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Biomedical subjects

B Dohmen

Publications and source records attributed to B Dohmen.

9 recordsLinked to original sources
PubMed2004

[Venous thromboembolism prophylaxis].

Venous thromboembolism is a common and frequent complication of hospitalized patients. Some venous thromboembolisms may be subclinical, while others present as symptomatic deep vein thrombosis and/or pulmonary embolism. Venous thromboembolism and pulmonary embolism contribute significantly to inhospital morbidity and mortality. The risk of venous thromboembolism is aggravated by dispositional and/or expositional risk factors. In patients at intermediate or high risk of venous thromboembolism, additional pharmacological thromboembolism prophylaxis becomes mandatory.

Anesthesia↗
PubMed2002

Maximal flow rates and sieving coefficients in different plasmafilters: effects of increased membrane surfaces and effective length under standardized in vitro conditions.

In Europe, capillary membrane filters are the favored method for plasmapheresis and detoxification systems including a plasma separation unit. Using capillary membrane filters clearance depends on the filtration rate and the sieving coefficient (Qs) for the plasma substrates. We investigated whether the increase of the effective membrane surface of plasmafilters enables higher clearance rates than a small plasmafilter. Heparinized porcine blood (5 I.U./l) of healthy pigs was used for an in vitro circuit. Filter types used were from GAMBRO: n = 5 PF1000N (effective membrane surface: 0.15 m(2)), n = 4 PF2000N (0.35) and from ASAHI: n = 4 PLASMAFLO OP-05W (L) (0.5). Spontaneous hemolysis was chosen to indicate the individual threshold limit for maximal flow rates. Sieving coefficient was determined for ten parameters at lowest and highest blood flow (Qb) and filtration rates (Qf). PF1000N enabled maximal flow rates as high as PF2000N and PLASMAFLO (Qb/Qf in ml/min: 200/40). Qs for most substrates were similar between the filter types and the flow rates. Compared to PLASMAFLO, the filter type with the largest membrane surface, the PF1000N provided significantly better Qs for triglycerides and albumin and a trend for a better elimination of cholesterol, GGT, and LDH. The sieving properties of the PF2000N ranged between PF1000N and PLASMAFLO. Under standardized in vitro conditions, the larger plasmafilters tested did not improve the overall performance of the plasmapheresis procedure. Thus, enlargement of the membrane surface such as provided by two commercially available and clinically well-established plasmafilters could not be proven to enable higher clearance rates.

Animals↗
PubMed2002

The influence of HES on the filtration properties of capillary membrane plasmaseparation.

Plasmaseparation is a treatment under discussion for critically ill patients, especially in sepsis and multiorgan failure. These patients receive a variety of different fluid substitutes, including hydroxyethylstarch (HES). HES is known to influence rheological properties, but nothing is known about the possible interactions between HES and the plamaseparation procedure. We used an in vitro plasmaseparation circuit with heparinized porcine blood. Before priming the system, 2 liters of blood were supplemented by adding 100 ml of either NaCl 0.9% or HES (n=6 in each group). We monitored the transmembrane (TMP) and the filtration pressure (PF) and measured free plasma hemoglobin (free Hb) and platelet counts before and after the two hours plasmaseparation procedure. The final transmembrane pressure was significantly higher with HES substitution. In the HES group we found negative filtration pressures from the very beginning with a significant further decrease toward the end of the experiments. A significant increase in free Hb and decrease in platelet counts were noted only in the HES group. Volume substitution with HES leads to impaired filtration properties and deteriorated hemocompatibility in in vitro plasmaseparation. Further studies have yet to evaluate whether or not the effects described also occur under clinical conditions.

Animals↗
PubMed2001

High-grade lymphoma mimicking bone crisis in Gaucher's disease.

A 33-year-old woman with type 1 Gaucher's disease developed painful swelling of her right tibia. Initial diagnostics suggested a typical bone crisis. However, clinical course and subsequent imaging pointed to malignant disease, which was specified as high-grade lymphoma. Chemotherapy was applied together with enzyme replacement and resulted in complete remission of the lymphoma. We conclude that osseous lesions, although suggestive of common manifestations of Gaucher's disease, should be discriminated very carefully from neoplastic infiltration to maintain curative treatment options.

Adult↗
PubMed1998

Influence of phase duration of biphasic waveforms on defibrillation energy requirements with a 70-microF capacitance.

BACKGROUND: Phase duration of biphasic shocks may be an important determinant of defibrillation success. The purpose of this study was to investigate the effect of changing phase duration of biphasic pulses delivered by 70-microF capacitors on defibrillation energy requirements. This may be clinically relevant for the optimization of implantable cardioverter-defibrillator design and programming. METHODS AND RESULTS: Defibrillation thresholds (DFTs) were determined for 13 waveforms in 13 pigs by application of a 70-microF capacitance and a transvenous/submuscular lead system. In part I, phase-1 duration varied, preserving a phase-1/phase-2 duration ratio of 60%/40%. The phase-1 durations were 1, 2, 3, 4, 5, and 6 ms. The DFT was lowest (22.9+/-7 J) for phase 1=3 ms compared with phase 1=1 ms (36.4+/-7.5 J), 2 ms (25+/-6.5 J), 4 ms (25+/-7.6 J), 5 ms (30.7+/-7.3 J), or 6 ms (32.9+/-8.1 J) (P<.001). In part II, phase-1 duration was 3 ms but phase-2 duration varied: 0.7, 1.3, 2, 2.7, 3.3, 4, and 6 ms. Significant DFT minima were found at phase 2=2 ms (22.5+/-4.2 J) and phase 2=4 ms (22.5+/-4.2 J) compared with phase 2=0.7 ms (31.7+/-9.3 J), phase 2=3.3 ms (26.7+/-6.1 J), or phase 2=6 ms (28.3+/-6.8 J) (P<.05). CONCLUSIONS: The strength-duration curve of biphasic defibrillation shocks demonstrates a single optimum for phase-1 duration. In contrast, two optima with minimal energy requirements were found for phase-2 duration. Optimization of both phases of low-capacitance biphasic shocks may reduce energy requirements for defibrillation.

Animals↗
PubMed1997

Fluorine-18 fluorodeoxyglucose positron emission tomography in the differential diagnosis of pancreatic carcinoma: a report of 106 cases.

The aim of this study was to evaluate fluorine-18 fluorodeoxyglucose positron emission tomography ([18F]FDG PET) as a tool for the differential diagnosis of pancreatic carcinoma while taking into account serum glucose level. A group of 106 patients with unclear pancreatic masses were recruited for the study. PET was performed following intravenous administration of an average of 190 MBq [18F]FDG. Focally increased glucose utilisation was used as the criterion of malignancy. In addition, the "standardised uptake value" (SUV) was determined 45 min after injection. Carcinoma of the pancreas was demonstrated histologically in 74 cases, and chronic pancreatitis in 32 cases. Employing visual evaluation, 63 of the 74 (85%) pancreatic carcinomas were identified by PET. In 27 of the 32 cases (84%) of chronic pancreatitis it was possible to exclude malignancy. False-negative results (n=11) were obtained mostly in patients with raised serum glucose levels (10 out of 11), and false-positives (n=5) in patients with inflammatory processes of the pancreas. Thus PET showed an overall sensitivity of 85%, a specificity of 84%, a negative predictive value of 71%, and a positive predictive value of 93%. In a subgroup of patients with normal serum glucose levels (n=72), the results were 98%, 84%, 96% and 93%, respectively. Quantitative assessment yielded a mean SUV of 6.4+/-3.6 for pancreatic carcinoma as against a value of 3.6+/-1.7 for chronic pancreatitis (P<0.001), without increasing the diagnostic accuracy. This shows PET to be of value in assessing unclear pancreatic masses. The diagnostic accuracy of PET examinations is very dependent on serum glucose levels.

Adenocarcinoma↗
PubMed1984

[Voluntary inerruption of pregnancy in adolescents from 13 to 18 years of age. Clinical and sociologic analysis of 295 cases].

The study reports on 295 cases of induced abortion in teenagers (13-18 years) performed in Belgium (where abortion remains illegal), in 1979. This group was compared with a group of 2968 women aged 19-48, also aborted in 1979, for clinical and sociodemographic analysis. The comparative situations of the young patient and he partner were also studied. The latter were elder (62% over 25 years), had higher levels of income, of education, and had better jobs. No difference was found between younger and older patients as concerns access to centres, mean ages of pregnancy (although teenagers presented more often advanced pregnancies: 9.5% between 12 and 16 weeks and 4.5% between 17 and 21), religion, instruction, psychological reactions. We found that different people came with patients at different age groups (parents with the younger, partners with the older). There were fewer foreigners in the younger group and of course there were differences in numbers of previous pregnancies, parity, marital status and income. A stable relationship was rarer in the younger (39%) than in the older (66%). Contraception was indeed used by young patients (61%) but they chose less effective methods (61%) and often admitted that they used the methods wrongly (66%). It is no surprise that young patients mainly ask for abortion (54%) because of socio-economic motives. The second reason was because there was no stable relationship (17%). The discussion covers the special problems of abortion in adolescents and emphasizes the very difficult social situation, the need for support by health workers. Better education should lead to conscious acknowledgment of the consequences of sexual activity.

Abortion, Induced↗
PubMed1982

Induced abortion in Belgium: clinical experience and psychosocial observations.

Abortion is illegal in Belgium, despite the pressure of public opinion, the feminist movement, and the numerous motions for liberalization presented to Parliament since 1971. Nevertheless, some hospitals and an association of outpatient clinics have practiced abortions openly since 1973. This study examines the socioeconomic and medical data of some 3,800 women who asked for an abortion in 1979, covering income, level of education, profession, religion, family structures, and personal relationships of the women and their partners. The women's reasons for seeking abortion are listed and their attitudes toward abortion and contraception are examined. Information on medical practice, stage of pregnancy, parity, and attendance at a routine follow-up visit is also given. The conclusion focuses on the probable benefits for women's well-being of a liberalization of the abortion laws.

Abortion, Induced↗