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Biomedical subjects

P Klug

Publications and source records attributed to P Klug.

12 recordsLinked to original sources
PubMed1998

[International interhospital transfer by scheduled airline].

BACKGROUND AND OBJECTIVE: International long-distance travel increasingly takes elderly and sometimes already ill persons to foreign countries. In case of illness it is usually best, for both medical and social reasons, that the person return home. This study was undertaken to assess possibilities and limits of bringing such patients home by scheduled airline. PATIENT AND METHODS: The transportation reports and case notes of 95 patients who had been repatriated to Germany in 1995 and 1996 for medical reasons were analysed retrospectively. The mean age was 56 (16-94) years. 50% of the patients had medical, 23% surgical, 19% neurological and 8% psychiatric illnesses. RESULTS: None of the patients died during transport. The NACA score (National Advisory Committee for Aeronautics, USA) for determining the degree of severity of an illness (point scale 1-7) in this group of patients was between 1 and 4, median of 3. Five patients with a score of 5 or higher were judged not to be fit for transport. Two were repatriated by ambulance plane, in three transport was postponed by a few days. No invasive procedures, other than providing intravenous access, were necessary. CONCLUSIONS: Patients who fall ill abroad can be safely and carefully brought home by scheduled airliner over great distances without additional risk caused by the transport. Ambulance planes are needed only in illnesses with an NACA score of 4 or higher.

Adolescent↗
PubMed1990

Effectiveness of the cryosupernatant fraction of plasma in the treatment of refractory thrombotic thrombocytopenic purpura.

Many patients with thrombotic thrombocytopenic purpura (TTP) satisfactorily respond to plasma therapy (plasmapheresis and/or plasma infusion). Some, however, respond either not at all or only transiently and incompletely. Evidence indicates that platelets and endothelial cell-derived unusually large von Willebrand factor (ULvWF) multimers, as well as the largest vWF multimers in plasma, form thrombi which are deposited in the microvascular circulation. Accordingly, platelet transfusions are avoided unless there is intra-cranial or other life-threatening hemorrhage. The largest plasma multimers of vWF are, however, replenished by the infusion of large volumes of whole plasma. We postulated that under conditions of massive plasma replacement, plasma depleted of the largest multimers of vWF might be preferable for the treatment of TTP episodes. The largest vWF multimers sediment in the cryoprecipitate, and the cryoprecipitate-poor fraction of plasma (cryosupernatant) is depleted of these forms. Seven patients responding inadequately to intensive plasma therapy were switched to receive cryosupernatant in place of whole plasma. All patients improved quickly following this change in therapy, and the TTP syndrome resolved in all seven.

Adult↗
PubMed1990

[Treatment of primary cancer of the fallopian tube].

33 patients treated since 1970 at the Medical School of the University of Graz, were classified using the FIGO system for ovarian carcinoma, fourteen were in stage I, 8 stage II, 8 stage III and 3 stage IV. In 17 patients, surgery consisted of total abdominal or vaginal hysterectomy with bilateral salpingo-oophorectomy; 12 patients underwent additional pelvic +/- paraaortic lymph node extirpation and in 4 the tumour excision was incomplete. Treatment in 6 patients was surgery alone (2/stage I, 4 with advanced disease) (Group A). Adjuvant radiotherapy was performed in 14 patients (Group B); the remaining patients were treated with single (2/13) or multiple agent chemotherapy (11/13) (Group C). The 3-year survival rate was 55% for stage I, 42% for stage II; 10/11 of the stage III/IV patients died within 26 months. The 4-year actuarial survival rate for group B was 68%, for group C 11%. There was no difference between the short-time results of stage II tumours when comparing radiotherapy against chemotherapy. The tumour progression rate was 60%, indicating the need for radical surgery as well as for more aggressive adjuvant treatment. Surgery alone is recommended for stage I disease confined to the mucosa. More advanced disease (extension to the serosa, stage Ic, stage II) requires whole abdominal irradiation with a boost to the pelvic lymph nodes. For stage III/IV tumours a multi-modality treatment is recommended. Chemotherapy (cis-platinum, cyclophosphamide) for recurrent disease resulted in remission in some cases.

Adenocarcinoma↗
PubMed1989

Mortality in children and adolescents with sickle cell disease. Cooperative Study of Sickle Cell Disease.

A study of the natural history of sickle hemoglobinopathies was begun in March 1979. By August 1987, a total of 2824 patients less than 20 years of age were enrolled. There have been 14,670 person-years of follow-up. Seventy-three deaths have occurred. Most of the deaths were in patients with hemoglobin SS. The peak incidence of death was between 1 and 3 years of age, and the major cause in these young patients was infection. Cerebrovascular accidents and traumatic events exceeded infections as a cause of death in patients greater than 10 years of age. There was limited success in identifying risk factors for death. Comparison of this study's overall mortality of 2.6% (0.5 deaths per 100 person-years) with previous reports indicates improvement of survival in US patients less than 20 years of age with sickle hemoglobinopathies. This improvement is most likely due to parental education and counseling about the illness and the early institution of antibiotics in suspected infections.

Adolescent↗
PubMed1985

Neutral steroid metabolites in patients with uraemia and after renal transplantation: a quantitative and qualitative study in body fluids.

Steroid metabolites enriched from urine, haemofiltrate, and CAPD-dialysate (Continuous Ambulatory Peritoneal Dialysis) were identified by gas chromatography-mass spectrometry and quantified by capillary gas chromatography. The study included twenty healthy controls, twenty-six non-dialysed uraemics, thirty-nine patients on regular dialysis treatment, and twenty-two allograft recipients. Compared to the 24 h urinary excretion rates of controls the excretion rates of androsterone and etiocholanolone were in the lower normal range up to significantly decreased in the body fluids of all patients, and those of the corticoid metabolites were also significantly decreased. 11-Oxygenated androstanolones in urine from non-dialysed uraemics correlated significantly decreased. 11-oxygenated androstano-levels and were significantly increased, but normal in haemofiltrate and CAPD-dialysate, while in urine of allograft recipients the values were significantly lower.

Adrenal Cortex Hormones↗
PubMed1984

Disturbed cardiac function possibly associated with mianserin therapy.

Two patients, who were receiving therapy with mianserin for depressive disorders, developed signs of disturbed cardiac function which resolved after mianserin therapy was discontinued. One of the patients also developed hypokalaemia which was probably caused by the drug. It is felt that these side effects warrant further research.

Aged↗