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Biomedical subjects

H Schild

Publications and source records attributed to H Schild.

7 recordsLinked to original sources
PubMed1992

[The value of the x-ray findings in the follow-up of the adult respiratory distress syndrome. A retrospective analysis].

Serial chest x-rays of 23 ARDS patients, taken in an 24 hour interval, were retrospectively analysed. Radiographic patterns of ARDS were divided into five stages and were related to corresponding parameters of respiratory status. Characteristic findings on chest x-ray films occurred after a short latency period following the clinical onset of ARDS. There was a close relationship between the time of maximum radiographic changes and maximum loss of lung function. The progression through successive radiologic stages was in many cases accompanied by a significant deterioration of functional parameters. Distinction between survivors and non-survivors was achieved while considering maximum radiographic abnormalities. The results suggest significance of serial chest x-rays in diagnosis and course estimation of ARDS.

Follow-Up Studies↗
PubMed1992

[Long-term observation after percutaneous transluminal angioplasty in the pelvic and leg areas].

In this study 163 patients had long term follow ups after PTA; the value of a test which had previously hardly been used, the "Cox proportional hazards model", for prognostic purposes is stressed. In this test account is taken of the severity of the stenosis before PTA, the extent of re-stenosis following PTA and the distance of the occlusion from the aorta and these are related to the likelihood of success. The use of the Cox proportional hazards model with an accurate description of the clinical material and the use of the Kaplan-Meier method is recommended in order to obtain comparable figures for the results obtained in various centres. In this study patency after six months was 77%, after a year 67%, after three years 46% and after five years 37%.

Angioplasty, Balloon↗
PubMed1992

[The clinical relevance of sonography in intensive care units].

336 sonographic examinations were performed with a portable ultrasound scanner on 217 patients in intensive-care units. In 302/336 (90%) cases, the region of clinical interest could be demonstrated completely or mostly by ultrasound. The clinical question could be answered by ultrasound in 270/310 (87%) cases partially. In 17/210 (5%) cases the clinical question could not be answered by ultrasound, in 26/336 (8%) cases there was no clinical question at all. 211/336 (63%) sonographic examinations were retrospectively classified as clinically relevant. A large part of clinically relevant examinations was found at the sonographic evaluation of the liver (100%), of the pericardium (96%), of the kidneys (89%), of the blood vessels (80%), of the gallbladder (78%), of the pleural space (76%) and on sonographic evaluation of patients with blunt abdominal trauma (91%). A relatively small part of clinically relevant examinations was found at sonographic evaluation of circumscribed or free intraabdominal fluid (59% resp. 57%), of cholestasis (53%) and of suspected neoplasm (11%). Sonographic examinations of the pancreas (40%) or the spleen (33%) and examinations without any clinical question (50%) also showed little clinical relevance.

Critical Care↗
PubMed1978

[Changes in liver haemodynamics after mesenterico-caval dacron prosthesis anastomosis ("H-shunt") in portal hypertension (author's transl)].

In fourteen patients with portal hypertension and bleeding from oesophageal varices, mesentericocaval anastomoses using a dacron-velour prosthesis ("H-shunt") were carried out. Evaluation of the haemodynamics showed: 1. Comparison of 13 pre- and post-operative angiograms showed an haemodynamicically effective shunt in 12 and a stenosed shunt in one. 2. The aim of relieving the portal circulation while maintaining antegrade portal flow was achieved in six patients. 3. In six patients, the portal vein was not seen in a splenic or mesenteric portogram despite an open shunt. Functionally, this corresponds to a porto-caval anastomosis. 4. Pressure reduction in the portal circulation can be so marked as to obtain retrograde portal flow from the hepatic artery. 5. If the portal blood flow through the liver disappears, the hepatic artery may obtain additional flow from the superior mesenteric artery (reversed flow in the gastroduodenal artery). 6. Increased arterial flow to the liver is made possible by a reduction in intrahepatic resistance. The role of collaterals, either arterio-portal shunts or shunts between the sinusoids, is discussed. 7. The hepato-fugal collateral circulation was reversed in twelve patients.

Adult↗
PubMedDate not supplied

Gianturco self-expanding stents: clinical experience in the vena cava and large veins.

Twenty-five patients with stenosis of the vena cava (21) and other large veins (4) have been treated with self-expanding Gianturco metallic stents. Eighteen patients had superior vena cava syndrome. In 17, the stricture was due to malignant superior vena cava compression recurrent after maximum tolerance radiotherapy and/or chemotherapy. In 16 of these patients there was early symptomatic relief. In 1 patient with a benign posttraumatic superior vena cava stricture, the stenosis was not relieved, and occlusion occurred after 1 month. Stenoses associated with dialysis shunts were relieved in 2 other patients. Two malignant and one benign inferior vena cava stenoses were relieved either until death, or in the benign case, for 30 months. One malignant subclavian vein obstruction occluded after 24 h due to stent misplacement and another with extrinsic mediastinal compression remained patent until death, extensive thrombus having been lysed prior to stent placement. The results of this short series suggest that the Gianturco self-expanding stent in the vena cava and large veins is easy and safe to place, and in most cases produces almost immediate palliation of the distressing effects of venous obstruction, often in a preterminal and inoperable patient.

Constriction, Pathologic↗