PubMed Health⌕ Search

Biomedical subjects

E Mangel

Publications and source records attributed to E Mangel.

7 recordsLinked to original sources
PubMed2000

Clinical manifestations of AB-amyloidosis: effects of biocompatibility and flux.

BACKGROUND: Highly permeable biocompatible dialysis membranes may postpone the development of AB-amyloidosis, but the relative contribution of enhanced flux or reduced inflammation by highly biocompatible membranes and sterile dialysis fluid remains unknown. METHODS: In this retrospective investigation, 89 patients with end-stage renal disease maintained on regular haemodialysis for at least 10 years and treated with one type of dialysis membrane exclusively were selected for analysis. They were divided into three groups: low-flux, bioincompatible cellulose (I), low-flux, intermediately biocompatible polysulphone or PMMA (II), or high-flux, highly biocompatible polysulphone or AN69 (III). In addition, the patients were analysed according to the microbiological quality of the dialysis fluid, which had been tested regularly and was classified either as standard or as intermittently contaminated. The clinical manifestations indicative of AB-amyloidosis, namely, carpal tunnel syndrome, arthropathy and bone cysts, were diagnosed after recruitment. RESULTS: Clinical symptoms were most pronounced in group I, intermediate in group II, and lowest in group III. Patients treated with intermittently contaminated dialysis fluid showed a higher prevalence of AB-amyloidosis than patients with less contaminated dialysis fluid. Logistic regression analysis demonstrated that the flux characteristics of the dialyser and the microbiological quality of the dialysis fluid as well as the biocompatibility of the dialyser were independent determinants of AB-amyloidosis. CONCLUSION: It would be prudent clinical practice to employ high-flux biocompatible membranes in conjunction with ultrapure dialysis fluid for the treatment of end-stage renal disease patients who need to remain on long-term haemodialysis.

Acrylic Resins↗
PubMed1996

[Percutaneous transhepatic stent implantation versus hepaticojejunostomy in palliative therapy of distal malignant bile duct stenosis].

The value of radiologically controlled stent implantation compared to hepatojejunostomy in palliative treatment of tumor induced cholestasis was examined in a non randomised retrospective study. 54 patients suffering of adenocarcinoma of the pancreas (n = 34), carcinoma of the distal bile duct (n = 10) and metastatic induced stenosis of the common bile duct (n = 10) were compared in regard to survival time, normalisation of cholestasis and complication rate. The survival time following stenting procedure (n = 31) is 6.0 months, after operation (n = 23) 7.1 months. The reduction of cholestasis showed no significant difference. The complication rate is lower (operated group 12.9%, stented group 9.6%) and the hospital stay following stenting procedure was much shorter (6.1 d vs. 18.0 d). Both a positive side effect of stent implantation.

Adult↗
PubMed1994

Interobserver agreement in defecography.

PURPOSE: This study was designed to test the reproducibility of the diagnostic assessment of defecographies in patients with a suspected disorder of defecation. METHODS: To evaluate interobserver agreement, 100 defecographic series of patients with complaints suggesting a disordered defecation were evaluated independently by three observers with a standardized questionnaire. After six weeks, a random sample of 35 of 100 defecographies was evaluated a second time with clinical data provided (history, proctologic examination). To evaluate whether the position of residual volume in the rectum would affect agreement, patients with substantial retention either in the upper or lower rectum were also evaluated separately. RESULTS: Total agreement regarding rectocele and internal prolapse was 0.81 and 0.75, respectively (1.0 = complete agreement), and was significantly higher than chance agreement. Total agreement regarding residual volume in the rectum at the end of defecography and clinical relevance of findings was not different from chance agreement, providing clinical data did not significantly improve agreement. When residual volume was situated in the lower rectum, agreement regarding incompleteness of emptying and its clinical relevance was much better (0.93). CONCLUSIONS: Interobserver agreement is good regarding the deformation of the rectum during defecography but not different from chance agreement regarding the completeness of evacuation.

Adult↗
PubMed1992

Is the volume retained after defecation a valuable parameter at defecography?

The intention of this study was to correlate the retained volume at the end of defecography to certain defecographic findings and to the sense of incomplete emptying. In 170 defecographic series, the retained barium was estimated planimetrically. No particular defecographic finding determined a higher or lower amount of remaining volume, and the sense of incomplete evacuation did not depend on the amount of retained volume. Thresholds of urge and perception on anorectal manometry did not differ between patients with and without the feeling of incomplete evacuation. A rectocele, isolated or combined with an internal prolapse, caused the retained volume to be in the lowermost part of the rectum, whereas, in the case of an isolated intussusception, the remaining volume was located in the middle or higher part of the rectum. It is concluded that defecographic findings do not in general explain incomplete emptying or the sense of incomplete emptying, but they may determine the localization of the retained volume.

Adult↗
PubMedDate not supplied

Indications, management, and complications of temporary inferior vena cava filters.

PURPOSE: We describe the results of a preliminary prospective study using different recently developed temporary and retrievable inferior vena cava (IVC) filters. METHODS: Fifty temporary IVC filters (Günther, Günther Tulip, Anthéor) were inserted in 47 patients when the required period of protection against pulmonary embolism (PE) was estimated to be less than 2 weeks. The indications were documented deep vein thrombosis (DVT) and temporary contraindications for anticoagulation, a high risk for PE, and PE despite DVT prophylaxis. RESULTS: Filters were removed 1-12 days after placement and nine (18%) had captured thrombi. Complications were one PE during and after removal of a filter, two minor filter migrations, and one IVC thrombosis. CONCLUSION: Temporary filters are effective in trapping clots and protecting against PE, and the complication rate does not exceed that of permanent filters. They are an alternative when protection from PE is required temporarily, and should be considered in patients with a normal life expectancy.

Adult↗
PubMedDate not supplied

Do computers teach better? A media comparison study for case-based teaching in radiology.

A prospective study was performed to better define the role of computers in teaching radiology to medical students. Two hundred twenty-five 3rd-year students were randomly assigned to one of four groups and exposed to 10 radiology cases as well as to a voluntary weekly radiology lecture. Group A used computer-based cases with interactive elements; group B used computer-based cases without interactive elements; group C used paper-based cases with interactive elements; and group D was not exposed to the cases and served as a control group. On a multiple-choice question test, groups A, B, and C showed significant improvement (+11.2%, +15.1%, and +13.0%, respectively), whereas group D did not (+0.6%). On an image interpretation test, group A showed the most improvement (+15.7% [P <.001]), followed by group B (+15.1% [P <.01]) and group C (+10.2% [P <.05]); group D showed no significant improvement (+8.5%). No significant differences in the learning outcome were found between the two interactive groups (computer based and paper based). Computer-based teaching with case studies (with or without interactivity) improves students' problem-solving ability in radiology.

Chi-Square Distribution↗