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Biomedical subjects

W Loos

Publications and source records attributed to W Loos.

At least 19 recordsLinked to original sources
PubMed1992

[HELLP syndrome--metamorphosis of pre-eclampsia].

During an eight year period, 100 patients with the diagnosis of pre-eclampsia and HELLP syndrome were treated at the Departments of Obstetrics and Gynaecology of 2 University Hospitals (Technische Universität München and Universität Göttingen). The clinical treatment concepts, which were used in common at the two hospitals, are presented and differ from the common clinical management of pre-eclampsia. The results and therapy concepts are compared and critically reviewed. In recent years, the number of diagnoses and cases of HELLP syndrome has been increasing. Case reports, epidemiological statistics and maternal and perinatal mortality rates indicate a change of the "Gestalt" of preeclampsia due to the HELLP syndrome and its complications.

Adult↗
PubMed1992

[HELLP syndrome].

Explore the source record for details and available documents.

Asphyxia Neonatorum↗
PubMed1992

[The Hellp syndrome. Clinical and laboratory test results].

The Hellp syndrome is a complication of toxemia. It may occur before, during or after childbirth and may not be accompanied by any sign of toxemia. The main clinical sign is pain in the hepatic region. Haptoglobin is the most reliable parameter to demonstrate hemolysis, which is one of the disorders related to this syndrome. In the authors' opinion, early diagnosis and immediate delivery by Cesarean are the appropriate methods to use to reduce maternal and perinatal mortality. Conservative treatment is not generally effective and is dangerous.

Adolescent↗
PubMed1990

A non-pharmacological treatment of vascular headache during pregnancy.

This study investigates the use of biofeedback, relaxation and psychotherapy on five patients with severe, vascular headaches that occurred during the course of pregnancy. The subjects received between four and twelve sessions of treatment overall. The subjects all showed a marked reduction or complete cessation of headaches during treatment, the term of pregnancy, and during a follow-up evaluation months after the birth of the child. Possible alternate explanations for improvement are discussed along with the study's limitations. This preliminary investigation strongly suggests that psychological treatment may be a particularly useful intervention for management of headaches that occur in pregnant women.

Adult↗
PubMed1989

[Measuring fetal vascular resistance with the Duplex scanner--a new fetal stress test].

In 77 women (phi 41 week, less than 7 days before delivery) we compared the resistance index (RI) in the umbilical artery (UA), descending aorta (DA) and intracranial artery (ICA) with an oxytocin challenge test (OCT) and a non stress test (NST). Proof criterias were asphyxia resulting in operative deliveries and metabolic acidosis. The sensitivity in predicting metabolic acidosis was low in all tests, but a high and comparable specificity could be achieved in both the RI and OCT. In predicting fetal asphyxia the RI in the ICA had a high sensitivity, the RI in the UA and DA had the highest specificity of all tests. Centralisation and increased brain perfusion seem to detect fetal asphyxia as a result of placental insufficiency.

Acidosis↗
PubMed1989

[Septic ovarian vein thrombosis--diagnosis and therapy].

Septic ovarian vein thrombosis is commonly the sequela of puerperal purulent endomyometritis. The incidence has been reported to be 1 in 600-6000 deliveries. The predominant location is the right ovarian vein according to the puerperal uterine drainage. The diagnostic and therapeutic experience in 9 cases is described. The leading symptoms were abdominal pain localized at the psoatic muscle and a tender, barrel-shaped tumor. Ultrasound and computed tomography (CT) added in the correct preoperative diagnosis. Antibiotic therapy and anticoagulation are recommended in an uneventful course; in complicated cases surgical intervention becomes mandatory.

Endometritis↗
PubMed1989

[The 10th anniversary of obstetric Doppler sonography--development and perspectives].

Using a review of the literature and own data, the paper describes the methods of obstetrical Doppler sonography, its technical development and its clinical application. The safety standards, physiological changes in vascular resistance and the clinical use of this new method were discussed and compared with the conventional methods. The technical perspective of the method seems to lie with the color flow duplex scanner and the possibility of computerized on-line evaluation. Clinically the method seems to be useful in the early detection of the hypoxic fetus. The Doppler sonography is assessed as an additive but valuable method.

Blood Flow Velocity↗
PubMed1988

[Puerperal ovarian vein thrombophlebitis--a rare puerperal complication].

Puerperal ovarian vein thrombosis (POVT) commonly results from purulent necrotic endomyometritis. The incidence is published to be 1 in 600 deliveries, however, according to own data, the incidence is at least 10 times less frequent. According to the puerperal uterine drainage, the predominant location is the right ovarian vein in 90% of all cases. The leading symptoms are lower abdominal pain localized anteriorly to the psoatic muscle and a tender, barrel shaped unilateral tumor. Discrepancy between the grave clinical picture and the insignificant findings on gyn. examination is common. Ultrasound and computed tomography frequently add in the correct diagnosis. Antibiotic therapy and anticoagulation are recommended in an uneventful course. If clinical improvement is delayed despite non-invasive treatment, surgical intervention with resection of the involved veins and all septic foci becomes mandatory. Despite non-invasive and invasive treatment, pulmonary emboli or septic complication refractory to therapy may contribute to mortality. Therefore POVT should always be included in the differential diagnosis of those patients presenting with a variable fever curve or an unexplained septic course following delivery or miscarriage.

Adult↗
PubMed1988

[Peri-operative preventive use of antibiotics in abdominal hysterectomy].

In patients undergoing abdominal hysterectomy, the efficacy of antibiotic prophylaxis was compared to no treatment. Additional studies on the influence of risk factors such as D&C, conisation and IUD's on post-operative morbidity were evaluated. 144 patients were recruited into the study and prospectively randomised into one of four groups. Groups IV and II received 2 g i.v. Cefotetan and were comprised of patients with or without risk factors, respectively. Similarly, groups III and I, again with or without risk factors, received no treatment and served as the control groups. Infectious post-operative morbidity was significantly reduced in both groups of patients receiving antibiotic prophylaxis, the maximum benefit being observed in those patients with accompanying risk factors. The need for additional antibiotic therapy was highest in those patients receiving no antibiotic prophylaxis, i.e. groups III and I. Additionally if concomitant risk factors were present, the duration of hospitalisation was increased by a further 1.4 days.

Bacteriuria↗
PubMed1988

[Significance of early laboratory diagnosis for obstetrical procedures in severe gestoses and the HELLP syndrome].

HELLP syndrome is a severe complication of preeclampsia, incalculable in its course and involving high risk for mother and fetus. Over a period of three years and eight months a total of 24 patients with HELLP syndrome were treated at Göttingen University Gynecological Clinic and the Gynecological Clinic of Munich Technical University. In all cases the correct diagnosis had already been made by the referring physician or by the obstetrician on admission, taking laboratory parameters into account. The chief clinical symptom was upper abdominal pain, All of the patients presented with thrombocytopenia and elevated liver enzymes. The signs of hemolysis derived from the increased bilirubin concentrations and the LDH; in 13 cases fragmentocytes were detected in the peripheral blood smear. No indications of a pronounced DIG were found. The mean time elapsed between hospitalization and delivery was six hours (0.5-40 hours); 22 patients were delivered within 24 hours. Cesarean section was performed in all cases. The mean gestational age at the time of birth was 35 weeks (25-38). Three of 24 children died prepartially; with the surviving infants no major problems arose in the postnatal course. In 19 cases the abdominal cesarean delivery and clinical course were without complications. Reoperation, in two cases combined with a puerperal hysterectomy, was necessary in three patients, due to subfascial and intraperitoneal or retroperitoneal hematomas.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

[Acute abdomen in gynecology].

The aim of the present study is, to describe the morbidity and mortality of 196 patients with an acute abdominal condition who underwent surgery at the Department of Gynecology and Obstetrics of the TU Munich between 1982 and 1986. This is a percentage of 2.7 of all 7,167 operations carried out during this period. 118 of these patients had an extrauterine pregnancy and were therefore excluded from the study. The second group of 79 patients, mostly with inflammatory diseases, were analyzed. In most of these cases the acute abdominal condition was caused by a tuboovarian abscess (48.1%), followed by peritonitis because of a bowel-disease (11.4%). 6 patients suffered from an abscessing endometritis due to a caesarean section with sepsis in 5 cases. A generalized peritonitis occurred in 5 cases and was treated with a planned relaparatomy with lavage. 63% of the patients had no complications within 28 days after operation, 13% developed a subileus; in 7% a relaparatomy was necessary. 6% of the patients had problems of wound-healing. One patient with stomach-cancer died 3 weeks after the operation because of a fulminant lung-embolism. Thus the mortality rate was 1.5%. A further 27% were treated at the intensive care-unit and 18% needed artificial respiration. The average postoperative period of hospitalisation was 15 days. In comparison, patients with elective operations remained 13 days. The morbidity and mortality of patients due to surgery of an acute abdominal condition was relatively small; postoperative complications could be well treated in all cases and is probably the result of a positive and early indication for surgical intervention.

Abdomen, Acute↗
PubMed1979

A model for duodeno-gastric reflux.

Electric stimulation of the duodenum can produce duodeno-gastric reflux. The functionability of this model was examined by intraluminal manometry, bromsulphtaline reflux and duodenal electrogram.

Animals↗
PubMed1976

[Haemodynamics, oxygen demand and oxygen uptake of the heart during isovolaemic haemodilution (author's transl)].

1. In experiments on 5 closed chest dogs an isovolaemic haemodilution with 6% dextran resulted in a drop of haemoglobin content to 6,4g%. Except for a small decrease of arterial pO2 and O2-saturation the body oxygen supply remained undisturbed. -- 2. According to only very small haemodynamic alterations (except compensatory cardiac output increase) myocardial O2-demand increased very little and mainly is caused by moderate augmentation of ventricular wall tension. The decrease of arterial O2 content was fully compensated by an increase of myocardial blood flow. O2 supply to the myocardium was not critically changed. -- 3. In accordance with other investigators it is concluded that in case of coronary insufficiency or increased myocardial O2 demand intentional hemodilution should be avoided. Patients with myocardial insufficiency considered for therapeutic hemodilution should be digitalized preoperatively.

Animals↗
PubMed1976

[Haemodynamics and tolerance to hypoxia of the myocardium under 6%-oxygen ventilation following acute isovolaemic haemodilution in experimental animals (author's transl)].

1. In experiments on closed chest dogs in a control group and a group of previous isovolaemic haemodiluted dogs a cardiovascular stress was produced by means of reduction of inspiratory O2 content to 6% O2--2. Under haemodilution only small changes of the heart rate, aortic pressure and dp/dtmax occurred, pointing to a decreased sympathoadrenergic response. Augmentation of LVEDP and pulmonary artery pressure is considered to be related to left ventricular insufficiency.--3. According to haemodynamic changes myocardial O2 demand in the control group during hypoxia is increasedby 120% and in contrast remains unchanged after previous haemodilution.--4. Despite the reduced oxygen content under haemodilution severe arterial hypoxemia affects mean survival time of the animals (18.5 min and 21.5 min respectively) only little. However, there is a greater variation from 11 to 26 min in the haemodiluted animals.

Animals↗