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Biomedical subjects

J Dahm

Publications and source records attributed to J Dahm.

6 recordsLinked to original sources

[Vasectomy today: a review of 1,275 vasectomies in 10 years].

We report on a large series of 1,275 patients who underwent outpatient vasectomy performed by a single urological surgeon within a 10-year period. In addition, the results of a prospective questionnaire-based study on 217 patients regarding their opinions and motivation, and the financial aspects of the vasectomy are discussed. The mean age was 37.0+/-5.9 years. A total of 98.4% of the patients had an uneventful postoperative course. The average duration of sick leave was 2.2+/-0.21 days. During the study period, the length of sick leave dropped significantly from 2.63 (1990/91) to 1.1 days (1998/99; P=0.001). Efficacy was documented with azoospermia rates of 96.6% and 98.5% in patients who presented for two and three sperm examinations, respectively. A vast majority of patients (94.6%) felt that the procedure should be covered by their health insurance, although 88.1% stated they would also pay by themselves. A minority of patients (0.7%: 9/1,275) subsequently considered vasectomy reversal. The wish to reverse the vasectomy was significantly associated with a younger patient age. In conclusion, outpatient vasectomy provides a safe and reliable form of contraception at low cost. Overall satisfaction in appropriately counselled patients is very high. Based on these findings, further attempts to propagate vasectomy as a timely form of contraception are medically and socioeconomically recommended.

Adolescent↗

Excimer laser revascularisation: current indications, applications and techniques.

The ultraviolet pulsed excimer laser (308 nm wavelength) is currently the only laser approved by the FDA for percutaneous intervention in patients with ischemic coronary artery disease. The clinical presentation of the treated patients varies from stable and unstable angina to acute myocardial infarction. Potential advantages of excimer laser revascularisation in acute coronary syndromes and in ischaemic obstructive peripheral vascular disease include concomitant plaque debulking and thrombus removal; absence of systemic lytic state; shortened thrombus clearing time and facilitation of adjunct balloon angioplasty and stenting. Improved understanding of laser-tissue interactions and positive clinical outcomes through the use of safe lasing techniques have led to expansion of indications/applications for laser angioplasty. These include stent restenosis, complex lesions and thrombotic stenoses, bifurcation lesions, balloon failure, total occlusions, focal saphenous vein graft lesions and peripheral arterial obstructions. The excimer laser can be effectively utilised in patients with depressed left ventricular ejection fraction and does not require implantation of a temporary pacemaker as no-reflow phenomenon and severe arrhythmias are rarely encountered. Careful case selection, proper utilisation of equipment and incorporation of efficient lasing techniques play a crucial role in effective and safe cardiovascular laser applications.

Angioplasty, Laser↗

Development of sucking in term infants from birth to four hours postbirth.

The development of sucking response was investigated in 30 clinically normal infants from 1 or 5 minutes postbirth until their first feeding 4 hours later. Maximum sucking pressures were measured with a research nipple attached to a portable electronic suckometer. Mean suction (negative pressure) began at 5 Torr at birth, peaked at 103 Torr at 90 minutes, and decreased thereafter to 65 Torr at 4 hours. Expression (positive pressure) began at 12 Torr, rose to 29, and decreased to 25. Mean expression pressures correlated with feeding scale scores, r = +.44(24); p less than .025, but suction pressures did not, r = +.26(24); p less than .1. Normative data were gathered on 10 additional stabilized newborns who had been fed twice successfully. Suction pressures were 96 Torr on Day 1, and 103 Torr on Day 2; expression pressures were 25 and 24 Torr, respectively. These pressures approximate those recorded in newborns between 1 and 2 hours postbirth.

Biomechanical Phenomena↗