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Biomedical subjects

R Eisele

Publications and source records attributed to R Eisele.

At least 37 records · Page 2Linked to original sources
PubMed1998

Drug prophylaxis of deep vein thrombosis in traumatology: is there a benefit of a score in outpatients?

INTRODUCTION: Guidelines are lacking for the administration of drug prophylaxis of deep vein thrombosis (DVT) in outpatients. This study attempted to develop such a guideline in the form of a score. PATIENTS AND METHODS: In a prospective study of 731 outpatients with injury or surgery of the leg or pelvis a score was assigned based on "simulated physiological conditions" of the venous flow, including breathing, mobilization (activity of daily live), weight bearing and range of motion of joints of the lower extremities, lesions of the venous endothelium, date of injury, and localization of injury. The decision as to whether to administer drug prophylaxis of DVT was made on the basis of the patient's score. The venous system was investigated by duplex color-coded ultrasound. RESULTS: There were two false-negative findings, meaning that patients without drug prophylaxis showed a thrombotic complication. In neither of these cases had the patient been compliant with medical instructions. In the group with drug prophylaxis there were 4% DVT (n=18). CONCLUSION: Compared to previous results of 10% DVT in outpatients, our score-assisted drug prophylaxis significantly reduced the incidence of DVT. The score also makes it possible to select patients not requiring drug prophylaxis.

Adolescent↗
PubMed1998

Soft tissue texture analysis by B-mode-ultrasound in the evaluation of impairment in chronic low back pain.

OBJECTIVE: Patients complaints in chronic low back pain do not always correspond to the results of X-ray and MRI investigations. The paraspinal muscle is very sensitive to all structural disorders of the spine. We used B-mode-ultrasound to investigate the change of the ultrasonic texture of the paraspinal lumbar muscle in people suffering from low back pain. METHODS: The quantitative texture analysis was defined by the ratio of the mean echo level of a unilateral cross-section (L2) of the paraspinal muscle and the level of a central area (L1) of the same cross-section (square 1 x 1 cm, defined by the ultrasonic device). In the lumbar spine there were five cross sections on either side starting at L1 through L5. In the first study healthy males were investigated (n=30). In the second study, 20 males with MRI controlled lumbar disc disorders were investigated. Finally screening was performed with a group of 40 male patients. The last investigation was a pathohistologic cross-check from the ultrasonic findings in five individual shortly after exitus. RESULTS: The ratio showed results >0.6 in the healthy group. The group with lumbar disc disorders showed at the affected levels ratios <0.5. All patients (with one exception) with a lumbar spinal history were detected. Pathohistology confirmed the ultrasonic findings. CONCLUSIONS: The ultrasonic texture analysis of the paraspinal lumbar muscle allows a rapid and easy to perform investigation for relating discal (actually all structural) disorders of the lumbar spine to the reported pain or disability.

Adult↗
PubMed1997

[Percutaneous ultrasound controlled drainage of large splenic abscesses].

UNLABELLED: Because of the rare incidence of splenic abscesses and bleeding, only a few cases are described in the literature on percutaneous drainage of splenic abscesses. We report on eight cases (three male, five female, average age 74.1 +/- 10.76 years) of percutaneous, sonographically controlled catheter drainage of large splenic abscesses. RESULTS: Percutaneous, sonographically controlled drainage of splenic abscesses was feasible in all eight cases in the last 5 years (trocar technique, drain: 12-16 F, abscess contents 70-750 ml). In seven of eight cases, therapy with percutaneous, sonographically controlled drainage of the splenic abscess and rinsing of the abscess cavity over several days was successful. In two cases, however, a recurrent abscess had to be drained repeatedly with sonographic control, and this was successful. In one case a colitis-related fistula prevented successful drainage of an infected subcapsular splenic hematoma. The following splenectomy, however, proved the infected hematoma to be completely drained. In this study there were no complications like bleeding, injury of pleura or colon. The advantages of percutaneous drainage are: the spleen is not removed; conservative therapy is beneficial, particularly in multimorbid patients with a high surgical risk; there is no transmission of bacteria; the method is safe and effective.

Abscess↗
PubMed1997

[Intramedullary pressure reduction in the femur shaft in total hip endoprosthesis. Effect on the rate of thrombosis].

The incidence of deep-vein-thrombosis is claimed to be reduced by avoiding intramedullary compression in the femur during implantation of the femoral part of a hip prosthesis. A double-blind randomized trial investigated 101 patients with and 102 without avoidance of intramedullary compression. There was no evidence of the benefit of this technique, for the reduction of postoperative deep-vein thrombosis.

Aged↗
PubMed1996

Influence of age, comorbidity, type of operation and other variables on lethality and duration of post-operative hospital stay in patients with peptic ulcer. An analysis of 303 surgically treated patients.

Three hundred and three consecutive patients operated on for peptic ulcer for the first time between 1 January 1984 and 31 December 1993 were evaluated in this retrospective study. Eleven variables (Period when operation took place, gender, smoking behaviour, history of former ulcers, ulcerogenic drug intake, ulcer location, epigastric pain, number of blood units substituted, patient's age, type of operation, comorbidity) were investigated regarding their influence on peri- and post-operative mortality and on the length of hospital stay after operation. We found that a high comorbidity score (> 2) and the indication "emergency operation" (vs "elective operation") had an adverse impact on survival. The importance of age was marginal. The duration of post-operative hospital stay in survivors was negatively influenced by age higher than 60 years, more than two red cell units substituted and a high comorbidity score according to Charlson.

Adult↗
PubMed1996

[Ultrasound diagnosis, follow-up and therapy of cystic degeneration of the adventitia. 2 case reports and review of the literature].

Two Case Reports and Literature Review: Adventitial cystic disease of the popliteal artery is an unusual but important cause of intermittent claudication. Two cases of adventitial cystic disease were diagnosed by ultrasound investigation. The changing size of the cysts is correlated with the clinical symptoms of the patient. One patient was treated by resection with interposition of saphenous vein; the other by ultrasound guided needle aspiration of the fluid.

Arteritis↗
PubMed1994

[Pacemaker therapy for the sick sinus node syndrome. Does the atrially involved pacemaker system lower the frequency of atrial fibrillation and thromboembolic complications as well as mortality?].

Between 1986 and 1992, pacemakers were implanted in 307 patients with symptoms caused by the sick sinus syndrome (SSS). 301 patients were regularly followed up (161 men, 146 women, mean age 72.9 [27-91] years) of whom 180 had a VVI, 65 and AAI and 58 a DDD/DDI pacemaker. Mean follow-up period was 58.3 months for VVI-stimulated patients and 35.6 months for atrial paced patients. The data were analysed retrospectively to ascertain whether a change in pacemaker treatment to a more physiological system produced any lowering in the mortality rate, incidence of permanent atrial fibrillation (AF), and thromboembolic phenomena. The annual mortality rate of the VVI-stimulated patients was 6.9%, that of atrial paced patients 2.8%. Age, abnormal ventricular function, survived resuscitation and diabetes mellitus each correlated with a shortened life expectancy already at the time of implantation, regardless of the pacemaker mode. Permanent AF was more frequent during VVI stimulation (16% vs 7%), especially if it had been preceded by intermittent AF (26% vs 13%). But there was no significant difference with regard to transitory cerebral ischaemic episodes and peripheral arterial emboli (15% vs 10%). Fewer patients with atrial pacing went into heart failure (20% vs 30%). Four patients developed a high-grade atrioventricular (a-v) block on AAI stimulation (annual incidence 2.4%). - These observations suggest that patients with SSS should always have atrial paced pacemaker systems. If a-v conduction is disturbed, a bifocal pacemaker is the system of choice.

Adult↗
PubMed1991

[Thrombolytic therapy of antithrombin III-deficiency-induced mesenteric vein thrombosis in a newly operated patient].

A 21-year-old patient presented with extensive thrombosis of the mesenteric veins. He was in a serious condition after laparatomy in another hospital. The cause of the thrombotic event was found to be an inherited antithrombin III-deficiency. As a sole therapeutic possibility a systemic lysis with streptokinase was performed and was followed by a favourable immediate result. Unfortunately the subsequent course was complicated by a histologically confirmed necrotizing arteritis which was responsible for the lethal outcome 57 days after admission.

Adult↗
PubMed1989

Clinical and pharmacokinetic evaluation of zuclopenthixol acetate in Viscoleo.

The purpose of the present study was to evaluate zuclopenthixol acetate in Viscoleo, a new preparation to be administered once every 3 days, in the early treatment of acute psychotic episodes and acute deterioration of chronic psychosis. 21 cases were included in the study: patients received 1 to 3 injections. Clinical evaluation was made at 24, 48 and 72 hours after each injection, using the Clinical Global Impressions (CGI) and the Brief Psychiatric Rating Scale (BPRS). Results at end-point indicated a marked or moderate therapeutic effect in the 11 cases of acute psychosis. A statistically significant decrease was observed for the total BPRS score as well as for its subscales. Among 8 cases of exacerbation of chronic psychosis, 4 patients showed a moderate therapeutic effect, and minimal or no effect was found in the other 4 subjects. The total BPRS decreased significantly, but to a lesser extent than for acute psychosis. Two patients suffering from mania showed a moderate therapeutic effect according to CGI. 8 cases of acute psychosis and 5 cases of chronic psychosis did not suffer from any neurological side-effects. Plasma concentration measurements suggest that a dose of 50 mg per 3 days may be sufficient for early treatment of most acutely ill psychotic patients.

Adolescent↗
PubMed1985

[Quantitative approach to treatment with incisive neuroleptics by therapeutic monitoring].

The problems encountered during the longterm treatment of psychotic patients with neuroleptics are illustrated by six typical case reports. A group of patients who had had a new acute episode despite seemingly adequate treatment were selected. In these six cases it was demonstrated that the neuroleptics dosage was inappropriate, being either too high or too low as judged from the plasma concentrations. Ways of improving the adequacy of the treatment of psychotic patients with neuroleptics are discussed.

Adult↗
PubMed1985

Comparative determination of flupentixol in plasma by gas chromatography and radioimmunoassay in schizophrenic patients.

A new method of measuring flupentixol in plasma was developed using gas chromatography (GC) with a nitrogen-phosphorus detector. The minimal quantifiable concentration was 0.5 ng/ml and the day-to-day coefficient of variation was 9.4% at 2 ng/ml. A comparison of flupentixol concentrations measured with radioimmunoassay (RIA) and GC was undertaken on 100 plasma samples obtained from 50 schizophrenic patients. The RIA method tended to overestimate flupentixol concentrations compared with GC. The reasons for this discrepancy might be the presence in plasma of the inactive trans(E)-flupentixol isomer and metabolites of flupentixol, which would cross-react with the antibody. The results of this study show that GC can be used for therapeutic monitoring of flupentixol.

Administration, Oral↗
PubMed1985

Plasma flupentixol concentrations and clinical response in acute schizophrenia.

Twenty-three acutely psychotic inpatients treated with flupentixol were included in the study. Steady-state plasma concentrations were compared with therapeutic outcome in a routine clinical setting. The threshold concentration for satisfactory antipsychotic effect appeared to be approximately 2 ng/ml. Controlled studies are needed to establish the existence and exact limits of a therapeutic window.

Acute Disease↗