Biomedical subjects

P Altmann

Publications and source records attributed to P Altmann.

84 records · Page 5Linked to original sources

PubMed1975

[Consequences of a delayed start of therapy in primary irradiated gynecologic malignomas on five-year healing and mortality. A clinical epidemiological study].

The cases of 627 women with gynaecological malignomas, who were primarily irradiated in 1967 to 1969, were interpreted, questioning the temporary difference between clinical and histological diagnosis and beginning of treatment with regard to five-years' healing-results and mortality. The study has demonstrated, that - a delay of only four weeks considered - the part of living patients waas 11,28% of the total number of living patients, the part of dead patients however was 21,62% of the total number of dead patients. We emphasize therefore the urgency of an immediate beginning of therapy following a reliable diagnosis.

Aged↗

PubMed1975

[Some considerations on forceps delivery with excenter handle (author's transl)].

The introduction of electronic monitoring techniques in delivery increasingly has lead to the use of vaginal surgery in delivery. Vacuum and forceps extraction, in our view, do not compete with each other. Years ago forceps extraction was decisively improved by introducing the axial traction forceps. However, we believe that this technique has not been given due attention and is not applied widely enough. In vacuum extraction and in forceps deliveries without axial traction considerable part of the force is exerted in the direction of the symphysis. When using the excentric handle forceps, it is necessary in addition to the traction and pressure components to include the lever action. This is a so-called couple of forces. The additional torque involved in the use of an axial traction forceps shifts the fetal head during extraction in the direction of the hollow of the sacrum. The force needed for this shift and the progression of the head is many times less than that required for conventional forceps extraction. This is due to the absence of the component directed at the symphysis which impedes delivery. The axial traction forceps may also be used in case of the infant's abnormal positioning of the head. In case of a transverse position of the fetal head, a special fastener on the forceps makes it possible to use an excentric handle on the traction hook of the Kielland forceps and thus render possible rotation of the fetal head from the transverse position. The extentric handle in forceps extraction is optimal in order to overcome increased mechanical resistance to delivery. Adjustment of the handles to all types of forceps being used today is possible. From the results mentioned it is clear that the use of the axial traction forceps constitutes a valuable contribution toward declining perinatal mortality rates.

Apgar Score↗

PubMed1975

[About the choice of extraction instrument for vaginal operative termination in vertex presentation (author's transl)].

The common separation of indications at the First University Clinic for Obstetrics and Gynecology in Vienna concerning the choice of extraction instrument in cases of operative termination of vaginal delivery out of vertex position is being demonstrated. When there is only a slight increase of resistance in the delivery mechanism, when the child is mature, when there is no attitude of deflexion, and where there is no real reason for a speedy termination of delivery, the vacuum extractor comes into use. In cases of child emergency, of considerable increase of delivery mechanism resistance, of immaturity and attitude of deflexion, an extraction by means of obstetrical forceps is performed. Out of 547 deliveries terminated by means of extraction the sub- and postpartal mortality amounted to 2,19%. The number of prematures (7,5%) in this material did not differ from the total delivery material of the clinic. After forceps extraction 5 out of 419 children (2,8%) died. After vacuum extraction one child out of 105 (0,95%) died. In 23 cases where obstetrical forceps had to be used after vacuum extraction 2 children died (8,7%). The morbidity of the children was measured by means of the Apgar Score and of the injury frequency. Here the two extraction methods showed no significant differencies. The combined application of both extraction instruments however, showed an increase of morbidity. Injuries of the mother were almost exclusively found after forceps extraction.

Apgar Score↗

PubMed1974