PubMed Health⌕ Search

Biomedical subjects

S Grüne

Publications and source records attributed to S Grüne.

27 records · Page 2Linked to original sources
PubMed1992

[Blood pressure measurement using the fingers].

An increasing number of devices for self-assessment of blood pressure has been developed over the past years. Accepted international standards for evaluation of such devices are still lacking. A new apparatus (T88, Marshall Electronics) measuring blood pressure on digital arteries by oscillometry was tested for accuracy. Comparative measurements in 36 patients indicated position-dependent results with a reasonable correlation with the measurements taken on the upper arm only if the device was used at the level of the heart. Significant differences for systolic values were noted on different phalanges. In a last series of measurements, comparing values obtained about the basal phalanges of the index positioned at the level of the heart, significant differences were found for systolic and diastolic values compared to the traditional measurement. The use of this device for evaluation of hypertension, monitoring of treatment or use in studies is thus not recommended.

Arteries↗
PubMed1992

[Self measurement of blood pressure: normal and pathological values].

To date, the normal range for self-recorded blood-pressure values has yet to be defined. In this paper possible definitions of the normal range of self-recorded blood pressure are discussed. In large epidemiologic studies self-recorded and casual blood-pressure values should be compared to each other, and in prospective interventional studies blood-pressure values for the initiation of therapy should be defined. Before the termination of these studies we recommend the start of an antihypertensive therapy above 140/90 mmHg. Although definite normal values for self-recorded blood pressure are still missing, a broader use of this method seems to be justified because of the well-known pitfalls of the causal clinical blood-pressure measurement.

Blood Pressure Determination↗
PubMed1992

[Are mercury sphygmomanometers obsolete?].

The measurement of blood pressure during medical visits is limited in its diagnostic, prognostic and therapeutic value by physiologic variability of hypertension and measurement errors. Repeated measurements reduce the effect of spontaneous variations of blood pressure. They allow a more secure assessment of real tension. Regular training for proper technique and elimination of arbitrary preference for rounded last digits or automated recording minimize erroneous measurements. By the multitude of recorded parameters the ambulatory measurement over 24 hours and the self-assessment of blood pressure provide a representative diurnal profile superior to individual measurements at the doctors office. Each of the two methods has its own field of application, although prognostic and therapeutic aims seem similar. The continuous recording over 24 hours is suited for initial assessment and identification of hypertensive patients. Self-assessment of blood pressure has its use for long-term follow up and optimization of therapy. Both methods are complementary and only limited from wider use by lacking internationally accepted normal values and standardization of available devices.

Blood Pressure↗
PubMed1992

[Combination therapy of cardiovascular risk factors].

Risk factors for cardiovascular diseases, which are the leading cause of mortality in the industrialized countries, are well investigated; however, the results of intervention studies on the therapy of single risk factors were disappointing in the past. Recently, there has been growing evidence that there might be a closer pathophysiological relation between arterial hypertension, hypercholesterolemia, obesity, impaired glucose tolerance and genetic disposition than previously thought. For the treatment of the individual patient, this concept requires a complete work-up and comprehensive therapy of all risk factors. The therapy of several mildly elevated risk factors may be more beneficial than a too vigorous reduction of the blood pressure alone. At the beginning of every therapeutic regimen, there has to be a nonpharmacological approach. Diet and weight reduction even in mild obesity are more efficient in influencing several risk factors at the same time than pharmacological therapy. Metabolic consequences of drug treatment have to be carefully monitored.

Cardiovascular Diseases↗
PubMed1991

[Primary sclerosing cholangitis].

In a 40-year-old patient unexplained recurrent attacks of epigastric colic with transient cholestatic icterus occurred over a 9-year period. When the patient was again hospitalised because of progressive pain-free icterus associated with mild pruritus (alkaline phosphatase 900 U/l, direct bilirubin 305 mumol/l, GOT 187 U/l, GPT 103 U/l) sonography revealed liver enlargement to 17 cm, extended intrahepatic bile ducts and an echodense area of about 1 cm size in the region of the bifurcation of the common hepatic duct. Fine-needle puncture did not yield clear cytological findings. Endoscopic retrograde cholangiopancreatography pointed to sclerosing cholangitis. This diagnosis was confirmed by liver punch biopsy. Since the patient did not agree to a liver transplantation, he was treated with 450 mg ursodeoxycholic acid twice daily, resulting in marked reduction of the liver parameters until severe cholangiosepsis and acute renal failure occurred about 4 months later. The septic condition and its complications could not be managed despite thorough intensive-care measures so that a liver transplant had to be performed after all. Histology of the explantate revealed a cholangiocarcinoma in the region of the bifurcation of the common hepatic duct. At first the patient's condition improved markedly but one and half months later the transplant was rejected and the patient died.

Adenoma, Bile Duct↗
PubMed1991

[Hypertension in the old age: how to treat it?].

Therapeutic agents for the treatment of hypertension in the elderly are the well known basic antihypertensive drugs (Diuretics, beta-blocking agents, calcium antagonists and ACE-inhibitors). Choice is determined by concomittant diseases increasing with age. In the elderly patient the assessment of benefit and risk is particularly essential. Drugs should therefore not be installed without exact information of the patient and be started at the smallest possible dose. If tolerance is good the dose may be raised of prescription of an additional drug be evaluated cautiously.

Adrenergic beta-Antagonists↗
PubMed1991

[Sources of error in the diagnosis and therapy of hypertension].

Possible errors in the diagnosis and treatment of hypertension are discussed. The problems of blood pressure determinations are reviewed by comparing the results of sphygmomanometry in the doctor's office, of automated ambulatory blood pressure recording and of blood pressure self-measurement. In screening for renovascular hypertension one should be aware that no test is yet available which shows adequate sensitivity and specificity. Therefore, the only investigation that should be used to demonstrate a true stenosis is arteriography. When treating hypertensives it must be kept in mind that the benefits of antihypertensive medication, i.e. reducing morbidity and mortality from cardiovascular disease, should exceed the costs and side effects of the treatment. Finally, the effects of reduction in dose and discontinuation of antihypertensive medication are discussed.

Antihypertensive Agents↗
PubMed1990

[Pain in the side].

In a 54-year-old patient who entered the hospital because of flank pain of the left side, a prevesicular urethral calculus was found. On further investigation hypercalcaemia and hypophosphataemia were detected, possibly indicating hyperparathyroidism. When an ultrasound of the abdomen was made to exclude hydronephrosis, a tumor in the pancreas was found. The result of the fine needle biopsy of this tumor showed a neuroendocrine tumor. The examination of neuroendocrine parameters was without any reference to an active secreting process. On suspicion of a multiple endocrine neoplasia, a MRI of the hypophysis was made which showed no adenomatous alterations. The examination of the neuroendocrine parameters were without any reference to an active secreting process of the hypophysis, too.

Humans↗