Biomedical subjects

Kristina Voigt

Publications and source records attributed to Kristina Voigt.

5 recordsLinked to original sources

PubMed2006

Postoperative analgesia after major spine surgery: patient-controlled epidural analgesia versus patient-controlled intravenous analgesia.

BACKGROUND: Spinal fusion surgery causes severe postoperative pain, hampering reconvalescense. We investigated the efficacy of patient-controlled epidural analgesia (PCEA) in a prospective, double-blind, randomized, controlled comparison with patient-controlled IV analgesia (PCIA). METHODS: After lumbar anterior-posterior fusion receiving an epidural catheter intraoperatively, 72 patients were given either PCEA (ropivacaine 0.125% and sufentanil 1.0 microg/mL at 14 mL/h; bolus: 5 mL; lockout time: 15 min) and IV placebo or PCIA (morphine 2.0 mg/mL; bolus: 3 mg; lockout time: 15 min) and epidural placebo. Pain levels (visual analog scale 0-10), functional capabilities (turning in bed, standing, and walking), analgesic consumption, and side effects were evaluated until 72 h after surgery. RESULTS: Fourteen patients were excluded by predetermined criteria, leaving 58 patients for data analysis. Pain levels at rest and during mobilization were significantly lower in the PCEA when compared with that in the PCIA group throughout the study period (P < 0.0001 in all cases). Time until able to turn in bed was achieved earlier in the PCEA group (P < 0.05). Patients in the PCEA group were significantly more satisfied with pain therapy (P < 0.01). CONCLUSION: We conclude that PCEA with ropivacaine and sufentanil, using intraoperatively placed epidural catheters, provides superior analgesia and higher patient satisfaction when compared with PCIA after spinal fusion surgery.

Adult↗

PubMed2004

Chemical databases evaluated by order theoretical tools.

Data on environmental chemicals are urgently needed to comply with the future chemicals policy in the European Union. The availability of data on parameters and chemicals can be evaluated by chemometrical and environmetrical methods. Different mathematical and statistical methods are taken into account in this paper. The emphasis is set on a new, discrete mathematical method called METEOR (method of evaluation by order theory). Application of the Hasse diagram technique (HDT) of the complete data-matrix comprising 12 objects (databases) x 27 attributes (parameters + chemicals) reveals that ECOTOX (ECO), environmental fate database (EFD) and extoxnet (EXT)--also called multi-database databases--are best. Most single databases which are specialised are found in a minimal position in the Hasse diagram; these are biocatalysis/biodegradation database (BID), pesticide database (PES) and UmweltInfo (UMW). The aggregation of environmental parameters and chemicals (equal weight) leads to a slimmer data-matrix on the attribute side. However, no significant differences are found in the "best" and "worst" objects. The whole approach indicates a rather bad situation in terms of the availability of data on existing chemicals and hence an alarming signal concerning the new and existing chemicals policies of the EEC.

Biodegradation, Environmental↗

PubMed2004

Postoperative epidural anesthesia preserves lymphocyte, but not monocyte, immune function after major spine surgery.

UNLABELLED: Extensive spine surgery is associated with postsurgical pain. Epidural pain therapy may reduce postoperative stress responses and thereby influence immune functions. In a randomized, controlled, double-blinded prospective trial, 54 patients received either conventional patient-controlled IV analgesia (PCIA; morphine 3 mg/15 min) or patient-controlled epidural analgesia (PCEA; 0.125% ropivacaine plus sufentanil 1 microg/mL at a base rate of 12 mL/h and bolus application of 5 mL/15 min). Circulating cytokines, C-reactive protein (CRP), cortisol, and cell-surface receptor expression of immune cells (cluster of differentiation [CD]14, human leukocyte antigen-DR, CD86, CD71, CD3, CD4, CD8, CD16, and CD19) were measured perioperatively to characterize immunological functions. PCEA, compared with PCIA, had no influence on altered levels of circulating cytokines (interleukin (IL)-6, IL-8, IL-10, tumor necrosis factor-alpha, monocyte chemoattractant protein-1, and macrophage inhibitory factor) or indicators of the stress response (CRP and cortisol). Also, no significant difference was found in monocyte numbers or their human leukocyte antigen-DR, CD86, or CD71 expression. In contrast, the postoperative decrease in B lymphocytes and T-helper cells was significant in the PCEA group. Natural killer cells decreased significantly in patients receiving PCEA compared with PCIA. Therefore, postoperative epidural pain therapy has no influence on monocyte functions but reduces natural killer cells and preserves B-cell and T-helper cell populations. Epidural analgesia thus influences the specific rather than the innate immune system and potentially blunts the postsurgical lymphocyte depression, which is relevant for infectious resistance. IMPLICATIONS: Epidural analgesia affects the immune system. Postoperative epidural analgesia, compared with conventional IV opioid therapy, preserves lymphocyte rather than monocyte functions. An improvement of postoperative immune function by epidural analgesia therefore may improve postoperative resistance to infectious complications or to chronic pain states.

Adult↗

PubMedDate not supplied

Order theoretical tools for the evaluation of complex regional pollution patterns.

The mathematical and statistical evaluation of environmental data gains an increasing importance in environmental chemistry as the data sets become more complex. It is inarguable that different mathematical and statistical methods should be applied in order to compare results and to enhance the possible interpretation of the data. Very often several aspects have to be considered simultaneously, for example, several chemicals entailing a data matrix with objects (rows) and variables (columns). In this paper a data set is given concerning the pollution of 58 regions in the state of Baden-Württemberg, Germany, which are polluted with metals lead, cadmium, zinc, and with sulfur. For pragmatic reasons the evaluation is performed with the dichotomized data matrix. First this dichotomized 58 x 13 data matrix is evaluated by the Hasse diagram technique, a multicriteria evaluation method which has its scientific origin in Discrete Mathematics. Then the Partially Ordered Scalogram Analysis with Coordinates (POSAC) method is applied. It reduces the data matrix in plotting it in a two-dimensional space. A small given percentage of information is lost in this method. Important priority objects, like maximal and minimal objects (high and low polluted regions), can easily be detected by Hasse diagram technique and POSAC. Two variables attained exceptional importance by the data analysis shown here: TLS, Sulfur found in Tree Layer, is difficult to interpret and needs further investigations, whereas LRPB, Lead in Lumbricus Rubellus, seems to be a satisfying result because the earthworm is commonly discussed in the ecotoxicological literature as a specific and highly sensitive bioindicator.

Analysis of Variance↗

PubMedDate not supplied

Structure-fate relationships of organic chemicals derived from the software packages E4CHEM and WHASSE.

A risk assessment of chemicals is to be performed on the basis of the model EUSES, developed by the Commission of the European Union. The model package E4CHEM (Exposure Estimation for Potentially Ecotoxic Environmental Chemicals), developed in 1984-1992, is presented and applied in this paper as a model which allows a model-supported evaluation of chemicals. E4CHEM consequently does not have the wide applicability and technical comfort of the more recently developed model EUSES. The simulation models of E4CHEM characterize the chemical behavior in the environment by many aspects. Hence, there is a need to condense all of these aspects to get a clear impression of what will be the fate of the chemicals. Starting with the already published concept of exposure maps, we will discuss how partial orders may be helpful in establishing generalized structure-fate relationships. The software WHASSE is applied.

Chemistry, Organic↗