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Biomedical subjects

G Drack

Publications and source records attributed to G Drack.

13 recordsLinked to original sources
PubMed2005

Pregnancy-associated spontaneous coronary artery dissection: impact of medical treatment. Case report and systematic review.

We report on a 22- year-old woman with postpartum dissection of the left anterior descending artery and the intermediate branch. The patient was treated with acetylsalicylic acid (ASA), clopidogrel, and betablocker only. Coronary angiography performed 20 months later revealed complete resolution of the dissection sites. The patient's cardiovascular risk factors included mild smoking and high total cholesterol and low-density-lipoprotein-cholesterol levels, which showed a marked fall after pregnancy without pharmacological cholesterol-modifying therapy raising the question whether pregnancy-related hypercholesterolemia contributed to the pathogenesis of pregnancy-associated spontaneous coronary artery dissection (P-SCAD). In a systematic review of the literature, 16 women [median age 34 (31-36.5) years] with P-SCAD and angiographic follow-up were identified. The majority (69%) of P-SCAD cases occurred postpartum [median time after delivery: 13 (7-21) days]. In 10/16 (63%) patients medical treatment including betablocker and antiplatelet therapy was given leading to complete resolution of the dissection in 5 of them (31% of all patients) at follow-up, whereas in the other 5 patients the dissections were persisting or even progressive. Of the medically treated patients, 80% were free of symptoms suggestive for ischemia at follow-up. In 5/16 patients percutaneous coronary intervention (PCI) was performed as first-line therapy. Three patients underwent coronary artery bypass grafting, which was performed primarily in one patient, and secondarily in two patients with persisting dissections and ongoing ischemic symptoms after previous medical treatment or PCI without stenting, respectively. In conclusion, medical treatment including ASA, clopidogrel and betablocker therapy results in an excellent clinical and angiographic result in approximately one third of patients with P-SCAD.

Adult↗
PubMed2005

[Selfmedication during pregnancy].

A growing publicity drives the growing market of OTC, also in pregnancy. A short overview from this giant market, composed of pharmaceutical drugs, herbal medicines and homeopathic medicaments for a selection of frequent health problems in pregnancy is presented.

Drugs, Chinese Herbal↗
PubMed2003

[Is continuing medical education under suspicion of corruption? Contribution to the discussion by the Committee for Quality Preservation of the Swiss Society of Gynaecology and Obstetrics].

The requirements laid down by law and by the medical profession itself with regard to continuing medical education have recently been tightened. The cost of good training is high, both in time and money. Sponsoring, especially by the pharmaceutical industry, has helped to keep costs down for individual participants. The question of a tariff system for the payment of compulsory training is now being raised. Rates have been set to ensure that, in the future, indirect costs are covered. In the event of a full tariff-based payment of costs being introduced, various disadvantages could be expected both for participants and the quality of the training. Changes in Swiss criminal law and the new medicines act do not forbid sponsoring, but they do call for rules of professional ethics and of personnel law in public hospitals governing behaviour in respect of funding by sponsors. Various sponsoring models are conceivable with differences in allocation to organizers, individual participants or distribution via a pool system. There are strong arguments in favour of continuing the existing practice of mixed funding by participants and sponsoring, provided that it is subject to certain rules of transparency. What is lacking to date is a political decision on the issue of funding for continuing medical education.

Conflict of Interest↗
PubMed1997

[Symposium "Prenatal diagnosis--clinical practice and counseling].

The growing demand for prenatal diagnosis appears to be making these technologies an increasingly normal part of care in pregnancy. Nevertheless, and in spite of an expanding lay literature on the subject, every expectant mother has an undiminished need for personal information and counselling by her physician. At a symposium staged by the Gynecological Clinic, St. Gall, on 1 April 1995 several experts highlighted the technical, ethical and psychological aspects of prenatal diagnosis as well as the practical problems involved in the counselling and care of women and couples in the prenatal situation.

Counseling↗
PubMed1994

[Midwives in Switzerland: a study of the work and recruitment status].

The aim of this study was an analysis of the working conditions for midwives in- and outside of obstetric clinics. The study is based on a representative survey carried out among Swiss midwives in 1991 and on statistics of the Swiss Red Cross and the Swiss Federal Statistical Office. It could be shown that there is a high degree of professional satisfaction especially among midwives working on their own; of the negative aspects, the irregular work load and an inadequate income were among the most often named problems. Recruitment problems were evident, as there is a clear lack between the available places in the Swiss schools for midwifery and the need for midwives in this country, at least during periods of a relatively favorable economic situation.

Female↗
PubMed1993

[Management of mono-amnion twin pregnancy].

There have been only a few reports on monoamniotic twin pregnancies from the period of modern perinatology. Consequently, available recommendations about the management of these high-risk pregnancies are uncertain. In this study, we present the management and the outcome of three monoamniotic twin pregnancies and two further pregnancies with acardiac acephalus twin in comparison to other case reports and case series from the literature. Practical ways of caring for these high-risk pregnancies are outlined, emphasising the continuous search for entanglement of umbilical cord by ultrasound and cardiotocography. The special importance of intensified cardiotocographic monitoring is demonstrated.

Adult↗
PubMed1991

[Magnesium sulfate 4% xylitol infusions solution for the treatment of hypertensive disorders in pregnancy].

A new magnesium sulphate solution with xylitol for the management of hypertensive disorders during pregnancy has been described. The solution contains 40 g MgSO4 and 16 g xylit in 1000 ml and is isoosmotic with blood serum. It can be sterilised for 15 min. at 121 degrees C without risk of decomposition of the ingredients during and after autoclaving. The solution has been proved in the clinical practice.

Female↗
PubMed1989

[The "HELLP syndrome" without fragmentocytes: do drug-induced antibodies play a role?].

This is a case report on a nulliparous women, who developed the HELLP syndrome following intravenous tocolysis. Contrary to our expectations, neither schistocytes nor signs of intravasal coagulation were apparent; however, we found Fenoterol-associated anti-erythrocyte antibodies. However, the low titre of these antibodies does not explain the massive haemolysis. It is suggested, that these antibodies represent a causal factor in developing the HELLP syndrome.

Adult↗
PubMed1988

[Pregnancy and delivery in a mother with Ebstein's anomaly].

Ebstein's anomaly is characterized by abnormalities both in the basal and in the free attachments of the leaflets of the tricuspid valve. Fairly frequently the developmental defect is associated with a WPW syndrome (Type B). The main obstetric problems arise from tachyarrhythmias. Since tachycardias in these patients are due to physical stress, correct planning of delivery calls for lightening of the hemodynamic burden of labor, careful analysis of the cardiac status, meticulous preparation for optimum antiarrhythmic therapy and correct timing for induction of labor. The case of a young primipara with Ebstein's anomaly is presented to typify the need for cooperation of subspecialities.

Adult↗
PubMedDate not supplied

[Doppler ultrasound studies before and following short-term maternal stress in late pregnancy].

Ten gravidae with normal course of pregnancy in the third trimester underwent a bicycle stress test (semi-supine, 75 W, 3 min). By means of pulsed Doppler sonography, a lowering of the resistance index (RI) in the maternal femoral artery from 93% to 69% was ascertained, though also a rise in maximum systolic velocity (VMAX (syst)) from 73 cm/sec to 194 cm/sec, in maximum diastolic velocity (VMAX diast)) from 5 cm/sec to 61 cm/sec, and in the time-averaged maximum velocity (TAVMAX) from 20 cm/sec to 101 cm/sec. These changes are statistically significant. In the maternal common carotid artery these parameters remained stable or changed little, for example VMAX (diast), which dropped from 24 cm/sec before to 19 cm/sec after exercise, and the RI, which rose from 77% to 84%. Neither in the uteroplacental vessels nor in the umbilical artery were any changes in the RI found (40% to 42% and 58% to 57%, respectively). The fetal cardiotachograms were normal in all cases, while not all cases manifested a rise in fetal heart rate following maternal stress. These results indicate that uteroplacental perfusion and the umbilical circulation remain constant. Doppler sonography thus demonstrates directly and noninvasively that provided placental function is normal the uteroplacental and fetoplacental circulation are not influenced by moderate physical exertion.

Blood Flow Velocity↗