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Biomedical subjects

S Duma

Publications and source records attributed to S Duma.

14 recordsLinked to original sources
PubMed2006

Substantia nigra echomorphology in the healthy very old: Correlation with motor slowing.

Transcranial sonography reveals an increase in echogenicity in the substantia nigra of patients with idiopathic Parkinson's disease. Marked hyperechogenicity has also been described in 9% of the healthy population and is associated with subtle clinical or functional neuroimaging findings suggestive of changes in nigrostriatal function. It has therefore been hypothesised that a hyperechogenic substantia nigra represents an early stage of nigral degeneration or a predisposition for Parkinson's disease. In the present study, we correlated sonographic findings with motor and cognitive deficits in a group of healthy, very elderly subjects. Marked and moderately increased substantia nigra echogenicity was present in 25% and 21% of our healthy, very elderly subjects, respectively, and correlated strongly with the presence of extrapyramidal symptoms in the absence of cognitive deficits. The high incidence of substantia nigra hyperechogenicity measured in our very elderly subjects compared with previous TCS studies suggests that the prevalence of this feature increases with age and is consistent with the higher prevalence of Parkinson's disease in advanced age, as well as the increased frequency of extrapyramidal symptoms. Our results indicate that this simple technique can be used to identify and quantify brain changes associated with subtle motor dysfunction in the very elderly.

Aged, 80 and over↗
PubMed2006

Research integrity and misconduct: a clarification of the concepts.

The commercialization of research and the ever changing scientific environment has led scholars to shift the focus from promoting research integrity to regulating misconduct. As a result, most literature explains research integrity in terms of avoidance of misconduct. The purpose of the paper is to stimulate reflection and discussion on research integrity and research misconduct. This article explores the meaning of research integrity and research misconduct, and how research integrity can be promoted to ensure safer research and scholarship. We believe that the discussion can help clarify some hazy areas in the research and publication processes, and appreciate some crucial aspects that they may have seen taken for granted. The purpose of this article is to share with the readers some clarification or analysis of the two concepts namely: research integrity and misconduct. The objectives are: (1) To explore and analyse the concepts of research integrity and research misconduct from the educational or developmental perspective and not the legal perspective as others in literature have done. (2) To stimulate the reflection and discussion on strategies to promote research integrity and thus prevent research misconduct Literature review and concept analysis was undertaken to clarify the two concepts. We argue that the two concepts can be viewed along a continuum, i.e. where research integrity ends, research misconduct starts. We also argue that it is the responsibility of the research community at large to always ensure that the scientific ethics balance is maintained throughout the research process to ensure research integrity and avoid research misconduct. We also argue that research integrity is interlinked with morality while misconduct is interlinked with immorality.

Attitude of Health Personnel↗
PubMed1988

[Perioperative treatment of patients with varicose veins using calcium dobesilate].

Altogether 120 patients with medium to serious forms of varicositas were examined perioperatively after having been divided into 3 groups. Groups I and II were administered perioperatively a daily dosage of 1000 mg (2 x 1 capsule) of the preparation Doxium (Ebewe Arzneimittel GmbH, Unterach am Attersee) during 8 weeks - 2 weeks preoperatively and 6 weeks postoperatively. Group III was used for control purposes. The following was valued as parameter of comparison: kind and seriousness of perioperative trouble, alteration of peripheric oedemas, results of plethysmographic examinations as well as light-reflex-rheography examinations and the post-operative healing-process. Groups I and II (medication of Doxium) showed a significant (p less than 0.05) reduction of the peripheric oedemas already in the preoperative state and postoperatively, the patients had less trouble and a quicker healing-process was observed compared with group III.

Adult↗
PubMed1987

A novel, stable high molecular weight urokinase: preliminary results.

In this study, we successfully performed local thrombolysis in 6 patients with peripheral arterial occlusions by using a novel high-molecular-weight urokinase. Mean duration of recanalization was 12.8 hours, mean fibrinogen consumption was relatively low (42%), reptilase time was relatively long (mean increase by 47%). These findings would suggest that the substance is highly effective, though systemic adverse reactions are mild.

Adult↗
PubMed1986

[Prevention of stress ulcers with cimetidine and ranitidine. Comparative studies within the scope of cardiosurgical interventions].

2 H2-receptor antagonists--Cimetidine and Ranitidine--were applied in our prospective randomized study in 100 cardio-surgical cases in order to test their therapeutical efficiency for the prophylaxis of bleedings of gastroduodenal stress-ulcers. During the phase of the intensive therapy of 2 days the patients of group A received t.i.d. 400 mg of Cimetidine i.v. and those of group B twice a day 150 mg of Ranitidine i.v. The following tests were realized: gastric acidity, plasma level, side-effects, hemorrhages and ulcers. The gastric 8 o'clock pH-level of group A (Cimetidine) during this intensive therapy was significantly (p = 0.0001) higher than the respective level of group B (Ranitidine). Other parameters were not showing any statistical differences between both groups. Acute gastro-intestinal hemorrhages because of stress-ulcers were not noticed during the test.

Cimetidine↗
PubMed1985

[Intraoperative changes in extravascular lung water. Study on heart surgery patients].

The intraoperative changes in extravascular lung water (EVLW) were studied in 40 patients undergoing aortic-coronary bypass grafting. The patients were divided into two groups on the basis of preoperative ejection fraction (EF) values (group I: EF greater than 45%; group II: EF less than 45%). EVLW was measured using the double-indicator dilution method (thermo/dye). In a control study, changes in transthoracic impedance (ZoTh) were recorded. The initial EVLW value in group I was 4.3 +/- 0.4 ml/kg body wt. and in group II, 4.4 +/- 0.3 ml/kg body wt. After extracorporeal circulation, significant changes in EVLW could be observed (group I: from 4.5 +/- 0.5 ml/kg body wt. to 7.0 +/- 0.2 ml/kg body wt.; group II: from 5.1 +/- 0.8 ml/kg body wt. to 7.8 +/- 0.9 ml/kg body wt. (p less than 0.001). At the end of the operation, no changes in EVLW were observed in group I. However, in group II EVLW was significantly different to initial values (6.3 +/- 1.0 ml/kg body wt., p less than 0.01). The results obtained using the double-indicator method were identical with those obtained using the transthoracic impedance method. A marked correlation could be seen between length of ECC recording and EVLW values at the end of the operation, especially when the ECC time was 90 min or more (r = 0.84). Based on our results, it must be assumed that intraoperative damage to capillary membranes occurs if the ECC time is above 90 min.

Coronary Artery Bypass↗
PubMed1984

[Control of spontaneous respiration with continuous positive airway pressure using transthoracic electrical impedance. Studies in subjects with healthy lungs].

A clinically practicable method for the control of intrapulmonary gas volume changes for patients with spontaneous respiration and CPAP has been evaluated. Changes of intrapulmonary gas volume caused by different continuous positive air-way pressures (CPAP) can be monitored sufficiently using a noninvasive technique of transthoracic electrical impedance (Z0). In 24 healthy volunteers Z0 (rheography) was measured. After stepwise increase of CPAP from 5-20 cm H2O a significant increase of Z0 could be observed. Z0 pressure relations, detected by regression analysis showed a correspondence of intrapulmonary gas filling changes and volume/pressure relation. We therefore conclude that the control of Z0 pressure relationship for the calculation of the maximum is of some importance for determination of therapeutic levels of CPAP.

Adult↗
PubMed1983

[Weaning postoperative artificial respiration in cardiac surgery patients, CPAP versus ZEEP].

Pulmonary lesions following extracorporeal circulation (ECC) are said to be responsible for decreased functional residual capacity (FRC). Weaning from controlled mechanical ventilation (CMV) in the postoperative period is commonly performed by a CPAP system in order to restore the impaired oxygen exchange. Testing the superiority of CPAP against insufflation at atmospheric pressure (ZEEP), 33 patients after coronary bypass grafting (CABG) underwent from the end of CMV till extubation either CPAP or ZEEP in a randomized distribution. Data sampling included respiratory rate, paO2, paCO2 and AaDO2-Quotient (gas exchange), as well as HR, MAP, CVP and LAP (hemodynamics). None of the obtained data showed statistical significant differences between the CPAP and the ZEEP group. Therefore there appears to be no necessity for CPAP when weaning CABG patients, due to the absence of previous lung damage and the short time range of intubation and CMV.

Air Pressure↗
PubMed1983

[A model for standardized treatment and therapeutic evaluation of severe ARDS. PIF and AaDO2 quotient with a demand-adapting respirator and a conventional respirator during ARDS].

In order to achieve a uniform, easy to teach and to manage respiratory management in severe adult respiratory distress syndrome (ARDS) a combined treatment--called "step by step scheme"--was settled. It was aimed towards a regulation of the arterial blood oxygen tension at levels between 90 and 130 mmHg and this was achieved by combination of PEEP and IRV in order to minimize the inspiratory fraction of oxygen. Nine patients underwent this schedule and Benzer's AaDO2 quotient as an estimation of lung function as well as PIF (PEEP X I:E X FiO2) as quantifying parameter for the "strength" of the respirator are calculated. AaDO2 Quotient showed no statistically significant differences but PIF performed a clearly marked day of maximum respiratory support during the clinical course. This seems to be a confirmation that a variable defined by therapeutic procedures may also be an estimation of a certain degree of sickness as a pure diagnostic parameter. In plotting AaDO2 quotient versus PIF characteristically formed loops result. These loops give some evidence about the interactions between improving or worsening ARDS and properly adjusted therapeutic efforts by means of a respirator. The diagram may be also helpful in deciding conventional respirator settings or weaning procedures and show marks, where one might consider to treat by new techniques like High Frequency Ventilation, extracorporeal devices or arteriovenous hemofiltration.

Adult↗
PubMed1982

[Postoperative arrhythmias in heart surgery].

After a brief comment on the origin and a summing up of types of postoperative cardiac arrhythmias in open heart surgery, mainly the therapy of these arrhythmias is discussed Besides drug therapy (antiarrhythmica) and cardioversion resp. pacing especially the possibility of a metabolic therapy is presented. In the postoperative phase after the trauma by the operation with the heart lung machine - which is similar to the shock phase after a myocardial infarction - a disordered energy metabolism with a decreased effectiveness of insulin occurs. It exists a diminished intracellular potassium-shifting, which causes an insufficient myocardial cell membrane potential. By means of exogenous high insulin and potassium supply with glucose infusion the potassium-shifting is improved, the FFA-level is lowered and the incidence of arrhythmias is reduced as sinusrhythm is induced.

Anti-Arrhythmia Agents↗
PubMed1982

[Intraoperative application of forced diffusion-ventilation (FDV)].

Forced diffusion ventilation (FDV), a modified high frequency jet ventilation (HFJV), was applied intraoperatively (mean duration: 126 min) in 14 patients (7 thoracic, 7 major abdominal surgery patients). Sufficient gas exchange could be achieved with extremely low tidal volumes (10-30 ml) at frequencies up to 1500/min. This resulted in an almost complete immobilization of the lungs allowing an excellent surgical exposure.

Abdomen↗
PubMed1982

[Inversed ratio ventilation (IRV) following cardiosurgical procedures].

Based on our positive experiences with "Inversed Ratio Ventilation" (IRV) in the treatment of ARDS, we applied this ventilation technique in patients with risk lungs after cardiosurgical operations. Immediately, after switching from conventional ventilation mode (I/E ratio 1:2) to IRV (I/E 2:1), however significant hemodynamic reactions could be observed. Especially a significant decrease of cardiac output can be observed in this phase. IRV leads to an improvement of gas exchange and lung mechanics. These improvement become even more significant continuing IRV. A decreasing tendency of the negative hemodynamic effects can be observed parallel to lung mechanics improvement. Carefully managed respirators adjustment, "step-wise" prolongation of I/E ratio and closed observation on hemodynamic reactions leads to successful use of Inversed Ratio Ventilation in cardiosurgical patients too.

Air Pressure↗