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Biomedical subjects

T Wilhelm

Publications and source records attributed to T Wilhelm.

31 records · Page 2Linked to original sources
PubMed1995

[Standardization and quality assurance exemplified by tinnitus].

Quality management will become another discipline for intensive care and research for the physician. Therefore, the first step in this process will be the need for standardised evaluation criteria and case record forms for documentation, leading to effective quality assessment and control. Only this approach may promote our attempts to improve the quality of patient care. Tinnitus is, due to the lack of objective measurable parameters and a missing rational basis of therapy, up to now a "crux medicorum" for every involved person. In this paper we reproduce a case record form and a patient's questionnaire for patients suffering from tinnitus. The presented forms are based on a consensus conference concerning the evaluation of treatment regimens held at the Fourth International Tinnitus Seminar in Bordeaux in August 1991. Epidemiological data, collected with this questionnaire, are presented and analysed. In conclusion, the presented case record form will lead to a standardised evaluation of symptoms according to tinnitus and improve our understanding of concomitant disturbances in tinnitus sufferers. Furthermore, this form of evaluation and documentation will produce comparable data in different centres allowing a pooling of patients data and history. A comparison of clinical trials in which the items are collected by the procedure shown here will be facilitated and lead us to a new understanding in determining the causes of the disease and the outcome of different therapeutic regimens.

Adolescent↗
PubMed1993

[Requirement for thoracotomy in thoracic trauma].

With intensive care, pleural drainage and judicious physiotherapy most thoracic injuries can be treated adequately. 571 patients were treated for severe thoracic injuries over the last 10 years. A thoracotomy was necessary in 14% of the patients with blunt trauma (BT) and 33% with penetrating trauma (PT). Thoracotomy for PT was performed earlier and had better results than thoracotomy for BT. Seventy-five percent of PT were operated in the first hour after admission against 29% of BT. Postoperative mortality for PT was three times lower than for BT (18% vs 56%). Reasons for this are the higher rate of injuries associated with BT. Surgical procedure depends on the type and extent of the thoracic and general injuries and on the patient's general condition.

Adolescent↗
PubMed1992

[Cicatricial mucous membrane pemphigoid with laryngeal involvement. Case report and review of the literature].

Benign mucous membrane pemphigoid (BMMP) is characterized by immunoglobulin deposits along the basal zone of the skin and mucous membranes, leading to blistering erosions of the involved regions. We report the case history of a 72-year old woman, in whom a cicatricial, supraglottic stenosis caused increasing dyspnea. Through immunohistochemical analysis the diagnosis of BMMP was confirmed. Therapy with cyclophosphamide and steroids led to a remission. Clinical, diagnostic and therapeutic aspects of this laryngologic-dermatologic disease are presented and discussed in the context of the available literature.

Adrenal Cortex Hormones↗
PubMed1990

Real-time ultrasound in the diagnosis of acute deep venous thrombosis of the lower extremity.

One hundred twenty-six patients with clinically suspected acute deep venous thrombosis of the lower extremity (DVT) were examined comparatively with ultrasound and venography. In total, 174 lower extremity venograms were obtained. Ultrasonic examinations were performed on patients in the supine position. The venous segments were evaluated almost exclusively with transversal scanning. In the thigh, the only criterion for DVT was the reduced or absent compressibility of the venous lumen when gently compressed with the transducer. In the calf, normal unobstructed veins can usually not be viewed in the supine patient, whereas thrombotic veins appear as sonolucent, incompressible channels. Eight-three of the 174 lower extremity venograms were positive for DVT. In the majority of cases (53 of 83) the thrombotic process had involved two or more segments in combination. The sites of involvement of the different venous segments were distributed as follows: 24 occlusions of the common femoral vein, 52 of the superficial femoral vein, 56 of the popliteal vein, and 71 of the calf veins. Ultrasound had a sensitivity of 100% for thrombosis of the common femoral vein, 96% for the superficial femoral veins, 98% for the popliteal vein, and 93% for the calf veins. For the entire lower extremity, in regard to the diagnosis of thrombosis, the overall sensitivity was 95%. In 90% the extension of the occlusion was foreseen correctly. In no cases were false-positive results reported. Thus the overall specificity was 100%. The authors conclude that real-time ultrasound is a highly accurate method for the diagnosis of DVT of the lower extremity. It is the only indirect method capable of evaluating the venous system of the thigh, as well as that of the calf, with high accuracy. It should be the first choice of diagnostic imaging method in the diagnosis of deep venous thrombosis of the lower extremity.

Adolescent↗
PubMed1988

[Diagnosis of deep leg vein thromboses by real-time sonography].

Real-time ultrasonography was performed on both legs of 104 patients with suspected deep-vein thrombosis of the legs. The results were compared with those of phlebography (146 one-extremity phlebograms) independently performed. During the first part of the study (69 individual phlebograms) only the upper leg and popliteal region were assessed: absent compressibility of the vessel lumen was the only criterion of thrombosis. In the second part (77 phlebograms) the lower leg was also investigated: non-compressible, echo-poor vessels were typical of thrombosis. Phlebography demonstrated 21 thromboses of the common femoral vein, 36 of the superficial femoral vein, and 41 of the popliteal vein. The 77 phlebograms in the second part demonstrated 29 thromboses of the deep veins of the lower leg. Sonography had a sensitivity of 100% and a specificity of 99% for the region of the common femoral vein, 95% and 99%, respectively, for the superficial femoral vein, 95% and 99% for the popliteal vein and 89% and 100% for the deep veins of the lower leg. Real-time ultrasonography of the deep-vein system of the leg is thus of great diagnostic value both for the upper and the lower leg and is very useful as the initial physical method of examination if thrombosis is suspected.

Adolescent↗
PubMedDate not supplied

[Neonatal suppurative parotitis].

This report describes the case of a 10 days old newborn of a diabetic mother with gestosis, who developed erythema and swelling of the right cheek. A diagnosis of acute suppurative parotitis due to S. aureus was made. Following this case report the most important facts of epidemiology, pathogenesis, clinical manifestation, diagnostics, and therapy of suppurative parotitis are discussed.

Administration, Oral↗