Biomedical subjects

H P Brütsch

Publications and source records attributed to H P Brütsch.

10 recordsLinked to original sources

PubMed2005

[Andropause].

The terms andropause, partial androgen deficiency of the aging male (PADAM) or late-onset hypogonadism (LOH) describe a clinical entity which has been defined as a syndrome associated with advanced age. This syndrome is characterised by a deficiency in serum testosterone levels that may result in significant alterations in the quality of life and adversely affect the function of multiple organ systems. Whereas in classic primary and secondary hypogonadism, the clinical picture of testosterone deficiency is clearly defined, the clinical diagnosis of PADAM might escape detection for various reasons: not all signs and symptoms necessarily present together; they often progress slowly and are subtle in nature; the non-specific signs and symptoms might not be discernible from the unavoidable process of aging itself. However, PADAM features many potentially serious consequences that can be avoided or treated, and is, therefore, clinically relevant. Testosterone substitution may be an effective way to manage this condition. Once patients begin treatment with testosterone substitution, follow-up and monitoring are essential.

Age Factors↗

PubMed1994

[Which hormone determinations are necessary in the initial assessment of erectile dysfunction?].

The assessment of an erectile dysfunction (ED) includes the history, a clinical examination and blood tests. There is some confusion about which basic hormonal tests are needed at the beginning of clinical evaluation. We feel that with the results from our patients we could help to answer this question. From 1 January 1990 until the December 31 1993 we evaluated 1134 patients for ED. Those who favoured a surgical correction of their ED were fully evaluated by nocturnal penile tumescence testing, penile arteriography, intracavernosal injection of vasoactive agents and dynamic pharmaco-cavernosometry. The results from these tests were correlated with luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone and prolactin. 183 (16.1%) of our patients with a mean age of 45 +/- 14 were fully evaluated. From these patients 76 were excluded because their ED was posttraumatic, undoubtedly psychogenic or could not be proven by the tests mentioned above. From the 107 patients finally included in this study, 90 had normal endocrine parameters. 17 patients had low testosterone. 14 of these patients had otherwise completely normal hormonal tests without evidence of secondary hypogonadism. Three patients had their low testosterone levels confirmed by repeated measurements. In addition, prolactin was significantly increased, and FSH and LH were near or below the lower reference value. When evaluating patients for the first time because of an erectile dysfunction, the measurement of testosterone as a single endocrine test is adequate. If testosterone is low, repeated measurements, combined with LH, FSH and prolactin, will identify patients with an ED due to an endocrine disease.

Adolescent↗

PubMed1993

[Experience with video transurethral resection].

During 14 months more than 300 endoscopic interventions were performed by video-control only: 160 TUR of prostate, 37 TUR of bladder-tumours, 7 ureteroscopies, 17 manipulations with bladder stones and stents, 9 sight-urethrotomies, 72 diagnostic cystoscopies, 2 percutaneous nephrolithotripsies and 12 laparoscopic interventions. Technical requirement is a light and rotatable camera, preferably a monitor mounted over the patient and a self-adjusting light-source. The advantages are better identification of tissue, the use where there is limited mobility of the patient's hip joint and the possibility of demonstration and documentation. The urologist's face is protected against blood contact (HIV-prophylaxis), and he is taking care of his spine. It is the best way of instruction for the learning urologist and even a good training for laparoscopic surgery.

Cystoscopes↗

PubMed1992

[Bone segment transport in femoral defects. Animal experiment study].

The aim of our experimental study was to realize the Ilizarov concept using a reamed intramedullary interlocking nail with an internal transport system. In 8 mature dogs a bone defect of 3 cm was performed at the femur. A distally osteotomized bone fragment (length 3.5 cm) was lowered through the bone defect. 4 times we had to exclude the animal from the evaluation. In this case the interlocking nails were broken within 6 weeks. In 3 dogs a regeneration of bone was found in the defect. In 6 dogs a deep infection along the transport system had developed.

Animals↗

PubMed1991

[Emergency hospitalization for acute, non-accidental abdominal pain. Prospective data of a surgical university clinic].

During a 19-month period 549 patients (278 women, 271 men) suffering from abdominal pain unrelated to trauma (mean age 48.2 years) entered the emergency room of the Department of Surgery of the University Hospital Zürich. 43% presented during business hours, whereas 57% were admitted during nighttime and/or weekends. Clinical examination, abdominal roentgenograms (upright and supine) as well as sonography were the most commonly used diagnostic tools. 40% suffered from abdominal pain of unknown cause. The most common diagnosis on admission was appendicitis. Only half of these cases really proved to be an appendicitis. In 36% the diagnosis on admission corresponds both to the initial diagnosis made by a member of staff during his first visit, as well as to the final diagnosis. The initial diagnosis agrees in 57% with the final diagnosis. In 10% of the patients the cause of pain was not elucidated despite extensive diagnostic procedures. High technology and sophisticated diagnostics are less important than the clinical evaluation. The decision between operative or nonoperative treatment was mainly based on clinical findings.

Abdomen, Acute↗

PubMed1991

Emergency room patients with abdominal pain unrelated to trauma: prospective analysis in a surgical university hospital.

During an 8-month-period, 241 patients suffering from abdominal pain unrelated to trauma (mean age 48 years) attended the emergency room of the Department of Surgery of the University Hospital, Zürich. Forty-three percent presented during working hours, while 57% were admitted during the night or at the weekend. Clinical examination, abdominal roentgenograms (upright and supine) and sonography were the most commonly used diagnostic tools. Forty percent suffered from abdominal pain of unknown origin. The most common diagnosis on admission was appendicitis, but only half of these cases proved to be appendicitis. In 36% the diagnosis on admission corresponded both to the initial diagnosis made by a member of staff during his first visit, and to the final diagnosis. The initial diagnosis agreed with the final diagnosis in 57%. In 10% of the patients the cause of pain was not elucidated despite extensive diagnostic procedures. High technology and sophisticated diagnostic evaluation are less important than the clinical evaluation. The decision between operative and nonoperative treatment was based mainly on clinical findings.

Abdominal Pain↗

PubMed1990

Reduced bladder capacity in patients receiving intravesical chemoprophylaxis with mitomycin C.

After complete resection of superficial bladder carcinoma (Tis-2, G1-3), 75 patients were treated prophylactically with either 20 or 30 mg mitomycin C. Six patients developed a substantial reduction in bladder capacity (less than 200 ml). In 2 patients radical cystectomy of an otherwise tumour-free fibrotic bladder was necessary. The results of long-term treatment (2 years) suggest that reduced bladder capacity correlates with the cumulative dosage of mitomycin C.

Administration, Intravesical↗

PubMed1990

[Perioperative prevention of thromboembolism with low molecular weight heparin and postoperative bleeding complications].

In three studies the effect and secondary effect of low molecular weight heparin (LMWH) were examined. Study 1: LMWH (Embolex-LM, n = 464) versus standard heparin (Liquemin, n = 452); Study 2: LMWH (Sandoparin, n = 298) versus standard heparin (n = 296). In the 3rd study controls of LMWH were performed in the clinic of visceral surgery, and the clinic of traumatology both. During these three studies all excluded patients who did not receive a thromboembolic prophylaxis were also examined. The first two studies showed no significant differences in the frequency of thromboembolic and bleeding complications. The bleeding complication was the same (3-6%) in the group of excluded patients. This is valid for study 3 too. In all studies the surgeon had an important influence on the frequency of bleeding complications.

Dihydroergotamine↗

PubMed1989

[Liquid-crystal-contact-thermography (LCCT)--a new diagnostic method for determination of skin circulation. Results of 300 studies].

In cases where minor differences in skin temperature are of importance, LCCT can be used. Furthermore LCCT can be used to document the malperfusion of the leg and postoperative flow control of a bypass after revascularization, as well as determination of the site of amputation in cases where revascularization is not possible. General surgery, traumatology: LCCT is well suited as a screening method in the diagnosis of deep venous thrombosis. Our clinical trial with more than 300 patients documents the simple, non-invasive use of LCCT. More than 80 patients had parallel ascending venography performed in order to document sensitivity and specificity of LCCT. We found LCCT to have a sensitivity to 95% and a specificity of 86% when compared to venography. LCCT must be performed by a physician to rule out other pathogenic factors leading to either a rise or a fall in skin temperature. As LCCT is an absolutely non-invasive method and having a high sensitivity and specificity it is well suited as screening method in the diagnosis of deep venous thrombosis. LCCT can be recommended to all angiologic wards and certainly to very surgical clinic, as the early recognition or exclusion of postoperative deep venous thrombosis is its main goal.

Humans↗

PubMed1989

[Liquid crystal contact thermography--a new screening procedure in the diagnosis of deep venous thrombosis].

In search of a sensitive, simple, non-invasive screening method in the diagnosis of Deep Vein Thrombosis (DVT) we become aware of the recent possibility of Liquid Crystal Contact Thermography (LCCT). From October 1987 all patients over 40 years of age undergoing visceral surgery were examined on the second postoperative day by means of the LCCT Method. Furthermore patients of the traumatological clinic with high risk for DVT (hip surgery) were controlled. In case of positive thermography or uncertain interpretation a phlebography was performed and thermography repeated. Until the end of February 1988 316 patients were submitted to LCCT. In the beginning of the study pathologic and iatrogenic factors which lead to a rise in temperature of the leg, caused differential diagnostic problems. In the course of the study the LCCT turned out to be a reliable screening method in the diagnostic of DVT. In our study the LCCT has a sensitivity of 94%. The specificity was, as expected, a bit lower and is 86%. The high sensitivity and somewhat lower specificity (which is without consequence for the patients) shows that LCCT is well suited as screening method, especially since it is non-invasive. Differential diagnostic aspects are discussed.

Abdomen↗