Biomedical subjects
H Klingemann
Publications and source records attributed to H Klingemann.
Extracorporeal photopheresis induces lymphocyte but not monocyte apoptosis.
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"To every thing there is a season"--social time and clock time in addiction treatment.
Research on therapeutic interventions and the development or efficacy of treatment services consider 'time' only as a technical, 'objective' condition. Time series analysis and cohort studies describe changes in addiction careers over time, but fail to take into account the role of 'subjective' or 'social time', e.g. the functions of organisational and individual patterns of time use and time budgets. This paper reviews the notion of 'time' in addiction treatment systems. More specifically, the explicit or implicit role played by 'the time factor' in specific types of treatment such as '12-step programs', in-patient, out-patient care and individual treatment plans differs considerably and implies a re-definition and interpretation of 'Past', 'Present' and 'Future'. Temporal conceptions and time estimations of patients and therapists may influence the access to treatment and treatment outcomes. Societal values--lack of time in affluent societies--and a general acceleration in the fields of communication, consumption, work and leisure are mirrored in the treatment system. Recovery as a long-lasting learning process stands in sharp contrast to the 'quick fix'. The question is raised whether a post-modern concept of time is gaining importance as a counter movement, promoting a more individualised and differentiated treatment response and not any longer based on assumingly objective, technical criteria such as cost-efficiency. More research is needed on group-specific time concepts in treatment programs and the acceleration hypothesis in treatment systems.
Intravesicular instillation of E-aminocaproic acid for patients with adenovirus-induced hemorrhagic cystitis.
Hemorrhagic cystitis (HC) is a known complication of allogenic BMT. We report a case of a 28-year-old female with CML in chronic phase, which was treated with a matched unrelated donor (MUD) transplant, complicated by hemorrhagic cystitis on day +42 after the transplant. Adenovirus was isolated from the urine and she was treated with ribavirin, 1 g twice a day for 8 days. We report the use of Amicar (E-aminocaproic acid), 2.5 g solution as bladder instillation to treat the intractable hematuria.
National treatment systems in global perspective.
Drug policy development is mostly viewed as emerging within the nation state. Processes of diffusion of innovative policies have been neglected to a large extent. The comparative study of public policy has demonstrated, however, that diffusion is an important predictor of early policy adaptation. Thus, the analysis asks the general question of the relative importance of endogenous and exogenous effects on the development of drug policies in various countries. Specifically it describes the Swiss debate leading to the popular initiative on 'Youth Without Drugs' as well as the international reactions regarding its liberal outcome. Results of an expert survey show two broad types of reactions. There is one set of countries where chances for the introduction of limited heroin-prescription trials during the next 5 years are considered probable and a second set of countries which seems to be strictly status quo oriented. In the concluding section a model is suggested which systematically considers endogenous as well as exogenous predictors of 'soft' or 'hard' drug policy adoption. Results of a first tentative test of the model are encouraging for future empirical research on diffusion processes of drug policies.
[Emergency Cesarean section--analysis of 143 emergency sections].
Since compromises must be accepted in emergency Caesarean sections in respect of preparation, anaesthesia and hygienic standards, 143 emergency caesarean sections out of a total number of 37,583 deliveries were analysed during 1981-1990 from four different obstetrical departments as well as risks, complications, maternal and foetal morbidity and mortality were studied. In connection with these operations, which are not influenced only by medical factors but also by logistics, two mothers died (1.4%). Perinatal mortality was 3.3% (unpurified perinatal mortality: 8.5%). Neither the influence of time, when the Caesarean section was performed, nor the place of operation (theatre or labor bed), nor the indication for the operation on foetal outcome and maternal morbidity were found. Maternal morbidity was mainly contributed to pre- and intraoperative bleeding. Intraoperatively 12.6% and postoperatively 10.5% of the patients had to be given heterologous blood conserves. In more than a third of the newborn, which had been delivered by emergency Caesarean section, because of a pathological cardiotocogram, the pH values showed no pathological findings. The benefit of an antibiotic prophylaxis in emergency Caesarean sections could be significantly demonstrated, showing the different rates of secondary healing complications. A particular problem exists in emergency Caesarean sections for the delivery of the second twin following spontaneous delivery of the first one (2.8%).
[Subcutaneous mastectomy and simultaneous Strömbeck skin sac reduction].
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