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  • Electronic Resource  (3)
  • 1995-1999  (3)
  • Risk factors  (2)
  • Embolisation  (1)
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  • Electronic Resource  (3)
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  • 1
    Electronic Resource
    Electronic Resource
    Management eines großen bilateralen Glomus jugulare Tumors (1999)
    Springer
    HNO 47 (1999), S. 816-820 
    Details
    ISSN: 1433-0458
    Keywords: Schlüsselwörter Glomus jugulare ; Bilateral ; Embolisation ; Key words Bilateral glomus jugulare tumors ; Paragangliomas ; Tumor embolization
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Bilateral glomus jugulare tumors are rare. However, their treatment should preserve not only the function of the facial nerve but also the caudal cranial nerves and the middle ears in order to avoid bilateral hearing losses. Further, venous cerebral drainage has to be ensured in order to avoid cerebral hypertension and hemorrhagic infarction after bilateral jugular ligations. In the case presented bilateral glomus jugulare tumors required super-selective angiography and embolization. Complete tumor removal on both sides was then possible by a transmastoid-transcervical approach without any further functional deteriorations. Middle ear function was preserved on both sides by temporary ventral translocation of the posterior wall of the auditory meatus. As the sigmoid sinus and internal jugular vein had been ligated during initial previous surgery, venous drainage was tested one year later by angiography and compression of the remaining internal jugular vein. A sufficient collateral circulation was found and permitted surgery on the second side.
    Notes: Zusammenfassung Beidseitige Glomus-jugulare-Tumoren stellen eine Rarität dar. Neben der Funktion des N. facialis muß bei ihrer Entfernung auch die Funktion der kaudalen Hirnnerven berücksichtigt werden. Die Funktionserhaltung des Mittelohrs ist ebenfalls anzustreben, um einen beidseitigen Schalleitungsblock zu vermeiden. Die venöse zerebrale Drainage muß gesichert werden, da eine beidseitige Ligatur des Sinus sigmoideus zur zerebralen venösen Hypertension führen würde. Am Beispiel eines großen bilateralen Glomus-jugulare-Tumors der Klasse C2 ermöglichte die superselektive Angiographie und Embolisation die beidseitige vollständige Tumorentfernung ohne Funktionseinschränkungen über einen transmastoidalen-transzervikalen Zugang. Durch temporäre Ventralverlagerung der hinteren Gehörgangswand gelang auch die Erhaltung der Mittelohrfunktion. Wegen der Ligatur der V. jugularis interna und des Sinus sigmoideus auf der 1. Seite konnte die 2. Seite erst 1 Jahr später operiert werden, nachdem die Angiographie und Kompression der verbliebenen V. jugularis interna ausreichende venöse Kollateralen bestätigt hatte.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001060050465
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
  • 2
    Electronic Resource
    Electronic Resource
    Scoring system for nosocomial pneumonia in ICUs (1996)
    Springer
    Intensive care medicine 22 (1996), S. 1155-1161 
    Details
    ISSN: 1432-1238
    Keywords: Nosocomial pneumonia ; scoring system ; Risk factors ; Intensive care units
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To develop a scoring system for stratifying patients in intensive care units (ICUs) by risk of developing nosocomial pneumonia (NP), based on variables generally available in an ICU, and to determine the probability of a patient developing NP in the ICU. Design and setting A 2-year prospective cohort study conducted in a medical and surgical ICU. Patients 756 patients admitted to the ICU for 48 h or more were followed up until the development of NP or death or discharge from the ICU. Measurements and results 129 (17.1%) patients developed NP, 106 (14%) in the first 2 weeks. The following independent risk factors were identified by multivariate analysis: no infection on admission [relative risk (RR)=3.1, 95% confidence intervals (CI)=2.0 to 4.8]; thorax drainage (RR=2.1, 95% CI=1.2 to 3.5); administration of antacids (RR=2.1, 95% CI=1.4 to 3.1); partial pressure of oxygen (PO2)〉110 mmHg (RR=1.6, 95% CI=1.0 to 2.6); administration of coagulation factors (RR=1.8, 95% CI=1.0 to 3.2); male gender (RR=2.7, 95% CI=1.2 to 6.3); urgent surgery (RR=2.4, 95% CI=0.9 to 6.4); and neurological diseases (RR=4.2, 95% CI=1.9 to 9.4). To obtain a predictive risk index for NP, a scoring system was developed using a multivariate model. The probability of developing NP varied between 11.0% in the lowest risk group and 42.3% in the highest risk group. The patients' risk of acquiring NP was seven times higher in the highest score category (IV) than in the lowest one (I). Conclusions ICU patients can be stratified into high- and low-risk groups for NP. No infection on admission, thorax drainage, administration of antacids, and PO2〉110 mmHg were associated with a higher risk of NP during the entire 2-week period.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709329
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    Scoring system for nosocomial pneumonia in ICUs (1996)
    Springer
    Intensive care medicine 22 (1996), S. 1155-1161 
    Details
    ISSN: 1432-1238
    Keywords: Key words Nosocomial pneumonia ; Scoring system ; Risk factors ; Intensive care units
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To develop a scoring system for stratifying patients in intensive care units (ICUs) by risk of developing nosocomial pneumonia (NP), based on variables generally available in an ICU, and to determine the probability of a patient developing NP in the ICU. Design and setting: A 2-year prospective cohort study conducted in a medical and surgical ICU. Patients: 756 patients admitted to the ICU for 48 h or more were followed up until the development of NP or death or discharge from the ICU. Measurements and results: 129 (17.1%) patients developed NP, 106 (14%) in the first 2 weeks. The following independent risk factors were identified by multivariate analysis: no infection on admission [relative risk (RR)=3.1, 95% confidence intervals (CI)=2.0 to 4.8]; thorax drainage (RR=2.1, 95% CI=1.2 to 3.5); administration of antacids (RR=2.1, 95% CI=1.4 to 3.1); partial pressure of oxygen (PO2) 〉110 mmHg (RR=1.6, 95% CI=1.0 to 2.6); administration of coagulation factors (RR=1.8, 95% CI=1.0 to 3.2); male gender (RR=2.7, 95% CI=1.2 to 6.3); urgent surgery (RR=2.4, 95% CI=0.9 to 6.4); and neurological diseases (RR=4.2, 95% CI=1.9 to 9.4). To obtain a predictive risk index for NP, a scoring system was developed using a multivariate model. The probability of developing NP varied between 11.0% in the lowest risk group and 42.3% in the highest risk group. The patients‘ risk of acquiring NP was seven times higher in the highest score category (IV) than in the lowest one (I). Conclusions: ICU patients can be stratified into high- and low-risk groups for NP. No infection on admission, thorax drainage, administration of antacids, and PO2〉110 mmHg were associated with a higher risk of NP during the entire 2-week period.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709329
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
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