PubMed Health⌕ Search

Biomedical subjects

B Bischoff

Publications and source records attributed to B Bischoff.

11 recordsLinked to original sources
PubMed2006

Inadequate medical treatment of patients with coronary artery disease by primary care physicians in Germany.

AIMS: The DETECT study was performed to obtain representative data about the frequency, distribution, and treatment of patients with coronary artery disease (CAD) in the primary care setting in Germany. METHODS AND RESULTS: The DETECT study was a cross-sectional clinical- epidemiological survey of a nationally representative sample of 3795 primary care offices and 55,518 patients. Overall, 12.4% of patients were diagnosed with CAD. Stable angina pectoris and myocardial infarction were the most frequent (4.2%) subgroups, followed by status post (s/p) percutaneous coronary interventions (PCI, 3.0%) and s/p coronary bypass surgery (2.2%). Patients with CAD were prescribed AT1 receptor antagonists (in 19.4% of cases), beta blockers (57.2%), ACE inhibitors (49.9%), antiplatelet agents (52.7%), statins (43.0%), and long-term nitrates (24.5%). When comparing all CAD patients with social health care insurance to those who had private insurance, private patients had significantly higher rates of revascularisation procedures and use of preventive medications. CONCLUSION: Great potential remains for improving secondary prevention in primary care in Germany to reduce the risk of further coronary or vascular events, especially in patients with social health care insurance.

Adolescent↗
PubMed2001

Clinical and neurophysiological observations after superior petrosal vein obstruction during surgery of the cerebellopontine angle: case report.

IMPORTANCE: Preservation of venous drainage during surgery of the cerebellopontine angle has received little attention. CLINICAL PRESENTATION: We describe changes in brainstem auditory evoked potentials after temporary obstruction of the superior petrosal vein during surgical resection of a small meningioma at the petrous apex via a standard suboccipital-lateral approach. Temporary clipping of the petrosal vein resulted in deterioration of the brainstem auditory evoked potentials. The tumor was removed with preservation of the superior petrosal vein. CONCLUSION: A transient postoperative cochlear nerve deficit emphasizes the importance of venous drainage and its preservation during surgery for small lesions of the cerebellopontine angle that do not distort normal anatomic structures.

Cerebellopontine Angle↗
PubMed2001

Vasoactive treatment for hearing preservation in acoustic neuroma surgery.

OBJECT: Delayed hearing loss following surgery for acoustic neuroma indicates anatomical and functional preservation of the cochlear nerve and implies that a pathophysiological mechanism is initiated during surgery and continues thereafter. Intraoperative brainstem auditory evoked potentials (BAEPs) typically demonstrate gradual reversible loss of components in these patients. METHODS: Based on this BAEP pattern, a consecutive series of 41 patients with unilateral acoustic neuromas was recruited into a prospective randomized study to investigate hearing outcomes following the natural postoperative course and recuperation after vasoactive medication. Both groups were comparable in patient age, tumor size, and preoperative hearing level. Twenty patients did not receive postoperative medical treatment. In 70% of these patients anacusis was documented and in 30% hearing was preserved. Twenty-one patients were treated with hydroxyethyl starch and nimodipine for an average of 9 days. In 66.6% of these patients hearing was preserved and in 33.3% anacusis occurred. CONCLUSIONS: These results are statistically significant (p < 0.05, chi2 = 5.51) and provide evidence that these surgically treated patients suffer from a disturbed microcirculation that causes delayed hearing loss following removal of acoustic neuromas.

Adult↗
PubMed2000

Contralateral hearing loss as an effect of venous congestion at the ipsilateral inferior colliculus after microvascular decompression: report of a case.

Contralateral hearing loss after surgical procedures within the cerebellopontine angle is rarely seen and its pathophysiological background is not yet understood. A patient with contralateral hearing loss after microvascular decompression for trigeminal neuralgia is described. Ipsilateral brainstem auditory potential (BAEP) monitoring and facial nerve EMG did not show major abnormalities. During otherwise uneventful and successful surgery a branch of the petrosal vein was sacrificed to widen the access to the trigeminal root exit zone. On the third postoperative day the patient complained about contralateral hearing loss, which was verified by audiometry. Contralateral BAEPs showed low amplitudes and delayed interpeak latencies. Brain CT was normal. Brain MRI on the 8th postoperative day disclosed abnormal signals within the ipsilateral inferior colliculus. Intravenous heparinisation was performed and hearing slowly recovered over a 3 month period. Results from this patient offer a pathophysiological mechanism for contralateral hearing loss after cerebellopontine angle surgery, illustrate the importance of venous drainage preservation, gives evidence about the generation of BAEP components within the contralateral brainstem, and stresses the importance of intraoperative BAEP monitoring.

Acoustic Stimulation↗
PubMed1999

Integration of generic indicators for quality management in hospital information systems.

Hospital information systems may contribute in different ways to quality management activities such as monitoring of quality indicators. Most existing quality management activities in hospitals are adjusted to a special medical field or particular disease. These activities often run simultaneously with other procedures and the documentation of patient care. To determine an interdisciplinary integrated quality management procedure, a pilot study was carried out at the Neurosurgery Department and Neonatology Division of the Medical Center of the University of Heidelberg. Predefined generic indicators that may be integrated in an existing information system and used in hospital routine were the basis of this project. The aim of the study was to support the quality management with periodic reports of these indicators. The pilot study showed that there were barriers along the path to an integrated generic quality management. To meet the requirements of routine monitoring, using predefined generic indicators of hospital care, much integration effort, directed at organizational aspects of information processing and information systems architecture, is still needed.

Germany↗
PubMed1999

The prognostic value of intraoperative BAEP patterns in acoustic neurinoma surgery.

Based on a consecutive series of 70 hearing patients with unilateral acoustic neurinomas and intraoperative monitoring of brain-stem auditory evoked potentials (BAEP), 4 dynamic BAEP patterns could be characterized. These patterns correspond with early and late postoperative hearing outcome. All patients with stable wave V (pattern 1) showed definite hearing preservation, all patients with irreversible abrupt loss of BAEP (pattern 2) lost their hearing, despite early hearing preservation in two cases. All patients with irreversible progressive loss of either wave I or wave V (pattern 3) eventually suffered from definite postoperative hearing loss, despite early hearing preservation in two cases. Those cases with intraoperative reversible loss of BAEP (pattern 4) showed variable short and long term hearing outcome. In 34% hearing was preserved, 44% suffered from postoperative hearing loss, the remaining 22% showed postoperative hearing fluctuation, either as a delayed hearing loss or as reversible hearing loss. Postoperative hearing fluctuation indicates anatomical and functional preservation of the cochlear nerve during surgery and is suggestive of a pathophysiological mechanism initiated during the surgical procedure and continuing thereafter. Patients at risk for delayed hearing loss can be identified during surgery by a characteristic BAEP pattern and may benefit from vasoactive treatment.

Audiometry, Pure-Tone↗
PubMed1997

[Measuring intraocular pressure in keratoconus. Effect of the changed biomechanics].

BACKGROUND: Keratoconus is associated with changes in the corneal structure, such as defects of Bowman's layer, a decrease of corneal thickness etc. They result in alterations of some of the biomechanical parameters of the cornea, namely, rigidity and elasticity. The present study was performed to examine how impression tonometry and applanation tonometry for determination of intraocular pressure (IOP) are affected by the changed biomechanical parameters associated with keratoconus. PATIENTS AND METHODS: We examined 20 normal subjects (40 eyes) and 17 keratoconus patients (25 eyes). The corneal thickness was measured by ultrasound pachymetry in the corneal center. In the keratoconus patients, an additional measurement was made at the conus peak. The corneal curvature was determined using the TMS keratoscope. The IOP measurements were made with the Schiötz tonometer (10 g). For comparison, additional IOP measurements in the corneal center and, in the keratoconus group, on the conus peak were made with the applanation tonometer. RESULTS: The normal subjects had a central corneal thickness of 548 +/- 30 microns, compared to 505 +/- 42 microns in the corneal center and 425 +/- 41 microns on the conus peak in keratoconus patients. The average corneal curvature was 43.3 +/- 1.8 D in the normal subjects and 47.8 +/- 4.1 D in keratoconus patients. Applanation tonometry produced results on 11.33 +/- 1.43 mm Hg in the normal group (corneal center) compared to values of 12.00 +/- 2.55 mm Hg (corneal center) and 7.30 +/- 1.95 mm Hg (conus peak) in the keratoconus cohort. The coefficient of rigidity was 0.0236 +/- 0.0026 microliter-1 in the normal subjects, compared to 0.0173 +/- 0.0050 microliter-1 in the keratoconus patients. CONCLUSION: The morphological changes associated with keratoconus may cause tonometry errors.

Adult↗