Biomedical subjects

Peter Martus

Publications and source records attributed to Peter Martus.

58 records · Page 4Linked to original sources

PubMed2002

Complications of endoscopic sphincterotomy: can heparin prevent acute pancreatitis after ERCP?

BACKGROUND: An exploratory analysis of a prospective study of risk factors for acute pancreatitis after ERCP combined with endoscopic sphincterotomy showed that the frequency of acute pancreatitis was lower in patients who received heparin compared with patients not treated with heparin. The study was continued to further analyze the effect of heparin on the frequency of acute pancreatitis. METHODS: Potential risk factors for acute pancreatitis and outcomes were evaluated prospectively for all ERCP procedures with endoscopic sphincterotomy performed between September 1994 and December 1998. The results were analyzed by univariate and multivariate methods to determine risk factors for complications. Heparin was administered to 32.9% of the patients (heparin group [HEP group], n = 268) for various clinical reasons (low-molecular-weight heparin, n = 208, unfractionated heparin n = 60). A group of 547 patients who did not receive heparin served as control patients (CON group). RESULTS: Eight hundred fifteen patients underwent ERCP with endoscopic sphincterotomy; acute pancreatitis occurred in 6.4% (n = 52). The frequency of acute pancreatitis was significantly lower in the HEP group versus the CON group in the final multivariate model, which included significant risk factors for acute pancreatitis (HEP group: 3.4%, 9/268 vs. CON group: 7.9%, 43/547; p = 0.005). HEP did not increase the risk of hemorrhage (HEP group: 1.1%, 3/268, 2 severe, none fatal vs. CON group: 2.0%, 11/547, 3 severe, 2 fatal). HEP (p = 0.005; OR 0.3: 95% CI [0.16, 0.73]) and the number of risk factors present (p = 0.0001; OR 2.5: 95% CI [1.80, 3.50]) influenced the frequency of acute pancreatitis independently. CONCLUSIONS: Heparin was significantly associated with an extremely low frequency of post-ERCP pancreatitis without increasing the risk of hemorrhage after endoscopic sphincterotomy. Because this effect could not be attributed to other known or suspected confounders, our conclusion was that heparin administration before ERCP reduces the risk of pancreatitis.

Acute Disease↗

PubMed2002

Corneal neovascularization after nonmechanical versus mechanical corneal trephination for non-high-risk keratoplasty.

PURPOSE: To analyze the influence of mechanical versus nonmechanical trephination of donor and host corneas on superficial, peripheral corneal neovascularization occurring after non-high-risk keratoplasty. METHODS: Patients of the prospective Erlangen non-high-risk keratoplasty study with standardized corneal photographs taken preoperatively and 1 year later were analyzed (n = 184). Slides of these photographs were projected (magnification x100) and corneal vessels graded in a standardized semiquantitative fashion into five categories with regard to limbus, sutures, and host-graft junction in each of 12 corneal sectors. Degree (total increase of grades in the 12 sectors) and maximal extent of corneal neovascularization (maximal centripetal extension of blood vessels) were analyzed. In 32 patients mechanical (17%) and in 152 nonmechanical trephination of host and donor tissue was performed (193-nm excimer laser, 83%). Statistical analysis was done using Fisher's exact and Mann-Whitney test. RESULTS: Corneal neovascularization within the first postoperative year was lower in the nonmechanical [73 of 152 (48%)] compared with mechanical trephination group [24 of 32 (75%); p< 0.01; Mann-Whitney test]. Maximal extent of neovascularization (i.e., vessels reaching the interface or growing beyond) was not yet significantly different between nonmechanical (8%) and mechanical (17%) trephination (p = 0.074). CONCLUSIONS: Nonmechanical trephination using the 193-nm excimer laser in non-high-risk keratoplasties might reduce corneal neovascularization occurring within the first postoperative year. This indicates that in the non-high-risk setting, development of postoperative corneal neovascularization may be affected by the trephination technique and subsequent wound-healing response.

Aged↗

PubMed2002

Morphologic predictive factors for development of optic disc hemorrhages in glaucoma.

PURPOSE: To evaluate which optic disc parameters are predictive factors for the development of disc hemorrhages in chronic open-angle glaucoma. METHODS: The prospective comparative clinical observational study included 432 eyes of 281 white patients with chronic open-angle glaucoma. Mean follow-up time was 38.8 months (median, 31.5). Eyes in the whole study group were divided into those with an optic disc hemorrhage during the follow-up period (hemorrhagic group; n = 38; 8.8%), those without disc hemorrhages and with neuroretinal rim loss as sign of progression of glaucoma (rim loss group; n = 42; 9.7%), and those with neither disc hemorrhages nor neuroretinal rim loss (stable group; n = 352; 81.5%). Color stereo optic disc photographs were obtained repeatedly in all patients and subjected to qualitative and morphometric evaluation. RESULTS: At baseline, neuroretinal rim area was significantly (P < 0.03) smaller and the beta zone of parapapillary atrophy (temporal lower sector) was significantly (P < 0.03) larger in the hemorrhagic group than in the stable group. Both study groups did not vary significantly (P > 0.05) in optic disc size and shape, optic cup depth, alpha zone of parapapillary atrophy, and retinal vessel diameter. In multivariate analysis, the neuroretinal rim area was the only significant predictor of hemorrhages. The hemorrhagic group and the rim loss group did not differ significantly (P > 0.05) in any optic disc parameter measured. CONCLUSIONS: In chronic open-angle glaucoma, morphologic predictive factors for the development of disc hemorrhages are small size of neuroretinal rim and, possibly, a large parapapillary beta zone. Development of disc hemorrhages is independent of optic disc size and shape, size of alpha zone of parapapillary atrophy, retinal vessel diameter, and optic cup depth. Optic nerve heads in eyes with eventual development of disc hemorrhages and in eyes with eventual progressive rim loss without observed disc hemorrhages do not differ markedly in appearance.

Adolescent↗

PubMedDate not supplied

Randomized clinical trial on the efficacy of a new bleaching lacquer for self-application.

BACKGROUND: This study evaluated the clinical efficacy and duration of effectiveness of a new bleaching lacquer for self-application without the use of mouth guards. It compared two different application times. METHODS: Forty-six adult subjects who requested bleaching treatment were selected to participate in this randomized, single-blind (examiner-blinded), single center, two-group trial. The subjects were randomly divided into two groups (n=23 each), each being instructed to bleach (8% carbamide peroxide) their six maxillary anterior teeth for two weeks. Daily contact time in Group 1 was 20 minutes once a day and, in Group 2, the time was 20 minutes twice a day. Efficacy was measured subjectively using the Chromascop Complete shade scores obtained at baseline and after one, two and three weeks, as well as after one, three, six and nine months. RESULTS: After two weeks of treatment, the teeth in the Group 1 subjects exhibited a 2.4 +/- 0.2 mean shade scores improvement compared to baseline (p < 0.001; t-test for paired samples), and the subjects' teeth in Group 2 exhibited a 3.5 +/- 0.1 mean shade scores improvement (p < 0.001). However, the difference between both groups was not statistically significant (p > 0.05). The observed effects were stable for six months. CONCLUSIONS: It can be concluded that the new bleaching lacquer is efficacious; however, a double application does not seem to be obligatory.

Adult↗