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Biomedical subjects

U N Dürst

Publications and source records attributed to U N Dürst.

7 recordsLinked to original sources
PubMed1991

[Myocardial infarction in pregnancy].

Myocardial infarction during pregnancy and puerperium is very rare. Increased awareness of its possible occurrence is important for diagnosis. We report on a 37-year-old woman without coronary risk factors who suffered an anterior septal infarction in the last trimester. Coronary angiography one month after normal delivery and two months after infarction revealed normal coronary arteries. Ventriculography showed anteroseptal akinesia. The assumed etiology of myocardial infarction appears to be coronary spasm. A history of vasospasm in other vascular beds, migraine and Raynaud's phenomenon support this hypothesis. The literature is reviewed with special emphasis on clinical picture, prognosis, etiology and management of myocardial infarction during pregnancy.

Adult↗
PubMed1991

[Cardiological diagnosis in arterial embolism].

Potential cardiac sources of arterial embolism are in particular thrombi within the left atrium or ventricle, or attached to a prosthetic valve, intracardiac tumors, and vegetations due to endocarditis. Patent foramen ovale and atrial septal defect may lead to paradoxical embolism, and spontaneous echo contrast within the heart has to be considered as a parameter of increased thromboembolic risk. In rare cases, atrial septal aneurysm, mitral valve prolapse or annulus calcification and calcified aortic stenosis has to be taken into consideration. Current method of choice for diagnosis of these abnormalities is echocardiography. When the transthoracic approach fails, transesophageal echocardiography (TEE) leads to a definite diagnosis in most cases. Precordial echocardiography allows the detection of left ventricular thrombi with a sensitivity ranging between 72 and 95%, and monoplane TEE does usually not increase these numbers. In contrast, thrombi within the left atrium and particularly in the left atrial appendage can be detected with a significantly higher detection rate when TEE is used. The same is true for spontaneous echo contrast in the left atrium, a phenomenon which is almost exclusively diagnosed by TEE, as well as for endocarditis associated vegetations that can be identified by TEE with a sensitivity higher than 90%. Patient foramen ovale is usually diagnosed by precordial contrast echocardiography combined with a Valsalva maneuver; color Doppler or contrast TEE allows to increase the detection rate. In the diagnosis of prosthetic valve attached thrombi and vegetations, TEE is clearly superior compared to the precordial examination, at least concerning prosthetic devices in mitral position. If echocardiography fails to identify a potential cardiac source of embolism, other techniques don't add significant information in most cases. Detection of a potential source of embolism, however, does not necessarily prove that the particular finding represents the true etiology of an embolic event; results of all clinical and technical examinations have to be evaluated in a critical synopsis. In addition, proper therapeutic consequences in quite a number of abnormalities considered as potential cardiac sources of embolism are not yet defined.

Echocardiography↗
PubMed1991

[Micrococcus luteus: a rare pathogen of valve prosthesis endocarditis].

A rare case of prosthetic valve endocarditis caused by Micrococcus luteus is described and compared with the few cases reported in the literature, as well as the clinical features, microbiological profile, therapy, and prognosis of common prosthetic valve endocarditis. Micrococcus luteus is a constituent of the normal human buccal bacterial flora which forms yellowish colonies and appears as a gram-positive coccus typically arranged in tetrades. Although of low virulence, the germ may become pathogenic in patients with impaired resistance, colonizing the surface of heart valves. In contrast to staphylococci (for which it may easily be mistaken) it is usually penicillin-sensitive. However, the most promising antibiotic regimen proposed for treatment of Micrococcus luteus seems to be a combination of vancomycin, amikacin, and rifampicin. If the infection leads to severe hemodynamic alterations, however, valve replacement may become necessary similar to the situation in prosthetic valve endocarditis caused by more aggressive and highly resistant bacteria.

Aged↗
PubMed1988

[Post-traumatic hypoliquorrhea syndrome].

A case of traumatic low pressure headache syndrome after a fall on the buttocks is described. This rare syndrome is probably caused by unusual cerebrospinal fluid leakage. The headaches are characterized by accentuation in the erect position and relieved by recumbency, and may be associated with nausea, vomiting, dizziness, photophobia and vertigo. Carefully executed lumbar puncture in the lateral recumbent position shows absent CSF pressure and even spontaneous aspiration of air through the lumbar puncture needle. Intracranial air resulting from puncture may be demonstrated on routine roentgenogram. In computed tomography the syndrome is associated with extremely small ventricles and tight basal cisterns. Management consists in bedrest and fluid substitution.

Accidental Falls↗
PubMed1986

[Anthrax meningitis].

Anthrax meningitis may complicate cutaneous, inhalation, or gastrointestinal anthrax, although it occurs in less than 5% of patients. Between 1935 and 1985 60 cases of human anthrax were notified in Switzerland. This report of a fatal case in a 54-year-old woman is the third case of inhalation anthrax and the second of meningeal complication with cortical hemorrhages in our country. There was no known source of infection. The clinical, microbiological and histopathological profile, therapy and prognosis are presented.

Anthrax↗
PubMed1986

[Toxic epidermal necrolysis (Lyell syndrome)].

Toxic epidermal necrolysis, a serious allergically triggered skin reaction, has a mortality of about 30% largely due to internal diseases. The management involves several specialties. Clinical picture and therapy are described in a case probably induced by allopurinol, with 70% involvement of body surface.

Aged↗