhancing tissue repair. 14 diabetics with chronic nonhealing wounds which did not respond to treatment for at least 3 months were treated by HBO. All had palpable pedal pulses. Transcutaneous measurements of tissue pO2 showed elevation from 20 +/- 10 mm Hg during air breathing to 643 +/- 242 mm Hg while breathing pure oxygen at 2.5 ATA. They were treated with HBO in 56 +/- 10 consecutive HBO sessions. In 11 there was complete wound healing, while in 1 there was partial response, in 1 minimal response, and in 1 a transient response. HBO is useful in chronic nonhealing wounds of the diabetic foot and of the diabetic foot with impending amputation. It is a safe mode of therapy, but further studies are required to establish its efficacy and to ascertain which diabetic patients and wounds will benefit the most from it.

Diabetes Complications↗

Hyperbaric oxygenation for arterial air embolism during cardiopulmonary bypass.

The incidence of systemic air embolism during cardiopulmonary bypass is estimated to be 0.1%. However, the vast majority of instances are unreported and quietly ignored. The result may be disability or death. The control of air embolism obviously lies in prevention. The definite and specific treatment of this complication is hyperbaric oxygen. We report 6 patients referred to our institute because of air embolism during cardiopulmonary bypass. Of the 4 patients in whom hyperbaric oxygen therapy was delayed for 17 to 20 hours, 2 showed partial neurological improvement, as opposed to the success of hyperbaric oxygen therapy in the 2 patients in whom the delay was minimal. We conclude that as soon as the proposed open heart operation has been completed and there is an indication that air embolism has occurred, the patient should be treated with hyperbaric oxygen as quickly as possible, even before neurologic manifestations of cerebral ischemia appear.

Aged↗

Treatment of necrobiosis lipoidica diabeticorum by hyperbaric oxygen.

Necrobiosis lipoidica diabeticorum is a chronic cutaneous complication of diabetes mellitus with microangiopathy as an important pathophysiologic factor. Because of the known success of hyperbaric oxygen in the treatment of chronic non-healing wounds, we used this mode of therapy to treat a diabetic patient with ulcerated necrobiosis lipoidica of 7 years' duration, refractory to medical and surgical treatment. The patient received daily sessions of hyperbaric oxygen therapy. There was considerable improvement during the course of the treatment, with complete closure of all the ulcerations after 98 sessions. The success of this treatment emphasizes the role of hypoxia in the pathogenesis of the lesion. This simple and safe treatment method may be a good solution for patients with chronic nonhealing necrobiosis lipoidica which fails to respond to other therapeutic approaches.

Adult↗

Pulmonary barotrauma after a free dive--a possible mechanism.

Pulmonary barotrauma during scuba diving is a life-threatening event. In a skin diver, who does not use compressed air, this complication is rare and its pathophysiology is not readily understood. We present a young, healthy skin diver who suffered pneumomediastinum and subcutaneous emphysema after a sequence of free dives to 5 m, and suggest a possible mechanism.

Adult↗

Oral magnesium supplementation as prophylaxis for noise-induced hearing loss: results of a double blind field study.

The effect of oral Mg-supplementation as prophylaxis against noise-induced hearing loss was tested in a placebo-controlled double blind study involving 320 voluntary subjects during a 2-month period of military training. The hearing thresholds of all subjects were checked and only persons with normal hearing were accepted. Before and after the 2-month training, blood samples were collected and Mg was analysed in serum, erythrocytes and lymphocytes. Seven days after the last exposure to firearm noise, the audiograms of all test subjects were checked and permanent threshold shifts (PTS) were determined. The total group received a drink containing either 4g Mg granulate verum (6.7 mmol Mg aspartate) or placebo every working day during the 2-month training period. The primary source of noise exposure were firearms: 420 shots per person, mean peak level 164 dB(A). The recruits used ear plugs with a mean insertion loss of 25 dB. In both groups Mg-concentration in serum and in erythrocytes increased with time. Lymphocyte Mg increased in the Mg group only. In the placebo group the percentages of ears with PTS > 25 dB at 4 kHz/6 kHz and/or 8 kHz after exposure to firearm noise were twice as high as in the Mg group.

Administration, Oral↗

[Acute viral hepatitis: pathogenesis and clinical manifestations].

This is a review of several mechanisms in the acute and chronic progress of viral hepatitis. Investigation of these mechanisms may have an important role in the diagnosis and treatment of chronic hepatitis. Clinical features of acute non-A, non-B hepatitis were studied in 110 patients. Most of the patients had a surgical intervention or/and received blood transfusion previously. The clinical course of the cases was very mild and most of the patients have the cholestatic form of the disease. A 39% anti-HCV antibody seropositivity rate was seen in these cases.

Acute Disease↗

Comparison of mortality and myocardial infarction rates in stable angina pectoris with and without ischemic episodes during daily activities.

The prognostic significance of ischemic changes during daily activities was assessed in 56 patients with stable angina pectoris. All patients had positive results on the treadmill stress test and angiographic evidence of significant coronary artery disease. Forty-three (77%) had ischemic episodes on Holter monitoring during everyday activities. During the follow-up period (mean 2 years), there were 6 deaths and 6 myocardial infarctions among the 43 patients with ischemic episodes, compared with none among the 13 patients without such changes (p less than 0.03). All 14 patients referred for coronary bypass surgery belonged to the group with ischemic episodes (p less than 0.02). The extent of coronary disease, the treadmill test parameters, and the duration and frequency of ischemia during daily activities were identical in the patients with and without subsequent cardiac events. Patients with only symptomatic ischemic episodes or those with both silent and symptomatic episodes had a frequency of cardiac events similar to that of patients with only silent episodes. Thus, it seems that patients with stable angina pectoris and ischemic episodes during daily activities have a worse prognosis than patients free from such episodes.

Activities of Daily Living↗

Characteristics of silent and symptomatic myocardial ischemia during daily activities.

In 191 patients with proven coronary artery disease, 24-hour Holter monitoring detected 587 transient episodes of ST depression during daily activities. Of that total, 424 episodes were silent (72.3%) and 163 were symptomatic (27.7%). There were no statistically significant differences between silent and symptomatic episodes as to their mean duration (15.1 vs 14.3 minutes, respectively), heart rate at onset of ST depression (93 vs 96 beats/min, respectively), heart rate at the time of maximal ST depression (114 beats/min, both) and mean maximal ST depression (1.9 vs 2.0 mm, respectively). Of the 191 patients, 104 (55%) had only silent episodes, 33 (17%) only symptomatic episodes and 54 (28%) had both types ("mixed"). All patients, regardless of episode type, were of similar age, received comparable medical therapy, had a similar extent of angiographically documented coronary artery disease and similar episode characteristics. However, mixed-episode patients had significantly more ischemic episodes per day (4.8) than silent-episode (2.6) and symptomatic-episode (1.9) patients (p less than 0.001 for both) and a longer total period of daily ischemia (60 minutes), than the other 2 groups (36 and 28 minutes, respectively, p less than 0.001 for both). Of the 191 patients, 97 (51%) had had a previous myocardial infarction. The characteristics of their silent and symptomatic episodes were similar to the 94 (49%) patients without infarction, except for a longer duration of the silent episodes.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗

Misinterpretation of instructions in an aftereffect task.

Some subjects in studies of kinesthetic aftereffect erroneously believe the task is to show the width of the aftereffect inducing rather than the standard stimulus. Although such subjects may be encountered rarely, the errors they make are very large. Precautionary steps are indicated.

Discrimination Learning↗