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Biomedical subjects

J Weindler

Publications and source records attributed to J Weindler.

4 recordsLinked to original sources
PubMed1990

[The effect of endonasal paranasal sinus surgery on lung function of patients with bronchial asthma].

Lung function tests of 13 patients suffering from manifest asthma and of 4 patients showing only bronchial hyperreactivity were performed before and on an average of 12 months after endonasal surgery of the paranasal sinuses. In the four subjects, bronchial hyperreactivity was no longer detectable postoperatively by provocation with carbachol. Five asthmatics could stop medication of 1 to 3 of their drugs, five others were able to reduce the dosage of one of their drugs to 50% or more. Lung function and medication was unchanged in two asthmatic patients, one patient had to add a drug to his medication while showing an unchanged lung function. In patients with asthma and chronic paranasal sinusitis, endoscopic endonasal sinus surgery (together with flanking measures, e.g. septal correction) is able to improve antiasthmatic therapy in a high percentage.

Adult↗
PubMed1989

[Postoperative respiratory therapy using incentive spirometry].

The optimal methods of prophylaxis and therapy of postoperative respiratory complications in surgical patients are still open to discussion. In spite of numerous recent clinical investigations, there is still no specific and universally acceptable therapeutic concept. In our department, we identify patients at risk of pulmonary complications by adequate screening, i.e. medical history, physical examination, chest X-ray, and spirometry. In the postoperative period there are a sequence of stages starting with early mobilization, respiratory therapy (including incentive spirometry and IPPB), and when necessary, controlled mechanical ventilation. We have measured and documented the flows and volumes required of patients using various types of incentive spirometer. In addition, we review on the literature and describe our experience with the technique, handling, and organization of sustained maximal inspiration (SMI). After thoracic or major upper abdominal surgery, all lung volumes decrease due to impairment of rib cage movement, changes in chest wall muscle tone, an increase in lung recoil, and airway closure. At the end of each expiration some of the smallest airways collapse either partly or totally. This process continues to some extent until, normally, a deep breath recruits the alveoli. Sighs to the limit of total lung capacity or oscillations of the expiratory baseline ought to be responsible for this effect in healthy humans; the same purpose is intended in incentive spirometry. For this therapy, it is mandatory that the central airways are not occluded by mucus and that the patient is able to breath volumes exceeding his normal tidal volume.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1988

[Genital infections and the course of pregnancy: a prospective study].

The reported study investigates the relationship of genital infections, pathobiochemical findings and demographic data to preterm labor, premature rupture of membranes (PROM) and premature delivery. The predictability of chorioamnionitis, puerperal and neonatal infections by these parameters was evaluated concurrently. 301 patients were included in this study between July 1985 and June 1986. 147 of these patients were studied longitudinally during pregnancy, delivery and puerperium (longitudinal group). A second group consisted of 154 women who presented themselves on start of labor to the labor and delivery unit of our Department (peripartal group). The incidence of preterm labor and of PROM was 26%. The incidence of premature delivery, chorioamnionitis, puerperal and neonatal infection was 11.4%, 5.5%, 7.6% and 3% respectively. Cervical colonization with Mycoplasma hominis correlated positively with PROM (relative risk 2.2), premature delivery (3.9) and neonatal infection (6.9). Chorioamnionitis, premature delivery and puerperal infection were also significantly increased in patients with positive vaginal Ureaplasma urealyticum cultures during pregnancy and delivery. Premature delivery (2.8) and puerperal infection (4.0) were associated with a vaginal group B-Streptococci (GBS) colonization during pregnancy, as was a positive GBS culture during delivery associated with puerperal infection. Bacterial vaginosis also correlated positively with premature delivery (5.6) and puerperal infection. Preterm labor correlated negatively with the socioeconomic level, PROM correlated negatively with the marital status, positively with age, a history of cervical cerclage, conization or PROM during former pregnancies. Sexual intercourse more often than once weekly during the last month of pregnancy was also associated with an increased number of PROM. Gardnerella vaginalis, Candida and Trichomoniasis during pregnancy and delivery were associated with preterm labor and puerperal infections. Levels of maternal plasma fibrinogen concentrations in patients with PROM were elevated 48 hours after delivery in accordance to the characteristics of acute phase proteins. In contrast, the maternal PMN-granulocyte-elastase concentration was significantly elevated at time of delivery and 24 hours thereafter in those patients who developed puerperal infections. The derived positive predictive value was 26%, the negative 94.7%, respectively. The overall accuracy of the prediction was 83.1%. Six out of seven mothers with neonates treated because of neonatal infection showed significantly elevated plasma concentration of PMN-granulocyte-elastase.(ABSTRACT TRUNCATED AT 400 WORDS)

Bacterial Infections↗