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Biomedical subjects

H A Hirsch

Publications and source records attributed to H A Hirsch.

At least 55 records · Page 3Linked to original sources
PubMed1982

[Short-term therapy of postoperative urinary tract infections in gynecology].

The clinical efficacy of short-term therapy was investigated in a prospective study of 100 patients with urinary tract infection following gynecologic surgery. Nitrofurantoin macrocrystals were administered to 50 patients in a dosage of 100 mg every 12 hours for two days, trimethoprim/sulfamethoxazole was administered also to 50 patients in a dosage of 160 and 800 mg respectively every 12 hours for two days. The cure rate for nitrofurantoin macrocrystals was 76%, that for TMP/SMX 86%. The differences between the cure rates of the two antimicrobials and the cure rates of the 2-days treatment and the 7-days treatment used previously were not significant (p greater than 0,1).

Drug Administration Schedule↗
PubMed1982

[The risk of infection to the mother prior, during and after delivery. A registration of nosocomial infections].

During 5 1/2 years all infections arising in the hospital (nosocomial infections) were registered prospectively by an infection control nurse. The incidence of all nosocomial infections in 3192 maternity patients was 2.1%. In 10,569 women following vaginal deliveries 2.6% and in 1,353 women following Caesarean section 21.1%. The commonest infections were urinary tract infections, endometritis, infections of the abdominal wound or the episiotomy, and a phlebitis of the intravenous infusion site. Measures to prevent infection resulted in a steadily decreasing incidence of infections during the 6 years of registration of nosocomial infections.

Cesarean Section↗
PubMed1982

[Amniotic infection syndrome after amniocentesis--a case report].

A severe amniotic infection syndrome with a septic shock and a consumption coagulopathy is reported after an amniocentesis in second trimester. In literature, the risk of an amnionitis after amniocentesis amounts to 0.1%-0.4% and the risk of a severe maternal infection reaches 0.03%-0.19%. The available data show, that the clinical symptoms (rise in temperature, signs of septic shock) start 24-36 hours after the punction. The earlier treatment (evacuation of the uterus or - if necessary - hysterectomy) is accomplished, the more favourable will be the course of the disease with respect to septic shock and DIC. Determination of germs in each amniotic fluid seems to be of prognostic value; thus treatment can be started before infection becomes detrimental for the mother.

Abortion, Therapeutic↗
PubMed1982

[Anatomy and tensile strength of the internal obturator muscle in the framework of a modified technic of the Marshall-Marchetti-Krantz operation].

In a modified technique of the cysto-urethropexy the elevation of the vesicle neck is accomplished by suturing the vaginal fascia to the obturator fascia and the internal obturator muscle. In 10 recently deceased female corpses the tensibility of the internal obturator muscle was tested in conditions similar to the modified marshall marchetti krantz technique. The tensibility of the fixation point to the point of tearing out of the suture is in the mean on each side short of 7 Kp. It can be assumed that the tensibility at the fixation point is increased by the contractility of the internal obturator muscle, which among other functions helps to fix the pelvis in the erect body position. In 7 formalin fixed and 3 non-fixed female corpses the thickness of the internal obturator muscle between the fascia and the obturator membrane was measured. In correct operative technique the obturator membrane is not incorporated into the suture since the thickness of the muscle is approximately 7.5 mm. The vessels and nerves in the obturator canal or not touched by the suture as long as the sutures are placed in the medial portion of the muscle. Variations of the arterial blood supply are mentioned.

Adult↗
PubMed1980

The therapy of anaerobic infections in obstetrics and gynecology.

The sites of infection and causative organisms found at the Department of Obstetrics and Gynecology of the University of Tübingen are reviewed. About 10% were wound infections, and 10% of all organisms were anaerobes. The principles of treatment of obstetrical and gynecological infections by surgery and chemotherapy are discussed. In cases of mixed infections, good antibiotic coverage of both aerobes and anaerobes should be provided.

Anaerobiosis↗
PubMed1980

[Urinary tract infections as a cause for urge incontinence? (author's transl)].

The clinical significance of urinary tract infections was investigated in a retrospective study in 160 patients with different types of urge-incontinence. The diagnosis of urge incontinence was entirely based on urethro-cystometry using the perfusion technique. Clinical signs of urgency were not necessarily evident. Motor urge incontinence was found in 83%, sensoric urge-incontinence in 17% of the patients. Urge-incontinence was rarely associated with urinary tract infection: significant bacteriuria was only found in 8.2%.

Adult↗
PubMed1980

[Initial clinical and cysto-urethral tonometric results with a new modification of the Marshall-Marchetti-Krantz-Operation].

From January 1976 to July 1978 a modified Marshall-Marchetti-Krantz-procedure for correction of urinary stress-incontinence was performed in 260 patients. A follow-up examination was done in 132 patients 6 weeks after surgery and in 96 pateints after 1 year. Urodynamic measurements were carred out in 66 patients, before and 1 year after after surgery. The incidence of perioperative complications was low, severe complications were found in less than 0.5%. Six weeks after surgery the subjective cure rate was 92%, after 1 year it was 80%. Cystoceles were corrected by the procedure and remained so in 87% one year after the operation. The urodynamic evaluations showed an increase of the maximal urethra-closure-pressure and, above all, a marked and significant improvement of the urethra-stress-profile. In 6 patients a motoric urge-incontinence was found at the follow-up examination after 1 year. The results of the new modification of the Marshall-Marchetti-Krantz-procedure are similar to those described in the literature after other operations for urinary stress-incontinence.

Adult↗
PubMed1979

[Nosocomial infections (author's transl)].

Within 3 years 2546 nosocomial infections were registered among 18 897 hospitalised patients of a gynaecological-obstetric university hospital, Results were obtained in a prospective study on the use of nurses specially trained in hygiene. The incidence of nosocomial infections was 13.5% including predominantly asymptomatic bacteriurias and 3.9% without bacteriurias. It was higher after major surgical intervention and lowest in pregnant women, postnatal patients, vaginal deliveries and minor operations. Bacteriurias were the most common infection in all patient groups. They made up 71% of the total, followed by postoperative pelvic infections (7.3%), phlebitis at the site of infusion (6.5%) and abdominal wound infection (4.2%). During the control programme, introduction and reinforcement of various hygienic measures and continuous instruction and control of the wards and treatment rooms by the specially trained nurses the incidence of all nosocomial infections decreased by 48.1% and of urinary tract infections by 42.7%.

Bacteriuria↗