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Biomedical subjects

P Bauer

Publications and source records attributed to P Bauer.

At least 163 records · Page 9Linked to original sources
PubMed1989

Prophylactic endoscopic sclerotherapy of oesophageal varices in liver cirrhosis. A multicentre prospective controlled randomised trial in Vienna.

The effect of prophylactic treatment of oesophageal varices by endoscopic injection sclerotherapy before the first episode of variceal haemorrhage was studied in patients with cirrhosis in a prospective, randomised and controlled multicentre trial. From February 1984 to March 1987 patients with liver cirrhosis and large varices (stage III-IV according to Paquet) were treated and followed up. The sample comprised 87 patients: 45 in the prophylactic treatment and 42 in the control group. After excluding drop outs, 41 patients were treated in each group. Twenty nine per cent of patients in the sclerotherapy group and 34% in the control group had a variceal haemorrhage during the period of observation. There was no significant difference in the distributions of the bleeding free intervals between the sclerotherapy and the control groups. During the follow up period 24% of patients in the sclerotherapy group and 46% in the control group died. The distribution of survival times indicates a tendency towards longer survival of patients with prophylactic sclerotherapy, particularly in those with alcoholic cirrhosis.

Austria↗
PubMed1989

Phosphorus nuclear magnetic resonance evidence of abnormal skeletal muscle metabolism in chronic alcoholics.

Pathophysiologic events leading to rhabdomyolysis in alcoholics are not clearly understood. We examined 18 alcoholic patients (10 with and 8 without a recent history of rhabdomyolysis) and 15 healthy non-alcoholic volunteers by phosphorus nuclear magnetic resonance spectroscopy of thenar eminence muscle. At rest, phosphocreatine, ATP, and pH levels were similar in patients and control subjects. During aerobic exercise, phosphocreatine utilization was greater, pH fell more slowly, and maximum acidosis was less in alcoholics with previous rhabdomyolysis than in control subjects. During ischemic exercise, both patient groups exhibited a significantly slower and smaller decrease in pH than did control subjects. These findings are consistent with impaired muscular glycolysis or glycogenolysis in both alcoholic groups. This metabolic myopathy may contribute to the onset of acute rhabdomyolsis.

Adult↗
PubMed1988

Long-term effect of occupational dust exposure.

In 1950-1960, a cohort of dust-exposed workers and a cohort of multiple matched unexposed subjects was set up from the files of preventive medical checkups performed in 1,089 Viennese plants. Male workers with a history of long-term exposure to nonfibrous particulates in different industries (metal, ceramics, brick, glass, stone etc.) aged greater than or equal to 40, and male workers without dust exposure (matched for residency, start of observation, age, and smoking) were followed up to 1980 or death (48,960 person yr). By life table methods, dust-exposed workers compared to unexposed workers showed a reduced survival of age 60 (p less than 0.0001), due to lung cancer (123 exposed, 87 controls, p = 0.001), stomach cancer (48/27, p = 0.003), silicosis (40/0), emphysema, bronchitis and asthma (41/23, p = 0.007). No difference in mortality from cardiovascular diseases was observed (p greater than 0.50). We concluded that heavy and long term exposure to respirable particulates is related to increased lung cancer mortality after age 60. A comparison of 2,212 deaths among Austrian silicotics, with deaths in the corresponding population showed a relation between lung cancer and silicosis (p less than 0.001), fairly independent of age and time-period. The estimated relative lung cancer risk of Austrian silicotics in the period 1955-79 averaged 1.41 (95% confidence 1.21-1.64).

Actuarial Analysis↗
PubMed1988

[Treatment using plasma exchange of massive acute hemolysis. 15 cases].

Fifteen patients admitted to an intensive care unit for massive acute hemolysis (MAH), defined by a free hemoglobinemia of more than 60 mumol/l, were treated by plasma exchange (PE) after a mean period following onset of 48.5 39 hours. The aim of plasma exchange therapy was to obtain early purification of hemoglobin and other substances released by red cell lysis and to prevent serious complications of MAH such as shock and RVHF or acute renal failure. Treatment by PE produced a decrease in initial hemoglobinemia of 76%, this level then remaining stable. The PE also appeared effective in the prevention and treatment of shock and RVHF, but much less so for installed acute renal failure. Comparison of results with those of a previous series of 16 patients with MAH treated by exsanguino-transfusion showed that PE was more effective, simpler to perform and less aggressive for early treatment of MAH, if rigorous conditions are applied.

Adult↗
PubMed1987

[Radical treatment and prognosis: results of a multicenter surgical-pathologic TNM stomach cancer study].

A multicentre observational study with 22 departments of surgery and 14 departments of pathology was started on April 1st, 1982 to validate TNM classification for patients with gastric carcinoma. 1417 patients with histologically proven gastric cancer entered the study. Follow-up is now 3-5 years. A subgroup of 138 patients (age under 65 years, no metastases M 0, curative resection R 0, only T 2-T 4-carcinomas and tumors situated only in the middle and lower third of the stomach) was studied. 65 had subtotal, 73 total resection. The 3 to 5 years cumulative survival time was at least not worse with subtotal in comparison to total resection.

Aged↗
PubMed1987

[Criteria for biostatistical assessment in surgery of stomach cancer].

The problem of making valid statements about the prognosis of survival after radical operation of stomach cancer, based on retrospective or prospective studies, is investigated. Some explanations are given for contradictory or non-reproducible results in different subgroups. Especially the problem of searching for "significant" results by multiple testing of different subgroups (data snooping) is treated critically. In case of remaining open questions randomised studies appear to be inevitable.

Gastrectomy↗
PubMed1987

[Asphyxic pulmonary edema caused by upper airway obstruction in adults].

A case of pulmonary oedema following acute pharyngo-laryngeal obstruction is reported. The case is compared with the results of the literature. The haemodynamic data suggested a non-cardiogenic effect, with low pulmonary arterial occlusion pressure of 1 mmHg and right-to-left shunting. Positive end-expiratory pressure was used with success. The mechanisms underlying such oedema are not well known, and may include disturbances in the balance of transpulmonary forces or hypoxia. However the outcome is usually favourable.

Adult↗
PubMed1987

[Thrombogenic thrombopenia related to heparin. Clinical, biological and therapeutic results. Apropos of 32 cases].

Heparin induced thrombocytopenia is characterized by often dramatic evolution of thrombotic arterial and venous complications. These occurred or are worsened in curative or preventive heparin therapy and the treatment remains delicate. The authors report 32 observations of thrombocytopenia complicated with thromboembolic events; seven deaths are to mention. The tests of platelet aggregation with standard heparin and platelets poor patient's plasma confirm the diagnosis in 28 cases of 30 very early studied and in 2 cases around the 6th day only after the stop of standard heparin. The choice of anticoagulant therapy is carried out the negative tests of platelet aggregation with low molecular weight heparin (L.M.W.H.) (CY 216, CY 222 Choay, PK 10109 Pharmuka). In L.M.W. heparin therapy, clinical and biological improvement is obtained in 26 cases of 30 treated cases. In three cases, the rapid climbing of platelet countings is not present although negative tests of platelet aggregation with selected L.M.W.H. In one case, after a initial climbing of platelet countings, the thrombocytopenia recurs rapidly with L.M.W. heparin after a operation. The immediate or secondary passage with K-antivitamins, platelet antiaggregant stabilized medium and long term's evolution.

Adult↗
PubMed1987

[Use of a low molecular weight heparin, CY 222, in the treatment of consumption coagulopathy].

UNLABELLED: Among the different treatments used for consumption coagulopathies, the most contested is classical heparin because of the risk of worsening of a hemorrhagic syndrome. A low molecular weight heparin was evaluated to determine possible improvement of this risk. METHODS: Treatment with CY 222 (Choay) was administered over 2 years to 29 patients (mean age 40 years, range 15-74) with coagulation coagulopathies. Diagnosis was based on the presence of 3 of the following 5 signs: platelets less than 150,000/mm, fibrinogen less than 2 g/l, QT less than 50%, ethanol test positive, PDF greater than 20 micrograms/ml. Etiology could be classed in 3 groups: gravido-puerperal (12 cases), medical disorders (15 cases), post-traumatic (2 cases). Dosage was 150 U/kg every 18 hours subcutaneously. The usual symptomatic treatment included: transfusion of red cells, frozen fresh plasma, platelets and antithrombin III as necessary. A hemorrhage syndrome was present in 16 cases. The course of the disease was evaluated on clinical findings and surveillance of hemostasis parameters; anti-Xa activity was determined in 15 patients. RESULTS: Hemorrhage was arrested and biological values normalized in 22 patients (76%) including 15 (52%) survivors. In the 7 cases where the coagulopathy was not improved, the hemorrhagic syndrome persisted in 4. In the 22 successful outcomes, the hemostasis was corrected within 48 to 72 hours, with the exception of the thrombopenia, which persisted up to the 6th day. Mean anti-Xa activity was 0.32 +/- 0.16 anti-Xa U/ml. CONCLUSION: Results of this preliminary, non-randomized study show CY 222 to be as effective as heparin in the treatment of consumption coagulopathies.

Adult↗
PubMed1986

Septic separation of the symphysis pubis.

Symphysial osteomyelitis has been distinguished from osteitis pubis because of the more serious nature of the disease. We report a case in which there was a pelvic separation similar to that seen after trauma or pregnancy. The previously undescribed complications of bladder perforation and pelvic instability are also noted. There was no predisposing cause in this case, in contrast to the 40 previously reported. The causative organism was staphylococcus aureus, but pseudomonas aeruginosa and escherichia coli have also been found in other cases.

Diagnosis, Differential↗
PubMed1986

[Scalpel and CO2 laser in the animal experiment. A comparative study of inoculation tumors of the mouse].

The study hereby submitted has been designed to show whether there are any differences between using a conventional knife or a CO2-laser when excising and grafting tumors in animal experiments. The animals were C57Bl/6 mice, the tumor was the Lewis lung carcinoma. Eight days after tumor inoculation into the subcutaneous layer of the back, 213 mice were treated by tumor excision either with a conventional knife or a CO2-laser. 86 excised tumors were cut and the tumor surface was swabbed into the subcutaneous layer on the nape of 86 tumor-free mice. Survival times of the laser-operated animals were insignificantly longer. However, small tumors showed markedly longer survival times. The interval without recurrence was longer for all tumor sizes when the laser was used (p less than 0.005). The laser method yielded lower growth rates when the tumor surface was swabbed into tumor-free mice (p less than 0.0001). Histological and cytological tests of the laser-excised and -swabbed specimen demonstrated a high rate of cell destruction. Therefore, the CO2-laser seems to have some importance in cases where the incision is made close to the tumor or where the tumor surface may be lesioned.

Animals↗