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Biomedical subjects

P Reuter

Publications and source records attributed to P Reuter.

At least 37 records · Page 2Linked to original sources
PubMed1997

[CT angiography of cerebral venous circulation: anatomical visualization and diagnostic pitfalls in interpretation].

PURPOSE: To show the frequency of visualisation of the dural sinuses and cerebral veins with CT-angiography (CTA) with special reference to anatomical variants. METHODS: 34 CTA (1 mm slice thickness, 120 ml nonionic KM, 2 ml/s flow, 40 s prescanning delay) were performed in 30 patients to examine the cerebral venous system. In an anatomic study of cadavers (n = 10) without known disease of the cerebral veins the great sinuses were opened and examined. RESULTS: The superior sagittal, the transverse, the sigmoid and the straight sinus could be evaluated in all cases (100%). The cortical and deep cerebral veins as well as the small sinuses were visualised in 12-97% of the examinations. A sinovenous thrombosis was diagnosed in 4 of the 30 patients. Asymmetric superior sagittal sinus bifurcation (12/30), a hypoplastic sinus transversus (2/30) and a persistent sinus occipitalis (4/30) were found as anatomical variants. In 10 of the 30 patients we discovered 17 dural sinus filling defects produced by large arachnoid granulations. Similar findings could be demonstrated in the pathologico-anatomic examination series. CONCLUSION: CT angiography is suitable for detailed evaluation of the cerebral veins. Anatomic variants, arachnoid granulations, as well as fibrous bands and septa, which may lead to misinterpretation in conventional CT, can be clearly demonstrated. The sensitivity and specificity of CT in diagnosis of sinovenous thrombosis were increased thereby.

Adolescent↗
PubMed1997

Influence of retroactive disability payments on recipients' compliance with substance abuse treatment.

OBJECTIVE: This study examined whether substance abusers who received large retroactive payments from Social Security disability programs were more likely to terminate residential treatment precipitously than those who did not receive payments. METHODS: The records of 43 patients of a long-term residential treatment facility who received disability payments at some point during their treatment stay were blindly examined. Twenty-six of these patients received a large one-time retroactive payment representing money that accumulated during processing of the claims. To test the hypothesis that receipt of such a payment would lead to precipitous discharge, a survival regression model was used. A control group of nonrecipient patients was sampled at a comparable point in treatment. RESULTS: Subjects in the recipient group were significantly more likely to have unplanned discharges than those in the comparison group. CONCLUSIONS: These preliminary data suggest that large cash infusions can be disruptive to the course of treatment for substance abusers.

Adult↗
PubMed1997

Effects of a novel perfluorocarbon emulsion on neutrophil chemiluminescence in human whole blood in vitro.

The effects have been studied of a novel perfluorochemical (PFC) emulsion (18.5% perfluorodecalin, 1.5% perfluorodimorpholine propane, 2.5% lecithin) on phorbol 12-myristate 13-acetate (PMA; 100 micrograms ml-1)-induced neutrophil chemiluminescence in citrated human whole blood in vitro. A transient, dose-dependent, decrease in chemiluminescence, to a maximum of 54% after 12 min (P < 0.05), occurred when blood was pre-incubated with 10-40 microliters of the PFC emulsion, compared to saline controls. The mean (+/- s.e.m., n = 6) chemiluminescence of neutrophils incubated with 30 microliters emulsion at 12 min following PMA stimulation (9.5 +/- 1.3 mV) was significantly lower (P < 0.05) than control (24.2 +/- 2.2 mV). Incubation of blood with lecithin up to 16 mg ml-1 and Pluronic F-68 or Pluronic PE 6800 up to 65 mg ml-1 did not affect chemiluminescence.

Anions↗
PubMed1997

Setting goals for drug policy: harm reduction or use reduction?

Historically, United States drug policy has focused on use reduction; harm reduction is a prominent alternative. This paper aims to provoke and inform more debate about the relative merits of these two. Since harm is not necessarily proportional to use, use reduction and harm reduction differ. Both terms are somewhat ambiguous; precisely defining them clarifies thinking and policy implications. Measures associated with use reduction goals are poor; those associated with harm reduction are even worse. National goals influence the many decentralized individuals who collectively make drug policy; clearly enunciating goals makes some policy choices transparent and goals serve a variety of purposes besides guiding programmatic decisions. We recommend that the overall objective be to minimize the total harm associated with drug production, distribution, consumption and control. Reducing use should be seen as a principal means of attaining that end.

Decision Making↗
PubMed1996

Assessing alternative drug control regimes.

The debate over alternative regimes for currently illicit psychoactive substances focuses on polar alternatives: harsh prohibition and sweeping legalization. This study presents an array of alternatives that lies between these extremes. The current debate lacks an explicit and inclusive framework for making comparative judgments. In this study, we sketch out such a framework, as a reminder of possible policy levers and their costs and benefits that might otherwise be neglected or go unrecognized. The framework identifies a range of pharmacological and economic characteristics of substances, potential harms and their bearers, and the sources of those harms, including drug use, trafficking, law enforcement, and illegal status per se. The framework highlights the difficulty of making objective, rigorous comparisons among regimes, but we believe that it can serve a useful heuristic role in promoting more constructive debate and identifying fruitful questions for research.

Drug and Narcotic Control↗
PubMed1996

Harm reduction and social policy: should addicts be paid?

Harm reduction principles have not been applied to social policy programs that affect drug users. This paper considers whether income supports for the drug-dependent poor might be harm reducing, given that a principal harm related to drug dependence is crime committed to finance drug use. We examine the political fate of the principal income support program in the United States that targeted the drug dependent. Revelations that the money was being used in part for the purchase of drugs has led to a scaling back and tightening of the program. We suggest that the program might have been more effectively defended if attention had been paid to community harms rather than only to drug consumption by recipients. European and Australian governments provide income support which is no doubt also used for drug consumption, but in the context of universalist income support programs they do not require a harm reduction defense. We conclude that great potential for reducing drug-related harm may fall well outside the domain of targeted drug policy, whether of the supply reduction, demand reduction or harm reduction variety.

Journal Article↗
PubMed1995

Redefining the goals of national drug policy: recommendations from a working group.

This paper discusses what the goals of national drug policy have been and suggests an alternative set of goals. The past emphasis on use reduction is found wanting. Total harm related to drugs can be viewed as the product of use and harm per use. Thus, reducing use usually serves to reduce harm. However, in some cases, use reduction programs may increase harm per use so much that they increase overall harm even as they succeed in reducing use. Hence, use reduction goals can be usefully augmented with the explicit objective of reducing the total harm created by the production, distribution, consumption, and control of drugs. Numerous programmatic recommendations flow from this approach.

Alcohol Drinking↗
PubMed1993

[The premedication of PTA. A double-blind and randomized comparison of midazolam/tramadol versus placebo/tramadol].

A prospective, randomised and double blind comparative study of Midazolam/Tramadol or placebo/Tramadol for premedication before PTA was carried out on 40 patients (12 female and 28 male, average age 66.1 +/- 12). The anxiolytic, analgesic and general findings were quantified by means of a visual analogue score. Pre- and peri-interventional blood gas, blood pressure and pulse rates were determined. The complications of the two schemes were compared. 19 patients received Midazolam/Tramadol and 21 placebo/Tramadol. Patient anxiety was reduced significantly from 25.8 +/- 25 to 4.3 +/- 6 by premedication. Significant increase in the pain score during PTA was observed only in the placebo group (4.3 +/- 12.6 to 27.4 +/- 20.9). There was no difference in the incidence of complications and respiratory depression due to the Midazolam/Tramadol combination was not observed.

Aged↗
PubMed1993

[Conventional local intra-arterial fibrinolysis, spray lysis and mechanically accelerated fibrinolysis. An assessment of their position in the spectrum of angioplasty technics].

Intra-arterial local fibrinolysis was performed in 72 patients (51 men, 21 women, mean age 66.8 years) during the course of 78 angioplasties. 11.1% were stage IIa (Fontaine), 38.9% were stage II b, 27.8% were stage III and 22.2% were stage IV. The methods used were conventional fibrinolysis (15.4%), spray lysis (47.4%) and mechanically accelerated fibrinolysis (37.2%). In 66.7% the urokinase dose was < 600,000 I.U., in 17.9% it was > 1,000,000 I.U. Additional balloon dilatation was performed in 72 cases, percutaneous aspiration of thrombo-embolic material in 41 cases and stent implantation in 7 cases. Angiographically the procedure was successful in 90.7%; the Doppler index rose from 0.47 +/- 0.27 to 0.85 +/- 0.3 (p < 0.001). At discharge, staging was: I = 38.9%, IIa = 38.9%, IIb = 5.6%, III = 1.4%, IV = 15.3%. There were no systemic bleeding complications. In 5.1%, complications had to be treated surgically.

Adult↗
PubMed1992

[A prospective study to determine the recanalization time with a guide wire/recanalization catheter system in arterial occlusions].

The success rate and time taken for recanalization was determined in a prospective study of 82 consecutive unselected patients (53 men, 29 women; mean age 65.7 +/- 13, from 28 to 88 years). There were 106 complete occlusions of infrarenal arteries and a hydrophilic guide wire with a special 5-F recanalization catheter was used. Mean occlusion length was 12.97 +/- 10 cm (from 1 cm-45 cm). 79.3% of occlusions were in the femoro-popliteal territory, 6.6% were iliac and 14.1% tibial. 101 of the 106 occlusions were recanalized (95.3%). Mean recanalization time was 120.8 +/- 228.1 s (from 1 s-1440 s), mean recanalization velocity was 0.11 cm/s. The majority of obstructions could be recanalized in less than one minute. The five occlusions which could not be recanalized were distal lesions in the superficial femoral artery and which were longer than 10 cm; two were calcified. There were no complications resulting from the recanalization apart from three perforations which were clinically not apparent. Consequent angioplasty proved successful in 78.1% of these patients.

Adult↗
PubMed1992

Biocompatibility of synthetic oxygen carriers and fluorosurfactants.

A system for testing the biocompatibility of synthetic oxygen carriers is described including tests of hemolysis, complement activation and proliferation of cell lines or lymphocytes. Of 17 surfactants tested in this system, 6 were compatible in all tests while the other compounds showed individually differing patterns of incompatibility. We conclude that, in order to conduct a meaningful screening, a series of different assays has to be applied. In addition to our system, further assays, covering cytokine induction and phagocytosis should be attempted.

Blood Substitutes↗
PubMed1992

On the perfluorocarbon emulsions of second generation.

For formulation of perfluorocarbon-emulsions (PFC-emulsions) of second generation new perfluorocarbons (F-dimorpholines, F-dipiperidines and F-cyclohexylmorpholine) were synthesized, acting both as oxygen carriers and as interfacial active compounds (IFACs). The stabilizing effect of these IFACs is interpreted and a new theory is introduced. Also new classes of fluorosurfactants were synthesized and tested for biocompatibility. In PFC mixtures compounds of the type RFRH (RF = CmF2m + 1, RH = CnH2n + 1) are acting as IFACs but also as anchor-groups for lipophilic surfactants.

Biocompatible Materials↗
PubMed1992

Syntheses, interfacial active properties and toxicity of new perfluoroalkylated surfactants.

New surfactants have been synthesized with perfluorohexyl-groups as hydrophobic tail, a polyethyleneglycol-methylether as hydrophilic head and a prolongator between them. The prolongator units are -C4H8-, -C2H4OC5H10-, -C2H4OC3H6C(O)- and -CH2CH(OEt)CH2-. The surface tension, CMC and the interfacial tension water/perfluorocarbon were measured and the surface excess concentrations of the surfactant molecules were calculated. The influence of the surfactants on in vitro proliferation of human cell lines Hela and Molt 4 was investigated as a parameter for biocompatibility. The influence of the surfactants led to a reduction of cell proliferation depending on the concentration and chemical nature of the surfactant. Thus the prolongators changed the properties of the surfactants. They reduced the interfacial tension water/perfluorocarbon and improved the biocompatibility of surfactants.

Biocompatible Materials↗