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Biomedical subjects

G Pauser

Publications and source records attributed to G Pauser.

At least 37 records · Page 2Linked to original sources
PubMed1982

[Psychological stress factors in intensive care].

In three intensive care units we looked into the question whether there are environmental situations somewhat equally stressful for the patients using 52 stress items designed by ourselves for the study. The patients had to place the various items in a sequence of increasing annoyance just one day after discharge from the intensive care unit. The most annoying factor for all patients, almost independent of sex and diagnosis, was the item "lack of information and communication". The item "noise and unrest caused by the daily routine and the nursing staff of the intensive care unit" was put in the first place by patients aged more than 50 years. Helplessness and physical impairment are the most annoying factors reported by the ventilated patients. The item "dependence on technical devices" (e.g. ventilators, dialyzer etc.) was surprisingly quoted low by our patients. We conclude that a human orientated intensive care medicine approach should be developed. Further investigations concerning psychical care and help should be performed.

Critical Care↗
PubMed1981

Endorphins: mechanism of acupuncture analgesia.

Discharges were recorded from spinal dorsal horn neurons in response to noxious skin heating (50 degrees C) in anesthetized cats. Repetitive electrical stimulation of the superficial peroneal (SP) and posterior tibial (PT) nerves inhibited these nociceptive discharges as well as systemic administration of met-enkephalinamide (synthetic endorphin). The inhibitory effects of electro-stimulation as well as administration of synthetic endorphin were partially but significantly antagonized by naloxone, thus arguing in favor of endogenous morphine release as the basis for the mechanism of acupuncture analgesia. However, non-responding neuronal units to the administration of enkephalin were also observed in the present study. These non-responding units may explain why acupuncture is not effective in some individuals.

Acupuncture Therapy↗
PubMed1981

[Home-respirator treatment in idiopathic hypoventilation (author's transl)].

A report is given on a 66 years old patient with severe idiopathic hypoventilation. Two years ago the disease had developed rather suddenly with severe hypoventilation during sleep, accompanied by marked hypoxemia and hypercapnia with pCO2-values above 100mm Hg and respiratory acidosis. No pulmonary, cardiac or neurological disease was found. After failure of two attempts of stimulation of the phrenic nerve the patient was admitted to a respiratory intensive care unit and ventilated by a respirator during sleep. After improvement of this general condition he was discharged at first only in the daytime, later he could be discharged fully from the unit, after a respirator had been installed in his home. Now the patient is connecting himself to the respirator during sleep and since 20 months is so in a tolerable condition. The indications for home-respirator treatment are discussed.

Aged↗
PubMed1981

[3-years' domiciliary respirator therapy in idiopathic hypoventilation syndrome (ondine's curse syndrome) (author's transl)].

A 67 years old patient with a tracheostomy and cribral cannula on account of severe idiopathic hypoventilation syndrome was discharged from the intensive care unit having been supplied with a respirator (MK 8-Bird) and compressor by his health insurance. The domiciliary respirator therapy was continued for more than 3 years. The disorder manifested itself initially in severe hypoventilation during sleep, acute hypoxaemia, hypercapnia and respiratory acidosis. The patient himself and his family took on the adjustment and maintenance of the respirator, having being appropriately trained before his discharge from hospital. The treatment succeeded for over 3 years in maintaining an acceptable quality of life for the patient.

Aged↗
PubMed1980

Rheospirography for determination of respiratory volume.

The method of rheospirography was investigated in 26 voluntary test persons. By means of a spirometric measuring method and after calibration, quantitative statements about size and changes of respiratory minute volume and inspiratory volume could also be evaluated. Computerizing the computation method, rheospirography is suitable for long-term monitoring in intensive care patients.

Computers↗
PubMed1980

[Cardiovascular effects of two synthetic enkephalin analogues following intracoronary administration in dogs (author's transl)].

Haemodynamic changes following intracoronary injection of two synthetic Met5-enkephalin analogues (FK 33-824 and DALA) with prolonged action as compared with "natural" enkephalines were investigated in anaesthetized dogs (n = 5; dosage; 200, 400, 600 micrograms of both substances i. cor.). DALA led to a shortlasting (5 minutes) rise in heart rate associated with an increase in cardiac output and left ventricular dp/dt max. Besides, a fall in mean arterial blood pressure was noted. No alterations in the pulmonary circulation were encountered. FK 33-824 elicited similar, but unpronounced changes. Direct influences on baroreceptor activity or endogenous release of vasoactive substances as the cause of circulatory effects occuring primarily under DALA were discussed. It is concluded that the cardiovascular effects of synthetic opioids resemble those of morphine and its related compounds.

Animals↗
PubMed1980

[Inversed ratio ventilation (IRV). Role of the respiratory time ratio in artificial respiration in ARDS].

Considering the advantages shown by the experiences of Reynolds on prolonged inspiration time it was suggested to study this type of ventilation also in ARDS. We tried the inverse ratio ventilation (IRV) in patients with ARDS and in postoperative cardiac surgical patients. An obvious improvement of gas transfer in the lung is seen and becomes better with increased duration of this type of ventilation. A better filling of various parts of the lung with longer time constants is achieved with prolonged inspiration. An effect similar to PEEP caused by an air trapping mechanism, can be seen with the shortening of expiration time. This air trapping mechanism is followed by autonomous adaption of PEEP for the local situation in various parts of the lung. A higher PEEP in poorly ventilated areas is automatically adjusted with IRV, than in areas with a short time constant (individual PEEP).

Biophysical Phenomena↗
PubMed1979

[Assessment of the cardiac output by impedance cardiography (differential rheography) to give optimum continuous positive pressure ventilation (author's transl)].

It is very important to know the cardiac output in artificial positive pressure ventilation for the determination of the exact dosage of dopamine and the endexpiratory pressure. Invasive monitoring of the cardiac output is not suitable for routine bedside use. In our study we looked into the question of whether the dosage of dopamine in continuous positive pressure ventilation could be controlled by impedance determination. Differential rheography, as described by Kaindl, Polzer, and Schuhfried, was used in the study. Relative changes in cardiac output after dopamine administration are shown with sufficient accuracy using the above-mentioned method.

Cardiac Output↗
PubMed1979

[The alveolar-arterial oxygen quotient. standard norms, clinical findings (author's transl)].

From the practical standpoint of view the A-aDO2 proved to be a good parameter for evaluation of global gas exchange. The endexspiratory oxygen pressure, recorded by mass spectrometry, is set equal to the alveolar oxygen pressure. Therefore it is possible for clinical use to have an on line monitoring of PETO2--PaO2. It is necessary to specify the pressure difference in dependence of the inspiratory oxygen pressure since the alveolo-arterial oxygen pressure difference increases with increasing inspiratory oxygen pressure concentration. For practical clinical purposes we come out with the relative ratio of the difference adjusted to the alveolar oxygen pressure. The alveolar-arterial oxygen quotient also called "quotient": formula: (see text) has proved to be a clinical suitable figure. For this quotient are no standard norms reported in the literature. This study was set up to evaluate the quotient in 9 healthy volunteers. The standard norms, found in our study, can basically used for practical clinical purposes. This quotient is demonstrated to be practicable in intensive care medicine (obstructive pulmonary disease, acute pulmonary failure, positive pressure ventilation).

Adult↗
PubMed1978

[Somatostatin in the treatment of acute haemorrhage from a duodenal ulcer (author's transl)].

A massive haemorrhage from a duodenal ulcer verified on endoscopy in a 21 year-old patient was stopped by a 62--hour infusion of somatostatin at a dosage of 250 microgram/hour. Suppression of gastric secretion is probably more important than the reduction in splanchnic blood flow with regard to the mechanism of action of this drug. No side effects were observed.

Adolescent↗
PubMed1978

[Inhibition in the spinal cord: a neuronal mechanism of hypalgesia produced by acupuncture (author's transl)].

Central nervous system mechanisms of nociception and pain were studied electrophysiologically in the spinal cord of cats. A great proportion of dorsal horn neurons respond to noxious skin stimuli, for instance to heating to 50 degrees C; such stimuli predominantly activate afferent C fibres. These spinal neurons participate in the transmission of nociceptive information to the brain. The heat-evoked discharges of dorsal horn neurons are effectively inhibited by repetitive electrical stimulation of large;, low-threshold cutaneous A fibres. The inhibition reaches its maximum effect after several minutes of nerve stimulation, and declines at a slow rate after the end of stimulation. This long-term suppression is considered to be a neuronal mechanism underlying hypalgesia produced in man e.g. by acupuncture and by transcutaneous nerve stimulation.

Acupuncture Therapy↗
PubMed1978

[Pain relief in childbirth; an analysis of the analgesic effects of transcutaneous nerve stimulation (TNS), pethidine and placebos (author's transl)].

The analgesic affects of TNS, pethidine and placebos on labour pain were studied in 30 parturient women during the first stage of labour. 10 had TNS paravertebrally in the region of the afferent nerves at Th 10-Th 12; one group of 5 had unspecific (wrong) TNS; in another group of five no current was applied (placebo); five women were given 50 mg of pethidine intravenously; five patients acted as a control group. To assess the analgesic effects the women were asked to estimate the intensity of pain (grades 1-6) over a period of 70 minutes. There was no significant difference between the placebo, unspecific TNS and control groups as regarded the increase in pain during the test period. Patients who had received pethidine and those who had been given TNS at the site of the afferent nerves transmitting impulses from the uterus experienced considerable relief of pain. The differences were highly significant. The observations prove the genuine analgesic action of TNS. The use of this technique in obstetrics is discussed.

Afferent Pathways↗