PubMed Health⌕ Search

Biomedical subjects

S Küster

Publications and source records attributed to S Küster.

18 recordsLinked to original sources
PubMed2005

[Psychoreactive disorders after motor vehicle accidents. Is it possible to predict the development of psychoreactive disorders after motor vehicle accidents?].

The aim of this study was to assess common risk factors for the early development of psychoreactive disorders during traumatological treatment and to estimate their predictive potential. The sample consisted of 126 consecutive patients with accidental injuries recruited in an emergency room of the university hospital. We assessed this population 1 week (T1) and-on average-8 months following the accident (T2). At T1 34.5% of all patients indicated moderate and 26.4% strong symptoms of an acute stress disorder; 26.7% of all patients assessed at T2 suffered from severe post-traumatic symptoms. Linear regression analysis, using morbidity status at T2 as the dependent variable, allowed the explanation of 46.2% of the variance. The degree of early acute stress symptoms, injury, and pain intensity contributed significantly to the predictive model. We conclude that a substantial proportion of severely injured accident victims that will develop PTSD can be screened to some degree by the assessment of early stress disorder, the degree of their injury, and pain intensity, enabling secondary prevention of trauma-dependent symptomatology.

Accidents, Traffic↗
PubMed2004

[Prehospital emergency airway management procedures. Success rates and complications].

BACKGROUND: Oxygenation and ventilation as well as prevention of aspiration are of vital importance for emergency patients. Prehospital airway management is not comparable to clinical anaesthesia. However, prehospital data of the occurrence of potential life-threatening complications and less severe adverse events of airway management procedures by emergency physicians are not yet available. METHODS: All airway management procedures predominantly performed by emergency physicians over a period of 36 months were recorded prospectively. RESULTS: Data of 598 consecutive patients were collected, in all patients prehospital airway management could be accomplished successfully. Of the patients 98.5% were successfully intubated endotracheally with a maximum of 3 attempts, 84.6% of patients were intubated at the first attempt, and in 9 patients other techniques such as the Combitube were required. In more than 80% of procedures, no complications or adverse events were recorded and potentially life-threatening complications occurred in 9% of patients only. CONCLUSIONS: Prehospital airway management by emergency physicians experienced in anaesthesia is associated with low complication and high success rates.

Anesthesiology↗
PubMed1995

Low-dose calcitriol prevents the rise in 1,84-iPTH without affecting serum calcium and phosphate in patients with moderate renal failure (prospective placebo-controlled multicentre trial).

BACKGROUND: Higher doses of calcitriol are effective in lowering markedly elevated 1,84 PTH levels of patients with renal secondary hyperparathyroidism. It has not been established, however, whether prophylactic administration of low doses of calcitriol prevents an increase of 1,84 PTH without causing side-effects, i.e. hypercalcaemia, hypercalciuria, or hyperphosphataemia. STUDY DESIGN: We carried out a placebo-controlled, double-blind prospective multicentre trial over 12 months in 45 patients with mild to moderate renal failure. Criteria for inclusion were S-creatinine 1.4 mg/dl and 1,84 PTH > 6 pmol/l (normal 6). Calcitriol 0.125 microgram/day per os was compared with placebo. The patients received calcium carbonate per os if serum P exceeded 1.7 mmol/l. RESULTS: Baseline 1,84 iPTH concentrations were not significantly different, i.e. 14.0 pmol/l (6.7-63.3) on placebo vs 16.2 (6.85-82.0) on calcitriol. Intention to treat analysis revealed a significant difference of final 1,84 iPTH, i.e. 27.8 (4.2-68.5) on placebo vs 18.2 (4.45-75.5) on calcitriol. On post-hoc analysis the difference was even more pronounced at S-creatinine concentrations above 3 mg/dl. S-calcium, S-phosphate, and urinary excretion of calcium did not change significantly on either placebo or on calcitriol. There were no episodes of hypercalcaemia or hyperphosphataemia. There was no significant difference of final S-creatinine or change in S-creatinine between placebo and calcitriol. One patient on calcitriol and two on placebo progressed to terminal renal failure. Bone alkaline phosphatase as a non-invasive index of bone metabolism was not decreased to subnormal levels. CONCLUSION: The results document that a therapeutic window exists in patients with moderate renal failure and elevated of 1,84 iPTH, where low-dose calcitriol (0.125 microgram/day) prevents the increase in 1,84 iPTH without causing side-effects. This observation suggests that the parathyroid is more sensitive to calcitriol than intestine and bone.

Adult↗
PubMed1994

Clinical nephrology in 19th century Germany.

Bright's work led to the recognition that coagulable protein in the urine indicated macroscopic kidney disease. After light microscopy was introduced, Simon, Nasse, Henle and Frerichs identified the major constituents of urinary sediment. By 1896, Senator had deduced that hyalin cylinders arise in the kidney tubules, and only the discovery of the Tamm-Horsfall protein in the next century separated him from the modern concept. Chemical analysis of urine also advanced greatly. Recognition of the pressure-volume relationship by Traube was probably the most brilliant achievement related to renal disease, and became the basis of the later pressure-natriuresis relationship. Traube also linked left ventricular hypertrophy with renal disease, recognizing that it maintained circulatory homeostasis at a higher level of pressure. The concept of nephritis changed considerably with technical progress, and Gluge was the first to see inflamed Malpighian bodies or glomeruli. The primary site of damage was disputed by many, including Henle, Pfeufer, Virchow, Reinhardt and Frerichs, but all these workers had to reconstruct the sequence of events leading to the autopsy findings. The term glomerulonephritis was first coined by Klebs, and the classification of nephritis adopted by Senator in 1896 led directly to the classic monograph of Volhard and Fahr (1914) on Bright's disease.

Germany↗
PubMed1991

Rapidly progressive glomerulonephritis: analysis of prevalence and clinical course.

Over a period of 68 months we observed 33 patients with biopsy-confirmed severe crescentic glomerulonephritis (GN) and another 5 patients who fulfilled the clinical criteria of rapidly progressive glomerulonephritis (RPGN; no biopsy confirmation) in a region comprising approximately 930,000 inhabitants. Additional 7 patients with Wegener's granulomatosis (WG)/microscopic polyarteritis (MP) from the same region were not seen by nephrologists. The calculated annual incidence of crescentic GN/RPGN is 0.7/100,000. Of the 38 patients 13 had classical WG, 7 MP, 3 systemic lupus erythematosus, 5 Schönlein-Henoch purpura, 3 Goodpasture's syndrome, 2 IgA glomerulonephritis. Of note is the high prevalence of WG/MP and the relative frequency of Schönlein-Henoch purpura. At the last follow-up, 3 patients were dead (8%), 7 patients were on dialysis (18%), 7 patients had elevated serum creatinine (18%) and 21 patients had normal serum creatinine (55%). We conclude that: (i) RPGN is more frequent than reported; (ii) WG and MP account for more than 50% of cases of RPGN; (iii) renal functional prognosis is good in WG/MP, but less favorable in RPGN of other causes; (iv) severe hypertension is not a feature of RPGN; (v) WG/MP, and not Goodpasture's syndrome, is the most common cause of pulmonary hemorrhage in association with RPGN; (vi) death from infection or malignoma is uncommon (not observed in this series); (vii) de novo IgA GN may occur in patients in remission from WG (2 observations).

Adult↗
PubMed1990

Blood pressure in minimal change and other types of nephrotic syndrome.

Blood pressure was evaluated in adult patients (n = 9) and children (n = 57) with nephrotic syndrome and minimal change glomerulonephritis (GN). Prior to steroid treatment in the edematous phase, hypertension was found in 78% of adults (BP greater than or equal to 140/90 mm Hg or antihypertensive treatment other than diuretics) and 95% of children (BP greater than 95 percentile of age). After complete remission, the prevalence of hypertension decreased to 33% in adults and 19% in children. In 21 children with early focal segmental glomerulosclerosis, the prevalence of hypertension (BP greater than 95th percentile) was 91% and 24% after complete remission. In 20 adult patients with membranous GN, the prevalence of hypertension in the edematous phase was 89% and 30% after complete or partial remission. It is concluded that, irrespective of age, hypertension is a common feature of the nephrotic syndrome unrelated to steroid therapy or renal failure.

Adult↗
PubMed1985

The flexor reflex--influence of stimulus parameters on the reflex response.

The flexor reflex evoked in the tibialis anterior muscle by stimulation of the medial plantar nerve was investigated in 54 normal subjects. Three main reflex components were identified (excitation--inhibition-- excitation), the early excitation being composed of two subcomponents. Occasionally, a fourth (excitatory) reflex component was seen breaking through EMG inhibition. The individual reflex components were differentially susceptible to facilitatory influences which suggested transmission via a central multichannel system. Methodological experiments showed that the amplitudes and to some degree also the latencies of the individual reflex components were modified by both the parameters of the stimulus as well as by the degree of pre-innervation. However, the patterning of the reflex response was basically independent from methodological permutations.

Adult↗