Biomedical subjects
E Deutsch
Publications and source records attributed to E Deutsch.
[Prof. Kurt Polzer on his 70th birthday].
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[Morbidity during regular dialysis treatment and after renal transplantation (author's transl)].
Renal transplantation was associated with a lesser degree of morbidity than chronic dialysis treatment in a group of 48 patients with end-stage renal failure. Morbidity was defined as total days of in-patient hospitalization divided by total days of risk. The morbidity during chronic intermittent dialysis, with a mean observation time of 296.1 (20 to 2255) days, was 11.8%, whereas after renal transplantation, with a mean observation time of 1004.0 (131 to 2400) days, only 7.6% of all days at risk were spent in hospital. Morbidity rises to 38.1% during chronic dialysis if all dialysis days on an out-patient basis are considered as hospitalization days. Morbidity was lowest (3.8%) in patients sent home for the first time with a functioning graft. Cardiac complications and fluid lung were the most common causes for morbidity during haemodialysis treatment; morbidity after renal transplantation was mainly due to renal rejection and infections under non-specific immunosuppression. Social and occupational rehabilitation was better after renal transplantation than during haemodialysis treatment. It can be concluded from these data that with regard to the quality of life renal transplantation is the preferable alternative in the management of end-stage renal failure.
Migraine, serotonin, and the carotid body.
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Effect of treatment with activated prothrombin complex concentrate (FEIBA) on factor VIII-antibody level.
The influence of treatment with an activated prothrombin complex preparation (FEIBA) on the antibody level was studied in 10 haemophiliacs with an antibody to factor VIII. The antibody level was observed to rise at least once in five patients, while in the remaining five patients no rise occurred. In all, 6 out of 31 treatments were followed by an anamnestic rise of the antibody level, corresponding to 19.4%. A rise of the inhibitor level following FEIBA treatment is likely to occur in patients who show a marked antibody rise after factor VIII treatment (good responders), but have a low antibody level at the time of treatment. High doses of FEIBA and simultaneous of red cells may also enhance the likelihood of an anamnestic response. Stimulation of antibody production is probably due to the presence of small amounts of factor VIII in this preparation.
Gastric infarction: a complication of selective vasopressin infusion.
This report describes a case of massive gastric hemorrhage, initially controlled by selective arterial vasopressin infusion. Infusion was followed by extensive necrosis of the gastric wall which necessitated subtotal gastrectomy. Gastric necrosis following arterial infusion is rare and in this case appears to be due to migration of the infusion catheter into a peripheral branch of the left gastric artery in a patient whose gastric circulation had been compromised by prior surgery. The complications related to the use of arterial infusion for the control of gastric hemorrhage are discussed and the literature is reviewed.
"Triple infections" (fungal, bacterial and viral) in immunosuppressed renal transplant recipients.
In a period of 5 years, 8 out of 77 renal transplant patients showed simultaneous fungal, bacterial and viral infections. Candida albicans was found in all cases. The most severe bacterial complications were infections with Klebsiella, Pseudomonas and Staphylococcus aureus. Cytomegalovirus, persistent HBsAg positive hepatitis, herpes zoster, and herpes simplex infections were also found. Seven patients died of bacterial superinfection and miliary tuberculosis. The data presented show that "triple infections" are associated with high mortality and that miliary tuberculosis occurred frequently in immunosuppressed renal transplant recipients.
Studies on the prothrombin--complex.
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Continuous body weight loss in chronic uraemia.
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[Panel discussion: problems of the specialist's duty to inform the patient (author's transl)].
The obligation of the physician to inform the patient--which he has to prove in case of a suit--is based on the patient's right of selfdetermination. This self-decision information was subject of the panel discussion. Not discussed in detail were the information concerning diagnosis and prognosis, and the instruction of the patient regarding his conduct postoperatively and during medical treatment. Not considered was the so-called malpractice and negligence respectively. Medical liability suits are increasing for various reasons and are frequently directed at a failure to inform the patient because the patient is often unable to prove a negligence of the physician ("surrogate liability"). The dimension of the duty of disclosure (complete information--no information at all) is discussed in general and with special regard to the radiological field.
[Changes in the pathology of middle ear infections through primary medical care in a Mexican preindustrial community].
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[Compulsory health education and consent to surgery].
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[Pathophysiology of blood coagulation].
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Comparison of the pharmacodynamic effect of muzolimine and furosemide in patients with advanced chronic renal insufficiency.
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[Cholesterol deficiency. A pathogenetic factor in chronic anemias? Preliminary report of a study in three states (author's transl)].
It has been shown in several studies that there is a statistically confirmed connection between cholesterol and Hb levels in the sense that hypocholesterolemia and anemia occur together particularly frequently. This was demonstrated in an epidemiological cross-section study of 3958 patient data, and also that in a retrospective case control study of 159 anemias there wasa concurrent hypocholesterolemia. It is explained by the fact that cholesterol deficiency leads to rigidity of the erythrocytes.
[How should oral anticoagulant therapy be ended?].
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[Successful haemodialysis treatment of acute renal failure in a patient with multiple myeloma (author's transl)].
A case of multiple myeloma with severe osteolytic destructions and myeloma kidney is presented, in whom a rapidly progressive renal insufficiency because of hyponatraemia and dehydration developed. After 5 months of regular dialysis treatment diuresis increased and a sufficient global kidney function recurred. Aetiological factors and the pathomechanisms of acute renal failure in multiple myeloma are discussed. We assume that acute renal insufficiency is - in rare cases - at least partly reversible. Therefore patients with acute renal failure and multiple myeloma should not be excluded from haemodialysis treatment because even complete rehabilitation can be achieved.
[Pathogenesis of thrombocytopenia. 2. Distribution disorders, pseudo-thrombocytopenias].
A review of the pathogenesis of thrombocytopenias is given. The various types of thrombocytopenia are classified according to the main pathogenetic mechanisms such as reduced platelet production, increased platelet destruction and disturbed platelet distribution by splenic pooling. Finally thrombocytopenia by artefacts is discussed such as platelet satillitism and spontaneous aggregation. In the second part of the paper the differential diagnosis of several forms of thrombocytopenic purpura is presented.