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Biomedical subjects

H Hartmann

Publications and source records attributed to H Hartmann.

At least 37 records · Page 2Linked to original sources
PubMed1979

[Results of 200 renal transplantations (author's transl)].

Two hundred renal transplantations were performed on 187 patients between July, 1972 and June, 1978. On a follow-up of 6--78 months the survival rate after allogenic transplantation was 80% at one year and 64% at five years. Satisfactory renal function was present in 62% at one year and 31% at six years. Gastrointestinal complications were common and caused about 40% of all deaths. Severe infections were the second most common cause of death. Local complications required explantation in 4%, and caused death in 0.5% of cases. Change in the treatment regimen, using less massive immunosuppressive measures during acute rejection, lowered the death-rate without a higher loss of transplants. The death-rate was 16% at three months and 26% at one year in the first of the 200 transplantations, but 6% and 12%, respectively, in the last 50 consecutive transplantations. The survival rate of patients with transplants is thus comparable to that of patients receiving chronic haemodialysis.

Azathioprine↗
PubMed1979

[Intoxication at the wheel].

A large body of experimental and statistical evidence demonstrates that even mild alcohol intoxication with blood alcohol concentrations above 0,5% is associated with a significantly increase in the susceptibility for an accident. The lowering of the critical concentration limit is indicated from a medical, social-political and economical point of view.

Accidents, Traffic↗
PubMed1979

[Etiology and prevention of pelvic injuries in traffic accidents].

With hospitalized traffic accident victimes fractures of the pelvis are not very frequent (4-10%). Fatal cases show a higher fracture incidence (20-25%). Pedestrains are with regard to pelvic fractures twice as frequently affected as other road users. Pedestrians over 60 years of age are most often involved. Modifications of the car front structure are expected to lead to significant improvements for the unprotected road user. Seat belts are capable of reducing pelvic fracture with car occupants only in certain frontal collisions. However, the geometry of the lap belt portion is of importance for the overall effectiveness of the belt system.

Accidents, Traffic↗
PubMed1978

Picotamide: effects on coagulation, fibrinolysis and platelet aggregation during prolonged administration in the aged.

Picotamide was administered in a daily dose of 1500 mg per os for 30 days to 30 aged, arteriosclerotic subjects and as single doses of 500 mg and 1000 mg to another group of 16 subjects. A reduction of platelet aggregation (methods of Born and Breddin) was observed within 24 hours of commencement of treatment and became more evident in the subsequent days. The reduction was both consistent and significant. A marked increase in fibrinolytic activity (fibrin plate method) was observed during the first 24 hours, particularly for euglobulins with activator. The reaction and clot formation times (r and k) were prolonged and the maximal amplitude (ma) in thrombelastogram was reduced by a definite, though small amount. After the administration of a single dose the maximal effect was observed after eight hours and was still evident after 48 and, to a lesser degree, after 72 hours. The drug was in all cases well tolerated, without any significant side-effects nor untoward reactions.

Administration, Oral↗
PubMed1977

[Therapeutic results and prognostic factors in acute lymphatic leukemia in the adult].

Induction chemotherapy consisting of vincristine, prednisone and L-asparaginase was given to 22 adult patients with acute lymphatic leukemia. Manintenance treatment consisted of methotrexate, 6-mercaptopurine, prednisone and vincristine. Of the 22 patients treated, 14 had a complete remission. The median remission duration was 14 months and the median survival 20 months. 8 further patients were included in an attempt to determine the significance of prognostic factors, but none of the parameters studied influence the course of disease with statistical significance. In general, younger patients and those with lower leukocyte counts at the time of diagnosis seemed to fare better.

Adult↗
PubMed1977

[Drivers license qualification for epileptics].

The question whether a person with epilepsy qualified for a driving licence must be examined from the point of view of the individual as well as that of the community. The general public should be protected against unduly high risks from epileptic drivers, whereas the patient has a right to live as normal a life as possible, which includes driving an automobile. Too rigid criteria for obtaining the license increase the number of persons who evade medical control and drive "illegally". To require physicians to report their epileptic patients to the authorities would be counterproductive; it would also destroy the personal confidence between physician and patient which is so essential for successful treatment. Epileptic persons endanger safety on the road only slightly: 0.1-0.3% of all traffic accidents are due to epileptic seizures. In contrast, abuse of alcohol plays a major role in 6-9% of all accidents, whereas 80-90% are attributable to evident mistakes by the driver. Epileptic patients under regular medical supervision who are licenced on grounds of approved criteria do not cause more accidents than the general population. A dangerous group are, however, those with mental alterations (organic or reactive) and particularly patients with aggressive and expansive-compensatory traits, as well as those driving without permission. Prognostic criteria as to the further course of the disease are paramount for the assessment of qualification for the licence. The following rules have proved their worth: 2 years freedom from seizures (with or without therapy), no abnormalities specific for epilepsy in the EEG, no serious mental changes, regular medical supervision and treatment mus be guaranteed. Departures from these rules should be confined to exceptional cases with the consent of a physician specialized in epileptology. The same holds for admission to higher categories of driving licence, the only practical eventuality being category D (lorries), and even this only in rare cases. It will scarcely ever be possibel to licence a person who has at some time had epilepsy for professional passanger transportation. The attitude of the physician who first sees the seizure patient is often decisive. It is important that he recognizes the problem, objectively informs his patient and from the very outset gives him realistic advice in order to avoid false decisions, particularly regarding his professional career.

Accident Prevention↗
PubMed1977

[The prevention of accidents in dental local anesthesia].

The relatively rare complications developing under local anaesthesia may be due to various causes. The possibilities of the development of accidents under local anaesthesia are outlined; and prophylactic and therapeutic measures are deduced. A schematic premedication cannot prevent the development of complications with a sufficient degree of certainty; for instance, in certain cases the administration of atropine alone will still worsen the course of a complication. On the contrary, an individual premedication should be aimed at, especially in risk patients; the dosage must take into consideration all important factors. Consequently, atropine is of less importance than, for example, psychopharmaca and beta-receptor blockers.

Adrenergic beta-Antagonists↗
PubMed1977

[Is ethanol suitable as an energy carrier in infusion therapy?].

Using experimental animals and human volunteers the suitability of ethanol for parenteral nutrition was investigated. The most evident disadvantage is the relatively low metabolic capacity for intravenous ethanol. A steady state was attained in the animal experiment with the low dose of 0.2 g/kg bodyweight per hour. No indications were found, however, that intravenous ethanol would contribute to the development of a lactate acidosis. Merely a short time before death because of hyperalcoholemia (5-7% blood concentration) an increase in lactate concentration is found which might be caused by circulatory collaps. Additionally, the effect of intravenous ethanol seems to be of minor importance. Small effects were found only in the experimental animal as well as in volunteers. A very strong inhibition of galactose metabolism was found to be a significant effect of ethanol application. Despite of similar metabolic reactions neither the application of xylitol nor of sorbitol causes an inhibition of galactose metabolism. These results might be interpreted as signs for compartmentalisation of the different metabolic reactions in the cytoplasma of the hepatocytes. According to the results of these investigations ethanol merely evokes small acute metabolic effects. The low metabolic capacity and the established hepatotoxicity are indications for a restrained use of ethanol in parenteral nutrition.

Adult↗
PubMed1977

[Studies on calf salmonellosis. 3. Preclinical evaluation of a Smd. Salmonella dublin live vaccine].

Results of preclinical assay, preparation and conservation of a S.-dublin live vaccine based on streptomycin dependent mutants and for oral application are demonstrated and discussed in detail. The used oral vaccine is very good tolerated by calves and results in stable immunity after administration of a daily dose of 5 x 10(10) bis 1 x 10(11) living Smd.-mutants for 10 consecutive days. Complete immunity developes in calves within a period of two weeks after the last antigen administration and persists up to the age of 5 to 6 months. Conserving the vaccine at low temperatures (-15 degrees C) the number of living organism is far-reaching preserved in the first 5 months after preparation. After thawing the vaccine is to be used within a period of 3 days. With respect to the preparation of the live vaccine on semisynthetic nutritiv media some informations are given concerning the improvement of bacterial yield.

Administration, Oral↗
PubMed1977

[Studies on calf salmonellosis. 4. Oral and parenteral immunization with live (Smd) and killed antigens].

Reported are results obtained from studies into oral and parenteral immunisation of calf. The approaches had included the use of live (Smd) or dead antigen from Salmonella (S.) dublin and a combination of the two immunisation methods. Live antigen (Smd) was superior to thermally activated dead antigen, when the oral route was used to prevent S.-dublin injection of calves. The above findings were supported by results from analogous studies in which S. typhimurium and S. dublin or live antigen (Smd) or dead antigen, made of the two, had been applied to mice. (One single subcutaneous) parenteral administration did hardly reveal any difference in favour of live vaccine (Smd). Parenteral administration of live or dead antigen proved to be less effective than repeated oral immunisation, particularly when live vaccine (Smd) was used. Immunity not less than up to six months of age against S. dublin wild strain infection can be provided for young calves by oral immunisation, with Smd vaccine (5. 1010 to 1. 1011 live germs/d) being given on ten consecutive days. Calves orally immunised with live antigen (ten repetitive applications of Smd mutants) are likely to develop an antibody titre (H-agglutinins) against S. dublin. Parenteral boostering,using live antigen, has been accompanied by sensitisation due to oral live antigen administration as well as by dose dependence, as was seen from the bactericidal values. Sensitisation was established from orally immunised calves up to three months old (typical booster reaction). Some of it was attributabale to confrontation with wild strains of Salmonella. The H-agglutinin titres of animals aged threemonths in a calf herd with salmonelloses in which all animals had been orally Smd-immunised were close to those recorded from calves in stocks with no salmonellosis occurrence. Under the conditions of oral immunisation, there had obviously been no action of the wild strain which might have triggered intensive antibody formation.

Administration, Oral↗