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P Federspil

Publications and source records attributed to P Federspil.

At least 19 recordsLinked to original sources
PubMed2005

[Antibiotic therapy in otorhinolaryngology].

First, the general principles for an antibiotic therapy are stated. The indications have to be well thought through. Frequent viral ENT infections, as well as numerous bacterial infections, should not be treated with antibiotics. Due to the current antibiotic sensitivity of the main ENT pathogens, the antibiotic choice for an empiric therapy is emphasized, and also the advantage of an optimized therapy based on the results of Gram stain (supercalculated empiric therapy) and an antibiogram (specific therapy). Pus characteristics may be the first step in diagnosing the pathogens. The degree of severity of an infection determines the oral or parenteral route of administration. As a rule, antibiotic therapy has to be checked after 2-3 days. The grouping of the different ENT infections with a similar spectrum of pathogens gives a better view of the therapeutic principles and reduces repetitions. The current recommendations for antibiotic treatment of numerous ENT infections with different degrees of severity are indicated. After the presentation of the appropriate antibiotics with their current spectrum of efficacy, the initial therapy, treatment in case of penicillin allergy, and of severe cases and complications or therapeutic failure are mentioned.

Anti-Bacterial Agents↗
PubMed2005

Update on treatment guidelines for acute bacterial sinusitis.

Acute bacterial sinusitis (ABS) is a common complication of viral upper respiratory tract infections and represents a considerable social burden both in terms of diminished quality of life for the patient and the economic implications of decreased productivity and treatment costs. Several national health authorities have developed guidelines for the management of ABS, which aim to promote rational selection of anti-bacterial therapy to optimise clinical outcomes while minimising the potential for selection of anti-bacterial resistance as a result of inappropriate anti-bacterial usage. This article provides an overview of current guidelines, with particular focus on the clinical significance of variations in treatment recommendations and new treatment options, such as the ketolide telithromycin, which was recently added to a number of national treatment guidelines.

Anti-Bacterial Agents↗
PubMed2004

[Prion diseases].

Explore the source record for details and available documents.

Clinical Trials as Topic↗
PubMed2002

[Diagnosis of prion diseases].

Prion diseases are histologically characterized by a spongiform encephalopathy. The early symptoms of Creutzfeldt-Jakob disease (CJD) and variant Creutzfeldt-Jakob disease (vCJD) are unspecific. To date, the definite diagnosis can only be made by histological examination of central nervous tissue, i.e. brain biopsy or post mortem. Therefore, diagnostic tests are being elaborated that suffice with cerebrospinal fluid or blood. Unlike the sporadic form of Creutzfeldt-Jakob disease, that involves the central nervous system exclusively, in the variant of the Creutzfeldt-Jakob disease the lymphoreticular system including the tonsils is involved, too. Hence, a tonsillar biopsy can be performed instead of a brain biopsy. In particular, the diagnostic criteria of both CJD and vCJD are described.

Adult↗
PubMed2002

[Transmission of spongiform encephalopathies (prion diseases)].

The transmissible spongiform encephalopathies (TSE), or prion diseases, constitute a form of degenerative disorders of the central nervous system, which are characterized by a typical spongiform histological pattern and a fatal course. According to Prusiner's theory, its agent consists of a protein without any nucleic acid, the "proteinaceous infectious agent", or prion. This is a pathologically folded form of the normal prion protein (PrPC), and then called PrPSc. TSE are observed in different mammals including humans. In humans, they include Creutzfeldt-Jakob disease (CJD), Gerstmann-Sträussler-Scheinker syndrome (GSS), fatal familial insomnia (FFI), Kuru and the new variant of the Creutzfeldt-Jakob disease (vCJD). The longest known TSE is scrapie in sheep. Since 1984 the bovine spongiform encephalopathy (BSE) and since 1996 the variant Creutzfeldt-Jakob disease have been documented. This paper gives an overview on the pathogenesis, epidemiology and the clinical features of the different prion diseases.

Animals↗
PubMed2001

[Squamous epithelial carcinomas of the external ear].

BACKGROUND AND OBJECTIVE: Squamous cell carcinoma of the pinna seems to be associated with a worse prognosis as compared to other locations. PATIENTS/METHODS: We studied 88 patients treated between 1975 and 1990 for a squamous cell carcinoma of the pinna. RESULTS: Lymph node metastases were present in eight cases (9%) prior to treatment. Treatment was intended to be curative in 83 patients (94%). Tumor therapy was operative in all cases. Radiotherapy was instituted postoperatively in three patients; five patients (5.7%) died due to the tumor. Of 83 curatively treated patients, only 2 died of tumor progression. The survival rate was 98% after 2 years and 95% after 5 years. The recurrence rate was 7% after 1 year, 13% after 2 years, and 18% after 5 years. The outcome with regard to local tumor control and survival was significantly poorer when neck metastases were present. CONCLUSIONS: We recommend tumor excision with wide margins (5-10 mm) as first-line treatment. Neck dissection with parotidectomy is indicated when suspicious lymph nodes are detected by ultrasound sonography, the tumor diameter is > 4 cm, cartilaginous invasion is present, and vertical tumor thickness is > 5 mm.

Adult↗
PubMed2000

[Functional and esthetically oriented reconstruction of lip defects].

Reconstruction of lip defects presents a challenge to the surgeon. Apart from attaining a good aesthetic result, preserving the function of the oral sphincter is an essential objective. A variety of techniques and modifications of procedures for reconstructing lip defects have been reported in the literature. It is up to the surgeon to select the reconstruction procedure ensuring optimum functional and cosmetic results, depending on the location, size, and depth of the defect. The division of the lips into aesthetic subunits can prove very beneficial in designing lip reconstruction procedures. The upper lip is divided into three aesthetic subunits: two lateral subunits and a median subunit, the philtrum. The lower lip constitutes a single subunit. In this study, established reconstruction techniques are discussed and a concept serving to facilitate the appropriate choice of technique is introduced. This concept differentiates between vermilion defects on the one hand, and partial-thickness and full-thickness lip defects on the other hand. For the lower lip, the full-thickness defects are classified as defects involving one-third, one-third to two-thirds of the lower lip width, and between two-thirds and complete loss of lip tissue. For the upper lip, a distinction is made between isolated defects of the central and lateral subunits and combined defects of the central and lateral subunits. Important principles of surgery and the advantages or disadvantages of different reconstruction techniques are discussed.

Basal Cell Carcinoma↗
PubMed1999

Functional and aesthetic objectives in the reconstruction of lip defects.

The reconstruction of lip defects presents a challenge to the surgeon. Apart from attaining a good aesthetic result, preserving the function of the oral sphincter is an essential objective. A variety of techniques and modifications of procedures for reconstructing lip defects have been reported in the literature. It is up to the surgeon to select the reconstruction procedure ensuring optimum functional and cosmetic results, depending on the location, size, and depth of the defect. The division of the lips into aesthetic subunits can prove very beneficial in designing lip reconstruction procedures. The upper lip is divided into three aesthetic subunits: two lateral subunits and a median subunit, the philtrum. The lower lip constitutes a single subunit. In this study established reconstruction techniques are discussed, and a concept serving to facilitate the appropriate choice of technique is introduced. This concept differentiates between vermilion defects on the one hand and partial-thickness and full-thickness lip defects on the other hand. For the lower lip the full-thickness defects are classified as defects involving one third and one third to two thirds of the lower lip width and between two thirds and complete loss of lip tissue. For the upper lip a distinction is made between isolated defects of the central and lateral subunits and combined defects of the central and lateral subunits. Important principles of surgery and the advantages and disadvantages of different reconstruction techniques are discussed.

Esthetics↗
PubMed1998

[Percutaneous therapeutic embolization in therapy refractory, non-traumatic epistaxis].

UNLABELLED: The records of 24 patients with severe intractable non-traumatic epistaxis were reviewed to evaluate the efficacy of embolism therapy. MATERIAL AND METHOD: The histories of 17 patients with idiopathic epistaxis, 6 patients with Osler-Rendu-Weber disease and 1 patient with a high-flow angioma were analyzed. All patients were treated by means of percutaneous embolization of the maxillary artery and its branches. RESULTS: In 5/17 patients with idiopathic epistaxis repeat embolization was necessary in 5 cases, while permanent hemostasis was achieved in 16/17 patients with embolism alone. Five of the 6 patients with Osler-Rendu-Weber disease labelled stage III before treatment were managed successfully with repeated embolizations, while all cases were reduced to stage I disease. The high-flow angioma was successfully ablated after embolization combined with direct injection of thrombosing material and laser resection.

Adult↗
PubMed1997

Cystadenoma of the parotid gland with unusual prominent lymphoid stroma.

A rare variant of the cystadenoma of salivary gland origin is presented, which occurred in the parotid of a 36-year-old, otherwise healthy female patient. The tumour showed a dense follicle-containing lymphoid stroma, resembling papillary cystadenoma lymphomatosum (Warthin's tumour). In contrast to that, the epithelial lining gave a more irregular impression and oncocytic metaplasia were completely absent. Light microscopic and immunohistochemical features of the tumour are described and compared with those of classical cystadenoma and papillary cystadenoma lymphomatosum (Warthin's tumour). Other relevant multicystic epithelial parotid lesions, which are commonly associated with a prominent lymphoid component are discussed.

Actins↗
PubMed1997

[Percutaneous embolization therapy in severe cervicofacial hemorrhages].

PURPOSE: To analyse the use of transcatheter embolisation. MATERIAL AND METHODS: We report on 43 patients treated by transcatheter embolisation for head and neck haemorrhage from 1987 to 1995. There were 13 patients with idiopathic intractable epistaxis, 6 with iatrogenic and three with traumatic bleeding, 7 patients with bleeding from vascular malformations, 12 patients with haemorrhage from tumours, one ruptured aneurysm of the inferior thyroid artery and one patient bleeding from a retrolingual dystrophic goitre. RESULTS: In 11/13 patients with idiopathic epistaxis, this could be stopped. In 8/9 of the traumatic and iatrogenic bleedings the haemorrhage was treated by embolisation alone. In two cases additional elective surgical interventions were necessary. In 6/7 patients with vascular malformations embolisation resulted in long-lasting periods free from bleeding. Palliative embolisation in bleeding tumours resulted in haemostasis in 10/12 patients. Bleeding was definitely stopped in a patient with aneurysm of the inferior thyroidal artery as well as in a patient with bleeding from a dystrophic goitre. We observed a total of three complications, two transitory neurological disturbances and one permanent amaurosis. CONCLUSION: Transcatheter embolisation is an effective tool in the treatment of life-threatening head and neck bleedings.

Acute Disease↗
PubMed1997

[Effects of standardized Myrtol in therapy of acute sinusitis--results of a double-blind, randomized multicenter study compared with placebo].

BACKGROUND: In the management of non-purulent acute sinusitis, alpha adrenergic substances are administered topically and secretolytics systemically. Antibiotic therapy should be restricted to purulent forms. This study was designed to demonstrate the importance of the maintenance of permanent ventilation and drainage of the sinuses as a therapeutic concept. PATIENTS/METHODS: In a multicentric trial the efficacy and safety of myrtol standardized and another essential oil were investigated in 331 patients with acute sinusitis in comparison to placebo. Three hundred thirty patients were evaluated in an intent-to-treat-analysis and 291 patients remained for statistical analysis. The study was conducted in 16 centers in a double-blind, double-dummy, randomized design versus placebo. During an observation-period of 14 days the patients were treated for 6 +/- 2 days with the respective study medication. RESULTS: With respect to efficacy, both myrtol standardized and the other essential oil proved to be significantly superior to placebo. As to the tolerance, a slight advantage of myrtol standardized was demonstrated in comparison to the other verum substance. CONCLUSION: These results which do support the value of essential oils like myrtol as an effective treatment in acute, uncomplicated sinusitis instead of antibiotics as first choice, are confirmed by the existing literature.

Acute Disease↗