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Biomedical subjects

H Pollmann

Publications and source records attributed to H Pollmann.

At least 37 records · Page 2Linked to original sources

[Effect of elevated head position in bed in therapy of gastroesophageal reflux].

In a randomized multicentric trial the effect of sleeping with the bed-head raised was studied in inpatients with reflux symptoms. All patients underwent an endoscopic and pH-metric examination. As a result from the diagnostic procedures three groups were formed: group 1 - refluxlike dyspepsia (endoscopic and pH-metric examination normal), group 2 - reflux disease without esophagitis (endoscopy normal, pH-metric examination abnormal), group 3 - refluxesophagitis (endoscopy abnormal). All patients were randomly assigned to either sleeping with horizontal bed-head or having the bed-head raised (15 cm). Furthermore, the patients in group 3 were put on treatment with omeprazole (20 mg twice a day) those in group 2 were treated with a procinetic drug (cisapride 30 mg). The patients in group 1 had no drug therapy. However, antacids were allowed in all patients. For a two-week-period reflux symptoms and use of antacids were registered. No difference was seen in the symptom-score or use of antacids. Also sub-group analysis (sex, age, body-mass-index, severity of esophagitis and nocturnal reflux) did not reveal any impact of sleeping with the bed-head raised on reflux symptoms or use of antacids.

Adult↗

[Current status of viral safety of virus inactivated factor VIII and IX concentrates in treatment of hemophilia].

Based on the results of seven ICTH-controlled PUP studies only the virus-inactivating procedures by pasteurization (60 degrees C for 10 h), tri-n-butyl-phosphate/detergent treatment, and vapor heating (60 degrees C for 10 h and 1,200 mbar) have prevented the haemophilic patients from infections with hepatitis B, C and HIV. After the disaster of the HIV infection in haemophilic patients at the beginning of the 80's the factor concentrates given today seem to be safe for virus infections during substitution therapy. To prove this high therapeutical standard there is a need for a prospective long-term pharmaco-vigilance study under the auspices of an independent body such as the Medical Advising Committee of the National Haemophilia Society or other scientific organisations.

Blood Component Transfusion↗

[The MR tomography of hemophilic osteoarthropathy with special reference to the synovial and chondrogenic changes].

52 knee and ankle joints of hemophiliacs were examined by MRI using FLASH and FISP-3-D sequences; and the degree of synovial hypertrophy and of cartilage destruction were assessed. Findings of synovial hypertrophy varied between thin membranes and tumorous tissue destroying the joint cartilage. Degree of cartilage destruction varied between focal signal decrease and total loss. In spite of recurrent joint bleedings no synovial or cartilaginous changes were seen in 31% and 29% of joints, respectively. Changes were more frequently seen and degree was more marked in the ankle than in the knee joints. With the exception of cysts, osseous destruction was more obvious with radiographs. MRI is suitable for the investigation of joints of hemophiliacs showing no osseous destruction.

Adolescent↗

[Behavior therapy in gastrointestinal functional disorders].

Almost all functions of the gastrointestinal tract have been shown to be under central nervous control and to respond to environmental factors such as stress. It is, therefore, not surprising that disturbed gastrointestinal functions may be altered through psychological therapy approaches. For motor dysfunctions of the esophagus and functional dyspepsia, there is a lack of behavioral therapy studies, while controlled studies utilizing relaxation techniques, stress management strategies and anxiety treatment have been shown to improve symptoms and prevent recurrence in reflux esophagitis and peptic ulcer disease despite the wide use of effective medication. Most studies have treated patients with symptoms of the irritable bowel syndrome: This approach usually combined conventional medical treatment with psychotherapy. Psychological management usually consisted of relaxation training, stress management and patient information. Additional behavioral modification, e.g. of eating and defecation behavior, is superior to pharmacological and dietary management alone. The role of biofeedback therapy in these patients remains to be clarified in the future. It is, however, therapy of choice in some patients with constipation due to spastic pelvic floor syndrome and in fecal incontinence, if the external anal sphincter is insufficient to maintain continence. There ist a systematic lack of treatment opportunities as compared to the number of patients seeking health care for functional bowel disorders.

Behavior Therapy↗

[Hemophilic osteoarthropathy with special reference to the elbow joint].

Hemophilia is a rare disorder, whereby recurrent bleedings into the joint can result in osteoarthropathy. Radiological changes consist of osteoporosis, enlargement of the epiphyses, irregularity of the subchondral bone surface, narrowing of the joint space, cysts, erosions, joint incongruence and joint deformity. The earlier and the more frequent bleedings have occurred that have not been treated adequately, the more of the changes mentioned above are present. In children, osteoarthropathy of the elbow is present in only about 50% of cases, and in the remaining cases the degree is mostly minimal or moderate. Differential diagnosis consists of juvenile rheumatoid arthritis in children, and rheumatoid arthritis and osteoarthritis in adults.

Adolescent↗

Vitamin K-dependent coagulation parameters during the first six days of life: incidence of PIVKA II in newborns.

The vitamin K-dependent carboxylation of the prothrombin precursor PIVKA II (protein induced by vitamin K absence analogous to Factor II) is essential for the synthesis of prothrombin. The noncarboxylated precursor is found in peripheral blood in the presence of vitamin K deficiency. In this study prothrombin time, Factor II and Factor VII activity, and PIVKA II were investigated in 57 newborns without vitamin K prophylaxis in order to assess their vitamin K status. Two-dimensional immunoelectrophoresis demonstrated the presence of PIVKA II in 21% of the newborns, predominantly on the second day. The PIVKA-II positive group showed significantly lower prothrombin times than the PIVKA II-negative group. An oral dose of 3 mg vitamin K (Konakion) was administered to 35 healthy newborns in a second group with the first feeding. On the second day of life, these infants showed significantly higher vitamin K-dependent laboratory parameters than the group not given vitamin K; only 9% of the treated infants were positive for PIVKA II.

Biomarkers↗

[Staging of hemophilic osteoarthropathy using the Pettersson score. A study of 40 children and adolescents].

The degree of haemophilic osteoarthropathy was assessed by the Pettersson-score in 219 knees, elbows and ankles of 40 children and adolescents suffering from haemophilia. 55.3% of the joints were unaffected and only 8 joints showed score values greater than 8. Enlargement of epiphyses (36.1%) and irregular subchondral surface (32.9%) were the most frequent observations, while osteoporosis (5.4%) was only rarely observed. Haemophilic osteoarthropathy was most severe in the ankles, while the knees were only moderately affected. Among 11 patients 493 bleedings into 61 joints were observed during a four-year period. If the bleedings recurred, more than 3 bleedings per year always resulted in haemophilic osteoarthropathy.

Adolescent↗

[Salmonella osteoarthritis in hemophilia A].

The unexpected course of a hemarthrosis in a young man with severe hemophilia and septic osteoarthritis is described. The arthritis appeared first as a relapse of a series of hemarthroses . However, the further course of the disease led to the diagnosis of a salmonella osteoarthritis.

Adult↗

[Vitamin K deficiency hemorrhages in 4 exclusively breast-fed infants 4 to 6 weeks of age].

Haemorrhages were observed in four wholly breastfed infants beyond the neonatal period. These infants were observed within a period of 8 weeks and showed the following characteristics: 1. Onset of bleedings was unexpected and without prior indication. 2. They were of a serious nature and involved the CNS in two children. 3. In all cases infants between 4 and 6 weeks of life were affected. 4. All infants had been wholly breastfed. 5. All were male. 6. There was a prompt improvement after administration of vitamin K or after blood or blood derivatives. Although preliminary own investigations do not indicate general lowering of vitamin-K-dependent coagulation factors in wholly breastfed infants in the postneonatal period, these 4 cases observed within a short time confirm the necessity to consider vitamin K deficiency in haemorrhages in infants in the postneonatal period. Diagnostic steps have to be initiated immediately.

Blood Transfusion↗

[The value of serum thyroglobulin determination in the after-care of patients with differentiated thyroid neoplasms].

Plasma thyroglobulin (Tg) was determined by radioimmunoassay in 219 patients with differentiated carcinoma of the thyroid gland after treatment by total thyreoidectomy and at least 2 131I therapies with a total of 170 mC. Of 145 patients without residual thyroid tissue and a negative whole body scan, 6 patients exhibited significant Tg levels. It remains unclear whether these individuals will develop recurrency later on. Of 23 patients with proven metastases, 14 had extremely high Tg concentrations of greater than 1000 ng/ml. In 6 cases Tg was between 20 and 280 ng/ml and in 3 individuals Tg levels below 10 ng/ml were measured. The reason for low Tg concentrations in some patients with proven metastases is unknown. At present plasma Tg measurements therefore cannot be recommended as substitution for whole body scanning. However, plasma Tg is an important additional parameter in the follow-up of patients with differentiated carcinoma of the thyroid.

Adenocarcinoma↗

DDAVP-induced changes of factor VIII-related activities and bleeding time in patients with von Willebrand's syndrome.

5 patients suffering from von Willebrand's syndrome were treated with DDAVP administered intravenously or intransally. The concentration of F. VIII-related activities (F. VIII:C, F. VIII R:AG, F. VIII R:WF), as well as the mobility of F. VIII R:AG in crossed immunoelectrophoresis and the alterations of bleeding time were continuously monitored. DDAVP induced both quantitative and qualitative changes of F. VIII-related properties. The bledding time was markedly reduced for some hours. The therapy was well tolerated and should be submitted to further clinical trials as a possible way to avoid the disadvantages connected with the transfusion of blood components.

Adolescent↗