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Biomedical subjects

T Mall

Publications and source records attributed to T Mall.

At least 19 recordsLinked to original sources
PubMed1995

Influence of carbon monoxide (CO) on the early course of acute myocardial infarction.

OBJECTIVE: To clarify the influence of an elevated carboxyhemoglobin (COHb) blood level on the course of acute myocardial infarction and to evaluate the administration of supplemental oxygen on the COHb level and the incidence of complications. DESIGN: Prospective clinical study with randomized, unblinded intervention. SETTING: Coronary Care Unit of a university hospital. PATIENTS: 78 consecutive patients with acute myocardial infarction. Excluded were patients with severe dyspnea, pulmonary edema or any other medical indication for supplemental oxygen therapy. INTERVENTIONS: Randomized therapy with 41/min oxygen in 35 patients. MEASUREMENTS AND RESULTS: COHb was measured at admission and 4 h later. The incidence of serious arrhythmias and the maximal creatine kinase (CK) values were recorded. In patients with initial COHb > or = 5%, there were significantly more arrhythmias and significantly higher maximal CK values than in those with normal COHb admission (89 vs 33%, p < 0.001; and 1897 +/- 1602 u/l vs 960 +/- 1097 u/l, p=0.05). This effect was seen only in patients with Q-wave infarction, not in those with non-Q-wave infarction. Supplemental oxygen had no effect on the incidence of arrhythmias. CONCLUSIONS: We conclude that myocardial infarction patients with acute Q-wave infarction and increased COHb levels at admission suffer a more severe course of the disease. This outcome was not influenced by oxygen therapy. Whether this finding indicates a casual relationship and whether higher oxygen concentrations would favorably alter the course of acute myocardial infarction remains to be determined.

Aged↗
PubMed1987

[Staphylococcal infection after intramuscular injection].

A 74-year-old woman and a 68-year-old man admitted to hospital for backache and somnolence both showed growth of Staphylococcus aureus in blood cultures. One patient died from septic shock. In both patients septicemia was secondary to a gluteal abscess after intramuscular injection of antirheumatic drugs. Diagnosis was particularly difficult due to lack of local signs. Local pain hardly differed from that of the original "rheumatic" backache. The literature is reviewed and diagnosis and treatment are discussed.

Abscess↗
PubMed1986

Benign intra- and extracranial meningioma.

Report of a case with nonmalignant multiple meningiomas at different levels (supratentorial and spinal) of the cerebromedullary axis. Literature is reviewed for epidemiological, clinical and pathophysiological features of such tumors. The possibility of multifocal intra-and extracranial growth of benign meningiomas should be remembered when patients with changing neurological findings are examined postoperatively.

Aged↗
PubMed1985

[Hyperhaptoglobinemia in plasmacytoma and amyloidosis].

Massive hyperhaptoglobinaemia (more than 8 g/l) was seen in a 58-year-old female patient with plasmocytoma and amyloidosis. In the literature, hyperhaptoglobinaemias of up to the three- or fourfold of the upper normal limit have been reported. However, they are very rare. In the present case it might be speculated that extrahepatic formation of haptoglobin occurred within paraproteinaemia of plasmocytoma.

Alpha-Globulins↗
PubMed1985

Moxalactam in nosocomial infections with Serratia marcescens.

Ten critically ill patients presenting with nosocomial infection caused by Serratia marcescens (SM) not responding to prior chemotherapy were treated in an open study with Moxalactam (MOX) alone [6] or in combination with an aminoglycoside [4]. In initial disc diffusion tests, all isolates of SM were highly susceptible to MOX. Clinically, three patients were cured and four improved. Three patients died: one from SM pneumonia, one from gangrenous cholecystitis and another from ARDS. Bacteriologically, SM were eliminated from blood cultures in all seven patients with septicemia but were recovered post mortem from the lung of one patient. In three cases with localized infection, SM were eliminated once and persisted twice. Selection of resistant SM was observed in three patients but became clinically relevant in one case only. Resistant SM strains also showed reduced susceptibility to other cephalosporins and aminoglycosides. Emergence of enterococci occurred four times, in two cases with clinical consequences. MOX is a useful drug for the treatment of SM infections, but a definite risk of selecting multiresistant SM strains and of enterococcal overgrowth must be kept in mind.

Adult↗
PubMed1985

Influence of moderately elevated levels of carboxyhemoglobin on the course of acute ischemic heart disease.

The purpose of this prospective study in 66 patients with acute ischemic heart disease was to analyze the possible effects of moderately elevated levels of carboxyhemoglobin (COHb) on the early course of this disease. Thirty-one patients presented with a level of COHb less than or equal to 2% and 35 with a level of greater than 2%. In the group with elevated COHb, more patients developed transmural infarction, but the difference was not significant (p = 0.123). Patients with transmural infarction had higher maximum CPK values (p less than 0.01), when COHb levels were greater than 2%. During the first 6 h after admission to hospital, these patients needed an antiarrhythmic treatment significantly more frequently (p = 0.003). Differences in rhythm disorders were still present at a time when nicotine, due to its short biological half-life, was already eliminated. We conclude that a moderately elevated level of COHb is not just a marker for recent smoking but may aggravate the course of acute ischemic heart disease.

Arrhythmias, Cardiac↗
PubMed1984

[Course and complications of rhabdomyolysis following heroin poisoning].

A report is presented on two patients with massive rhabdomyolysis following heroin intoxication. Due to massive muscle edema of the lower legs, both patients needed early fasciotomy to prevent compression syndrome. The two cases followed a different course as regards complications and especially renal insufficiency and disorders of serum calcium and phosphorus regulation. Pathophysiology, prevention and therapy of complications are discussed. As a result of intensive physiotherapy, the long term functional outcome was satisfactory in both cases.

Acute Kidney Injury↗
PubMed1984

[Hypertriglyceridemia in intravenous hyperalimentation with glucose. Observations on patients treated with cyclosporin-A following bone marrow transplantation].

The authors report marked hypertriglyceridaemia with peak values of up to 14 mmol/l in patients who have undergone bone marrow transplantation (BMT) and who are receiving 925 g/d glucose and 70 g/d crystalline amino acids for parenteral nutrition. Larger doses of insulin lead to only slightly better control of mean blood glucose level and to a clearly less marked increase in triglycerides (TG) in a series of patients otherwise treated identically. Only a slight increase in serum TG was seen in BMT patients receiving 325 g glucose per day. There was no increase in serum TG to values above normal in a small group of surgical patients receiving 700-900 g glucose/d and high doses of insulin. Peripheral insulin resistance is presumed to be the pathogenetic factor in this hypertriglyceridaemia, mia, which can be avoided by higher doses of insulin or decreased glucose load.

Adult↗
PubMed1984

Episode resembling immune complex disease after cholera vaccination.

The case of a 25-year-old patient is reported who suffered from a syndrome similar to immune complex disease following cholera revaccination. The clinical picture included fever, muscle, joint and abdominal pain, vomiting, serositis, hepatitis, suspected myocarditis, anaemia and thrombocytopenia. Clinical symptoms subsided spontaneously within two weeks. This case illustrates a hazard of cholera vaccination so far not reported in the literature.

Adult↗
PubMed1982

[Creatine kinase (CK) activity and its isoenzyme MB in the serum of randomly selected patients without acute coronary disease].

Elevations of creatine kinase (CK) are not specific for myocardial disease. However, enzyme release due to extracardial factors is not necessarily comparable in healthy and diseased persons. It is therefore questionable whether normal values obtained in a group of healthy or mildly ill subjects are also valid for severely ill patients. The activity pattern of CK and its isoenzyme MB was therefore examined in the serum of 100 consecutive patients attending the medical outpatient clinic and of 170 patients at the time of admission to the medical emergency ward. The clinical and laboratory findings and diagnoses for all patients are recorded. Acute coronary disease was excluded. Determination of CK was performed according to the method described by Oliver [21] and Preston [27], but the results were calculated for a reaction temperature of 30 degrees C and determination of CK-MB was in cue with the method described by Prellwitz [25]. 4% of the outpatients and 14% of the emergency patients had CK values of over 100 U/1. In the majority of the patients (19 of 28) with CK values of over 100 U/1, the history revealed that the elevated values could be attributed to skeletal muscle trauma. After these values had been excluded, the 95% percentile was 20-85 U/1 (outpatients) and 20-110 U/1 (emergency ward) for men and 15-90 U/1 (outpatients) and 20-75 U/1 (emergency ward) for women. Without this selection, the newly admitted male patients in particular would have presented considerably elevated values. Since an explanation was found for most of the elevating values, the adjusted figures show no major differences between outpatients and hospital patients. The limit for CK-MB activity indicative of cardiac origin is presumed to be between 4-10% of the total CK activity. However, individual variations are observed, since CK-MB activity in skeletal muscle in variable and atypical isoenzymes may interfere with CK-MB determination. In this study 14% of the patients admitted to the emergency ward with CK values of under 100 U/1 presented false positive CK-MB values of over 10% of the total CK activity. It is concluded that CK-MB determination using the antibody method does not afford reliable results when there is no elevation of total CK.

Adult↗
PubMed1981

[Atrioventricular block after carotid pressure in hypothyroidism: normalisation after substitution treatment (author's transl)].

Severe auto-immune hypothyroidism, probably after hyperthyroidism, was diagnosed in a 79-year-old woman with hypothyroidism (T3 and T4 immeasurably low) without the classical signs of myxoedema heart. On carotid sinus pressure transitory first degree AV block occurred and, on one occasion, complete AV block. This response disappeared after substitution treatment for four weeks with 50 microgram L-thyroxine. Further examination half a year later, on a maintenance of 75 microgram thyroxine, also gave a negative response to carotid sinus pressure.

Aged↗