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Biomedical subjects

W Rasch

Publications and source records attributed to W Rasch.

18 recordsLinked to original sources
PubMed2000

Influence of a nonionic, iso-osmolar contrast medium (iodixanol) versus an ionic, low-osmolar contrast medium (ioxaglate) on major adverse cardiac events in patients undergoing percutaneous transluminal coronary angioplasty: A multicenter, randomized, double-blind study. Visipaque in Percutaneous Transluminal Coronary Angioplasty [VIP] Trial Investigators.

BACKGROUND: The potential merits and disadvantages of the use of ionic or nonionic contrast media in patients undergoing percutaneous transluminal coronary angioplasty (PTCA) have been the subjects of controversy. The present study was designed to evaluate the possible influence of both types of contrast media on major adverse cardiac events (MACE) in patients undergoing PTCA. METHODS AND RESULTS: In a randomized, parallel-group, double-blind study, 1411 patients received either iodixanol (a nonionic, iso-osmolar contrast medium) or ioxaglate (an ionic, low-osmolar contrast medium) during PTCA. A standardized anticoagulation regimen was followed. Patients were monitored in the hospital for 2 days and followed-up at 1 month. The primary end point, a composite of MACE (death, stroke, myocardial infarction, coronary artery bypass grafting, and re-PTCA) after 2 days, occurred in 4.3% of the total population, with no statistically significant difference between groups (iodixanol, 4.7%; ioxaglate, 3.9%; P=0.45). Further, between 2-day and 1-month follow-ups, no significant difference (P=0.27) existed between the groups in the rates of MACE. Hypersensitivity reactions (P=0.007) and adverse drug reactions (P=0.002) were significantly less frequent in the iodixanol group. The only significant predicting factors for the occurrence of MACE were dissection/abrupt closure and country. CONCLUSIONS: No significant differences were observed between the iodixanol and ioxaglate groups with regard to MACE, although hypersensitivity and adverse drug reactions were significantly less frequent in patients who received iodixanol.

Aged↗
PubMed1993

Vasomotor response of the human face: laser-Doppler measurements during mild hypo- and hyperthermia.

The skin of the face is reputed not to vasoconstrict in response to cold stress because the face skin temperature remains steady during hypothermia. The purpose of the present work was to measure the vasomotor response of the human face to whole-body hypothermia, and to compare it with hyperthermia. Six male subjects were immersed in cold and in warm water to obtain the two conditions. Skin blood flow, evaporation, and skin temperature (Tsk) were recorded in three loci of the face, the forehead, the infra orbital area, and the cheek. Tympanic (Tty) and oesophageal (Toes) temperatures were also recorded during the different thermal states. Normothermic measurements served as control. Blood flow was recorded with a laser-Doppler flowmeter, evaporation measured with an evaporimeter. Face Tsk remained stable between normo-, hypo-, and hyperthermia. Facial blood flow, however, did not follow the same pattern. The facial blood flow remained at minimal vasoconstricted level when the subjects' condition was changed from normo- to hypothermia. When the condition changed from hypo- to hyperthermia a 3 to 9-fold increase in the blood flow was recorded. From these results it was concluded that a vasoconstriction seems to be the general vasomotor state in the face during normothermia.

Adult↗
PubMed1993

Selective brain cooling is affected by wearing headgear during exercise.

The purpose of this work is to relate the concept of selective brain cooling (SBC) during exercise to heat loss from the head while either bare or covered. During hyperthermia, SBC is considered to occur if tympanic temperature (Tty) is lower than esophageal temperature (Tes). In experiment I the head heat loss was measured with and without headgear. Each of four subjects took part in three sessions of exercise on a cycle ergometer. The face was cooled to simulate outdoor conditions. The first session (no headgear) served as control for the two following sessions in which a headband and a woolen cap were worn. Evaporative and radiative-convective heat loss were monitored from the head. Wearing a cap significantly reduced the heat loss from the head compared with the control condition. During the headband session the heat loss was not significantly lower than the control values. Tty, Tes, and head skin temperatures (T(sk)) were also recorded. Tty was significantly lower (-0.55 +/- 0.15 degrees C) than Tes at the end of exercise (150-W exercise load) when no headgear was worn. During headgear sessions, Tty was no longer significantly lower than Tes, either during the headband (-0.15 +/- 0.31 degrees C) or during the cap session (-0.30 +/- 0.13 degrees C). In experiment II the influence of wearing headgear on temperature regulation was studied. Hand skin blood flow, hand T(sk), and heat loss from the hand were recorded in addition to the variables monitored in experiment I. Wearing headgear elevated Tty and peripheral vasomotor responses, whereas Tes evolved in the opposite direction.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Heat loss from the human head during exercise.

Evaporative and convective heat loss from head skin and expired air were measured in four male subjects at rest and during incremental exercise at 5, 15, and 25 degrees C ambient temperature (Ta) to verify whether the head can function as a heat sink for selective brain cooling. The heat losses were measured with an open-circuit method. At rest the heat loss from head skin and expired air decreased with increasing Ta from 69 +/- 5 and 37 +/- 18 (SE) W (5 degrees C) to 44 +/- 25 and 26 +/- 7 W (25 degrees C). At a work load of 150 W the heat loss tended to increase with increasing Ta: 119 +/- 21 (head skin) and 82 +/- 5 W (respiratory tract) at 5 degrees C Ta to 132 +/- 27 and 103 +/- 12 W at 25 degrees C Ta. Heat loss was always higher from the head surface than from the respiratory tract. The heat losses, separately and together (total), were highly correlated to the increasing esophageal temperature at 15 and 25 degrees C Ta. At 5 degrees C Ta on correlation occurred. The results showed that the heat loss from the head was larger than the heat brought to the brain by the arterial blood during hyperthermia, estimated to be 45 W per 1 degree C increase above normal temperature, plus the heat produced by the brain, estimated to be up to 20 W. The total heat to be lost is therefore approximately 65 W during a mild hyperthermia (+1 degrees C) if brain temperature is to remain constant.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Reduced systolic blood pressure elevations during maximum exercise at simulated altitudes.

Ten healthy female subjects performed maximum exercise on a bicycle in an altitude chamber during normoxia and hypobaric hypoxia simulating altitudes of 2,450, 3,700 and 4,600 m. The increases in systolic blood pressure responses were reduced with the degree of hypobaric hypoxia, whereas heart rate and diastolic pressure responses were unchanged. The increases in blood levels of aldosterone, plasma renin activity, adrenaline, noradrenaline, neuropeptide-Y and vasoactive intestinal peptide were similar at the different simulated altitudes. Angiotensin-converting enzyme and vasoactive intestinal peptide levels were not affected by hypoxia or maximum exercise. The present results suggest that the decreases in systolic blood pressure responses during hypobaric hypoxia could not be explained by altered responses of the measured vasoactive substances from the renin-angiotensin, gastrointestinal, and autonomic nervous systems.

Adult↗
PubMed1986

[Commitment prerequisites according to paragraph 64 of the German penal code].

Article 64 of the Penal Code of the Federal Republic of Germany provides for the commitment of alcohol and drug addicts to special institutions if further severe offences are to be expected due to their addiction. The measure of correction cannot be applied if treatment endeavours are given no chance. As the lack of compliance very often only appears in the course of the treatment, an amendment was made which added a new article. According to the new legal regulations, the measure of correction can be annulled after one year of detainment if the addict shows no aptitude for the therapy. The new regulation implicates an intensification of the therapeuticts role conflict, which is based on the fact that coerced therapy was little chance to be successful. Before establishing the deficient therapeutical capability of a patient, it should be conscientiously verified how far a team conflict or an insufficient therapeutical offer determines the decision. It should be considered that possibly one only wants to get rid of a troublesome patient.

Alcoholism↗
PubMed1985

[Segregation of psychiatrically ill offenders in specialty clinics--the end of the deportation game?].

Forensic psychiatric institutions (mentally ill offenders) have not developed according to the recommendations of psychiatric experts as suggested in the 'Psychiatric Enquete'. Paragraph 65 StGB with its provisions was eliminated from the penal code on the 1. Jan. 1985, hence independent social-therapeutic institutions will not come into existence in the FRG. Taking the current institutional conditions into account the authors investigate the chances and possibilities of client-orientated treatment.

Alcoholism↗
PubMed1983

[Inclusion of psychiatric-psychologic diagnoses among the 4 psychiatric symptoms of irresponsibility in articles 20 and 21 of the West Germany criminal code].

The reform efforts in the Federal Republic of Germany after the end of the war have led to a reformation of the regulations concerning legal responsibiltiy. The new law enumerates in articles 20 and 21 as prerequisites of irresponsibility or diminished responsibility for concepts: pathological psychic disturbance which comprises all psychic diseases like schizophrenia and manic-depressive states as well as psychic alterations resulting from brain damage. The second term is feeble-mindedness. The third one is profound disturbance of consciousness which refers to states of strong mental agitation not caused by an illness. Finally the new law used the concept of sever other mental abnormalities. Rather unfortunately the law has introduced the German expression "Abartigkeit" which has a derogatory tinge, insinuating the idea of degeneration. The adjudgment of irresponsibility or diminished responsibility does not depend on the type of psychiatric diagnosis. The new regulations offer the chance to psychiatry to take on more therapeutic responsibilities for mentally disturbed offenders.

Forensic Psychiatry↗
PubMed1983

[Criminologic aspects in the treatment of sex offenders].

The conditions determining statutory offences as represented by indictable sex offences, have been amended and revised by the 4th Penal Reform Law of the Federal German Penal Code, in 1973, under the heading "Indictable Offences against Sexual Self-Determination". This heading, which is meant to convey a programme, however, does not agree with the actual contents or core of various paragraphs. These new statutes have been violently criticised by opponents coming from quite different camps. The development of sexual delinquency shows a rather decreasing crime rate since the end of World War II, compared to the increase in other categories of crime. The most frequently recorded sexual offences concern the performance of sexual acts with children, rape and exhibitionism. It is in these groups of criminal offences that we are most likely to find delinquents in whom psychotherapy seems indicated. Criteria for indicating such treatment are the desire of the person in question to receive treatment, and the presence of a personality disturbance; it is not the deed by itself. The article then cites the paragraphs under German penal legislation which are important when arriving at a decision to refer a delinquent to psychotherapeutic treatment; these are Sections 56 c, 63, 64 German Penal Code, Section 10 Penal Code for Adolescents, and Section 9 of the Federal Law Enforcement Act.

Commitment of Persons with Psychiatric Disorders↗
PubMedDate not supplied

Injection-associated pain in femoral arteriography: a European multicenter study comparing safety, tolerability, and efficacy of iodixanol and iopromide.

PURPOSE: To evaluate injection-associated pain, safety, and efficacy with the isotonic contrast medium iodixanol (Visipaque 270 mg I/ml) compared with iopromide (Ultravist 300 mg I/ml) in femoral arteriography. METHODS: A multicenter, double-blind, randomized, parallel-group clinical investigation was carried out in 54 hospitals in Europe. Of the patients evaluated, 1225 received iodixanol and 1227 iopromide in conventional and/or digital subtraction angiography. RESULTS: The iodixanol group reported statistically significantly less injection-associated pain (0.9%) than the iopromide group (9.5%) (p << 0.001). Further, 4.1% in the iodixanol group experienced pain and/or severe heat sensation vs 19. 8% in the iopromide group (p << 0.001). In the iodixanol group, 1.8% of the patients experienced contrast-related adverse events vs 2.4% in the iopromide group (p = NS). Overall diagnostic information was optimal for 94.1% in the iodixanol group and 95.3% in the iopromide group (p = NS). CONCLUSIONS: Iodixanol 270 mg I/ml causes significantly less injection-associated pain during femoral arteriography and is as safe and efficacious as iopromide 300 mg I/ml.

Aged↗