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Biomedical subjects

M Arndt

Publications and source records attributed to M Arndt.

At least 19 recordsLinked to original sources
PubMed1994

Nurses' medication errors.

This paper reports on a qualitative study of nurses' experiences with medication errors. Using discourse analysis within a framework of an interpretive research design, the phenomenon of a not too uncommon occurrence in nursing practice was examined. Insight into nurses' involvement with medication errors was gained from interviews, group discussions and self-reports. Documents of disciplinary proceedings, where the Professional Conduct Committee of the United Kingdom Central Council for Nursing, Midwifery and Health Visiting has dealt with incidents of medication errors, supplemented the data. Decisions made in situations of medication errors have moral implications at personal, institutional, and professional levels. The moral courage that is needed to learn from mistakes can be enhanced through honest dealings with the situation. Where the attention is shifted from the person involved onto the problem at hand, fair judgement may be advanced and the fear of owning up to a mistake be diminished. Only when reflected upon, can personal experience merge into the stream of development and progress. This study contributes to such reflection. Three key issues are discussed in-depth as they evolved during analysis of the data: These issues deal with identification and change; with guilt and shame and the reconciliation with human precariousness; and with teaching and learning. The manner in which discourse analysis was used here represents an innovative attempt to advance qualitative methodology in nursing research.

Adaptation, Psychological↗
PubMed1994

[The risks of anesthesia in obstetric interventions].

In obstetric anaesthesia, general anaesthesia combined with endotracheal intubation, spinal anaesthesia and peridural anaesthesia is used. The main risks of general anaesthesia are: difficult intubation, aspiration of acid gastric content in non-fasting patients, depression of the fetus with narcotics and the occurrence of awareness of the mother. The main dangers of spinal anaesthesia are: hypotension of the mother leading to reduced utero-placentar blood flow due to sympathetic block, post-spinal headache and vomiting. The specific risks of peridural anaesthesia are: maternal hypotension, the possibility of inadvertent intravenous injection of local anaesthetics leading to cardiac and cerebral intoxication, inadvertent intrathecal application of local anaesthetics followed by total spinal block which requires reanimation and inadvertent dura perforation followed by long-lasting headache. Most anaesthesia-related maternal deaths by far occur during Caesarean section performed under general anaesthesia, but at present there is no clear evidence that the anaesthetic risk of spinal or peridural anaesthesia, on the one hand, is lower than that one of general anaesthesia, on the other.

Anesthesia, Epidural↗
PubMed1994

[LEVEL 1--a new blood warming device].

Hypothermia of less than 35 degrees C, which frequently occurs in connection with massive blood transfusion, is a serious problem in many patients, in particular in those with polytrauma. The restoration of normal body temperature is very important and requires the use of a rapidly-acting, efficient and safe blood warmer, which is able to work effectively at high flow-rates. The LEVEL 1 (Technologies, Rockland, MA) is such a new blood warmer and works as a heat-exchanger via an aluminium column. This system is highly effective. Six hundred ml of sodium chloride 0.9% are warmed from 4 to 35 degrees C within one minute. This device is quickly operational and has a low priming volume. The LEVEL 1 is the only device currently available which is able to warm blood sufficiently during a very rapid blood transfusion.

Blood Component Transfusion↗
PubMed1993

Response synchronization in the visual cortex.

Recently, the classic idea of a 'relational' code in the brain received new impetus from the observation of stimulus-dependent synchronizations in the visual cortex. Work over the past two years has focused on documenting the functional dependencies of such synchronizations. We review and classify the experimental findings with respect to separate spatial and temporal schemes. Thus, we distinguish between different signal classes (spikes, continuous signals), and different types of time-locking to the stimulus. These various classes of synchronization phenomena are discussed with regard to their properties, the underlying mechanisms and their possible relevance for visual processing.

Animals↗
PubMed1993

[10 years experiences used resorbable synthetic mesh in treatment of rectal prolapse].

Rectopexy is the most widespread method in the treatment of rectal prolapse. In the Department of Surgery of the University Hospital Münster and the Josephs-Hospital Warendorf in 102 cases absorbable mesh was used for the fixation of the mobilized rectum. The role of lethality and infection was 0%. The rate of recurrence was 4.9%, as low as it can be achieved with non-absorbable material.

Adolescent↗
PubMed1992

[Reversible fixation of the small intestine for minimizing radiation damage with polyglycolic acid mesh--initial experiences].

In ten patients with tumors of the small pelvis the bowel was fixed to the upper abdomen by use of Polyglycolic acid mesh (Dexon) to minimize radiation associated small bowel injury. In one case formation of abscess was seen ducto suture dehiscence of the rectal stump which could successfully be handled by lavage. No severe disturbance of bowel motility was seen. By sonographic and barium controls it could demonstrated that it was possible to keep the small intestine above the radiation fields as long as it was necessary for radiation treatment. After 3-4 months it could be demonstrated that the small bowel had descended into the pelvis again.

Adult↗
PubMed1991

[Use of resorbable synthetic net as implanted tamponade in hard-to- manage hemorrhagic lesions].

The use of Hemostypic agents like oxised regenerated cellulose and collagen sponge is widespread in cases with severe hemorrhage that cannot be treated by conservative measure. With these materials however one cannot bring compression to the source of bleeding. We therefore have been using absorbable mesh (Vicryl, Dexon) instead of these situations. In 42 cases mesh were used as a remaining tamponade. Hemorrhage in all cases was successfully stopped. Complicated surgical measure could be avoided. Although up to 30 mesh were implanted in a single patient we saw no sign of infection. Considering our clinical experiences absorbable mesh is a valuable auxiliary agent to solve difficult bleeding problems in general surgery.

Adult↗
PubMed1991

[Can resorbable suture material be used in surgery of the supra-aortic branches?].

The experience with the use of monofilament absorbable suture (5/0 USP) in supraaortal vessels shows the same results related to neurological complication. The postoperative technical complications (bleeding, occlusion, restenosis) could be significantly reduced (p less than or equal to 0.05). Suture ruptures of aneurysms were not observed after resorbable vascular suture. The resorbable monofilament suture material is useful in high pressure vessel system.

Blood Vessel Prosthesis↗
PubMed1990

[Polyglycolic acid mesh in surgery of the liver and spleen].

Since 1987 absorbable PGA-mesh (Dexon) has been used as a pad for mattress sutures and as remaining tamponade in surgery of the liver and spleen. In 25 cases atypical resections of liver tumors have been performed using PGA-mesh to secure mattress sutures. Blood loss was below 500 cm3 in all cases, operating time was decreased and no infection was seen. Six times this technique was also used in cases with splenic trauma. In all patients the organ could be preserved. In 10 patients with severe trauma of the liver PGA-mesh was successfully used as a remaining tamponade. Also in these cases no infection occurred although 50 mesh had been implanted in one case.

Humans↗
PubMed1989

[Effects of roentgen contrast media containing barium sulfate on enterocutaneous fistulas].

Fistulation in the wake of thoracic and epigastric interventions are conservatively treated, as a rule, because of the high rate of complications expected from reoperation. With properly functioning anastomotic transit, insufficiencies usually undergo spontaneous healing, within four to six weeks. Enterocutaneous fistulae developed in 29 of 271 patients with intrathoracic oesophagogastric or oesophagojejunal anastomosis. Syringeal ramification into pleural or abdominal cavities were ruled out by means of an absorbable contrast medium, before barium sulphate was orally administered to all patients. Thoracic fistulae were closed after 21.8 days on average, while 20.3 days was the average period required for closure of epigastric fistulae. Barium sulphate was found to exercise stimulating effects on fistular tissue granulation, so that obliteration of the fistular system occurred much sooner, as compared to conservative treatment. The patient's quality of life can thus be improved, and hospitalisation can be shortened. Neither locally delimited nor systemic complications were observed in any of the cases described.

Adult↗
PubMed1988

Absorbable mesh in the treatment of rectal prolapse.

Transabdominal rectopexy is a widely used method with excellent results in the treatment of rectal prolapse; a variety of absorbable and non-absorbable materials has been described in the literature. In the Department of Surgery in the University of Munster we have been using absorbable mesh (Vicryl/Dexon) routinely to perform rectopexy. These materials are practically identical in their mode of degradation. Both are absorbed completely, releasing glycolic acid which is believed to be bacteriostatic. In this series of 62 cases absorbable mesh was used to fix the mobilised rectum to the sacrum. The operations were performed using one-dose antibiotic prophylaxis. There were no deaths. Two recurrences developed within two weeks of operation, one complete and one incomplete. Both cases, however, had been operated upon by inexperienced surgeons. Two further recurrences occurred after 36 and 45 months; thus the overall rate of recurrence was 6.4%. In no case was there abdominal or pelvic infection. We believe that absorbable mesh is a suitable material for performing rectopexy, reducing the rate of abdominal and particularly pelvic infection without increasing recurrence rate.

Adolescent↗
PubMed1988

The price of nursing care.

This paper discusses cost identification and its role in internal resource allocation and price determination. It draws on findings from the Relative Value Matrix (RVM) Project of the Massachusetts Eye and Ear Infirmary. The project demonstrates and validates a technique for isolating the differential impact of volume and unit cost on the nursing cost per case and for comparing these costs across hospitals.

Accounting↗
PubMed1988

[Extracorporeal blood circulation in the unanesthetized free-moving rabbit--an animal model for biocompatibility studies].

The rabbit is suitable as a basis model for the extracorporal circuit (ECC) in long-term test (20 days). A decrease of the leucocytes and platelets is established already in the blank test qualified by catheter material and pumping influence. This effect can be compensated by the rabbit in long-term test. The typical decrease of the leucocytes and platelets does not show any significant alteration during many test days independent of the number of tests which were carried out in one rabbit (blank test and hemoperfusion). A hemoperfusion across activated carbon--independent of the albumin coating--leads to a significant decrease of the leucocytes in comparison to the blank test. This rabbit model is well-suitable for biocompatibility investigations respectively also for effective investigations of detoxication techniques taken as a basis of our results.

Animals↗
PubMed1985

Do eye hospitals have a role in our future?

Eye hospitals, originally founded to care for the poor, have developed into academic centers and tertiary "hospitals of last resort." Inexorable economic pressures, especially price competition, are likely to close many of them, particularly those which are marginal in quality or management. Survival of the remainder may further depend on their ability to adapt to a rapidly changing environment and to fulfill, better than anyone else, the special mission of basic and clinical research and training. Society must be convinced that some of these complex, highly differentiated, relatively expensive eye hospitals are significant national resources, serve the public welfare, and are worth preserving.

Cost Allocation↗