[Causes, prognosis, mortality and treatment of traumatic paraplegias].
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Biomedical subjects
Publications and source records attributed to H Kunst.
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The case of a 42-year-old female patient with central disturbance of respiration was reported which, contrary to the previously described forms of central alveolar hypoventilation, could be characterized by paroxysmal-like apnoic conditions without any feeling of suffocation. Clinically, initial cardiopulmonary complications were primary in this central disturbance of respiration. The possibility of isolated apnoic paroxysms as an expression of a true cerebro-organic nature of the attacks was described. In addition, the attempt was made to localize the morphological or functional disturbance at the basis of the observed pathological process in the bulbopontine area of the brain stem on the ventral side of the medulla in the area of the point of exit of the seventh to the twelfth cranial nerves. With anticonvulsive and analeptic treatment, a distinct improvement could be observed in the disease after the cardiopulmonary complications had subsided.
In recent years the lethality of purulent meningitis has not fallen significantly in spite of antibiotic therapy. Aspects are indicated which complicate the successful treatment of purulent meningitis, and in addition the problems of artificial respiration, the provocation of cerebro-organic paroxysms by high dose penicillin therapy, the not uncommonly observed hemorrhagic diatheses, disturbances of acid-base balance and the results of neuropathologic and echoencephalographic investigations are discussed. In addition to beginning treatment early and selective antibiotic therapy, intensive medical measures can contribute to an improvement in the prognosis of purulent meningitis.
No fundamental change in the pathogen spectrum of purulent meningitis in adults has occurred between 1951 and 1974. It should be noted, however, that there is an increase in gram-negative pathogens. The lethality has in fact decreased during the period of observation, but the prognosis of pneumococcal meningitis has not been decisively improved by high dosage therapy with penicillin or ampicillin.
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