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W Albrich

Publications and source records attributed to W Albrich.

At least 19 recordsLinked to original sources
PubMed2001

The effect of a selenium supplementation on the outcome of patients with severe systemic inflammation, burn and trauma.

Patients with systemic inflammatory response syndrome (SIRS) and sepsis exhibit decreased plasma selenium and glutathione peroxidase activity. This has been shown in several clinical studies. Moreover, the degree of selenium deficiency correlates with the severity of the disease and the incidence of mortality. Patients with SIRS and sepsis are exposed to severe oxidative stress. Selenoenzymes play a major role in protecting cells against peroxidation, especially lipid peroxidation and are involved in the regulation of inflammatory processes. Therefore, selenium substitution in those patients might be effective in the prevention of multiorgan failure. The results of randomised clinical trials investigating selenium substitution in critical ill patients with inflammation are reviewed. In two independently performed randomised, prospective clinical trials, including patients with systemic inflammatory response syndrome or sepsis, the supplementation of selenium revealed a significant reduction in multiorgan failure and, especially, a lower incidence of acute renal failure and respiratory distress syndrome. One of those trials also could demonstrate a significant reduction of mortality in the most severely ill patients. Two other studies, where selenium together with other trace elements or a mixture of antioxidants were used in the treatment of patients with severe burn injuries or trauma showed a significant reduction in the secondary infection rate, including sepsis. Thus, selenium supplementation seems to improve the outcome of patients with SIRS, sepsis and severe injury, however, pivotal prospective clinical trials with sufficient statistical power are now necessary to finally prove the efficacy of a selenium supplementation in these diseases.

Adult↗
PubMed2001

Control of multiply resistant cocci: do international comparisons help?

Antibiotic resistance has become a worldwide problem. However, the reasons for the uneven geographic distribution of antibiotic-resistant microorganisms are not fully understood. For instance, there are striking differences in the epidemiology of multiresistant gram-positive cocci between the USA and Germany. According to recent reports, the prevalence of high-level penicillin-resistant pneumococci (PRP), meticillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE) in clinically relevant isolates of hospitalised patients in the USA and Germany are: PRP, 14% versus less than 1%; MRSA, 36% versus 15%; and VRE, 15% versus 1%. These disparities may be explained by several determinants: (1) diagnostic practice and laboratory recognition (all three pathogens); (2) clonal differences and pathogen transmissibility (VRE); (3) antibiotic prescribing practices (all three pathogens); (4) population characteristics, including extensive daycare exposure in the USA (PRP); (5) cultural factors (all three pathogens); (6) factors related to the health-care and legal system (all three pathogens); and (7) infection-control practices (MRSA and VRE). Understanding these determinants is important for preventing further spread of multiresistant cocci within the USA. A rational approach to national surveillance is urgently needed in Germany to preserve the favourable situation and decrease MRSA transmission. Finally, we suggest that a macro-level perspective on antibiotic resistance can broaden the understanding of this worldwide calamity, and help prevent further dissemination of multiply resistant microorganisms.

Anti-Bacterial Agents↗
PubMed1997

Fertility after organ-preserving surgery of ectopic pregnancy: results of a multicenter study.

OBJECTIVE: To evaluate the postoperative fertility rate after ectopic pregnancy (EP) and to compare the impact of different surgical techniques. DESIGN: Prospective, multicenter trial. SETTING: Twenty-five centers with microsurgical facilities. PATIENT(S): A total of 1,025 patients with EP were enrolled between 1984 and 1990. INTERVENTION(S): Organ-preserving operation and at least one patent remaining tube. Evaluation of postoperative outcome by standardized questionnaires. MAIN OUTCOME MEASURE(S): Postoperative fertility in terms of pregnancy rate (PR) and recurrent ectopic implantation. RESULT(S): The PR was similar after wedge resection (45.9%) and salpingotomy or milk out (42.0%). The recurrence rates did not differ between both groups (7.5% versus 8.2%). In patients with a blocked or absent contralateral tube, the PR was poor (31.2%), and the recurrence rate of EP was high (16.0%), indicating that most pregnancies are achieved through the contralateral tube. CONCLUSION(S): The postoperative fertility rate after an EP is reduced. The type of surgery usually has no significant impact. In the case of a blocked or absent contralateral tube, the patient must be informed about the significantly reduced fertility rate and the elevated risk for EP recurrence.

Adolescent↗
PubMed1983

[Cutaneous coumarin necrosis of the breast].

In a 62-year-old female patient petechial haemorrhages of the right breast were observed after the 4th day of treatment with phenprocoumon. Within a few hours large cutaneous necroses developed. Histology showed lymphocytic vasculitis with vessel wall destruction and erythrocytic extravasates as well as necrobiotic changes of the middle and lower corium. High-dosage treatment with prednisolone was started after withdrawal of phenprocoumon. Progression of the necrosis to the left breast could be prevented. However, necrosis of the haemorrhagic area of the right breast could not be arrested. Aetiology and pathomechanisms of coumarin-induced necrosis have to date not been ascertained. Allergic precipitating mechanisms probably were of no importance in our patient.

4-Hydroxycoumarins↗
PubMed1981

Long-term results following fixation of the vagina on the sacrospinal ligament by the vaginal route (vaginaefixatio sacrospinalis vaginalis).

Vaginaefixatio sacrospinalis vaginalis is an operative procedure whereby the vaginal stump is affixed to the sacrospinal ligament of one side of the vaginal route. Intercourse is not inhibited by this operative method. This technique was performed on 81 patients, starting in 1959, with a follow-up period of up to 10 years. In 78 cases the indication for operation was a true vaginal vault prolapse following hysterectomy; in three cases it was a prolapse of the uterus and the vagina because of complete incompetence of the visceral fascia of the pelvis. The vaginal vault prolapse was alleviated by the colpopexy technique in all patients. However, coexisting cystocele, rectocele, and enterocele and related incontinence remained in a few instances.

Female↗
PubMed1981

[Pregnancy and birth after jejunoileostomy because of adiposity (author's transl)].

Five pregnancies in two patients after jejunoileal bypass because of adiposity are reported. One pregnancy ended with a spontaneous abortion of two dystrophic children one died postpartum after a pregnancy complicated by cholecystectomy, cholangitis and pancreatitis. The extent of postoperative weight loss acquires a certain importance in assessing the risk of dystrophy to the child.

Adult↗
PubMed1981

[The early diagnosis of pregnancy by the enzyme immunoassay of beta-1-glycoprotein (sp1) (author's transl)].

The enzyme immunologic determination of SP1 in the serum is suitable for the early diagnosis of pregnancy from 14 days after ovulation onwards. In the control group of 64 non-pregnant and of healthy men no SP1 was detected in the serum. At least six weeks after the cessation of trophoblast activity SP1 can still be detected in the serum. The enzyme immunoassay technique of SP1 in the serum has a high sensitivity of 1 ng/SP1/ml serum and a short measuring time of 2 1/2-4 hours. This test is therefore excellent for the early diagnosis of pregnancy.

Adolescent↗
PubMed1977

[Incidence of different types of urinary incontinence (author's transl)].

The incidence of different forms of incontinence is reported as a short survey. Particular attention is given to the various opinions on the effect of pregnancy, birth and diminishing ovarian function on the occurrence of closure insufficiency. Also the frequency of urinary incontinence arising from bladder conditions is variously assessed. The proportion is certainly high in "operation failure" or recurrent incontinence. Organic causes are only found in a bare fifth of patients with stress incontinence, Iatrogenic urinary incontinence is rare, but imposes particular demands on the attending doctor. Involuntary loss of urine is very widespread among women, but it is relatively seldom found to be troublesome and to require treatment.

Adolescent↗