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Biomedical subjects

S Lampe

Publications and source records attributed to S Lampe.

12 recordsLinked to original sources

[Typical forms of choriocarcinoma in clinical practice--diagnosis and therapeutic course in four patients].

The paper reports on four patients with choriocarcinoma. In two of them, the choriocarcinoma was found after abortion, in one of them following termination of pregnancy, and in the last patient a hydatidiform mole was present. In all patients increased beta-HCG was found. One patient had lung metastasis at the time of diagnosis. In another patient, choriocarcinoma was suspected owing to ultrasonographic vaginal examination. According to the Bagshawe Score, 3 patients were low-risk and were subjected to methotrexate. One patient was medium-risk and received PEB chemotherapy. All four patients are regarded as cured.

Abortion, Induced↗

[Clinical results of pulse oximetry sub partu for measuring fetal arterial oxygen saturation].

By means of reflexion pulse oximetry the arterial oxygen saturation (SpO2) of 100 fetuses intrapartum was measured in a high-risk group and compared with clinical parameters. There is a connection between the duration of SpO2 measurements below 30%, the delivery mode and reduced pH-values in the umbilical artery measured post partum. SpO2 values below 30% also occur temporarily with uneventful deliveries but they occur with increased frequency within the group of operatively delivered children with a duration of more than 20 minutes. On the other hand the group with SpO2 values ranging between 40 and 60% showed less operative deliveries and a better condition of the newborn (Apgar, pH-metry). If prognostically unfavourable additional criteria with variable decelerations increase, a tendency towards decreasing fetal oxygen saturation values is recognisable. In the case of suspicious heart rate patterns or patterns difficult to assess the continuous registration of saturation values is both medically and forensically of inestimable value. There were no increases in fetal morbidity or signs of amnion infection syndrome. By means of a new sensor, a longer registration time with a reliable signal quality is achieved, so that assessment of the oxygen saturation in relation to labour activity becomes possible.

Acid-Base Equilibrium↗

[Chorioangiomatosis of the placenta--diagnosis and obstetrical management].

Chorioangiomas are the most common benign tumors of the placenta. The pathologist is able to recognize these tumors in 1% of all examined specimens, but 80% of them are small and of no clinical significance. The larger chorioangiomas are very rare and often associated with complications such as placental abruption, fetal anemia, premature labor and preterm delivery. Early diagnosis of such a large placental tumor is necessary for the obstetrician to adjust the management of pregnancy to reduce fetal and maternal mortality and morbidity. We present a case of multiple placental chorioangiomas, in which the largest was 8 cm in diameter, detected in the 33rd week of pregnancy and associated with polyhydramnion and fetal anemia because of fetomaternal transfusion. Early diagnosis and well-timed delivery avoided severe complications for mother and neonate.

Adult↗

The role of the head nurse in primary nursing.

Primary nursing brings about changing roles, responsibilities, and communication patterns for all members of the health care team. The head nurse, as she introduces new staff to primary nursing and its day-to-day applications, is in an ideal position to generate enthusiasm for the goals of the concept. In attempting to implement this new care pattern, she must continually promote the philosophy behind it by her support and recognition of its principles. In the long run, it is the positive attitude and high motivation of the head nurse that will determine the success or failure of the program wherever it is introduced.

Humans↗

[Empirical report on acute twin-twin transfusion syndrome with single intrauterine death].

We report on a case of acute twin-twin transfusion syndrome in a twin pregnancy in the 26 th under primarily unclear conditions. On admission to the hospital, one fetus was not showing signs of life anymore, while the Doppler indices and CTG of the living fetus showed signs of acute distress. On the scan both fetuses showed adequate and symmetric growth as well as symmetric and normal amniotic fluid amounts, indicating a lack of typical signs for chronic twin-twin transfusion syndrome. The emergency cesarean section performed under the assumption of acute twin-twin transfusion syndrome, which unfortunately could not save the second twin, confirmed our suspected diagnosis.

Adult↗

[Nuchal translucency measurement--an effective method for early recognition of fetal disease?].

BACKGROUND: In recent years, an increasing amount of experience has been collected in measuring the nuchal translucency (NT) of the fetus in early pregnancy. While all fetuses develop a measurable collection of fluid in the area of the neck between the 11th and 14th weeks of pregnancy, the fact that fetuses with chromosomal disorders, cardiac defects, and syndromal diseases, in particular, reveal an above-average incidence of increased NT has been noticed. OBJECTIVE: By processing our own patient data from the past two years, we intend to elucidate the question of whether NT measurement is a sensible investigation for the early detection of fetal problems. PATIENTS AND METHOD: NT measurements were carried out in 199 fetuses; these measurements were standardized according to the guidelines of the Foetal Medicine Foundation in London, in whose multicentric study we are participating. The patients were under the care of our prenatal diagnosis and therapy department and were referred to us from external sources. RESULTS: NT within the reference range was determined in 152 fetuses; NT exceeded the reference value in 47 fetuses. Of those fetuses with increased NT, 7 fetuses revealed a chromosomal anomaly, 1 foetus was suffering from a cardiac defect, 3 fetuses were suffering from other organ abnormalities, and 3 fetuses were determined to be suffering from syndromal disease. None of the fetuses whose NT measurements were within the reference range was discovered to be suffering from any of the above-mentioned problems. CONCLUSION: Even this relatively small group of patients reveals that NT measurement is a very effective filter for detecting certain fetal diseases during the early fetal period.

Abnormalities, Multiple↗

TAT results in a longitudinal study of bereaved college students.

The authors analyzed projective data obtained from 141 college students who wrote stories on three separate occasions to selected cards from the Thematic Apperception Test (TAT). The students included 46 members of support groups for bereaved college students, 34 members of a bereavement control group, and 61 nonbereaved students. The study used a repeated-measures pretest-posttest control group design to gather longitudinal data about the trajectory of bereavement with and without support group intervention. Coders, who reached consistently high interrater reliability, looked for themes of death, grief, coping, and affiliation in the stories. Multivariate analysis of variance (MANOVA) and repeated-measures MANOVA tests were applied to analyze coding results. Overall MANOVA results indicated significant group differences in the responses to the TAT cards. Repeated-measures MANOVA found group differences in use of themes of death and grief and found Group x Time differences in maintaining a sense of self-efficacy while in a crisis. A majority of the stories contained affiliation imagery but without any group differences in the use of such imagery.

Adolescent↗

[Terminal CTG as an expression of high degree fetal distress--1 case reports].

The cases of two patients, in whom conspicuous CTGs with restricted oscillation and late decelerations were registered in the final trimester of pregnancy, are presented. Following immediate hospitalisation and the rapid execution of a caesarean section, two depressed, severely acidotic neonates were born. Whilst the course of the pregnancy in the first case had been completely inconspicuous up to that point, and the acute occurrence of placental insufficiency must be assumed, the second patient was subject to pregnancy-induced hypertension with discrete foetal growth retardation. It is shown that two almost identical pathological CTG registrations may have different causes but that one must assume a high degree of sub partu risk to the child on the occurrence of a terminal CTG witch is characterised by line-shaped oscillation, possibly in combination with late decelerations.

Adult↗

[Fetal pulse oximetry sub partu: on morbidity of infection and acceptance in intrapartum monitoring].

156 mothers and their newborns (Group A), whose deliveries were monitored using cardiotocography and fetal pulse oximetry, were investigated during and after delivery regarding amnioninfection as well as changes in morbidity und compared to matched controls (Group B). The parameters observed were temperature during labor and delivery and after delivery, infection parameters of mother and baby, bacterial smears of the vagina before placement of the oximetry sensor and smears of the sensor tip when the evaluation was concluded. An amnioninfection syndrome was registered twice in group A and three times in control group B. In 22 cases the evaluation of the smears showed an increase of bacterial growth or additional bacteria, but in no case an amnioninfection syndrome was noted. Three of the newborns in Group A who had an infection after delivery showed negative bacterial smears from the sensor tip. The temperatures of the mothers during and after delivery in Group A were not significantly different from Group B. The results show that the intrauterine application of a sensor even for longer periods of time does not result in an increase of maternal or fetal infection morbidity during labor and delivery and after delivery. In addition, 65 patients were evaluated with an anonymous questionnaire after delivery regarding their acceptance of this new method. 88% of the patients were satisfied with the procedure and stated that they felt an additional sense of security through this supplementary method.

Adult↗