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R Steffen

Publications and source records attributed to R Steffen.

At least 199 records · Page 11Linked to original sources
PubMed1990

[Technique of thyroid gland operation: prevention of lesions of the superior laryngeal nerve].

The anatomical variant of the external branch of the superior laryngeal nerve is at risk during thyroid surgery. We recommend a careful dissection of the upper thyroid pole strictly avoiding even minor mass ligatures and all vascular structures have to be selectively identified. Of a consecutive series of 161 upper pole dissections the superior laryngeal nerve was found in 31% and no postoperative injury was detected by video stroboscopy.

Humans↗
PubMed1990

[Medical advice for travellers].

When counselling travellers to overseas countries, attention should be paid not only to the health and safety conditions within the country of destination, but also to the general health of the traveller and to the personal risk he might take on his journey. Rarely, though, a person has to be discouraged from an overseas trip these days because of a constitutional or medical incapacity, a classification of which is given in the article. It is, however, indispensable to give advice on how to avoid exposure for a number of nuisances and diseases, particularly diarrhea, insect-stings and arthropod borne diseases and STD, as well as accidents.

Accident Prevention↗
PubMed1990

[Vaccinations for travel abroad].

Travel to the developing world by Swiss citizens has been increasing. Vaccine-preventable diseases challenges the physician to provide pre-travel advice. Each traveler's itinerary, duration of stay and medical history, including previous immunization, should be reviewed. Vaccinations are required or recommended according to the requirements and the epidemiology of countries being visited. This article summarizes updated recommendations to individual vaccines and immunoglobulins.

Child↗
PubMed1990

Malaria incidence and prevention among European and North American travellers to Kenya.

A longitudinal survey was conducted among travellers departing from Nairobi airport to determine the use of malaria prevention measures and assess the risk for malaria while travelling in Kenya. Among 5489 European and North American travellers, 68 different drug regimens were used for prophylaxis, and 48% of travellers used both regular chemoprophylaxis and more than 1 antimosquito measure during travel; 52% of 3469 travellers who used chemoprophylaxis did so without interruption during their travel and for 4 weeks after departure. Compliance was lowest among travellers who visited friends and relatives, who were young, or who stayed more than 3 weeks. Sixty-seven (1%) travellers experienced symptoms of malaria, but the diagnosis could be verified for only 16 of these. Long-stay travellers appeared to be at higher risk for malaria than short-stay travellers, and health information needs to be targeted especially to the former. Similar investigations are needed among international travellers to other malaria-endemic countries. With comparable data available, consistent and effective malaria prevention guidelines can be developed.

Adult↗
PubMed1990

Management of portal venous thrombosis in hepatic transplant recipients.

Portal venous thrombosis in hepatic transplant candidates is considered a relative contraindication to transplantation. In addition to thrombectomy, which is often technically impossible, donor portal venous arterialization or extra-anatomic venous bypass have been described. Two patients who underwent portal venous resection and subsequent anatomic reconstruction are presented herein. In the first patient, a graft with donor common iliac vein was interposed, and in the second, the donor portal vein was long enough to be anastomosed to the mesentericosplenic venous confluens. One patient is well 12 months after transplantation with patent portal vein and the other died of fungal sepsis after rejection treatment (the portal vein being open and unobstructed at autopsy).

Anastomosis, Surgical↗
PubMed1990

Malaria chemoprophylaxis among European tourists in tropical Africa: use, adverse reactions, and efficacy.

In order to determine knowledge, attitudes and practices towards malaria prophylaxis, as well as its side-effects and efficacy, a self-administered questionnaire was distributed to European travellers on return flights from tropical Africa to Europe. Between 1985 and 1988 the questionnaire was completed by 44,472 passengers (80.1% of those on board) on 242 flights. A follow-up questionnaire was completed by 42,202 (94.9%) of the same travellers 3 months later. Almost all knew about the risk of malaria, but 10% relied solely on advice from nonmedical sources. While 55.6% had taken at least one measure against mosquito bites, only 4.5% adopted three such measures (used repellents and insecticides and wore long clothing after dusk). Compliance with chemoprophylaxis use was reported by 57.0% of travellers who spent less than 3 months in Africa, compared with 29.2% who stayed 3-12 months. Depending on the antimalaria regimen taken, 11-44% of the travellers experienced adverse effects, while four deaths were attributed to the chemoprophylaxis. The incidence of malaria per month of exposure for travellers who took no chemoprophylaxis was 15.2 per 1000 in East Africa and 24.2 per 1000 in West Africa. In East Africa, the prophylactic efficacy of the currently recommended antimalaria regimens (relative to that of no chemoprophylaxis) was zero for a chloroquine dosage of 300 mg base per week (4 malaria fatalities), 64.1% for a chloroquine dosage of 600 mg base per week (P = 0.03), and 94.0% for mefloquine (P = 0.003).

Adult↗
PubMed1990

Closed reduction by two-phase skin traction and functional splinting in mitigated abduction for treatment of congenital dislocation of the hip.

A method of a two-phase closed reduction using longitudinal skin traction followed by abduction was employed by the authors for treatment of children with congenital dislocation of the hip (CDH). Longitudinal traction was used for two to four weeks, depending on the child's age and the degree of dislocation. Traction in abduction required two weeks. Splinting after reduction was used with an intermediate abduction device, which allowed immediate hip function and motion without the risk of redislocation. The results of 1178 treated hips, with follow-up examinations in 809 cases, demonstrate the efficacy of this method even for completely dislocated hips. The procedure is nonaggressive, results in a low incidence of femoral head osteonecrosis (3.4%), and is suitable for children with CDH aged six weeks to about 2.5 years.

Child, Preschool↗
PubMed1989

Beyond 1 year after liver transplantation.

We retrospectively reviewed the long-term results in 46 patients who survived at least 1 year after liver transplantation. Only one death has occurred, and one patient has required retransplantation. Biochemical liver function tests showed median values in the normal range, except for mild elevation of serum gamma-glutamyltransferase. In patients with primary biliary cirrhosis, these test results were completely normal. A liver biopsy 1 year after transplantation disclosed normal histologic findings in 31 patients (67%). The other patients had either transient (acute rejection) or stable (chronic rejection) abnormalities, except for two patients with progressive graft dysfunction attributable to chronic rejection. A clinically significant vascular anastomotic abnormality was noted in one patient who had hepatic artery thrombosis. Late bile duct complications occurred in 15% of patients, all of whom had a satisfactory outcome after surgical or radiologic intervention. Cyclosporine-related nephrotoxicity and hypertension each occurred in 67% of patients; however, conversion to a low-dose cyclosporine-azathioprine regimen yielded stabilization of renal function after the first postoperative year, and hypertension has been easily controlled medically. Diabetes necessitating insulin treatment developed in three patients. The body weight of the study patients had increased by a median of 6.5 kg at 1 year but stabilized thereafter. Subjective well-being and satisfaction with life were reported by 91% of the patients. Of the 46 patients, 26 were employed, 16 were homemakers, and only 4 did not work, 2 because of transplant-related medical problems. Thus, we conclude that liver transplantation rehabilitates patients with end-stage liver disease and enhances their quality of life.

Adolescent↗
PubMed1989

Measurement of human lumbar spine ligaments during loaded and unloaded motion.

Length changes in the ligaments of human lumbar spine motion segments were investigated in order to find conditions under which unusual stress or stress reduction is found in the longitudinal ligaments and facet joint capsules. Flexibility measurements were performed under load. Increasing load and height reduction in the motion segment increases the flexibility. The anterior and posterior longitudinal ligament normally operate in the elastic part of their stress-strain curve. Destruction of the intervertebral disc leads to a dislocation of the centers of rotation in the motion segment. Two types of facet joint capsules were observed. Height reduction in the motion segment leads to abnormal strains in one type sooner than in the other, which can be normalized by slight flexion. Injection of a silicone compound into the disc normalizes many of the changes in the motion segment due to height reduction.

Humans↗
PubMed1989

[Indications and current developments in liver transplantation].

Today, liver transplantation has become a routine treatment in many centres and will be increasingly applied in the future. Principal indications for liver transplantation are endstage chronic liver diseases, namely cirrhoses of various origin, fulminant hepatic failure, metabolic liver disease, and rarely non-resectable malignant tumors of the liver. Clinical and biochemical parameters indicative of the indication for liver transplantation can be stated with greater confidence. Advances in organ preservation with a new cold storage solution (University of Wisconsin solution) and further refinements in surgical technique and immunosuppression with application of multimodal protocols have led to a one-year-survival rate of 70%-80% in experienced centers. Since October 1988, 32 patients underwent liver transplantation in Berlin, currently, 31 patients are alive, while one patient died due to systemic fungal infection.

Carcinoma, Hepatocellular↗