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Biomedical subjects

H Lübbers

Publications and source records attributed to H Lübbers.

15 recordsLinked to original sources
PubMed2005

[Diagnosis and therapy of chronic pancreatitis].

Chronic pancreatitis is characterized by recurrent or persisting pain. As the exocrine pancreatic insufficiency occurs early in the progression of the disease, the endocrine function may persist intact. Imaging procedures and pancreatic function tests are used to make a diagnosis. Therapy consists of pain reduction, which might require endoscopic or surgical intervention. Treatment of exocrine and endocrine pancreatic insufficiency is based on diet and substitution of pancreatic enzymes, minerals and vitamins, as well as insulin.

Abdominal Pain↗
PubMed2003

[Acute pancreatitis].

While interstitial acute pancreatitis usually takes a benign course, necrotizing acute pancreatitis takes a severe course, mainly because of severe local and systemic complications. After a quick diagnosis it is necessary to rapidly assess a degree of severity of the disease and thus the prognosis. The clinical picture and the result of imaging procedures do not always correspond. The management basically includes to treat pain as well as to administer fluid, electrolyte, protein and calories. In addition, systemic treatment of complications such as shock or respiratory and renal insufficiency--if occurring--is necessary. In case of pancreatic necrosis, prophylactic administration of pancreas-penetrable antibiotics is recommended to avoid infection. In the severely ill with infected pancreatic necrosis, surgery is the treatment of choice. In approximately 10% of all patients with alcohol-induced pancreatitis, there is a gradual transition to chronic pancreatitis.

APACHE↗
PubMed2000

Does gastroscopy induce myocardial ischemia in patients with coronary heart disease?

BACKGROUND AND STUDY AIMS: Gastroscopy has been reported to be dangerous for unstable patients with coronary heart disease (CHD). The aims of this study were to find out whether endoscopy is equally liable to cause myocardial ischemia in stable CHD patients, and whether this can be predicted prior to endoscopy, and to find out the frequency of abnormal findings in patients for whom a secondary prophylaxis with acetylsalicylic acid (ASA) is indicated. PATIENTS AND METHODS: Electrocardiograph recording using a Holter monitor was performed during gastroscopy in 71 patients with stable CHD, to check for silent ischemia. To predict potential ischemia during gastroscopy, the Holter monitoring ECG was applied prior to a treadmill test, and withdrawn after gastroscopy 16-22 hours later. RESULTS: During gastroscopy, 30 patients (42%) had silent ischemia, but only 1 patient (1%) became symptomatic. Ischemia was dependent on heart-rate (median heart rate with ischemia 124 beats/min, without 104 beats/min). Abnormal findings on gastroscopy were found in 53 patients (75%). They implied a potential bleeding risk in 30 patients (42%) and prevented the indication for ASA in 6 of them (8%). CONCLUSIONS: Gastroscopy is potentially a harmful procedure for CHD patients, but the incidence of ischemic periods may be reduced by conscious sedation and, if the patient is receiving beta-blocking agent therapy, by applying this medication prior to gastroscopy.

Adult↗
PubMed1999

Relapsing pneumonia due to a migrating intrathoracic foreign body in a World War II veteran shot 53 years ago.

In the great majority of cases of long-standing intrathoracic foreign bodies, patients are asymptomatic. However, symptoms may occur years later from the migration of the foreign body. We report on a 70-year-old patient who developed relapsing pneumonia due to obstruction of a bronchial branch of the left apical group by a migrating infantry bullet impacting 53 years ago. This was not diagnosed until the second attack of pneumonia in 1998. The bullet remains were removed bronchoscopically and the pneumonia resolved completely without further complications.

Aged↗
PubMed1999

Gallstone ileus: endoscopic removal of a gallstone obstructing the upper jejunum.

In a 91-year-old female patient admitted with an ileus, ultrasound and computed tomography demonstrated the obstruction of the upper jejunum by a large gallstone. Due to concurrent diseases the patient was unfit for surgery. An attempt was made to remove the impacted stone endoscopically. After successful mobilization and fragmentation by mechanical lithotripsy the obstruction was cleared away. Since the patient improved considerably after this procedure, the gallbladder and the cholecystoduodenal fistula were left in place.

Aged↗
PubMed1998

Splenic abscess in chronic calcifying pancreatitis.

Abscess formation in chronic pancreatitis is rare and the pancreas and liver are the most frequent localizations. We present a novel case of splenic abscess in chronic pancreatitis that led to diabetic ketoacidosis in an alcoholic patient. Percutaneous drainage and antibiotic treatment sufficed to resolve completely the abscess.

Abscess↗
PubMed1993

A new fine needle for easier, single handed, ultrasound-guided biopsies, requiring less advancing forces into solid organs.

A fine punch needle with a new bevelled geometry for easy, single-handed, ultrasound-guided biopsies is presented. The needle requires a significantly lower advancing force compared with the commonly used punch needles of the Menghini type. Since, therefore, our needle penetrates the organs to be investigated easier, it enables the puncture of easily movable (stomach, gut) and/or solid organs (kidney) with the yield of sufficiently long punch cylinders. The first 196 biopsies were well tolerated and histological diagnosis could be made in 94% of the cases.

Biomechanical Phenomena↗
PubMed1990

Prospective study of the incidence of ultrasound-detected hepatic hematomas 2 and 24 hours after percutaneous liver biopsy.

Recently, a high incidence of hepatic hematomas following percutaneous liver biopsy was reported. This induced us to undertake this prospective ultrasound examination before, as well as 2 and 24 h after, percutaneous liver biopsy, using a Menghini needle (O 1.4 mm), in 93 patients for diagnostic purposes. Two hours after biopsy a small subcapsular fluid margin was found in one patient (1.1%) which disappeared within 24 h. We conclude that hepatic hematomas are not frequent following percutaneous liver biopsy and that it remains a safe diagnostic procedure to find out the reason for chronically elevated liver enzymes and evaluate suspected diffuse parenchymal lesions of the liver.

Adolescent↗
PubMed1989

Synthesis and properties of new luminescent acridinium-9-carboxylic acid derivatives and their application in luminescence immunoassays (LIA).

Two new groups of chemiluminescent acridinium labels have been presented: (a) acridinium-9-thiocarboxylates, (b) acridinium-9-(N-sulphonyl)carboxamides. Both groups show higher light yields and faster emission kinetics compared with the known acridinium carboxylate. Owing to the poor storage stability of the thiocarboxylate tracers they are not suitable for commercial use. Acridinium-9-(N-sulphonyl)carboxamides allow a variation of the structure, their stability after conjugation to antibodies is in most cases clearly better than the stability of thiocarboxylate and carboxylate tracers. Light yields and emission kinetics are also superior and good immunoassays have been developed. Therefore, this new class of chemiluminescent labels seems to be suitable for use in commercial assays.

Acridines↗