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D Schött

Publications and source records attributed to D Schött.

At least 19 recordsLinked to original sources
PubMed2000

Prediction of angiographic carotid artery stenosis indexes by colour Doppler-assisted duplex imaging. A critical appraisal of the parameters used.

The aim of our study was to establish colour Doppler-assisted duplex imaging (CDDI)-criteria to predict an angiographic internal carotid artery (ICA) stenosis of at least 70%, according to the North American Symptomatic Carotid Endarterectomy Trial (NASCET) and European Carotid Surgery Trialists (ECST) methods of measurement. In the following, we describe the findings in 79 patients who were screened for carotid endarterectomy by CDDI and further evaluated by digital subtraction angiography (DSA). In 158 carotid arteries, 107 stenoses of > 30% and nine occlusions were found. Receiver operator characteristic graphs were constructed in order to calculate sensitivities and specificities of the assessment by CDDI in the prediction of high-grade stenoses determined by angiography. Optimal cut-off points were defined by highest accuracy which reflects the combination of high sensitivity and specificity. The critical index of a high-grade ICA stenosis according to the ECST method could be predicted with an accuracy greater than 90% by a systolic peak velocitiy of 1.25 m/s or an area reduction by CDDI of 70%. Corresponding values, 1.6 m/s and 80% area reduction, predicted the stenosis indexes according to the NASCET method less reliably, with accuracies of between 80% and 90%. Flow velocity criterion was slightly less accurate than the area reduction criterion by CDDI. Finally, double-blind evaluation performed by two readers per examination modality showed that the measurement of area reduction in CDDI is at least as reliable as stenosis indexes according to ECST and NASCET methods.

Adult↗
PubMed1998

[Dyspnea and lung function. Results of a multicenter study].

UNLABELLED: In seven pneumological centres 266 patients with different pneumological diseases were investigated. After having clarified several questions regarding the severity of the dyspnoea, cough intensity and the volume of sputum, as well as basic clinical investigation and after an x-ray of the thorax, the diagnosis was arrived at. Subsequently the lung function investigation with the flow-volume curve (including IVC, FVC, PEF, FEV1, MEF50%) and the body plethysmographic Rt and IGV were carried out. Different quality control procedures at and between the different centres ensured comparable results. All centres agreed to using methods well compatible with each other. The question as to which kind of parameters of lung function would agree best with the amount of the dyspnoea, was resolved. The causes for the large scatter of the results are described. Cough and sputum exercise an influence even on the degree of dyspnoea, but not by deteriorating the lung function. The results are shown for the entire collective (Part I) in respect of the different diagnoses (Part II). With different diagnosis the same significant correlations exist but the curves are positioned at different levels of the coordinate system. CONCLUSION: Significant correlations exist between the dyspnoea scale and function parameters. There are individual differences between the dyspnoea scale and disturbances of the function parameters. Carefully performed lung function analyse definitely important in any case.

Adult↗
PubMed1997

[Etiology and reproducibility of blood gas findings during stress testing in patients with obstructive respiratory tract diseases].

After the stabilization of the obstructive airways disease 14 patients performed 4 times exercise-tests of 6 minutes at a bicycle during one week. The basic values of the lung function showed with FEV1 of 66%, Rt of 5,74 hPa/l/s and IGV of 155% a strong disturbance of the mechanical features of the lung. At the mean during the exercise tests the PO2a remained with 69 Torr constant. PC2a increases at the same time for 3 Torr. After the exercise test a significant increase of PO2a of 11.4 Torr takes place. At the individual patients there was a great variability of the results between the different tests. Only three patients showed always a decrease of PO2a-values. The reason for this variability is the ventilation/perfusion inhomogeneity, which changes between the investigations. There are significant multilinear correlations between the FEV1%- as the IGV%-values and PO2a for the values at rest, during exercise as 5 min after the end of exercise. The exercise tests show at the PO(2a)-values the variability of the ventilation/perfusion inhomogeneity which dominates the bloodgas values. The important increase of the PO2a after the exercise test even at this patients can be of importance. The duration of this effect after multiple loads and the dependence of the workload should be investigated.

Aged↗
PubMed1997

COPD: results of long-term treatment.

During the last decades the life expectation of patients with COPD increased continually. Today the life expectation of these patients reach that of the normal general population. Most important for this effect is the improvement of the therapeutical possibilities. Following the experience over nearly 3 decades the treatment regime is described. Glucocorticosteroids are at first line as much as necessary and as less as possible, starting with the inhalative forms adjusted at the clinical course stabilizes the situation. Bronchodilatation around the clock and as good as possible is a further important step. These effects have to be functionally-analytically controlled. It is not enough to follow only the clinical impression. beta 2-sympathicomimetics are the overall dilators with strongest effects and increase even the clearing mechanisms of the bronchopulmonary system. Short- as long-acting medicaments are available, but the duration of the action at each of the different forms is sometimes clearly shorter as the mean values describe. Anticholinergics and theophyllines have weaker bronchodilatation power, but they show additive effects, which could be used at special situations. Combinations as Berodual (beta 2-sympathicomimetics and anticholinergics) can decrease the dosage of the beta 2-sympathicomimetics and therefore increase the therapeutic range. At the situation of exacerbation antibiotics can be very helpful, but sometimes an increase of the dosage of glucocorticosteroids is necessary and sometimes the increase of this dosage alone can control the situation. It is very important to detect the deterioration which can end with a severe life threatening exacerbation as early as possible and to control the situation already at this stage. It is shown at examples of 56 patients functionally-analytically controlled over 5 years that the function values do not deteriorate during the constant treatment regime any more. Even in spite of the constant treatment with beta 2-sympathicomimetics no signs of any kind of down regulation or of tachyphylaxis of the bronchodilatation power could be detected. A bronchodilatation test after 4.2 years of constant bronchodilatation treatment together with beta 2-sympathicomimetics showed at 25 patients the same effect as normally at acute tests without pre-treatment seen. Because after the start of this treatment regime to-day a further deterioration does not take place, it is important to detect signs of the disease as early as possible. This can be achieved as the basis of lung function values measure over a long time. The best basis for this is the individual norm known from measurement at healthy days.

Anti-Bacterial Agents↗
PubMed1996

[Clinical investigation of the action of tramazoline inpatients with chronic obstructive bronchitis. The importance of mucosal swelling].

Swelling of the bronchial mucosa is discussed as part of the increased airways on patients with obstructive bronchitis (OB). The excellent effect of alpha-receptor-stimulants like tramazoline for the deblockage of the nasal mucosa has been previously established experimentally as well as clinically. On 19 patients with OB tramazoline (CAS 74195-73-6) aerosol (Rhinospray) (0.14 (n = 9) resp. 0.19 (n = 10 mg) was administered into the bronchial system. There were no effects seen on airways resistance nor on the intrathoracic gas volume. The important improvement on patients with OB and nasal blockage at the same time seen after tramazoline aerosol given into the nose is caused only by the effect on the nasal mucosa.

Administration, Inhalation↗
PubMed1994

[Diagnostic value of right thoracic ECG recording in detection of pulmonary hypertension in chronic obstructive respiratory disease].

There are many electrocardiographic criteria of pulmonary hypertension and cor pulmonale. These criteria are generally highly specific but not sensitive. Therefore many patients with pulmonary hypertension remain undetected. The aim of this study was to delineate a sensitive as well as a specific ECG parameter for noninvasive prediction of pulmonary hypertension under special consideration of the right thoracic leads. 75 patients were included in this study, 62 male and 13 female, mean age 62.7 +/- 9.5 years. All presented with chronic obstructive lung disease known since 12.1 +/- 9.7 years. The underlying disease had been confirmed clinically and by body plethysmography. Laboratory and lung function data showed a high air way resistance with a mean value of 6.8 +/- 3.3 cm H2O/l/s and a high intrathoracic gas volume of 149.1% of the expected value. The severity of hypoxemia was variable but generally moderate with a PaO2 of 65.3 +/- 11.6 mm Hg on average. All patients applied aerosols with ipratropiumbromid, fenoterol and glucocorticoids. 92% additionally received aminophylline and 87.0% oral glucocorticoids. Diuretics and glycosides were prescribed in 50.0% and 34.8% respectively. The four right thoracic ECG leads Vr3 to Vr6 were recorded in addition to the common twelve leads I to III, a VR, aVL, aVF and V1 to V6. A modified Sokolow-Lyon-Index (SIm) as a sum of amplitudes of R in lead Vr3 and S in lead V6 and the combination of SIm with PaO2 (SIm-PaO2, n = 44) according to the formula SIm + 0.02 (100--PaO2%) were established. Additionally a right heart catherization by Swan-Ganz technique was performed. The mean values of hemodynamic data demonstrated a constellation of precapillary pulmonary hypertension with high PAPm and pulmonary resistance and low pulmonary capillary wedge pressure (26.4 +/- 12.9 mm Hg, 396.0 +/- 294.0 dyn.s./cm5 and 8.7 +/- 4.2 mm Hg, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

[Chronic obstructive bronchitis. Effect of Gelomyrtol forte in a placebo-controlled double-blind study].

In a double-blind study involving two groups of ten patients with chronic obstructive bronchitis, the expectorant Gelomyrtol forte was tested against placebo for its effectiveness and tolerance. The parameters: amount of sputum, Rt and IGV, together with all the usual clinical laboratory parameters, were determined. In addition, the color of the sputum was always noted. On the basis of patient scores, daily entries on the ability to expectorate, attacks of coughing, general coughing, and shortness of breath were made by the patients for the duration of the 14-day treatment period. On conclusion of the study, the patients were asked to assess the effectiveness of the supplementary medication, and the care-providing physician also assessed effectiveness. All score parameters related to coughing improved, in some cases appreciably, relative to the placebo group. The findings in term of sputum volume and color, were also distinctly better in the Gelomyrtol forte group. Correspondingly, both patients and physicians assessed the effectiveness of Gelomyrtol forte to be distinctly better than that of the placebo. Although the groups are relatively too small and heterogeneous, to establish statistically significant differences, the results do strongly suggest a favorable and major effect in patients with relevant cough symptoms. Both subjective and objective tolerance was excellent.

Cough↗
PubMed1990

[Obstructive airway diseases--emphysema. Diagnosis and therapy].

Spirometric examinations are suitable for the diagnosis of airway obstruction, but not of pulmonary emphysema. Whole body plethysmography, in contrast, is the most reliable diagnostic procedure for both conditions, both qualitatively and quantitatively. The basic treatment of any form of airway obstruction consists in the inhalation of beta-2-sympathomimetic drugs; theophyllines are also good bronchodilators, but are less powerful than beta-2-sympathomimetics. Glucocorticoids must always be given when bronchitis also presents, which is only rarely treatable with antibiotics alone. Although regression of pulmonary emphysema is not possible, progression of the destructive process would appear to be inhibited by intensive treatment of the inflammatory bronchitis. Only in the case of patients with congenital alpha-1-antitrypsin deficiency is it possible to administer such causal treatment in the form of substitution therapy. Surgical treatment can be considered only in the case of bullous pulmonary emphysema.

Airway Obstruction↗
PubMed1990

Treatment of severe chronic bronchitis with ceftazidime.

The aim of this study was to determine whether ceftazidime is more effective than other antibiotics in the treatment of severe acute exacerbation of chronic bronchitis, particularly when other antibiotics have previously failed. Our investigations showed that ceftazidime is effective and well tolerated in patients with severe chronic bronchitis and purulent sputum. The effectiveness of ceftazidime was seen in a reduction of the volume of sputum produced daily and in a colour change from yellow-green to clear-white. The absence of an effect on parameters of lung function was not unexpected since our patients had long-lasting chronic bronchitis.

Aged↗
PubMed1989

[Liver function of patients with arterial hypoxemia in chronic obstructive respiratory tract disease and the effect of nasal oxygen insufflation].

Patients suffering from chronic obstructive airway disease often have arterial hypoxemia, which is more or less severe. If hypoxemia deteriorates the function of the liver is still unknown. The aim of this study was to determine, if a mostly oxygen dependent process of liver metabolism (galactose elimination capacity) is disturbed and if it can be increased by oxygen insufflation. Under the same conditions an oxygen independent process (indocyaninegreen clearance) should not be influenced. Our results show, that galactose elimination capacity under room air was pathologic and can be increased significantly by oxygen breathing. No change of indocyaninegreen clearance was seen under the same conditions. After termination of oxygen therapy the galactose elimination capacity was as bad as before oxygen breathing. Dysfunctions of the liver, which are caused by hypoxemia, can be positively influenced by oxygen, but only for the duration of oxygen insufflation.

Aged↗