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Biomedical subjects

H Kretschmer

Publications and source records attributed to H Kretschmer.

At least 19 recordsLinked to original sources
PubMed1998

[Spontaneous spinal epidural hematoma: good outcome after delayed treatment].

Spinal epidural haematomas are rare and are often encountered after previous operations on spinal disease and in combination with anticoagulation therapy. Usually early diagnosis and surgical treatment are the most important factors for a good result and neurological recovery. In 4 cases of spinal epidural haematoma treated in our institution, we found that also after some delay of diagnosis and treatment, surgery is always worthwhile even after some days to achieve a better neurological function.

Aged↗
PubMed1997

Exchange blood transfusion in severe falciparum malaria: retrospective evaluation of 61 patients treated with, compared to 63 patients treated without, exchange transfusion.

The rationale for exchange blood transfusion (ET) in severe falciparum malaria is threefold: reduction of parasitaemia, reduction of presumptive 'toxic' factors, and improvement of the rheological quality of the blood. We evaluated the records of 61 patients treated with ET to describe the present status of malaria treatment in Germany, Austria and Switzerland and to assess the efficacy of ET. Clinical data of 61 patients treated with ET were compared to data of 63 patients treated in 2 hospitals where ETs were generally not performed. We found that exchange transfusion is applied according to the clinician's subjective impression rather than strict guidelines. Logistic regression analysis adjusting for the differences in clinical parameters between patients treated with or without ET did not identify treatment as a prognostic indicator (odds ratio for relative risk of death with ET: 1.3; 95% CI: 0.4-4.9). Exchange transfusion did not significantly improve the unfavourable prognosis in cases of severe falciparum malaria. However, failure to reach statistical significance may be due to the retrospective design of the study and therefore non-systematic approach.

Adult↗
PubMed1996

Splenectomy for suspected malignant lymphoma in two patients with loiasis.

Intrasplenic lesions can cause diagnostic difficulties because malignant diseases can be excluded only by histologic examination. We present the cases of two patients with splenic manifestations of loiasis. Both patients had visited central Africa. Several years later, intrasplenic lesions were found during routine examinations (for chest trauma and employment, respectively). Both patients underwent splenectomies because malignant lymphoma was suspected. In both cases, histologic examination of the spleen showed eosinophilic granulomata with multiple Loa loa microfilariae.

Adult↗
PubMed1993

[Halofantrine in the treatment of imported malaria in nonimmune travelers].

The efficacy (criteria: cure rate, time to resolution of fever or absence of parasites) and safety (criteria: clinical side effects, altered laboratory parameters) of halofantrin were investigated in a multi-centre study of 96 non-immune patients (71 men, 25 women, mean age 34.3 [21-62] years) with malaria imported from regions of high resistance into Germany or Switzerland. The initial 63 patients received one-day treatment (three doses of 500 mg halofantrin), while the last 33 patients received an additional course of treatment one week later. Treatment was curative in all patients in the second group, but relapses occurred in five of the 41 patients (12.2%) with falciparum malaria who received one-day therapy. Fever resolved after a mean of 45 hours and parasites were absent after a mean of 66 hours. There were small increases in transaminase values (most probably because of the infection) in five patients, but all became normal again within a few days. Halofantrin is a safe drug and is suitable for both therapy and stand-by therapy of resistant Plasmodium infections. Treatment should be repeated after 7 days.

Adolescent↗
PubMed1992

The efficacy of halofantrine in the treatment of acute malaria in nonimmune travelers.

A multicenter prospective trial was performed to investigate the efficacy and the tolerability of halofantrine in nonimmune patients with malaria imported from areas with drug-resistant falciparum parasites (mainly Africa). Forty-five of the 74 subjects were treated with a one-day regimen (3 x 500 mg) of halofantrine, and the other 29 received the same regimen with an additional treatment on day 7. In the second group, a 100% efficacy rate was demonstrated, but in the group receiving the one-day regimen, four recrudescences were observed in patients with falciparum malaria. Only five mild adverse reactions were seen, which disappeared spontaneously after the end of the treatment. We conclude that halofantrine is highly effective in curing malaria in nonimmune subjects. The treatment scheme for such persons should include an additional treatment on day 7 for nonimmune individuals. This drug was well tolerated in our patients, indicating that halofantrine will be useful in the treatment of multidrug-resistant malaria in nonimmune persons.

Acute Disease↗
PubMed1991

Different changes of n-6 fatty acids in lipoproteins from hyperlipemic subjects after diets supplemented with n-3 fatty acids.

After diets supplemented with canned mackerel or herring, in a cross-over design, containing different amounts of long-chain n-3 fatty acids (eicosapentaenoic acid, C20:5n-3-EPA, and docosahexaenoic acid, C22(6)n-3-DHA) an increase of both EPA and DHA was confirmed in triglycerides (TG), cholesterol esters (CE) and phospholipids (PL) of very low density (VLDL) and low density lipoproteins (LDL) as well as in high density lipoproteins (HDL) from hyperlipidemic subjects. An unexpected finding was the simultaneous increase of arachidonic acid (C20:4n-6-AA) in TG and CE and its constant portion in PL of lipoproteins, whereas linoleic acid (C18:2n-6-LA) appeared lower in CE and in PL of VLDL + LDL and HDL. In general, the changes were minor after a diet supplemented with canned herring providing a lower dose of n-3 fatty acids. The results indicate dose-related changes not only of n-3 fatty acids, but also of n-6 fatty acids in serum lipids after fish diets. This different behavior of LA and AA in serum lipids might be a new aspect in the interrelations and the dietary modulation of both families of polyunsaturated fatty acids (PUFA). The accumulation of AA in neutral lipids could be linked with an elevation of prostaglandin I2, which was found apart from an increased formation of prostaglandin I3 after diets supplemented with n-3 fatty acids. The concomitant increase of prostaglandins I2 and I3 spotlights widely ignored interrelations within the eicosanoid pathway, which become evident after diets enriched with long-chain n-3 fatty acids.

Adult↗
PubMed1990

[Dengue fever with hemorrhagic manifestations after a stay in Thailand].

On returning from a 24-day long stay in Thailand a 30-year-old German woman fell ill with high fever and head and limb aches. Soon after a confluent petechial exanthem was noted, as well as conjunctival and gastrointestinal bleedings. Biochemical findings (fall in haemoglobin concentration and haematocrit, leucopenia and thrombocytopenia, rise in lactate dehydrogenase) and a rise in Dengue antibody titre to 1 : 320 (on the 13th day of illness) confirmed the diagnosis of Dengue fever with haemorrhagic manifestations. This mosquito-transmitted viral disease, while so far only rarely reported in tourists, should be considered in the differential diagnosis of fever of undetermined origin in travellers to the tropics.

Adult↗
PubMed1990

Extreme decrease of linoleic acid in renal medulla from rats after a diet supplemented with cod liver oil.

Spontaneously hypertensive (SHR) and normotensive rats were fed a diet supplemented with linseed oil or cod liver oil for 22 weeks. The most remarkable finding was an extreme fall of linoleic acid in lipids from renal medulla after cod liver oil supplementation. In free fatty acids (FFA) eicosatrienoic acid (C2): 3n-9) appeared increased as a sign of essential fatty acid (EFA) deficiency.

Animals↗
PubMed1986

Evidence for a circaseptan and a circasemiseptan growth response to light/dark cycle shifts in nucleated and enucleated Acetabularia cells, respectively.

Nucleated as well as enucleated Acetabularia mediterranea cells were subjected to 14 different patterns of shifts in a regimen of 12 hr of light alternating with 12 hr of darkness in four 30-day long experiments. With one exception, which might be due to a circannual modulation, these experiments showed that nucleated cells had maximal growth rates when a shift was performed every 7th or 15th day. In enucleated cells, maxima were observed on shift schedules that were about 3-4 days rather than about 7 days apart. The results indicate that in the unicellular green alga Acetabularia a rhythm of about 7 days (circaseptan) exists and that removal of the nucleus results in a circaseptan frequency multiplication.

Acetabularia↗
PubMed1984

[Fronto- and laterobasal injuries in childhood and adolescence].

Within a period of 5 years, the author treated, among 106 children and adolescents up to 15 years of age with craniocerebral injuries, 12 who had frontobasal and laterobasal lesions. These were extended comminuted fractures, impression fractures, linear fractures (fissures), ethmoidal fractures, as well as a petrosal bone fracture. Principal signs were rhinoliquorrhoea or otoliquorrhoea, traumatic disturbances of consciousness and intracranial air accumulations. Less frequently, traumatic shock, signs of CSF infection and concomitant eye injuries were seen. Surgical care (treatment of the dural defect and plastic occlusion by means of Lyodura, galea-periosteal flap or fascia lata) was mostly effected transfrontally, in two cases transethmoidally and in one case with combined technique. In two cases, primary frontal decomminution had to be followed by a transethmoidal second intervention to close a lesion of the dura in the region of the sphenoid sinus. Surgery was carried out as an immediate operation in case of open injuries and in massive liquorrhoea if the general condition of the patient was good. In all other cases, operation was delayed until the second week after injury.

Adolescent↗
PubMed1983

Prognosis of severe head injuries in childhood and adolescence.

In a retrospective, non-random study, the effect of supplementary medical treatment (Dexamethasone, barbiturates) was investigated upon the prognosis of severe head injuries. Of 107 children and adolescents up to 16 years of age, 51 were treated with Dexamethasone; 56 received only standard therapy. Evaluation of the results shows that Dexamethasone therapy in high doses clearly reduced mortality in cases of severe head injuries (from 33.3% to 13.6%) without causing any noteworthy neurological defects. Among the individual types of injury, the effect was most evident in cases of intracranial hematoma (drop in mortality from 36.8% to 11.8%). On the other hand, definitive effects of therapy could not be established in the most severely injured patients with extreme brain damage and those with milder forms of trauma without substantial cerebral edema. Barbiturates were given only when severe intracranial pressure could not be alleviated by other means. Remission was successful in a few cases but the total number is not yet sufficient for a conclusive evaluation. Further important factors for prognosis are: depth and length of the initial disturbance of consciousness, age, concomitant injuries as well as some peculiarities of childhood and adolescence (tendency to develop severe cerebral edemas, clustering of atypical intracranial hematomas).

Adolescent↗