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Biomedical subjects

W Kamke

Publications and source records attributed to W Kamke.

9 recordsLinked to original sources
PubMed2003

Cardiac rehabilitation in patients with implantable defibrillators. Feasibility and complications.

OBJECTIVE: We examined patients with implantable cardioverter defibrillators (ICD) in order to demonstrate their safe participation in a standard rehabilitation program. DESIGN: Prospective cohort study of a consecutive series of patients after ICD implantation. Setting Inpatient rehabilitation center. PATIENTS AND METHODS: A total of 118 patients (73.7% male, mean age 60+/-11 years) took part for 23 +/- 4 days in a standard inpatient rehabilitation program including physical activity, psychological care, heart function seminars, and resuscitation exercises with family members. The following noninvasive tests were performed: symptomlimited exercise testing, two-dimensional echocardiography, Holter monitoring, telemetric ICD interrogation, optional fluoroscopy or X-ray examination of the thorax, and (in some patients) defibrillation threshold testing. RESULTS: Out of 118 patients 101 patients (85.6%) participated in regular ergometer training during which the initial workload of 23 +/- 11 Watts could be increased to 45 +/- 18 Watts. An individual conditioning program was assigned to 15% (n = 17) patients, thereby enabling the inclusion of all patients in the rehabilitation process. Under these conditions 12 patients (10%) experienced ICD malfunctions requiring therapy. As a consequence of all cardiac function tests, ICD reprogramming was necessary in 26 patients (22.1%). CONCLUSION: Following ICD implantation, patients may participate in a standard rehabilitation program without serious complications and with a significant increase in physical capacity. However, ICD malfunction occurs in approximately 10% of patients. Additional tests performed by skilled medical staff and appropriate technical equipment allows the ICD program to be optimized.

Aged↗
PubMed1999

Hemodynamic effects of double bolus reteplase versus alteplase infusion in massive pulmonary embolism.

BACKGROUND: Thrombolytic agents are given in massive pulmonary embolism to dissolve or reduce the clot and normalize hemodynamics. Comparative clinical studies have shown that administration of a 2-hour infusion of alteplase is more effective than urokinase over a 12-hour period. Reteplase is a new generation thrombolytic with a longer half-life that can be administered more conveniently as a double bolus. We compared efficacy and safety of reteplase with the approved regimen of alteplase in massive pulmonary embolism. METHODS: Thirty-six patients were enrolled and randomly assigned: 23 received reteplase and 13 received alteplase along with intravenous heparin. Reteplase was administered as 2 intravenous bolus injections of 10 U 30 minutes apart, and alteplase was administered as an intravenous infusion of a total dose of 100 mg over a 2-hour period, including an initial 10-mg bolus. Diagnosis of pulmonary embolism was confirmed by selective pulmonary angiography. Hemodynamic monitoring was conducted during the first 24 hours after administration. The primary end point was change in total pulmonary resistance. Secondary variables were pulmonary pressure, cardiac index, clinical parameters, and adverse events. RESULTS: The primary parameter of total pulmonary resistance showed a significant decrease after just 0.5 hours in the reteplase group and after 2 hours in the alteplase group, with a further decrease persisting for up to 24 hours in both treatment groups. A similar pattern was seen in other directly measured hemodynamic parameters, especially mean pulmonary artery pressure and cardiac index; there was no significant difference between reteplase and alteplase. There was also no apparent difference between the treatment groups with respect to safety, and no stroke or intracranial hemorrhage occurred. The rate of bleedings and the incidence of nonhemorrhagic adverse events were as expected for patients with pulmonary embolism treated with a thrombolytic agent. CONCLUSIONS: Reteplase is suitable for treatment of massive pulmonary embolism with a standard double bolus 10 + 10 U. Efficacy of reteplase appeared to be at least as good at decreasing pulmonary vascular resistance as that of the approved alteplase regimen of 100 mg infusion over a 2-hour period.

Adult↗
PubMed1992

Facilitation of DDD follow-up using the DDT mode.

To facilitate follow-up, modern dual chamber pacemakers provide a variety of diagnostic features like ECG interpretation channels and intracardiac electrograms. For evaluation of the sensing performance at rest and during exercise, for assessment of the presence of crosstalk, and for measurement of the retrograde conduction time, dual chamber triggered pacing, particularly the DDT mode, can be used alternatively or additionally in pacemakers equipped with this option. In contrast to ECG interpretation channels, ECG documentation is not required for evaluation of the sensing performance, because the triggered pulses serving as markers for sense events can also be seen on the monitor. Selection of the DDT mode not only as temporary but also as permanent program serves to facilitate pacemaker ECG interpretation for exercise tests and Holter recordings as well.

Cardiac Pacing, Artificial↗
PubMed1983

[ Food allergy ].

Food allergies' following food incompatibilities, which are not caused immunologically. Mostly allergic symptoms are caused by cow's milk or chicken eggs. Allergic reactions are preceded by sensitizing events; certain characteristics of foodstuffs and conditions in the human body facilitate their development. Gastrointestinal symptoms very often are just accompanying signs. In differential diagnosis the so-called "pseudo-allergies' following food ingestion have to be separated. Most important diagnostic measures are clinical history, prick-/scratch test, RAST, gastrointestinal provocation and abstinence test. The therapeutic program consists of allergen abstinence, avoiding all allergy-arousing factors, oral desensitizing and pharmaceutical treatment.

Allergens↗