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At least 397 records · Page 22Linked to original sources
PubMed2001

[Continuous stroke volume monitoring as "hemodynamic online monitoring" in polytrauma intensive care patients: technically possible--clinically necessary?].

PURPOSE: Is the measurement of continuous cardiac output useful for the management of polytrauma patients? METHODS: In a prospective non randomized study (ethic commission file 43/96) we evaluated the diagnostic and therapeutic impact of the CCO (continuous cardiac output measurement) for polytrauma patients on the ICU. The Baxter Vigilance System was used for measuring the continuous cardiac output. The CCO values were controlled once a day by the conventional "cold" thermodilution technique. RESULTS: All values are given as mean +/- standard deviation. The Patients were scored on the first day for ISS (injury severity score) (47 +/- 17) and APACHE II (15 +/- 5). The CCO was used no later than 12 hours after the initial treatment in 20 polytrauma patients. As clinical outcome parameters were chosen: days on ventilation (23 +/- 23 days), days on the ICU (31 +/- 26 days) and mortality (20%). The treating ICU physicians were asked in a standardized questionnaire, whether or not there was an impact of the CCO measurement on their therapy. Seven different surgeons were working with the system. CONCLUSION: The unique opinion was that the CCO device had an impact on their decision making in the fluid and drug management of the study patients. Our first experience, however, suggests that this device may become an important improvement in the management of haemodynamics in the early trauma phases. Before a wide-spread application of this method on the ICU an evidence based prospective randomized trial should be performed.

Adult↗
PubMed1997

Biological monitoring and biochemical effect monitoring of exposure to polycyclic aromatic hydrocarbons.

Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous carcinogenic substances to which man is exposed in the environment and at certain workplaces. Estimation of the resulting health risk is therefore of great occupational-medical and environmental-medical importance. Determination of the DNA and protein adducts of PAHs is the most suitable way of estimating this risk. The analytical methods used thus far, above all, 32P postlabeling, immunoassays, and synchronous fluorescence spectroscopy, are, however, too nonspecific; therefore, the results lack accuracy and are not comparable with one another. Only the use of very specific methods of instrumental analysis [above all, high-performance liquid chromatography (HPLC) and gas chromatography/ mass spectrometry (GC/MS)] can counteract this deficit. However, these methods can successfully be used mainly to determine the protein adducts of PAHs. Hemoglobin adducts, for example, do not have repair mechanisms like DNA adducts. They therefore occur in higher concentrations and can thus be analytically detected more easily. At present, mainly the monohydroxylated metabolites of PAHs are being determined in urine with great success. Using specific enrichment methods and HPLC with fluorescence detection it is even possible today to determine the internal PAH exposure of the general population. The detection limits lie in the lower nanogram-per-liter range. In view of the importance of this group of substances, determination of PAH adducts and the detection of their metabolites in urine will remain at the center of future occupational-medical and environmental-medical/toxicological research. In general, the lack of reference substances must be lamented.

Benzo(a)pyrene↗
PubMed2004

Four-year monitoring of parasite communities in gobiid fishes of the southwest Baltic: III. parasite species diversity and applicability of monitoring.

The parasite infrapopulations of five goby species (Pomatoschistus minutus, P. pictus, P.microps, Gobiusculus flavescens and Gobius niger) were investigated during spring, summer and autumn of the years 1997-2000. In total, 34 parasite species were found: 17 Digenea, 6 Nematoda, 5 Cestoda, 3 Acanthocephala, 2 Protozoa, and 1 Monogenea. The dominant parasites were the digeneans Podocotyle atomon and Cryptocotyle concavum, which represent different ecological groups in terms of their modes of transmission, either indirectly by prey or directly by larvae. The relationship between the parasite Cryptocotyle concavum and the host P. microps is a special one which results in a mean intensity of several hundred cysts (max. 1,329) which settle in the kidney. The diversity of the parasite component community was highest in autumn, but low in spring and summer, with the exception of P. microps for which high values were already found in spring when direct parasites were disregarded. These results depend on the respective seasonal variation in species, some of which occur in huge numbers in some hosts. The diversity of the prey parasite assemblage is higher in Pomatoschistus microps and Gobius niger than in the whole parasite spectrum; the other hosts present the opposite trend. A combination of the island theory of biogeography as modified for parasite infection with the theory of screens and filters leads to a model which considers three handicaps or distances for parasite colonisation: genetic, phylogenetic and ecological. Long-term investigations, as performed here over a time-span of 4 years, can detect more than 80% of parasite species in single hosts after 3 years, and in the whole goby guild after 2 years. Long-term investigations can be useful for finding rare parasites, in analysing parasite diversity, and for determining the seasonality of parasites.

Acanthocephala↗
PubMed1992

Residential exposure to chromium waste--urine biological monitoring in conjunction with environmental exposure monitoring.

To determine whether a population living on or adjacent to four sites of chromate production waste was measurably exposed to environmental chromium, spot samples of urine were collected along with wipe samples of household dust and lifestyle/activity interview data. Findings were compared to those from a control population in two communities with no significant chromium use or waste sites. Urine samples were collected and analyzed, employing measures to minimize background chromium contamination. The average Cr mass in dust was 3.7 times that in control houses. The mean creatinine-corrected urine Cr (Cr/c) level of the exposed subgroup residing in households in the 75th percentile of Cr mass in wipe samples was significantly greater than that of the control population. This subgroup was primarily located at a single exposure location. Using lifestyle/activity data, significantly elevated Cr/c urine levels were identified in other exposed subgroups defined by employment location and by outside play time. These data show an association between elevated exposure to chromium in household dust and elevated urine levels of chromium, consistent with residential exposure to chromate production waste. These data also suggest an association between chromium exposure and activities outside the home which are consistent with exposure to chromate production waste.

Adolescent↗
PubMed1997

Ambulatory patient-activated arrhythmia monitoring: comparison of a new wrist-applied monitor with a conventional precordial device.

A wrist-applied transtelephonic device (WrTTD) and a precordial (PrTTD) patient-activated transtelephonic electrocardiographic (ECG) recorder were compared objectively (quality of ECG traces) and subjectively (device preference) in a prospective randomized crossover study of 24 patients. All underwent cardioversion for chronic atrial fibrillation and were then randomized to each device for 1 month. The ECG traces were sent weekly with additional traces if symptomatic. Self-administered questionnaires were completed after 1 month with each device, and the first five telemetered ECG traces for each patient were blindly assessed by two experienced cardiologists. Although the QRS complexes were smaller with the WrTTD (P < .001), the quality of the traces was similar. In particular, there was no significant difference in number of nondiagnostic traces, ability to detect atrial activity, degree of baseline fluctuation, or amount of artifact. Overall, patients preferred the PrTTD (P = .02). Patients found the PrTTD easier to use (P = .007) and were able to apply it more rapidly (P = .02). The quality of ECG traces obtained from the upper limbs by using a wrist-applied transtelephonic device was concluded to be comparable with those obtained by direct precordial application. In order to increase patient acceptability of the former, further improvements to simplify its operation are necessary.

Adolescent↗