Biomedical subjects

B Attinger

Publications and source records attributed to B Attinger.

7 recordsLinked to original sources

PubMed1993

[The first successful lung resection].

In 1883 Krönlein resected a sarcoma of the ribs in an 18 year old female. Six months later he reoperated the patient for a local recurrency. At the second operation which necessitated a wide exposure of the thoracic cavity he deliberately removed a pulmonary metastasis about the size of a walnut. Two years later a new recurrence had to be resected. The three interventions led to a survival of 7 years. The patient succumbed to a further recurrence in 1890. Krönleins operation opened two new chapters in surgery, pulmonary interventions in general and in particular surgery of pulmonary metastasis. Surgery of lungs was not a topic of that era, particularly since some incisions for abscesses and resections of pulmonary parenchyma had not been successful. By limiting the indication to patients with sufficient pulmonary function and by following the successful pneumonectomy experiments in animals Krönlein favored pulmonary resection. The success of this intervention confirmed these considerations especially since it lasted for years. It was followed in 1885 by a pulmonary resection by G. Ruggi in Bologna. Surgery of the lung, however, came in general use only 50 years later.

Germany↗

PubMed1992

[Honey-induced poisoning].

Because of the increasing preference for natural products intoxications induced by consumption of honey will reappear, especially with products bought directly from the beekeeper. In the hospital of Trapezunt about 8 cases of intoxications induced by honey were reported per year. The courses observed appear to be identical to those already described by Xenophon 2400 years ago. Symptoms begin acutely but last rarely for more than 24 hours. Fatal cases are extremely rare. Most prominent symptoms are loss of consciousness, weakness, severe salivation, sweating, vomiting and diarrhea. Beside these symptoms circumoral paresthesias and bradyarrhythmia may occur. Intoxication is induced by certain diterpenes, so called gray-anotoxins, that appear in flowers of different species of rhododendron. Next to close surveillance only symptomatic therapy is generally necessary.

Diterpenes↗

PubMed1992

[Fewer negative appendectomies thanks to improved clinical diagnosis].

108 consecutive patients presenting with suspected acute appendicitis were studied prospectively. To improve clinical performance, 19 clinical criteria were evaluated. For cases with unclear diagnostic situations laparoscopy was performed. With 10 of the above mentioned criteria the score published by de Dombal, which can reach a maximal value of 7 points, was calculated. For data processing the rate of negative appendectomies as well as the de Dombal score were used. 61 appendectomies with 7 (11.5%) perforations, 48 (78.7%) acute inflammations and 6 (9.8%) normal appendices have been performed. 39 (36.1%) patients with non-specific abdominal pain were observed for 3 +/- 2 days before discharge, while 7 (11.5%) had another surgical disease. In the appendectomized patients the score was 4.3 +/- 1.1 with perforation, 4.4 +/- 1.0 with acute inflammation and 3.8 +/- 1.3 with a normal appendix (p = ns). The score for non-specific abdominal pain in patients not undergoing surgery was significantly lower (2.2 +/- 1.2; p less than 0.01). Patients with other surgical diseases had a score of 3.1 +/- 1.1 with no significant difference from patients who had undergone appendectomy or from those with non-specific abdominal pain. Laparoscopy was performed in 16 (14.8%) patients. 9 patients had appendicitis, 4 non-specific abdominal pain and 3 another surgical disease. Improved clinical examination significantly (p less than 0.05) reduced negative appendectomies from 20.3% to 9.8% without a rise in the rate of perforation due to prolonged observation. The 6 patients with negative appendectomy could not be identified even by improved clinical examination.

Acute Disease↗

PubMed1991

[Hospital infection, risk and consequences].

Approximately 5 to 10% of all patients acquire infections at the time of their hospitalisation. The most common nosocomial infections are urinary tract infections, wound infections, pneumonias and septicemias. Deaths due to nosocomial septicemias are estimated to be in Switzerland around 1000 per year. The treatment of nosocomial infections consumes a considerable amount of the total health care budget. The annual costs in Switzerland are estimated to be in the range of 100 to 300 million swiss francs per year. Prevention and control of nosocomial infections is therefore considered essential.

Costs and Cost Analysis↗

PubMed1991

[Uni- and ipsilateral pulmonary edema after surgery on the lung].

Unilateral pulmonary edema can develop after evacuation of pleural liquid and pneumothorax, after pneumonectomy at the contralateral side and as a special form in left ventricular failure. Unilateral ipsilateral pulmonary edema in the remaining parenchyma after operations of the lung has been described very rarely. Eight patients are here described, once after a decortication and seven times after a pulmonary resection. Radiologic signs occurred generally 12-24 h after the operation and persisted for three to seven days. The first postoperative X-ray was always more or less normal. We believe that the cause of the edema is a mechanical traumatisation of the remaining parenchyma of the lung at the time of the operation which results to a capillary leak. Left ventricular failure and excessive fluid application after the operation can be a risk factor. Generally no clinical signs are present during the edema, but respiratory insufficiency, as with patient 8 can occur. Therefore it is important to distinguish unilateral pulmonary edema from other diagnosis like pneumonitis, hemothorax and atelectasis.

Aged↗

PubMed1991

[Bassini or Shouldice operation?].

Between October 1988 and March 1990 a controlled, prospective study was conducted comparing the operative methods of Bassini and Shouldice for hernia repair. On 100 patients (11 female, 89 male) the Shouldice-technique was used, on 55 patients (6 female, 49 male) the Bassini-technique. Most patients were operated under local anesthesia. No significant difference was noted between the two groups regarding the postoperative complication rate (hematoma, wound infection). However, patients had a shorter hospital stay after the Shouldice operation. Six patients (10.9%) had recurrent hernia after the Bassini procedure, one patient (1%) after the Shouldice procedure. An increased risk for recurrent disease was found in patients with the Bassini operation who already had recurrent hernia. Because of the significant shorter hospital stay and the significant lower incidence of recurrent hernia, we abandoned the operative method of Bassini in favour of the Shouldice procedure.

Female↗

PubMed1990

[Nosocomial lung infections. Epidemiology and problems of stress ulcer prevention].

The incidence of pulmonary complications in patients with tracheal intubation is 17-25%. The mortality rate is considered to be between 50 and 81%. Aspiration of contaminated gastric fluid has been suggested to be a source of many of these complications. Gastric fluid contamination depends on the pH of the gastric fluid among other things. This results in a much higher incidence of nosocomial pneumonias in patients receiving H2-blockers (36%) or antacids and H2-blockers (38%) than placebo (8%) or sucralfate (10%). In contrast H2-blockers, antacids, omeprazole, pirenzepine and sucralfate show similar bleeding rates due to stress ulcers, but all are significantly lower than that of placebo. The routine application of prophylaxis for stress ulcer bleeding should nowadays be reserved for risk patients only. If necessary antimuscarinic drugs or sucralfate should be applied.

Anti-Ulcer Agents↗