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Biomedical subjects

H Troidl

Publications and source records attributed to H Troidl.

At least 163 records · Page 9Linked to original sources
PubMed1987

Quality of life: an important endpoint both in surgical practice and research.

Surgery asks patients to trade present discomfort and risk for future gains. Although research reports on the effectiveness of surgery have largely focused on mortality, length of hospital stay, major complications, and laboratory analyses, the principal criteria guiding surgeons' clinical decisions and patients' acceptance of treatment are most often the patients' subjective feelings and capabilities, the quality of their lives. This is true for both major and minor surgical procedures. We discuss the role of information on functional capacity, overall well-being, and quality of life in the assessment of surgical outcomes. Broadening the choice of endpoints beyond traditional, so-called "hard" variables in surgical studies has advantages for both surgeons and patients.

Clinical Trials as Topic↗
PubMed1987

[Long-term results following resection arthroplasty and prosthesis implantation in idiopathic saddle joint arthrosis].

Thirty-six patients with arthrosis of the carpometacarpal joint of the thumb were treated, 19 patients by resecting the trapezium and interposing a tendon, 17 patients by replacing the resected trapezium with silastic prosthesis (Swanson). The follow-up time was in average 22 respectively 44 months; both groups were comparable. The patients treated by resection of the trapezium and tendon interposition were more satisfied and had less pain than those treated by implantation of a Swanson prosthesis. There was no difference in mobility and strength of pinch between the two groups. After resection of the trapezium and tendon interposition the authors found a proximal translocation averaging 7 mm (6 to 14), however these patients had a good functional result and no pain. Five patients had a luxation of the Swanson prosthesis, and four required a second operation.

Arthritis↗
PubMed1985

[Gastric outlet stenosis (benign): definition, incidence, therapy?].

According to a strict definition of a benign gastric outlet obstruction i.e. delayed vomiting, changing of symptoms, weight loss and intraoperative test by Hegardilators (less than 14), 2.2% real stenoses among 619 operative treated duodenal ulcer patients were found. All patients were treated by SPV and digital dilatation of the stenosis through a gastrotomy. During up to a 10 year follow-up no reoperation was necessary. All patients showed Visick-classification of I and II. In conclusion SPV with digital dilatation showed good clinical results for patients with benign gastric outlet obstruction in long-term follow up.

Adult↗
PubMed1985

[Stapler suture or single button suture? A controlled clinical study on the comparison of both skin closure methods].

In a controlled randomized clinical trial, skin closure with a skin-stapling technique was compared with interrupted sutures on 50 patients (26 sutured and 24 stapled). The two groups were similar in all important respects. The clinical side of the study was to compare 1) the cosmetic results, 2) the time taken to close the skin, and 3) advantages and disadvantages of the two techniques by a questionnaire completed by the clinical staff. The study suggested a cosmetic advantage for the stapling when the results at 6th postop. week were compared. The only significant difference was in cross hatching (22 out of 26 sutured wounds but none of the 24 stapled) which was predominantly visible in sutured wounds. A clear difference was found in operating time. Skin closure with interrupted sutures took 310s, compared with 122s for stapling (alpha = 0,001). Similarly time required to remove the closure material was less with the staples than with sutures. Staples are more expensive than sutures. However the advantage of the staples over the suture in avoiding cross hatching is significant as well as time saving.

Abdomen↗
PubMed1985

[Endoscopic percutaneous gastrostomy--a simple technic for long-term nutrition].

A simple procedure: 'Percutaneous endoscopic gastrostomy' was useful to provide seriously ill patients with a long-term enteral nutritional support. The catheter remained in place for 26 days in median, up to 1 year. No complications were related to the puncture of stomach. One leakage after changing the catheter through a narrowed channel had to be treated surgically.

Adolescent↗
PubMed1984

Effects of steroid hormone therapy on primarily xenotransplanted human colorectal adenocarcinomas.

Primary xenotransplantation of six different human colorectal adenocarcinomas onto nude mice yielded a mean tumor take of 85%. Administration of steroid hormones induced tumor remissions in some cases. Neither the stage of the original patient's tumors nor their hormone receptor content seemed to be related to the result of the hormone therapies. It is concluded that some colorectal cancers can be treated as hormone-sensitive tumors.

Adenocarcinoma↗
PubMed1984

Evaluation of tomography and mediastinoscopy for the detection of mediastinal lymph node metastases.

In a prospective study of 88 patients seen consecutively with proven or suspected bronchial carcinoma, the validity of x-ray tomography and routine mediastinoscopy was tested for the detection and evaluation of mediastinal lymph node metastases. Positive mediastinum was defined as malignant tissue found in the mediastinum and negative mediastinum as mediastinoscopy with negative results plus a negative intraoperative mediastinal lymph node dissection. Thirty-four patients were eliminated from the analysis because carcinoma was not found or because mediastinal evaluation was incomplete by these criteria. Twenty-eight of the remaining 54 patients had mediastinal metastases. Sensitivity was 67% for tomography and 79% for mediastinoscopy. Specificity was 92% for tomography and 100% for mediastinoscopy. The differences were not significant. Sixty-six of 85 mediastinoscopies were unnecessary or unhelpful in the decision to exclude a patient from surgical intervention. Among 19 patients with lesions presumed to be inoperable based on results of mediastinoscopy (i.e., perinodal metastatic growth suspected by palpation or histologically proven), 14 patients had positive tomographic scans and 1 could not be evaluated radiographically because of right upper lobe atelectasis. We conclude that tomography of the upper mediastinum should be used to select patients for mediastinoscopy.

Adenocarcinoma↗
PubMed1984

[Dissociation behavior of peptide diets].

The solution stability of different diets (Peptisorb, Salvipeptid, Survimed and Survimed neutral) was investigated. All diets exert a more or less cream formation. Additionally in some of them one can observe the sedimentation of particulates. When these diets were pumped out of the nutrient bag, as usually done in clinical practice during enteral nutrition, some of them produce an effluent, which contains a high portion of sedimenting particulates at the beginning of the infusion. All of them show a very high colloidal portion in the last pumping fraction. The question is raised, whether these phenomena may lead to an osmotic burden of the bowel, thus in consequence, causing the often observed diarrhoea in tube fed patients.

Chemical Precipitation↗
PubMed1984

[Modern technics of tube feeding].

A prospective study was done in 101 patients and clinical usefulness of a fine needle-catheter-jejunostomy was investigated; this procedure was modified according to the procedure devised by Delany (2). The instruments used were two split canules and a polyurethane catheter (inner diameter 2.1 mm); these instruments are simple, safe and can be applied quickly. Formation of fistulae, peritonitis, ileus or deaths caused by the procedure could not be observed. The catheter needs to have certain mechanical qualities as e.g. sufficient rigidity. Percutaneous endoscopic gastrostomy is an alternative to corresponding surgery procedure. The stomach is punctured under sight and a Foley catheter is applied immediately. We performed this procedure without major complications in seven cases, and found it to be very useful. The techniques described here are essentially important if the advantages of the enteral as compared to the parenteral nutrition are to be made use of. As soon as the problems of diarrhea and belching are solved, tube feeding will offer in the near future a real alternative to parenteral nutrition, especially in patients who need long time artificial nutrition.

Enteral Nutrition↗
PubMed1983

Surgically treated bronchial carcinoma patients--results of systematic follow-up.

A systematic follow-up was carried out on 63 patients treated surgically for bronchial carcinoma. Thirty-four patients died within 2 years after the operation. No evident benefit was noted when comparing their preoperative and postoperative physical status. The quality of life was considerably influenced by surgery and adjuvant therapies. While 19 patients died from the tumor disease alone, the death of 14 patients was caused by additional therapeutic complications (surgery, irradiation, cytostatic treatment). Eighteen patients survived more than 2 years without evidence of recurrence. Performance status reached the preoperative level after 9 months. All had good or excellent objective findings, but the disease had altered the lives of 7 patients considerably, psychological problems being the main reason.

Adenocarcinoma↗
PubMed1983

[Immediate postoperative enteral feeding with an elemental diet (Survimed) using a new application form of the so-called fine needle catheter jejunostomy. A prospective study].

In a prospective study (n = 50) the clinical usefulness of a fine-needle-catheter-jejunostomy based on the method of Delany et al. [1] was studied. In all cases the jejunostomy was inserted intraoperatively without difficulty and without complication. The set used (Intestofix) consisted of one polyurethan-catheter (75 cm length), 2.1 mm inner diameter) and of two hollow needles constructed as split-cannulas. This system has been proved in our study to be simple, rapid and safe. Patient's tolerance of the feeding was, however, unsatisfactory; diarrhea occurred on the 5th postoperative day in 35% of all patients, in addition we observed inconvenient belching (42.5%) and sensation of repletion (25%). There may be different causes for these uncomfortable symptoms; for example application schedule or the composition of food. We think that the operation itself exerts an important influence upon patient's tolerance because patients without operation but under the same conditions tolerate the nutrition via jejunostomy better than those in our study (with concomitant operation).

Catheterization↗