Biomedical subjects

A Lechleuthner

Publications and source records attributed to A Lechleuthner.

5 recordsLinked to original sources

PubMed1992

[Multiple trauma: preclinical needs, transportation, time sequences].

Compared to the magnitude of the trauma problem few precise data exist on prehospital care of trauma patients. The aim of the study was the collection and careful evaluation of prehospital data on trauma patients concerning time sequences, patients' status and prehospital interventions. From 1. 1. 1987 to 31. 12. 1990 all 49,045 prehospital emergencies in Cologne were prospectively registered. 8792 trauma patients were treated by an emergency physician in the field. 9.5% were severely injured, defined by a trauma score less than or equal to 12. 9.9% of the trauma patients were intubated, 54.9% received an i.v. line, and 20.6% were triaged to a trauma center. Our data form a valid base for analysis of the effectiveness of prehospital trauma care.

Adult↗

PubMed1992

Pharmacotherapy in shock syndromes: the neglected field of pharmacokinetics and pharmacodynamics.

Promising effects of adjuvant drugs in experimental shock models often are not confirmed in subsequent clinical trials, e.g., steroids, fibronectin, naloxone, immunotherapeutics. A key difficulty in establishing a therapeutic benefit in clinical studies, apart from study design shortcomings, is the lack of knowledge and application of principles of clinical pharmacokinetics and -dynamics. In shock states the relationship between an administered fixed dose regimen and the drug effect is strongly influenced by dynamic changes in absorption, distribution, metabolism, and elimination of the drug, all of which vary between individual patients. This article describes several neglected aspects of clinical pharmacology relevant to shock research under clinical conditions and discusses the indications, prerequisites, and limitations of "applied pharmacokinetics." The inclusion of therapeutic drug monitoring in clinical shock studies should be applied more frequently to establish experimental results in the "real world" of ICU settings.

Animals↗

PubMed1991

[Glucocorticoids in multiple trauma and infection--still a topic for discussion?].

The clinical use of glucocorticoids in trauma and sepsis has not yet been approved on the basis of clinical trials. Current knowledge in the area of pathogenesis is reviewed, and against this background the mechanisms of steroid action will be discussed, the current status of clinical testing in both trauma and sepsis will be evaluated, and ways of testing the effectiveness will be proposed. Although most trials up to now have shown a positive overall effect in trauma patients, a further prospective randomized controlled study with a more homogeneous study population and including trauma scores is necessary before trauma can be reliably accepted as a firm indication for glucocorticoid treatment. In the discussion on sepsis syndrome a variety of reasons are suggested for the failure of earlier studies to show beneficial effects. Besides methodological aspects, one of the main reasons is the neglected field of pharmacologic-pharmacokinetic principles. A new study should be performed under therapeutic drug-monitoring (TDM) conditions once more is known about the target concentration range.

Animals↗

PubMed1989

Nonsuture microsurgical vessel anastomosis using an absorbable cuff.

The nonabsorbable cuff used for nonsuture anastomosis can cause residual vessel stenosis as well as regional wall rigidity. Resulting disturbances in laminar flow promote the development of irregularities in the intimal endothelial vessel lining distal to the anastomosis. Using absorbable cuffs, the degree of stenosis can be appreciably reduced, thereby diminishing thrombogenic flow turbulence. The absorbable cuff can thus facilitate clinical application of nonsuture microsurgical vessel anastomosis.

Anastomosis, Surgical↗

PubMed1988

Atresia of the right atrial ostium of the coronary sinus.

A case of asymptomatic congenital occlusion of the ostium of the coronary sinus is described. The myocardial venous drainage was maintained via a persistent left superior vena cava as well via ectatic, widened atrial veins of the dorsal wall of the left atrium. The study shows that complete ostial occlusion of the coronary sinus does not reduce cardiac venous drainage. The view of the literature allows a comparison with the comprehensive classification of coronary sinus anomalies.

Aged↗