Search PubMed⌕ Search

Biomedical subjects

P Kessler

Publications and source records attributed to P Kessler.

At least 127 records · Page 7Linked to original sources
PubMed1991

[Thiamine deficiency as a cause of life threatening lactic acidosis in total parenteral nutrition].

Two patients aged 37 and 44 years developed life-threatening lactic acidosis following abdominal surgery and a period of about 3 weeks of total parenteral nutrition. Septicaemia and hypoxia were excluded as possible causes. Conventional treatment including high doses of buffer agents was unsuccessful. Thiamine (vitamin B1) depletion was suspected as the cause of the metabolic acidosis, and two doses of 400 mg thiamine were given. In both patients, the lactic acidosis improved immediately, and it disappeared following the second dose of thiamine. Both patients were subsequently discharged as symptom-free. As part of the pyruvate-dehydrogenase (PDH) complex, thiamine was capable of improving the life-threatening situation.

Acid-Base Equilibrium↗
PubMed1987

[The pharmacokinetics of midazolam in various kinds of anesthesia].

Several authors reported a decrease in metabolism of drugs during inhalational anesthesia. In this study we investigated the influence of several kinds of anesthesia on the metabolism of midazolam. Methods. In 43 patients who underwent minor surgery, anesthesia was induced by injecting 0.2 mg fentanyl followed by 0.15 mg/kg midazolam. Anesthesia was maintained by either halothane/nitrous oxide (group 1), isoflurane/nitrous oxide (group 2), fentanyl/droperidol/nitrous oxide (group 3), or halothane/air/oxygen (group 4). Venous blood was drawn after 5, 15, 30, 60, 90, 120, 180, 240, 300 and 360 min. Using the two-compartment model we estimated distribution half-life (t1/2a), elimination half-life (t1/2el), clearance (Cl), and volumes of distribution (Vz = volume in elimination phase). Results. There were no significant differences of elimination parameters between the four groups. Elimination half-life ranged from 0.72 to 15.06 h. Cl ranged from 2.5 to 12.8 ml/min per kilogram. Four patients (= 9%) had a t1/2el of 7-15 h; in 16 cases we found secondary concentration peaks. There was no correlation between drowsiness in the postoperative period and midazolam concentration. Conclusion. Even if anesthesia should influence the metabolism of midazolam, for example by reducing liver blood flow, we did not find any difference between the four groups. In accordance with others, we found some patients with a half-life of up to 15 h, which might reflect the influence of the anesthesia itself.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

Caries, oral hygiene and periodontal disease in handicapped adults.

Caries, periodontal disease, oral hygiene and treatment needs were assessed in a group of handicapped adults. The study group comprised 199 individuals aged 17-64 yr, most of whom were mentally subnormal. The mean DMFT values ranged from 17.4 in the 17-24-yr-old age group to 26.9 in the 55-64-yr-old age group. Tooth loss increased rapidly with advancing age. In all age groups the F component was less than 20% and high numbers of untreated carious lesions were found. Of the group studied, 90% needed some conservative treatment. Oral hygiene was poor and a high prevalence of periodontal disease was found. Of the dentulous persons, 49% needed scaling and 34% complex periodontal treatment. The percentage of study group patients requiring dental treatment was very high, so that it can be concluded that dental care for the handicapped is insufficient. This situation must be improved and a suitable system for the delivery of preventive measures must be devised for this group of the population.

Adolescent↗
PubMed1985

[Treatment of tuberculous coxitis with special reference to modern surgical therapy].

The medicamentous therapy of tuberculous coxitis follows the general rules of antituberculous chemotherapy. This treatment should be completed by an operative therapy in every case. The method of radical surgery with sine-plastic, described by Göb in 1980, provides best conditions to highest radicality of this treatment. Between 1980 and 1984 13 patients were operated upon by this method in the Orthopedic Department of the Bad Berka Central Hospital. The results are mainly good. By means of a modification installed by the author a more subtle approach is achieved.

Abscess↗
PubMed1983

[Ventricular pre-excitation revealed by idioventricular rhythm and large QRS tachycardias. Apropos of an operated case].

A 15 year old boy presented with palpitations of sudden onset and termination over a two month period. The heart was clinically and radiologically normal. The electrocardiogramme showed sinus rhythm with a short PR interval (0,11 sec) and narrow QRS complexes (0,08 sec) associated with an intermittent escape accelerated idioventricular rhythm (AIVR). During an attack of palpitations a regular tachycardia (250/min) with wide QRS complexes of the same configuration as those of the AIVR (left side delay). The diagnosis of ventricular tachycardia was retained. Endocavitary electrophysiological recording demonstrated preexcitation of the right ventricle associated with accelerated nodal conduction explaining the narrow QRS complexes in sinus rhythm. The wide complex tachycardias initiated and terminated by paired ventricular stimulation were identical to the spontaneous attacks and were attributed to an antidromic reciprocating rhythm. The hypothesis of a rhythm arising from the accessory pathway is suggested. This would explain the identical configuration of the QRS complexes of the AIVR and of the antidromic reciprocating-rhythm and the disappearance of the AIVR after surgical section of the accessory pathway.

Adolescent↗
PubMed1982

[Osteoarticular tuberculosis. Review - current status of diagnosis and therapy].

Osteo-articular tuberculosis has become now a relatively rare disease in civilized countries. This fact makes the recognition of this infectious disease more difficult. In comparison with the pre-chemotherapeutical era, the time of falling ill has shifted from childhood and youth to the adult age. In our own 804 cases (1970 to 1980) the mean age is now in the seventh decade. The localisation most common seen is the spine, followed by hip- and knee joint. As far as the best therapy is concerned, diagnostics is nowadays as important as formerly. The highly efficient tuberculostatic chemotherapy changed the therapeutic conception concerning osteo-articular tuberculosis. Lengthy immobilisation of the affected joints and bones, in former years the therapy of choice has now be replaced by functional treatment in combination with surgical procedures (radical cleaning of foci).

Adolescent↗
PubMed1981

Use of a microcomputer for recording dental epidemiologic data.

A portable data recording system that works on the basis of a microcomputer has been developed. The main advantage of this system consists in the carrying out of checks for illogical and contradictory entries during the process of recording. False entries can immediately be corrected. The data are temporarily stored on disks. Subsequent to the completion of the investigation they are automatically transmitted by a transfer program to the computer-system in the computer center. This excludes any human errors occurring in the course of the transfer of the data. During a pilot study, the advantages of the microcomputer system were shown by comparing frequency of examination and recording errors using conventional recording methods and the microcomputer system.

Computers↗