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Biomedical subjects

H Rudolph

Publications and source records attributed to H Rudolph.

At least 19 recordsLinked to original sources
PubMed1999

Pain relief using smart technology: an overview of a new patient-controlled analgesia device.

A new adaptive patient-controlled analgesia (PCA) system designed to improve PCA through the use of a variable bolus dose and a variable background infusion is outlined here. The handset allows patients to rate their pain on a scale of 1-10. Data derived from the handset signals are used by an expert algorithm to repeatedly adapt the drug dosage of the bolus and the background infusion according to both pain intensity and patient response to previous dosages. A feasibility study of the system consisted of a small number of randomized, double-blind, crossover clinical trials. The new system was alternated with a conventional system every 12 h. When the new system was active, 12-h questionnaire pain scores were significantly lower and a trend toward fewer bolus requests was found in alternating intervals. In addition, when the new system was used to commence trials, the number of bolus requests were significantly lower and there was a trend toward lower handset scores, lower questionnaire pain scores, and lower verbal pain scores over the entire trial period. The new adaptive PCA system was well accepted by both patients and clinical staff. The trials successfully established the feasibility of the new system. Further development is being carried out as a result.

Analgesia, Patient-Controlled↗
PubMed1999

Smart technology improves patient-controlled analgesia: a preliminary report.

UNLABELLED: A new adaptive system has been designed to improve patient-controlled analgesia through the use of a variable bolus dose and a variable background infusion of analgesic. A novel hand set allows patients to rate their own pain on a linear scale of 1 to 10. Data derived from the hand set signals are used by an expert algorithm to repeatedly adapt the drug dosage of the bolus and of the background infusion according to both current pain intensity and the patient's response to previous dosage. To test the system, we performed a small pilot clinical study, using a randomized, double-blinded, cross-over design. The new system was alternated with a conventional system every 12 h. Use of the new system was associated with significantly lower pain scores and fewer bolus requests but more analgesic administration, though without increased adverse effects. It was very well accepted by both patients and clinical staff. IMPLICATIONS: Pain relief after surgery is often best provided by patient-controlled analgesia, which uses an IV infusion pump and a patient-activated switch. We have developed a new computer-controlled or "smart" patient-controlled analgesia that rapidly learns a patient's individual needs and provides continuously tailored pain relief.

Adolescent↗
PubMed1996

The new gastarbeiter system in Germany.

"Germany's new gastarbeiter policy is evaluated in the context of a long tradition of labour recruitment, particularly the last period of active recruitment abroad (1955-1973). The policy's characteristic features (of permission to stay being dependent on a work permit; this being limited to a certain period and linked to the requirements of a specific employer) [imply] that the gastarbeiter regime is a low cost means of increasing flexibility in cases of regional and/or sectoral bottlenecks in the employment system as well as a way of ¿exporting' problems.... The mounting employment crisis in Germany has prompted the German government repeatedly to take advantage of provisions to restrict the conventions on labour movement."

Demography↗
PubMed1993

[Operating room clothing and patient draping. Status: 3 July 1992].

OR clothing and patient draping materials must provide an effective barrier against spread of infection from both staff and patient to the wound and, just as important, from patient to staff. Today, conventional cotton fabric is still being widely used, the pore size of which being at least 80 mu i.e. this material can be penetrated by all bacteria and bacteria-carrying particles less than 80 mu. The three main demands on material properties, i.e. liquid impermeability, absorbency and water vapour permeability cannot be optimally combined with each other. From the hygienic viewpoint, the most important criterion is liquid "impermeability".

Clothing↗
PubMed1993

[The lay theology of Paracelsus from the traditional historical viewpoint and its classification to Reformation and Catholic reform].

Certain aspects of the theological oeuvre of Paracelsus--a body of work first described in painstaking detail and on the basis of the sources by Kurt Goldammer--still resist our understanding of them in appropriate historical terms. This circumstance is apparent in the various unanswered questions posed by the very biography of the physician and theologian: was his critical, reform-minded position vis-à-vis the Church in any way relevant to his choice of Strasbourg as a place of residence or to his being called to the position in Basel? Can certain manifestations in the activities of Paracelsus, who died within the Roman Catholic Church, be viewed as signs of a Nicodemism such as characterizes Agrippa von Nettesheim (a figure in some ways so close to Paracelsus)? From the very start, Hohenheim's accounts of himself reveal the art of medicine and theology as inextricably linked to one another. And in its development this linkage becomes in turn an essential element of autobiographical interpretation, with the result that the healing art, Christian faith, and the living of life are fused, through the self-awareness and activity of Paracelsus, into a fascinating unity. From this perspective, it proves to be difficult to assign his theological, world', having as it does its place in his total view of things, one based on Renaissance philosophy, to any single tendency or direction within the spectrum of Reformation thought and its critical approaches to the church establishment. Admittedly, in particular areas we may well suppose such a dependence to have existed, and certain classifications remain a possibility. But an affiliation of this kind, despite partial parallels in, say, the thought of Schwenckfeld, seems to break down precisely in the case of Paracelsus's teaching on the Eucharist; for at the heart of his Eucharistic ideas stands a distinctive concept of, limbus'--very likely unmatched in the thought of the Spiritualists--which is shaped by a distinction between what is earthly or mortal and what is heavenly, immortal. The same difficulty persists as well with the Paracelsian notion of the Christian magus. Here there are definitely models to be found in Renaissance philosophy; the magus concept peculiar to Paracelsus, however, is especially evocative of the unity (v.s.) characteristic of this physician-theologian in particular.

Catholicism↗
PubMed1991

[Laryngeal cancer in men and occupation. A comparison with male patients with stomach cancer].

A statistical comparison of the professions of 1119 male patients with malignant laryngeal tumours and the profession of 708 male patients with malignant tumours of stomach, shows the influence of occupational exposures. The quantity of malignant laryngeal tumours is high in the group of steelworks- and foundry workers, workers in the glass-, porcelain-, quartz- and chemical industry and motorists. The inhalation of exogenous cancer-poisons are the probable cause.

Humans↗
PubMed1990

[Skin lesions following the use of a tourniquet].

In a questionnaire study including 44 AO-clinics in German speaking countries, we investigated frequencies and possible causes of skin lesions under the cuff occurring after surgery in a bloodless field. Though these lesions are hardly dealt with in the literature available, the number of legal claims made by patients for these lesions has significantly increased in recent years. What has to be clearly differentiated are the known changes deeply extending into the soft tissues we see in the tourniquet syndrome. The precise pathogenetic mechanisms of these lesions are unknown. The combination of fluid collecting under the cuff and pressure applied to the skin by the cuff seems to be a likely cause. The most important precautions for avoiding these skin lesions consist in correct application of the cuff and in sealing the edge of the cuff the way that at least distally it will be safely fluid-tight. Correspondingly, fluid must under no circumstances (disinfectants) be allowed to collect or pool between the operating table and resting parts of the body (sacral region!). Based on present knowledge it is not possible to safely avoid these typical skin lesions. Strict adherence to the precautions listed above and explained in more detail in the text should therefore lead to the rejection of legal claims brought in such instances.

Germany↗