PubMed Health⌕ Search

Biomedical subjects

W Stenzinger

Publications and source records attributed to W Stenzinger.

At least 19 recordsLinked to original sources
PubMed2001

Fever, cancer incidence and spontaneous remissions.

OBJECTIVE: Accumulating evidence exists for (1) an inverse correlation between the incidence of infectious diseases and cancer risk and (2) an inverse correlation between febrile infections and remissions of malignancies. This review is part of an effort of the Office of Alternative Medicine at the National Institutes of Health to examine this evidence. METHODS: A review of the literature to a key word search was undertaken, using the following key words: fever, infectious diseases, neoplasm, cancer incidence and spontaneous remission. RESULTS: The data reviewed in this article support earlier observations on the topic, i.e. that the occurrence of fever in childhood or adulthood may protect against the later onset of malignant disease and that spontaneous remissions are often preceded by feverish infections. CONCLUSION: Pyrogenic substances and the more recent use of whole-body hyperthermia to mimic the physiologic response to fever have successfully been administered in palliative and curative treatment protocols for metastatic cancer. Further research in this area is warranted.

Communicable Diseases↗
PubMed1998

[Intensity of oral anticoagulant therapy after heart valve replacement].

In recent years randomized clinical trials using standardized prothrombin time (international normalized ratio, INR) for the control of oral anticoagulant therapy have demonstrated that the use of a less intense therapeutic range decreases the rate of bleeding without reducing antithrombotic efficacy. Based on these results, the following guidelines for therapeutic ranges in heart valve replacement can be presently recommended: INR of 2.0-3.0 in patients with bioprosthetic valves for the first 3 months-except, probably, for patients with tissue valves in aortic position who are in sinus rhythmus; long-term anticoagulation corresponding to an INR of 2.0-3.0 in all patients with bioprosthetic valves and either atrial fibrillation or postoperative arterial embolism or a left atrial thrombus at surgery; long-term treatment equivalent to an INR of 2.5-3.5 in all patients with mechanical prosthetic heart valves.

Administration, Oral↗
PubMed1996

Volume-controlled versus biphasic positive airway pressure ventilation in leukopenic patients with severe respiratory failure.

OBJECTIVE: To study comparatively the effects of volume-controlled vs. biphasic positive airway pressure mechanical ventilation on respiratory mechanics and oxygenation in leukopenic patients with severe respiratory failure. DESIGN: Prospective, comparative study. SETTING: Medical intensive care unit of a university hospital. PATIENTS: Leukopenic (<1000 leukocytes/microliter) patients (n=20) after cytoreductive chemotherapy requiring mechanical ventilation for severe respiratory failure (Murray score of > 2.5). INTERVENTION: Patients were assigned in a consecutive, alternating manner to receive either volume-controlled or biphasic positive airway pressure mechanical ventilation, starting within 12 to 24 hrs after endotracheal intubation. MEASUREMENTS AND MAIN RESULTS: Tidal volume, inspiratory flow, peak inspiratory and positive end-expiratory pressures, FIO2, and arterial blood gas analyses were recorded hourly for a study period of 48 hrs. Biphasic positive airway pressure ventilation was associated with a significant reduction in peak inspiratory pressure (mean differences at 24, 36, and 48 hrs: 4.4, 3.4, and 4.2 cm H2O; p = .024, .019, and .013, respectively) and positive end-expiratory pressures (mean differences at 24, 36, and 48 hrs: 1.6, 1.4, and 1.5 cm H20; p = .023, .024, and .023, respectively) at significantly lower FIO2 (mean differences at 12, 24, 36, and 48 hrs; p = .007, .015, .016, and .011, respectively). PaO2/FIO2 ratios and CO2 removal were similar under ventilatory conditions. CONCLUSIONS: Biphasic positive airway pressure ventilation offers the advantage of significantly reduced peak inspiratory and positive end-expiratory pressures at a lower FIO2 and with at least similar oxygenation and CO2 removal as achieved by volume-controlled mechanical ventilation. Our results are in line with previous reports on nonleukopenic patients and suggest that the positive effects of pressure-limited mechanical ventilation are independent of circulating white blood cells. Further studies are mandatory to demonstrate clinical benefit in this critically ill patient population.

Acute Disease↗
PubMed1993

[Arterial embolism and thrombocytopenia during heparin therapy].

This is a case report of heparin-associated thrombocytopenia syndrome (white clot syndrome). An 81-Year-old patient was treated with sodium-heparin for proximal deep-venous thrombosis and pulmonary embolism. During administration of heparin, the platelet count decreased to a nadir of 27/nl on day 14 after initiation of this therapy. We also observed a recurrence of pulmonary embolism as well as arterial thromboembolism in the right arm and the right leg. After immediate discontinuation of heparin therapy and change of anticoagulation to oral anticoagulants with overlapping administration of a low molecular weight heparin and application of immunoglobulins, we observed total recanalization of the arterial occlusions, normalization of lung-perfusion scan and rapid recovery of the platelet count.

Aged↗
PubMed1993

[Peripheral arterial occlusive disease--acute intervention and after-care].

Acute ischemia in peripheral arterial occlusive disease due to progressive atherosclerosis is most commonly caused by thrombotic or thromboembolic events. Such a condition is a threat to both the limb and the life of a patient which requires rapid therapeutic decisions based on close cooperation between vascular surgeons, angiologists and radiologists. In complete ischemia with sensomotoric deficit and in suprainguinal occlusions surgical management remains the treatment of choice. Patients with incomplete ischemia and infrainguinal occlusions and patients unfit for major vascular surgery are appropriate candidates for local thrombolysis and percutaneous revascularization procedures. Available data on the main thrombolytic agents fail to show convincing difference between these drugs with regard to their efficacy and safety. Full heparinization is recommended before any definite therapy, after thrombolysis and if necessary after percutaneous transluminal angioplasty (PTA). Antiplatelet drugs should be given before and after reconstructive surgery and PTA and following heparinization after thrombolysis and PTA. In all conditions long-term treatment with antiplatelet drugs is recommended.

Angioplasty, Balloon↗
PubMed1990

Identification of platelet antigens by immunoprecipitation of unlabelled platelet glycoproteins.

A time-saving and sensitive method for the identification of antigens on unlabelled platelet glycoproteins (GP) based on immunoprecipitation has been developed. Platelet solubilisates were incubated with antibodies to form GP-antibody complexes that were precipitated with Protein G Sepharose 4 Fast Flow (PGS). PGS-bound material was eluted, separated by SDS-PAGE under reducing conditions and visualized by silver staining. The method was designed as an alternative to radioimmunoprecipitation for laboratories not equipped to work with radioactive substances. It is proposed as a complementary procedure for the characterization of platelet GP antigens by murine monoclonal antibodies and human alloantibodies.

Acids↗
PubMed1989

[Anti-phospholipid antibody with recurrent venous thromboembolism and severe autoimmune thrombocytopenia].

A 51 year-old man with a history of deep venous thromboses and recurrent pulmonary embolism on long-term anticoagulant treatment was admitted to our department because of insidious onset thrombocytopenia. He had neither a history nor clinical signs of abnormal bleeding. On admission, the platelet count was reduced to 21 x 10(9)/l, platelet associated IgG was increased, and bone marrow specimens showed megakaryocytic hyperplasia. Platelet survival was slightly shortened with enhanced platelet sequestration in a normal size spleen. Laboratory evaluation after discontinuation of anticoagulant treatment revealed persisting prolongation of both the prothrombin time and the activated partial thromboplastin time which could be attributed to the presence of a lupus-type circulating anticoagulant. Further relevant laboratory findings included an elevated titer of IgG anti-cardiolipin antibodies and a reduced euglobulin clot lysis activity after venous occlusion due to increased plasminogen activator inhibitor activity. In recent years, it has become apparent that a striking correlation exists between the presence of antibodies to phospholipids and thromboembolic disease and immune thrombocytopenia respectively. The present case report on the association of these autoantibodies with both, recurrent venous thromboembolism and severe thrombocytopenia, supports the hypothesis that anti-phospholipid antibodies may play a crucial part in the pathogenesis of these clinical conditions. A reduced vascular fibrinolytic capacity may be involved in the thrombophilic state induced by anti-phospholipid antibodies.

Autoantibodies↗
PubMed1988

High-dose cytosine arabinoside and mitoxantrone: preliminary results of a pilot study with sequential application (S-HAM) indicating a high antileukemic activity in refractory acute leukemias.

In an attempt to further improve on the encouraging results achieved by high-dose cytosine arabinoside (HD AraC) and mitoxantrone (HAM) in refractory acute leukemias, a timely modified sequential schedule of both drugs was developed (S-HAM) and applied to 13 patients with far advanced acute leukemias, 8 of whom had been treated with the original HAM protocol before. Based on the cell kinetic and pharmacokinetic rationale outlined by Capizzi et al., HD AraC 3 g/m2 was applied every 12 h on days 1 and 2 followed by mitoxantrone 10 mg/m2/day on days 3 and 4. After 3 days without therapy the identical sequence was repeated on days 8 and 9 (HD AraC) and 10 and 11 (mitoxantrone), respectively. Of the 13 patients 9 (69%) achieved a complete remission, 2 were resistant and 2 were early deaths. Six of the 8 patients with prior HAM treatment obtained a further complete remission with S-HAM. In 2 of these patients a longer remission was induced by S-HAM than by the preceding original HAM treatment. Although these data are preliminary and need confirmation on larger numbers of patients, they strongly suggest a high antileukemic activity of the S-HAM protocol which may even be superior to the previously used HAM regimen.

Adolescent↗