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W Maleck

Publications and source records attributed to W Maleck.

At least 19 recordsLinked to original sources
PubMed2005

[Who contributes to research in intensive medicine in Germany? An update].

INTRODUCTION: In today's times of financial short-cut, it is of highest interest to improve quality. Research in intensive care medicine is an important instrument to improve therapeutic strategies. The origin of papers published in the field of intensive care medicine by German universities were evaluated and compared to a previous analysis (1992 - 1997). METHODS: Using a Medline analysis, 10 international journals (Crit Care Med; Intensive Care Med; Resuscitation; J Crit Care; Crit Care Clin; Circulation; Chest; Am Resp Crit Care Med; Stroke; J Inf Dist) that exclusively or often publish intensive care papers were analysed over the past 6 years (1998 to 2003). Only original papers from German universities were included and the publications were listed according to the origin of specialty: anesthesiological, surgical, cardiac surgical, neurosurgical, internal medicine, neurological, pediatric intensive care medicine. RESULTS: The total number of publications has markedly increased (1998 - 2003; n = 1245) compared to a previous analysis (1992 - 1997: n = 621). The number of publication from surgical institutions was still significantly lower than that of other intensive care units (cardiac surgery: n = 44; anesthesia: n = 356; internal medicine: n = 463). Institutions from the formerly eastern part of Germany participated much more to international journals than in the former analysis. DISCUSSION: Scientific research in intensive care medicine is important to develop new strategies for treating the critically ill. Although the total number of publications has increased, it is astonishing that some intensive care units from German universities did almost not publish in the selected intensive care journals.

Critical Care↗
PubMed2003

[Current status of non-invasive ventilation in German ICU's -- a postal survey].

The status of non-invasive ventilation (NIV) in intensive care units (ICU) in Germany was analysed by a national survey. Questionnaires consisting of multiple-choice and short-answer questions were sent to ICUs of university hospitals, hospitals with >1000 beds, with 500 - 1000 beds, and hospitals with <500 beds separated with regard to different specialties (anesthesia ICUs, surgical ICUs, cardiac surgical ICUs, neurosurgical ICUs, internal ICUs, interdiscipline ICUs). Of the 716 questionnaires sent 223 (32 %) were returned and analysed. The use of NIV in all specialties increased during the last 3 years. 14 % of ICUs in some specialties treated more than 30 % of patients with NIV. CPAP (88 %), BIPAP (45 %) and ASB/PSV (48 %) were most frequently used as NIV-strategies. 10 % of all ICUs reported to have experience with proportional assist ventilation. NIV was most frequently used for disease states like COPD (82 %), pneumonia (64 %), pulmonary oedema (50 %), bronchial asthma (35 %) and ALI/ARDS (22 %). The use of NIV was considered when clinical signs of ventilation (93 %) and oxygenation [arterial blood gas analysis (92 %) and oxygen saturation (66 %)] were inadequate. Complications observed during NIV were panic reaction (83 %), ulceration of nose (38 %) and aspiration (14 %). The reasons to reject NIV were (total 13 %): lack of ventilators (64 %), expenditure of personnel (57 %) and risk of the procedure (11 %). 38 % of the ventilators used were older than 5 years. 56 % of the ICUs were content with the equipment for NIV. 76 % of the ICUs were interested to buy new equipment of NIV. 99 % of the survey have declined NIV as an alternative method of ventilation. In summary we found NIV as an accepted additional method of ventilatory support in respiratory failure in German ICUs. We found no significant increase in frequency of NIV in the last three years.

Anesthesia↗
PubMed2001

Influence of coconut water on hemostasis.

Coconut water (CNW) can be used as short-term intravenous hydration and resuscitation fluid. We investigated the influence of coconut water on plasma coagulation in vitro. Either CNW or physiological saline (PS) was added to citrated plasma of 8 healthy volunteers. Coagulation capability of diluted plasma was evaluated by thrombelastography (TEG). Replacement of up to 50 % of citrated plasma by CNW or PS did not influence initiation of coagulation as indicated by split point and reaction time, respectively. Strength of fibrin clot as expressed by maximum amplitude (MA) of TEG recording dose dependently declined in both groups. Replacing 50 % of citrated plasma by CNW or PS reduced MA by 39% and 32%, respectively. The influence of coconut water on hemostasis as assessed by TEG does not differ from the effect caused by an identical volume of PS.

Blood Coagulation↗
PubMed2001

[The standing of clinical research in Germany - distribution of experimental versus clinical research in anaesthesia].

OBJECTIVE: Clinical research has been proposed to be less active and less attractive in Germany. The distribution of clinical versus experimental research of German university departments of anesthesiology was analysed. METHODS: With the help of Medline all articles published from all German university anesthesiology departments in German and English in 1998 and 1999 were analysed and specified with regard to the following subtypes: experimental research, clinical research, miscellaneous (reviews, questionnaires). RESULTS: 369 articles in German and 545 articles in English language were specified. From the German publications 129 articles were derived from clinical research (35 % of all papers), 29 papers were from experimental research (8 % of all papers), and 211 papers were miscellaneous articles (57 % of all papers). From the publications in English language, 291 papers were from clinical research (53 % of all articles), 195 were from experimental research (36 % of all articles), and 59 papers were miscellaneous articles (11 % of all articles). CONCLUSION: Clinical research was published more often in German, whereas experimental studies were published more often in English. Some anesthesia departments prefer to focus their research efforts mainly on experimental research. It is tempting to speculate whether concentration on experimental research is beneficial for research in the field of anesthesia in Germany.

Anesthesia↗
PubMed2000

[Publication rate of Deutsche Forschungsgemeinschaft (DFG)-supported research projects. An analysis of the "fate" of DFG-support methods in anesthesia, surgery and internal medicine].

OBJECTIVE: Outstanding medical research is not possible without financial support. The success of supported research projects have been evaluated only rarely. The publication rate of research projects supported by the German Research Council (Deutsche Forschungsgemeinschaft [DFG]) was assessed separately for internal medicine, surgery, and anesthesiology. METHODS: Based on the "Figures and Facts" published by the DFG all supported projects of 1996 for all three specialities were included. In a Medline-based analysis all published papers dealing with the supported project and all papers published by the supported persons from 1996 to may 2000 were documented. RESULTS: A total of 315 grants were analysed (internal medicine: 234; surgery: 63; anesthesiology: 18). Projects with clinical topics were less often supported (n = 80) than experimental projects (n = 235). 162 (69.3%) of the grants in internal medicine, 41 (65.1) in surgery, and 14 (77.8%) of the grants in anesthesiology were published. In anesthesiology all published projects were in English language (internal medicine: 98.2%; surgery: 95%). Independent of the topic of the grant, several supported persons in internal medicine and surgery did not publish any papers between 1996 and may 2000, whereas all supported anesthesiologists published papers in peer reviewed journals in this time period. CONCLUSION: The publication rate of DFG supported projects is not sufficient. Except for a final internal report after finishing the research project no quality control exists for DFG grants. Unfortunately, not all supported projects were published. A better feedback between the financial support by the DFG and the publication rate of DFG grants is desirable.

Anesthesiology↗
PubMed2000

Phospholipase A2-induced coagulation abnormalities after bee sting.

We will examine the correlation between various bee venom phospholipase A2 (PLA2) concentrations and several parameters of coagulation in human plasma in order to offer a rationale for requesting a particular laboratory coagulation test after bee sting(s). We will also evaluate in vitro the influence of clinically available drugs with a noncompetitive inhibitory effect on PLA2 on the anticoagulant effect of bee venom PLA2. Prothrombin index (PTi), partial thromboplastin time (PTT), antithrombin III (AT III), soluble fibrin monomers (SFM), the activity of coagulation factors I, II, V, and VIII, and thrombelastography (TEG) parameters (split point [Sp], reaction time [R], kinetic time [K], coagulation time [R + K], maximal amplitude [MA], and the growth angle [alpha]) were determined before and after addition of 1.4, 2.7, and 4.1 units (1, 2, and 3 microg protein respectively) of bee venom PLA2. Linear regression was used to determine the significance of the relationship between these coagulation parameters and bee venom PLA2 concentrations used. To study the influence of ketamine, lidocaine, magnesium, furosemide, and cromolyn on the anticoagulant effect of bee venom PLA2, PTi and factor II- and V-activities were measured before and after addition of 2.7 units of PLA2 and PLA2 plus one of the tested substances. Determinations of F II, PTi, F V, and F VIII showed a negative correlation to bee venom PLA2 concentration (r = -0.88, -0.86, -0.81, and -0.79 respectively). A positive correlation was found for PTT (r = 0.69). FII- activity and PTi correlated better with bee venom PLA2 concentration than other parameters. F I, AT III, and SFM showed no changes. Whereas Sp, R, and K were prolonged by bee venom PLA2 and a was reduced, there was no correlation to the PLA2 concentration. Addition of none of the 5 substances could correct the effects of bee venom PLA2 on the coagulation. In a patient with toxic reaction or a severe anaphylactic reaction after bee sting(s) we suggest determinations of FII and/or PTi. This will allow a quick and economical assessment of coagulation abnormalities after bee sting(s). Noncompetitive PLA2-inhibitors (ketamine, lidocaine, magnesium, furosemide, and cromolyn) are unable to correct in vitro the anticoagulant effect of bee venom PLA2. They cannot be recommended at this stage for this purpose. Further investigations with competitive PLA2-inhibitors are warranted.

Animals↗
PubMed2000

Retracted: Composition of the editorial/advisory boards of major English-language anesthesia/critical care journals.

BACKGROUND: Publications represent a central part of the research process. An analysis of who is responsible for acceptance of publications in major English-language anesthesia/critical care medicine journals was carried out. METHODS: All English-language journals listed in the SCI Journal Citation Reports 1997 under the subheadings Anesthesiology (n=18) and Emergency Medicine & Critical Care (n=16) were analysed with regard to the editorship and the membership of advisory boards listed in the 1998 issues of the journals. The two groups were analysed separately with regard to their country of origin. RESULTS: In the Anesthesiology section, 140 persons were listed as editors and 423 persons were identified as members of the advisory boards. Editors came from 14 different countries, with editors from the USA representing the majority (n=83; 59% of all editors, followed by the UK: n=24; 15% of all editors). Editors from other countries represent only a minority (n=33; 24% of all editors). The advisory boards came from 30 countries and were also dominated by the USA (n=220; 52% of all persons from the advisory boards). In the Emergency Medicine & Critical Care section 159 persons were listed as editors, of whom 119 originated from the USA (75% of all editors). Of the 835 persons listed in the advisory boards, 72% came from the USA, with 37 other countries sharing the remainder (second, UK: 8%; third, Canada: 2.5%). CONCLUSION: Most editors/editorial board members of important Anesthesiology, Emergency and Critical Care journals came from the USA. Other countries play a significantly less influential role even in journals which are characterised as 'International Journals'.

Anesthesiology↗
PubMed2000

[Emergency tracheotomy in Göttingen minipigs. Comparison: standard technique versus Nu-Trake cricothyrotomy set].

STUDY OBJECTIVE: To compare the time required, success rate and complication rate of the standard surgical approach for cricothyrotomy versus a prepacked kit in regard to the experience of the surgeon. METHODS: The cricothyrotomies were performed in Goettingen mini-pigs (n = 14) under general anaesthesia. 7 different surgeons (2 Otorhinolaryngologists, 2 Emergency Physicians, 3 medical students) used each technique (standard surgical approach and Nu-Trake device) once to perform the cricothyrotomy without prior practice. RESULTS: The fastest time to do the cricothyrotomy with Nu-Trake was 40 s, the slowest 93 s and the mean time of all 7 surgeons was 58 +/- 18 s. Using the standard approach it took 42 s up to 154 s until ventilation with a mean time of 106 +/- 48 s. The use of Nu-Trake was significantly faster than the standard surgical approach (p < 0.05, t-test). Otorhinolaryngologists were quicker using the standard technique (46 s versus 58 s with Nu-Trake), whereas each surgeon of the other two groups (emergency physicians and medical students) was quicker with the Nu-Trake Set (58 +/- 21 s) than with the conventional method (135 +/- 18 s). The number of complications was similar with both methods, but a difference was detected in the type and severity of the complication: An injury of the posterior tracheal wall was observed twice with Nu-Trake. CONCLUSIONS: Experienced personnel should maintain the standard surgical approach for cricothyrotomy. Inexperienced personnel can use the Nu-Trake device which was found to be quicker as it facilitates the procedure, but causes more severe complications. We recommend to practise cricothyrotomy regularly in human cadavers, in the animal model if possible or on mannequins to be sufficiently trained in advanced airway management.

Animals↗
PubMed1999

Intravenous paraoxon (POX) exposure: coagulation studies in mini pigs.

The in vivo effects of the organophosphorus compound (OPC) paraoxon (POX) on blood coagulation of mini pigs were assessed by measuring the partial thromboplastin time (PTT), prothrombin time (PT), fibrinogen, factor V, factor VII, factor VIII, antithrombin III, protein C, and platelet count. The mini pigs were randomly assigned to a POX-treatment group (n = 9) receiving 54 mg POX kg(-1) BW(-1) or the control group (n = 9). Measurements were carried out over a period of 150 min after poisoning. The exposure to POX did not have any influence on measurements of PT, factor VIII, factor VII, factor V, antithrombin III, protein C, or fibrinogen compared to the control group evaluated by rank order test (ROT) during the time of observation (150 min). Changes seen in the intrinsic coagulation followed a biphasic pattern corresponding to an early sympathomimetic phase with PTT-shortening and a decrease of the platelet count, and a late vagal phase, with PTT-prolongation. The hypercoagulability seen in the sympathomimetic phase is probably due to a massive release of catecholamines from the adrenals. Previous studies showed in vitro no coagulation activating effect of POX. The hypocoagulability in the vagal phase shown by the PTT-protongation is probably due to POX influencing platelet function or its inhibition of clotting factors, which are serine proteases, or a combination of the two.

Animals↗
PubMed1999

[Fate of presentations given at German anesthesia congresses].

BACKGROUND: To evaluate the publication rate of abstracts presented during the German Anaesthesia Congress (DAK) in MEDLINE-listed journals in comparison to the publication rate of abstracts presented during the meeting of the European Society of Anaesthesiologists (ESA). METHODS: All abstracts of free papers (FP, orals) and posters of the 1994 DAK and the 1994 ESA meeting were included. Over a period of approximately 7 years (1993 to May 1999) the appearance of authors and abstracts topics in the literature were searched with the help of MEDLINE. Only original papers were included in the analysis. RESULTS: All 322 abstracts (268 FPs and 54 posters) of the DAK and all 244 abstracts (81 FP and 163 posters) of the ESA were analyzed. A total 122 of the DAK abstracts (37.9% of all abstracts) and 111 of the ESA abstracts (45.5% of all abstracts) were published in MEDLINE-listed journals. Posters presented at the DAK were as published often (37%) as were oral presentations (38%). Of the 122 abstracts of the DAK that were published 71 (58.2%) were published in English (in 38 different journals) and 51 (41.8%) were published in German (in 8 different journals), whereas 102 (92%) of the ESA abstracts were published in english (in 42 different journals). CONCLUSION: The overall portion of abstracts of the DAK published in MEDLINE indexed journals within 7 years was disappointing. The reasons for this may include deliberate avoidance of a publication (e.g. due to lack of interest to publish, no time) or low quality of the abstract that hinders publication in a MEDLINE indexed journal.

Anesthesiology↗
PubMed1999

[Intensive care research in Germany--an analysis of papers in important international journals].

OBJECTIVE: The present study was designed to assess who is responsible for publications in important english-written intensive care journals. METHODS: 10 english-written journals that exclusively or mainly publish intensive care papers were analysed over the past 10 years (from 1988 to 1997). All German universities were included and publications were specified according to the speciality (e.g. anesthesiology, internal medicine, neurosurgery) and the university of origin of the publication. Letters, abstracts, editorials, meeting-reports, and news were not included in the analysis. RESULTS: A total of 804 publications was found in the analysed journals. 343 publications were originated from interne medicine departments (433 of all publications), 207 were from anesthesiology departments (26%). Papers from surgical departments were only rarely found (cardiac surgery: 14 papers; neurosurgery: 12 papers; general/trauma surgery: 34 papers). 150 publications originated from neurology departments, and only 44 pediatric intensive care papers were found. A wide range of contributions from the specific universities were seen (ranging from 0 to 43 papers). Universities from former East Germany published very rarely in international intensive care journals (3%). CONCLUSION: Only few German universities have published in important intensive care journals over the past 10 years. Some interne medicine and some anesthesia departments were markedly engaged in this speciality, whereas several other universities and most universities from former East Germany did not participate significantly in the international intensive care literature.

Critical Care↗
PubMed1999

[Contribution of german university departments of anesthesiology to the international literature].

OBJECTIVE: According to the president of the "Wissenschaftstrat", Prof. W. Schulze, the university is in the center of research and scientific development. The contributions of the different anesthesia departments of all german universities in international anesthesia and intensive care medicine journals were studied in a descriptive analysis. METHODS: A Medline analysis covering the past 10 years was focused an all contributions from anesthesia departments from all german universities (n = 37). Contributions in important international anesthesiology and intensive care journals were separately analysed. RESULTS: Within the investigation period of 10 years contributions in all Medline-listed international journals increased (1988:55 contributions-1997:236 contributions). There was a wide variety in the activity among the different university departments ranging from no publication up to a total of 132 publications. Only a few university departments of anesthesia contributed to the increase in papers in international intensive care journals (1988: 11 publications-1997:35 publications). CONCLUSION: Marked differences in the numbers of publications of the different universities in anesthesia and intensive care medicine journals were observed. Universities from former East Germany are still less involved in international publications.

Anesthesiology↗
PubMed1999

Which countries publish in important anesthesia and critical care journals?

UNLABELLED: Using a MEDLINE-based analysis, we studied the national origin of articles published in important anesthesia, pain, critical care, and emergency medicine journals. All journals in English listed in the Science Citation Index (SCI) of Journal Citation Reports under the subheadings Anesthesiology (n = 17) and Emergency Medicine & Critical Care (n = 13) were analyzed with the help of MEDLINE. Issues from 1996 and 1997 were included and summarized. Letters, abstracts, editorials, meeting reports, and news were not included. MEDLINE printouts were studied, and we classified the country of origin of the first author. The following subsets were defined: Anesthesia, Regional Anesthesia and Pain, Clinical Monitoring and Computing, Intensive Care Medicine and Resuscitation, and Emergency Medicine and Trauma. A total of 10,643 publications in 30 journals were published during 1996 and 1997. Of the 30 journals, 17 originate in the United States (US) and 8 from United Kingdom (UK). In 14 of the 17 US journals, >50% of the publications came from the US. The US was the most active nation, with a total of 4,283 articles (40.2% of all contributions), followed by the UK with 1,418 articles (13.3%). When looking at the number of publications with regard to inhabitants or impact factor per million inhabitants, small highly industrialized nations (Finland 35.41 and Sweden 33.9 articles/million inhabitants) were significantly more active than large highly industrialized countries (US 16.2, Germany 6.1, Japan 4.5 articles/million inhabitants). It is presumed that indicators of productivity in medical research are the number of articles published and the cumulative impact factor. During 1996 and 1997, the US was the most active nation with regard to publications in important journals in the areas of anesthesia, pain, critical care, and emergency medicine. Small highly industrialized nations, however, had a higher activity rate than larger countries. IMPLICATIONS: In a MEDLINE-based analysis, we examined the number of publications in important anesthesia, pain, critical care, and emergency medicine journals (n = 30) for the years 1996 and 1997 and analyzed these with regard to national origin. The United States was by far the most active nation in this medical area (4283 articles [40.2%]), followed by the United Kingdom (13.3%). With regard to publications per million inhabitants, small highly industrialized nations contributed overproportionally to publications in this area.

Anesthesiology↗
PubMed1997

In vitro paraoxon (E 600) exposure: no activating effect on human blood coagulation.

The in vitro effects of the organophosphorus compound (OPC) paraoxon (POX) on human blood coagulation were assessed by fibrin monomer (FM) concentration measurements and thrombelastographic (TEG) determinations. Increasing doses of POX dissolved in alcohol (POX + ALO) or alcohol (ALO) only in corresponding quantities were added to blood drawn from six human volunteers. In both series (POX + ALO and ALO-only) FM concentrations increased in comparison to the baseline levels. No statistically significant differences exist, however, between FM measurements performed on blood with POX + ALO and those performed on blood with ALO-only. No coagulation-activating effect of POX in vitro was demonstrable; the changes seen in vitro are due to the ALO used as a vehicle. The thrombelastographic parameters showed several changes in the POX + ALO series as dosage increased. At high POX levels, reaction time r and clot formation time k became longer than in the baseline measurements, the clot formation rate alpha and the maximum amplitude MA were reduced. The TEG changes indicate a hypocoagulable state, probably due to the POX effect on platelet function and/or inhibition of clotting factors (serine proteases).

Blood Coagulation↗
PubMed1997

[The Mallampati Score. Prediction of difficult intubation in otolaryngologic laser surgery by Mallampati Score].

UNLABELLED: The Mallampati score (MS), later modified by Samsoon and Young, is a common method used to predict difficult intubation. We tested its predictive value in otolaryngologic (ENT) laser surgery. METHODS: Ninety-one patients scheduled for elective ENT laser surgery had the modified MS noted prior to induction in the supine position, with the tongue fully protruded and phonating "ah"; 22 patients were female, 69 male. The mean age was 54 +/- 15 (6-84) years, height 171 +/- 9 (130-190) cm, and weight 72 +/- 21 (20-99) kg. After a standard induction, the laryngoscopic view was graded according to Cormack and Lehane (C&L). An intubation was considered difficult if the C&L score was > or = 3, i.e., no part of the glottis seen during laryngoscopy. The hypothesis tested was that a MS > or = 3 (i.e., only the base of the uvula or nine of the uvula was seen) is predictive of difficult intubation in this group of patients. This chi-square test was used for calculation of significance. RESULTS: All intubations were performed in less than three attempts, and no C&L score of 4 (i.e., not even the epiglottis seen during laryngoscopy) was observed; 10 patients had a C&L score > or = 3, i.e., a difficult intubation according to our definition. Sixty-two patients had a MS < or = 2; of these, 4 (= 6%) were difficult to intubate. Twenty-nine patients had MS > or = 3; of these, 6 (= 21%) were difficult to intubate. This difference was significant (chi-square = 4.1, P < 0.05). CONCLUSION: Difficult intubation was significantly more common in patients with MS > or = 3. Low sensitivity (60%) and specificity (72%) limit the clinical value of this test, however.

Adolescent↗
PubMed1997

[Difficult intubation in otorhinolaryngologic laser surgery. Is there a predictive parameter?].

In the planning of laser surgery for ENT operations, the specialist is often consulted by the anesthesiologist to predict possible intubation problems. Intubation problems in such operations can occur frequently due to the pathological findings present in the upper aerodigestive tract and the different constructions of laser-resistant endotracheal tubes. The aim of this study was to determine if a known predictive parameter could have a sufficient sensitivity and specificity to reliably predict possible intubation problems for ENT-related laser surgery. In a prospective study, 91 patients were included and the Mallampati-score modified by Samsoon and Young was analyzed and compared to a score describing the actual conditions of intubation. The results showed a significant correlation (p < 0.05, Chi-Square test). However, the specificity was only 72% and the sensitivity of 60% was too low to be of practical use. The results were independent of the endotracheal tube used. Although use of the laser for ENT operations provides a special situation for the anesthesiologist, there is still no system that is sensitive and specific enough to be of practical use. This problem is demonstrated in a literature review.

Adolescent↗