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Biomedical subjects

M Brandl

Publications and source records attributed to M Brandl.

63 records · Page 4Linked to original sources
PubMed1983

[Artificial nutrition in neurology--indications and problems].

36 patients with severe neurological diseases (craniocerebral trauma, cerebrovascular insufficiency, meningo-encephalitis, polyneuropathy, paraplegia, intoxication etc.) received for more than 3 months monosaccharides and polyols (Triofusin E 1000) and a 10-%-concentration of crystalline amino acids (Aminofusin L10% kohlenhydratfrei) via the parenteral route in combination with / or exclusively a nutrient-defined diet (Biosorb). Exclusive enteral nutrition was given preference if possible. Numerous laboratory parameters, as for example blood counts, "hepatic enzymes", electrolytes, trace elements, plasma proteins, lipids, urea and creatinine were determined once a week. Substitutions and secondary complications were registered in addition. Iron and plasma proteins had to be substituted most frequently. It could be proved that hypoferremia was caused by insufficient iron supply in case of exclusive/prevailing parenteral nutrition, incorrect application of the iron preparations, inflammatory complications with iron moving into the R.E.S., as well as malabsorption syndromes probably induced by bacteria. Inflammatory complications were also the major cause of protein deficiency syndromes (hypoalbuminemia). In case of relatibely often occurring diarrhea, however, it could clearly be proved that it was not induced by nutrition but was produced by a broad-spectrum antibiosis. Chronically persistent diarrhea with colitis-like colonic changes required enteral feeding with an oligopeptide diet (z.B. Peptisorb) via jejunal feeding tube. Nitrogen balances which were determined after more than 3 months of artificial nutrition formed the basis of a nutritional plan differentiated according to diagnostic groups and stages of disease.

Adolescent↗
PubMed1982

Influence of high caloric parenteral nutrition on catabolism and cellular immune competence in carcinoma patients.

Urea production rate and cellular immune reactivity measured by skin stamp test were used to determine the extent of protein catabolism in 30 surgical patients with histologically diagnosed gastrointestinal carcinoma. All patients received high-caloric total parenteral nutrition (TPN) preoperatively. In those patients with an urea production rate of less than 15 g/day (according to definition of non-catabolic state) TPN was discontinued and the operation performed immediately, whereas the remaining 13 patients with an urea production rate exceeding 15 g/day (according to definition a catabolic state) were given TPN a total of 10 days prior to operation. Nine of the 13 patients could be converted from a catabolic to a non-catabolic state. Only one of these patients died, whereas of the remaining 4 patients who - according to the definition - remained in a catabolic state, two died. The course of nutrition positively influenced the serum levels of IgG, IgA and IgM. The skin stamp test was positive in only three of the 13 patients. Obviously, a positive skin test reaction occurred only in those patients who could be returned to a non-catabolic state during the course of TPN. By means of preoperative TPN catabolic patients can be converted into a non-catabolic state which is associated with a reduction in morbidity and mortality. Moreover, high caloric parenteral nutrition rich in amino acids seem to improve the prognosis for patients with negative skin test reactivity.

Amino Acids↗
PubMed1981

[Parenteral and enteral feeding of neurologic patients in crisis from the viewpoint of long-term intensive therapy].

32 patients in a neurological intensive-care unit with severe disturbances of conscious or impaired function of the swallowing muscles had to receive artificial nutrition on an average of 164 days. They were nourished either parenterally, with the nutrient defined diet Biosorb in combination with parenteral nutrition, or exclusively via a feeding tube. Enteral nutrition was given preference over parenteral nutrition if justified under the clinical circumstances. A multivariable study was intended to investigate to what extent the respective type of nutrition and its individual components met the actual clinical requirements during such a long period. Moreover, the study was intended to demonstrate to what degree adverse factors influenced the different nutritional regimens and necessitated--in addition to infusion programs and dietetics--supplementary steps which might also be of use under completely optimized circumstances.

Adolescent↗
PubMed1981

[Postoperative respiratory therapy: bronchospasmolytic activity and side-effects of some recently introduced beta-sympatheticomimetic agents (author's transl)].

Intensive respiratory therapy is essential for reducing postoperative morbidity and mortality in older persons with pre-existing chronic obstructive pulmonary diseases. A new series of beta-adrenergic agents is being frequently used to effect bronchodilatation. Three substances from this group, viz.: reproterol (Bronchospasmin), terbutalin (Bricanyl) and fenoterol (Berotec) were examined in a randomized study in 90 patients. All three substances produced a significant increase in FEV1 and PEFR of up to 10.6 and 15.7 per cent respectively above the initial values. There were no significant differences between the three groups. Contrary to the results obtained by other investigators PaO2 fell in all groups. In the case of fenoterol this decrease was statistically significant with a mean value of 0.36 kPa. The causes for this fall in arterial oxygen pressure are still unknown. It may possible be due to an increased intrapulmonary right-left shunt as a result of increased cardiac output together with a ventilation-perfusion mismatch despite improved airways resistance. Since drastic falls by as much as 2.53 kPa have been observed during treatment with these agents they constitute a potential risk.

Adult↗