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PubMed1978

Modern management of hypertensive disorders of pregnancy.

Hypertensive disorders of pregnancy contribute significantly to perinatal mortality. Successful application of modern tests of antepartum fetal status and appropriately timed delivery, with monitored labor and liberal use of cesarean section led to significantly improved fetal and neonatal salvage in 242 patients with hypertensive disorders of pregnancy between 1973 and 1975. The reduction in perinatal mortality to a corrected rate of 12/1000 in the years 1973-1975, compared to a previous rate of 75/1000 between 1970 and 1972, justifies the modern aggressive management of hypertensive disorders in pregnancy.

Acute Disease↗
PubMed1982

[Modern detergents and their application in pediatrics].

During the past half of this century there has been a tremendous development of chemical products. Their application in every day life is widespread, and problems arose summarized under the term of civilisation damages. An important aspect is the effect of detergents on human skin. Every day more than 100 million people have contact with surface active substances--an influence on the physiologic steady state of the skin or its protective mechanisms was thought to be possible. After reviewing the relevant literature of the past ten years following conclusions can be drawn: As to the problem of tolerance we can say that there is no objection against the use of anionactive detergents. Under extreme conditions, e.g. constitutional anomalies, or intense application on previously damaged skin, injury of the skin can be observed. In the age group between 6 and 12 years there exists no difference in the resistance against alkali or acids in comparison to adults. It has not been demonstrated yet, however, whether the buffering capacity is already active in the skin of the newborn, or when it becomes effective after birth. We can recommend the use of modern detergents in pediatrics, they represent an important part of modern hygiene in childhood, especially in infancy. For optimal efficacy one has to adjust the substance to every constitutional skin type and to preexisting skin damages.

Adult↗
PubMed1980

[Evaluation of the MPEL for SO2 and NO2 and the development of new MPELs for atmospheric pollutants based on modern epidemiological, ecological and toxicological studies].

Proceeding from modern experimental and natural observations on the effect of sulphur dioxide and nitrogen dioxide on live organism and environment, the now, operative in Bulgaria maximum allowable concentrations of these contaminants are reassessed. The maximal single and mean diurnal SO2 MAC are proposed to be reduced to 0.15 mg/m3 and 0.03 mg/m3, while those of NO2 remain the same. Based on data available in modern literature and equations proposed by the authors for express determination of MAC for some atmosphere contaminants, MAC for some nonstandardized contaminants in Bulgaria are suggested: ozone (maximal single - 0.06 mg/m3 and mean diurnal - 0.03 mg/m3 asbestos (mean dirnal - 0.25 fibers/cm3), zinc (mean diurnal - 0.05 mg/m3, copper (mean diurnal - 0.01 mg/m3. The use of mathematical equations for determination of MAC of differrent hydrocarbons is suggested.

Air Pollutants↗
PubMed1995

[Special complications of cholecystectomy performed by micro- and modern mini-laparotomy].

There is no data on the special complications of micro (less than 4 cm incision) and modern mini laparotomy cholecystectomies (4.1-6 cm incision). Out of 710 non selected patients, 643 micro laparotomy cholecystectomies were performed and 61 modern mini laparotomies due to choledocholithiasis. On three occasions, conventional mini (6.1-10 cm) laparotomy was performed and in another three, conventional laparotomy (over 10 cm incision) was executed. Intraoperative bleeding was encountered in 15 cases (2.1%) while accidental hepatic duct clipping occurred in one case (0.1%). Damage to the bile duct did not occur in any case reported. Postoperative bleeding was reported in 8 cases (1.1%) and delayed bile leakage was reported in 10 cases (1.4%). Special complications reported as a result of pathological alteration in the bile tract as follows: Intraoperative bleeding encountered during simple cholecystectomy-1% but cholecystectomy due to obstructive cholecystitis 3.8%, also caused by intraoperative bleeding. Delayed bile leakage in simple cholecystectomy was not observed, but after cholecystectomy for obstructive cholecystitis it encountered in 3.4%. Special complications resulted in four early reoperations (0.5%). Two other patients were re-operated within three weeks, independent of special complications. The percentage of both intra and postoperative complication was significantly higher in obstructive cholecystitis with an operative delay of 11 or more days.

Adolescent↗
PubMed1995

[The place of micro- and modern mini-laparotomy in the management of biliary calculi].

The authors treated 537 patients biliary stone disease between 1-st january 1991. and 1-st june 1994. With the conventional method of 20 cm of the subcostal incision, they operated 250 patients, among them 17 (6.8%) also had the common bile duct stone. There was no case of mortality and common bile duct injury. The postoperative morbidity was 12.8%. The average days of treatment was 9. With micro- and modern mini-laparotomy 287 cases were operated, 16 (5.5%) of them had common bile duct stones which were extracted during the process of cholecystectomy. In one case transduodenal sphincterectomy was performed. There was no case of mortality and injury of common bile duct. The postoperative morbidity was 10.4%. There was 6 cases of conversion (2.09%). The average period of treatment was 5 days. The treatment of biliary stone disease by micro- or modern minilaparotomy does not cause more danger to the patients than the conventional subcostal method. This approach is suitable for the surgical treatment of all kinds of biliary stone disease. This method is also suitable to extract a stone (stones) from the common bile duct discovered during cholecystectomy. This method has a pleasant cosmetical results.

Adolescent↗
PubMed1976

[Modern criticism of psychiatry -- rebellion or return to tradition? (author's transl)].

Modern criticism of psychiatry started about 10 years ago with violent attacks on the ways in which psychiatric patients were handled in practice. In its attempt to shatter rigid structures and to adopt attitudes, wellknown for many years, for therapeutic action, this criticism remains in an historical scientific tradition which can be traced back to the beginning of this century. With the advance of sociologic thinking and the adoption of radical sociogenetic demands, mainly in the Anglo-Saxon literature, this criticism finds its own feet towards the end of the sixties as a kind of antipsychiatry. It obtains its leverage in the lack of differentiation between diagnosis and psychopathologic description in psychiatry ignoring like Birnbaum the "essential" history of psychiatric science dating from the middle of the 19th century, it returns to the psychiatry of late romanticism. It assesses the place of psychiatry within the range of sciences. In a similar manner it opposes the detached, individual-psychologic, approach or classical psychopathology and sees the various psychopathologic data as forms of a deviation in the sense of symbolic interactionism. Modern criticism of psychiatry could, therefore, mark the start of a developing interactional psychopathology which would certainly not have to compete with traditional psychopathology. It could take its place as an independent approach on equal terms with existing trends. A precondition would be a disnissal of a- and antihistoric basic tendencies which alone would make possible the necessary re-interpretation with the developments up to date and with present-day achievements.

Germany, West↗
PubMed1976

[Heidegger and modern research].

The unity of thought content and its corresponding object in reality - an unsolved problem till now - is explicated in a gestaltqualitative-neurobiological way. This gives the opportunity of analyzing Heidegger's concepts of truth as "lichtendes Bergen", of "Gestimmtheit" and "Angst", of life and death and "Dasein" in an actualgenetic framework. In opposition to Heidegger's postulation of the non-thinking modern science it results that Heidegger's conceptualization of thought contents is emphasizing primarily the aspects of unity and constancy versus division of unity and complexity by the modern science.

Brain↗
PubMed1994

[Application of modern thermal methods in pharmaceutical analysis].

Main applications of modern thermal methods in the pharmaceutical analysis are reviewed. While these methods are widely employed in pharmaceutical industry, they are only recommended--but not prescribed--in the general part of the VIIth Pharmacopoea Hungarica and consequently, this field is practically unknown for the pharmacists. The aim of this paper is to call attention to the advantage of the application of modern thermal methods (DTA, TG, DSC) in contrast to the classical ones. They permit a quick and accurate measurement of the melting point, the determination of purity and eutectic point, to clear up the possibility of conditions for the development of polymorphic modifications, and to follow the process of loosing the water of crystallization.

Hot Temperature↗
PubMed1994

Informed consent as an ethical issue in modern optometry.

BACKGROUND: Modern optometric practice contains many more mildly invasive procedures than it has traditionally. Concurrently, patients expect a more active role in decisions concerning their own health care, as, increasingly, these decisions may have harmful, as well as, salubrious, consequences. METHODS: Literature from the philosophy of ethics as it pertains to the issue of informed consent was examined and applied to optometric procedures and practices. RESULTS: A strong analogy exists between particular aspects of optometric practice and corresponding elements of medical practice with respect to well established ethical principles of informed consent. The legal doctrine of informed consent is not the only view applicable to optometry. CONCLUSION: Modern optometric practice may easily and advantageously be adapted to incorporate ethical principles of informed consent. These principles, which should be distinguished from legal principles which bear upon the same issues, may enhance the quality of health-care decisions by optometrists without creating serious obstacles to the individual optometrist's practice mode.

Ethics, Medical↗
PubMed1994

An in vitro study of femoral intramedullary pressures during hip replacement using modern cement technique.

Five femora (four cadaveric and one plastic) were used to measure the intramedullary pressures simultaneously at two different locations along the proximal femur during the insertion of bone cement and the femoral component using modern cement technique. The pressures were monitored by transducers located at the midpoint of each femoral stem (P1), and just beyond the tip of the femoral stem proximal to a cement plug (P2). Transient increases in intramedullary pressure were noted during the initial compaction of the bone cement using a conventional device. However, during insertion of the femoral component, the pressures at P1 and P2 increased dramatically to peak pressures exceeding 2385 mm Hg at P1 and 3710 mm Hg at P2 respectively. These pressure elevations were not sustained; eight to 10 minutes after prosthesis insertion, the pressures decreased to below baseline levels in all five femora. This probably resulted from contraction of the cement during the curing phase. Transient elevations of intramedullary pressure to levels greater than 100 times capillary pressure are produced during hip replacement using modern cement technique. The highest pressures are generated during insertion of the femoral component rather than during the cement compaction step. These findings suggest that the use of a cement compactor to improve intrusion of the cement into bone is probably unnecessary.

Bone Cements↗
PubMed1994

[The heyday of medicine and modernization in the 19th century].

The numerous highlights of medicine in the 19th century represent an integral part of the successful development of science, especially with regard to the natural sciences. By the end of the century the sciences will have developed into an economic factor required and relied upon by state and society, after having originally functioned as the mere purveyor of meaning. This process should be interpreted as a component of the larger process of modernization. The main factors that constitute the necessary context within which medical science could develop were rationalization (M. Weber), professionalization, differentiation and individualization, all of which are the core elements of modernization, as well as governmental regulations and assistance and the growth of requests with regard to medical achievements.

Europe↗
PubMed1993

Modern approach to the evaluation of combined effects of single-dose trials and clinical time-course studies, exemplified by combinations of pirenzepine and H2-receptor antagonists.

A modern approach to the evaluation of combined effects of two active drugs, A and B, in clinical trials is described, based on modern understanding of actions and interactions of drugs which act at distinct molecular sites. It rests on a comparison of observed combined effects with calculated effects of independent action of A plus B--greater than independent effects are considered as a potentiated response. It is illustrated by reanalysis of single-dose and time-course studies of the antisecretory action of pirenzepine and H2-receptor antagonists (cimetidine, ranitidine). Briefly, peptone-stimulated acid output was measured in 15 min periods over 3 h after the injection of drugs in three trials, one with five duodenal ulcer patients, two of them with 8 healthy volunteers each. The doses of pirenzepine and H2-blockers were fixed in each trial. The results were either expressed by the total acid output (single-dose analysis) or by the acid secretion over 15 min as time course. The results with the drug combination show greater reduction in acid secretion in all three trials with respect to independent effects. The time-course studies more clearly showed greater reduction in acid output than the analysis of total acid output, not the least with respect to p-values of differences between observed combined effects and calculated independent effects. They were obtained by the chi-square (chi 2) goodness-of-fit test, recently applied for the evaluation of dose-response curves.(ABSTRACT TRUNCATED AT 250 WORDS)

Cimetidine↗
PubMed1977

Modern management of the diabetic pregnancy.

The effect of modern antepartum and intrapartum fetal monitoring technics on the outcome of the pregnancy complicated with diabetes was studied by comparing the perinatal mortality of 2 groups of patients whose management differed primarily by the use of these tests. The perinatal death rate was halved to 9.2%, and when corrected for major congenital defects and referred fetal deaths it was 5.3%. Modern fetal diagnostic tests clearly add a degree of objectivity in the management of the diabetic pregnancy not previously available.

Amniocentesis↗
PubMed1995

[Modern examination methods in pneumology].

In addition to qualitative establishment of diagnosis the aim of modern investigational procedures is quantitative analysis of disease extension and of functional impairment. The most important endoscopic-bioptical techniques for establishment of diagnosis are bronchoscopy and thoracoscopy. In bronchology flexible bronchoscopy with a relative share of about 90% clearly holds now a dominant position versus the rigid technique. Suspected cancer is the most prominent indication (ca. 60%). Visible intrabronchial lesions can be diagnosed in more than 90%. In extrabronchial and peripheral bronchopulmonary disease technical aids like transbronchial needle aspiration (TBNA), bronchoalveolar lavage (BAL) or transbronchial biopsy (TBB) are required, resulting in a diagnostic yield, that may range between 30 and 90% depending on the particular disease entity. Thoracoscopy is the second most important endoscopic procedure and accounts for about 1/10 of the investigational frequency of bronchoscopy. Pleural - generally exsudative - effusion provides by far the most frequent indication with a relative incidence of 75%. Etiological diagnosis can be established in about 90% of pleural effusions. The maximum yield of 100% may be achieved in tuberculous effusions, in malignant effusion sensitivity comes close to 100%. Non-endoscopic bioptical techniques include guided perthoracic needle aspiration and "blind" pleural biopsy. Diagnostic escalation or tumor staging may require surgical procedures, which can be performed by conventional techniques (mediastinoscopy, minithoracotomy) or video-assisted thorascopy. Explorative thoracotomy is the most extensive investigation. For functional evaluation of number of "classical" techniques are available (spirometry, gas transfer analysis, spiroergometry) more recently expanded by radionuclide perfusion and ventilation studies. Besides grading of functional impairment they allow clinical diagnosis of diseases characterized by specific functional patterns (asthma, bronchitis, emphysema, sleep associated disorders) and serve preoperative assessment in surgery. Increasingly important modern imaging techniques like computed tomography (CT), nuclear magnetic resonance (NMR) or ultrasonic investigation are not featured in this clinically focused article.

Bacteriological Techniques↗
PubMed1996

On the history of modern resuscitation.

The development of modern cardiopulmonary-cerebral resuscitation (CPCR) has given every person the ability to challenge death anywhere. Despite sparks of knowledge and occasional applications of possibly effective lifesaving efforts since antiquity, the possibility to reverse acute terminal states or clinical death by modern, physiologically sound, and effective measures did not come about until around 1900 inside hospitals, and around 1960 outside hospitals. Additional potentially effective cerebral resuscitation, research since around 1970, may be taken to clinical trials before the year 2000. The history of resuscitation medicine around 1900, when many opportunities to assemble existing bits of knowledge into an effective system were missed, should be a warning for those individuals who will lead CPCR beyond the year 2000. History has shown the need for continuing communication and collaboration among investigators of different countries, and between laboratory researchers, clinicians of various disciplines, and prehospital rescuers. The lessons learned from history, for research challenges in the near future, include: a) the development of ultra-advanced life support to be initiated outside the hospital, to bridge cardiopulmonary resuscitation (CPR)-resistant cases to definitive cardiac procedures in the hospital; and b) cerebral resuscitation to complete recovery after 10 to 15 mins of normothermic cardiac arrest without blood flow. Both challenges above will require research projects at multiple levels--from the molecular and cellular levels, to the use of small and large animal models (with organs' and organisms' process and outcome evaluations), to studies of patients and communities. Beyond the year 2000, resuscitation research might become more challenging and cost-effective in the area of multiple trauma, which concerns the young and fit. Research challenges concerning brain trauma, uncontrolled hemorrhagic shock, and "suspended animation" for delayed resuscitation have their own histories, and are not covered here. The author apologizes for not having recognized many important contributors to the history of CPCR because of space constraints or lack of knowledge about such contributions. Input on this subject from readers of this paper is hereby invited.

Cardiopulmonary Resuscitation↗
PubMed1977

[Effect of machine modernization on the level of noise and its characteristics in the textile industry].

Results of noise measurements on work post before and after modernization are presented. In the majority of examined work areas noise levels were lowered by 2--20 dB(A) after machine modernization. Present noise level is there about 90 dB(A). On the other hand limit the noise level on work post of rewinders, trosiners and looms has not been changed. So far noise level on these areas has exceeded permissible level by 5--14 dB(A).

Noise↗
PubMed1996

Dermabrasion, chemabrasion, and laserabrasion. Historical perspectives, modern dermabrasion techniques, and future trends.

BACKGROUND: Modern skin resurfacing techniques began with wire brush surgery. Chemabrasion techniques were developed combining the peel and fraise surgery. The newer CO2 lasers provide technology to also resurface the skin and provide an alternative approach to correct facial defects and facilitate facial rejuvenation. OBJECTIVE: This review article focuses on important aspects of dermabrasion, chemabrasion, and laserabrasion. An emphasis is placed on indications, preoperative skin conditioning, modern equipment, anesthesia, and postoperative dressings. RESULTS: The mainstay of therapy for skin resurfacing continues to be chemical peels. Combinations with dermabrasion are important for deeper lesions such as acne scars, or combined with laserabrasions for deeper rhagades. CONCLUSIONS: With a thorough understanding of the important principles of skin resurfacing and wound healing, the management of complexion improvement becomes straight forward, complications become manageable, and patient satisfaction is excellent.

Acne Vulgaris↗