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Biomedical subjects

T Fuchs

Publications and source records attributed to T Fuchs.

At least 91 records · Page 5Linked to original sources
PubMed1991

[Role of benzodiazepines in neuroanesthesia].

For the induction of anesthesia in neurosurgical patients, the choice between thiopental and midazolam cannot be done on the basis of their respective cardiovascular, respiratory or cerebral effects, since they are similar. Among the advantages of midazolam are the absence of histamine release and excitatory effects. On the contrary the onset and the duration of action as well as the intensity of sedation are less predictable with midazolam when compared to thiopental. Therefore thiopental remains the first drug of choice in this clinical setting. For preoperative sedation in neurosurgical patients, the use of benzodiazepines should be limited, since they can induce respiratory depression mainly in patients with cranial trauma or with chronic obstructive pulmonary disease. The preoperative administration of a benzodiazepine in neurosurgical patients who are under chronic treatment should be decided individually, according to the level of the conscience of the patient and on the half life of the drug.

Anesthesia, Intravenous↗
PubMed1991

[Time perspective in the treatment of elderly depressed patients].

Coping with depressive illness in old age is impeded by particular strains: an increasing incidence of loss events, physical constraints, lack of social support and narrowing prospects for the future may lead to relapse as well as retarded recovery or chronification. Treatment directed toward long-term rehabilitation therefore requires, in addition to medical measures, psychotherapeutic and social interventions which help the patient cope with past loss, solve current problems and open up new perspectives for the future. This integration would overcome a dichotomy, still prevalent in psychotherapy for the elderly, between retrospection and life review on the one hand, activation and extension of competence on the other--or "involution" versus "evolution". A therapeutic approach which thus integrates personal aspects of the past, present and future may also combine various methods such as reminiscence therapy, interpersonal therapy, behavioral and social interventions.

Adaptation, Psychological↗
PubMed1990

Role of the sympathetic nervous system in the genesis of ventricular arrhythmia.

Activation of the sympathetic nervous system is an important factor in the genesis of ventricular arrhythmias in patients with impaired ventricular function. Such patients have an appropriate substrate that is capable of generating rhythm abnormalities, which may be related to enhanced automaticity, triggered automaticity, and reentrant mechanisms; all three mechanisms are markedly potentiated by the action of catecholamines. Additionally, the sympathetic nervous system can provoke the development of hypokalemia and ischemia (which can independently lead to the occurrence of rhythm disturbances), and catecholamines may negate the beneficial electrophysiological actions of antiarrhythmic drugs. A substantial amount of experimental data implicates the sympathetic nervous system as a potent stimulus for ventricular tachyarrhythmias and sudden cardiac death, especially in the setting of myocardial ischemia. Two important mechanisms that have been identified include 1) enhanced sympathetic outflow from the central nervous system and 2) nonuniform myocardial denervation resulting in beta-receptor up-regulation and catecholamine hypersensitivity in the infarct zone. Disruption of sympathetic neural innervation of the heart and the use of beta-blocking agents may reduce the occurrence of sudden death and improve survival in animal models of arrhythmias and in some subsets of patients, including those with the long QT syndrome, a recent myocardial infarction, and perhaps those with a cardiomyopathy. The mechanism of this beneficial effect remains to be defined.

Adrenergic beta-Antagonists↗
PubMed1990

[Contact allergies to CN and CS ("tear gas") in participants in demonstrations].

56 occasional demonstrators were interviewed with regard to former skin contact with omega-chloroacetophenone (CN) or ortho-chlorobenzylidene malononitrile (CS). 33 persons (59%) reported skin reactions of various kinds. Patch testing with CN, the structurally related preservative chloroacetamide, and CS revealed clinically relevant reactions to CN in 3 cases and questionable positive reaction to CS in one case. 8 further patients showed mild reactions to CN and CS. We did not find any indication of cross reactions between CN and chloroacetamide.

Adult↗
PubMed1990

[Contact urticaria caused by rubber gloves].

We present 9 patients with contact urticaria due to rubber gloves. Others have reported an increasing incidence of the disease among females, patients with atopic dermatitis, and hospital personnel. Our data confirm these results. Scarification with water, in which the suspected glove was incubated, is a simple diagnostic method, both reliable and cheap, in order to test the solubility of the allergen(s) in water. In one of our patients, we proved a type-I allergy caused by tetramethyl thiuram disulfide.

Adult↗
PubMed1989

[Contact allergies caused by bufexamac].

Between 1983 and 1987, there were 24 cases of contact allergy due to bufexamac seen at the Dermatological Hospital of the University of Göttingen. Of these patients, 20 were female und four male. It was noticeable, that the course of disease was particularly protracted and refractory: 16 of 22 patients were hospitalized with an average duration of inpatient treatment of 2.9 weeks. Seven patients had a generalized allergic contact dermatitis. Five patients had used topical preparations containing bufexamac for only one week or less. In 15 of 24 patients, further epidermal sensitization could be found. In all forms of eczematous diseases, especially in patients with chronic eczema, contact allergy to bufexamac should be considered, even if bufexamac preparations were used for only a short time.

Administration, Topical↗
PubMed1989

Role of Ca2+ and Mg2+ for endothelial permeability of water and albumin in vitro.

The permeability of endothelial monolayers grown on a polycarbonate filter membrane and continuously exposed to a hydrostatic pressure of 10 cm H2O was studied. The ionophores A23187 and ionomycin dose dependently (0.1-10 microM) enhanced the hydraulic conductivity of sealed endothelial cell monolayers 10 to 15-fold, at the same time the reflection coefficient of albumin dropped from 0.75 to 0.2. The effects of A23187 were dependent on extracellular Ca2+. In the absence of Ca2+, however, Mg2+ could substitute for Ca2+. Phase contrast- and scanning electron-microscopy showed that the A23187-induced effects were accompanied by gap-formation in the intercellular clefts. These gaps probably are the sites which allowed enhanced fluid exchange. Ionophore-induced effects on permeability could be modified by antagonists of calmodulin function and of arachidonate liberation and metabolism. The data suggest that alterations of endothelial Ca2+-homeostasis induce metabolic events which result in an increased permeability of an endothelial monolayer.

Albumins↗
PubMed1989

Clinical application of a human-collagen fleece as haemostatic agent.

Local haemostatic agents have been employed for years in all surgical fields. Collagen has proved superior to other materials in terms of its haemostatic effect and good tolerability. A human-collagen fleece (Beristypt) is now available for the first time. A special manufacturing process excludes the possibility of human-pathogenic viruses being transmitted. The good clinical efficacy of human-collagen fleece for the indication haemostasis and the fact that it is easy to use, have been demonstrated in 63 operations in four surgical fields. Human-collagen fleece was well tolerated; no adverse effects were reported. The use of human-collagen fleece is a promising adjuvant method for improvement of surgical haemostasis.

Adolescent↗
PubMed1987

[Treatment of acute intermittent porphyria with a new protein-bound lyophilized hematin].

Hematin (iron-III-protoporphyrin 9) has been used for several years in the treatment of acute attacks of inducible porphyrias. Three patients were treated with a new, albumin-bound lyophilized hematin preparation (manufactured by Behringwerke). In all patients it achieved a reduction in the urine of the porphyrin precursors porphobilinogen and 5-aminolevulin acid. In two patients the clinical symptoms were clearly improved, while a third patient died with tetraparesis. Hematin administration proved superior to the preceding glucose treatment. No abnormality of clotting or thrombophlebitis was detectable after hematin infusion.

Acute Disease↗
PubMed1987

Application of the first international standard of Dermatophagoides pteronyssinus (house dust mite) in the evaluation of allergen extracts produced from two different source materials.

The first international standard (IS) of the house dust mite Dermatophagoides pteronyssinus was used to compare side-by-side two allergen extracts prepared from two different house dust mite sources, namely whole mite cultures (WMC) and purified mite bodies (PMB), by employing several biochemical and immunochemical methods. In most methods employed, IS and WMC resembled more to each other than to PMB. These similarities comprehend protein contents, protein patterns, antigen and allergen patterns as well as total in vitro activity obtained in RAST inhibition (RI). The differences between WMC and PMB could be reproduced in different batches. Standardization in relation to IS of D. pteronyssinus yields activity ratios ranging from 2.4 to 70.1 between WMC and PMB depending on the variation of RI employed, indicating quantitative differences between the two preparations. When coupled to BrCN activated paper disks and employed in direct RAST, both preparations yielded almost identical binding values of specific IgE. Also in skin prick test, WMC and PMB produced very similar results in 12 mite-allergic patients. It was not possible to differentiate between the two preparations when used in concentrations which are usually employed for diagnostic purposes. These findings demonstrate the diversity of allergens in mite extracts derived from different sources and reveal the problems which are involved with the use of the WHO D. pteronyssinus IS.

Allergens↗
PubMed1987

A prospective study of Chlamydia trachomatis infection following legal abortion.

In a prospective study, 288 women were tested for Chlamydia trachomatis (CT) in the cervix prior to legal abortion. In the control group (n = 259), CT culturing was carried out only when postoperative infection was suspected. CT was isolated in 14.2% of asymptomatic women. These patients were treated preoperatively with Doxycycline. In this group, no cases of postoperative infection were detected. Among those cases where CT was not detected, 4.9% contracted the infection, while in the control group the rate of infection was 9.7%. In the control group all the infections due to CT gave late symptoms after the operation (1-4 weeks).

Abortion, Induced↗
PubMed1984

[Dirt tattooing following an explosion in a chemistry class].

Traumatic tattooing following an explosion can generally be removed by rubbing with a hard-bristle handbrush within 48 h after the accident occurs. This measure failed, however, in the case of a pupil with extensively dispersed granular material in the face. The patient had mixed approximately 5 g of potassium permanganate and red phosphorus together during a chemistry lesson (!), thereby causing an explosion. A conservative treatment of applying compresses moistened with a sodium bicarbonate solution led to healing without scars.

Adolescent↗
PubMed1983

The A-rod--a new possibility for cervical dilation and/or induction of uterine contractions for abortion or delivery by combined pharmacological and mechanical action.

A hydrogel compound (Sauflex, Special Polymers Ltd., London) which has the capacity to swell by absorbing surrounding fluid, was found to be capable of absorbing prostaglandins (PGE1, PGF2 alpha) in alcohol or saline during this process. After evaporation of the hydratized hydrogelic compound which restored its initial proportions and stiffness, rehydratization of the hydrogelic compound caused it to release the respective prostaglandin to the surrounding medium or tissues. The endocervical canal of first-trimester abortions was dilated by plain mechanical action of a rod-shaped hydrogel body (A-rod) inserted in the cervical canal. By loading the A-rod with PGF2 alpha (2-110 mg) the cervical canal was additionally widened and abortive contractions were elicited in the uterus. Further implications of the medical use of the A-rod are discussed.

Abortion, Induced↗