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Biomedical subjects

B Schöning

Publications and source records attributed to B Schöning.

12 recordsLinked to original sources
PubMed1988

Prediction of risk for pseudoallergic reactions and histamine release in patients undergoing anaesthesia and surgery: a computer-aided model using independence-Bayes.

A computer-aided model for the prediction of pseudoallergic reactions was developed using prospective data collected from 581 patients in a controlled clinical trial examining pseudoallergic reactions to the plasma substitute Haemaccel (outdated formulation). The multivariate analysis of 22 proposed risk factors was performed using Bayes theorem. This enabled the accurate prediction of 86% of the patients who had a systemic reaction. The clinical use of such system would enable a selection of patients to receive the effective prophylactic measure of pretreatment with H1 plus H2-receptor antagonists.

Anesthesia↗
PubMed1979

[Infusions emergencies following the administration of plasma substitutes -- analysis of case reports to the committee on drugs. The problems of medical statistics, prophylaxis and immediate therapy (author's transl)].

In the period 1967 to 1976 the Adverse Drug Reaction Committee of the Medical Association of the Federal Republic of Germany (AMK) received 323 reports of transfusion emergencies following the administration of colloid plasma expanders (dextran, gelatin, starch). The reports ranged from medium to severe cases. Nine percent of the reported cases had a fatal outcome. The data contained in these case reports could only be statistically analyzed within certain limitations as the reports were incomplete and other parameters necessary for a definite statistical evaluating were missing. Furthermore the results do not cover the following points: 1. What percentage of reactions to plasma expanders in W. Germany was reported? --2. What percentage can be attributed to the individual colloids within the entirety of these undesirable side effects? --3. What percentage of the individual colloids can be allocated to the varying degrees of severity of these reactions? -- Further limitations which complicated the analysis of the case reports are discussed individually. Despite these difficulties an attempt was made to analyse the parameters necessary in the diagnosis of acute transfusion emergencies and to compile a guide for the clinical symptomatology. Grading of reactions into four degrees of severity has proved useful both in terms of diagnosis and immediate therapy. The medical statistical evaluation presented in this paper gives an indication as to the significance of the observed side-effects and confirms the statement and recommendations made elsewhere in the literature. In these emergency cases life-threatening incidents appear to be more common than is generally assumed and the user is aware of. The incidence of product-specific emergencies can only be determined to some degree of accuracy by randomized prospective studies. These would have to be conducted with numerous strict guidelines. On the basis of the results presented here, these studies should be attended to with a sense of urgency. Regardless of the difficulties encountered in the evaluation of the case reports, guidelines as to the recognition of reactions, prophylaxis and immediate remedial therapy could be established. These would appear to suffice as urgently required comprehensive information for the nursing staff as well as all doctors. Recognizing side-effects and instituting immediate remedial therapy along the principles laid down in these guidelines can in most cases of severe reactions remove the acute threat to life.

Adolescent↗
PubMed1977

[Notes on the indication of corrective osteotomy in Perthes' disease (author's transl)].

The results of surgical (corrective osteotomy) and conservative therapy (Thomas splint treatment) are compared in 88 patients suffering from Perthes' disease. It is attempted to show whether the age of the patients, the stage of disease, centric or excentric head of femur, Cattherall's stage or any risk factors influence the results. Statistics show that only young children profit from surgical treatment whereas it offers no advantage to children over six years of age. Among the young children only those with excentric head of femur, show significantly better results as opposed to conservative splint treatment. Surgery is otherwise only indicated when it is seen as an alternative to prolonged splint treatment.

Child↗
PubMed1977

[The incidence of hepatitis following orthopedic operations with massive blood-loss in adolescents (author's transl)].

Blood replacement in 527 thoracic spinal grafts (n=295) was greater (F=17.99; 1.116; 0.01) when grafting had to be done in two stages. Between 1953 and 1972 3 cases of postoperative jaundice were seen, negative to Australia-Antigen. Transfusion hepatitis appears to be rarer in this operative material of adolescent orthopedic patients then in other disciplines published. The reasons may be: homogenous material, intact youthful immunity reactions, thorough prevention of infection in orthopedic departments. More could be said only in polycentric prospective study. Preventive measures for hepatitis prophylaxis are discussed.

Adolescent↗
PubMed1976

[Deformity and arthrosis in slipped upper femoral epiphysis (author's transl)].

X-rays of 104 slipped upper femoral epiphysis (without reduction of epiphysis and complications) showed pathological datas of the hip joints (ACM-angle, CE-angle, Hüftwert) in one third of the cases in the beginning and 60% until 12 years later. With higher degree of slip the arthrosis increase, but not the pathological datas of the hip joint. There is no dependence between deformity of the hip and arthrosis. Apparently the articular cartilage necrosis partially determine the development of arthrosis.

Adolescent↗
PubMed1975

[Randomised study on histaminelike side-effects of 5 common plasmasubstitutes in orthopedic surgery (author's transl)].

Preceding anaesthesia 750 randomised patients, sub-divided into 5 different age groups, were given 500 ml of a standard plasma-substitute at a flow rate of 25-30 ml/min. There was direct correlation (p=0.1%) of the frequency of side-effects to the substance used; none, however, to the age or general surgical risk. Side-effects were observed in 21.3% with derivates of gelatin as compared to 3.7% with Macrodex and Plasmasteril combined. The rate of more serious anaphylactoid reactions was 6% with Haemaccel, 1.3% with Gelifundol-S, 0.67% with Macrodex and less than 0.67% with Neo-Plasmagel. The study reveals that serious side-effects may be expected in orthopaedictic patients after application of plasma substitutes. As a prophylactic procedure for those patients we recommend, therefore, the application of these substances only after careful consideration of the indications for their use.

Adult↗