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  • 1
    ISSN: 1432-1440
    Keywords: Calcium antagonism ; Nimodipine ; Cerebral blood flow ; Global cerebral blood flow ; Regional cerebral blood flow ; Vasospasm ; Stroke
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effects of Nimodipine on the global and regional cerebral blood flow were studied in 42 patients with cerebrovascular disorders. In 25 patients with focal deficits such as transitory ischemic attack (TIA), prolonged reversible ischemic neurological deficit (PRIND), and minor stroke due to arteriosclerosis, and in eleven patients with cerebral vasospasm after subarachnoid hemorrhage, the cerebral blood flow was measured by133Xenon inhalation technique 60 min after oral administration of 40, 60, or 80 mg Nimodipine. In 6 patients with vasospasm the effects of Nimodipine i.v. were examined. The result in twelve patients with minor stroke who were only given placebo (lactose; “test-retest”) was identical regional (rCBF) and global (CBF) cerebral blood flow before and 60 min after; placebo, blood pressure, and arterial pCO2 remained constant as well. After Nimodipine, however, the CBF increases, the increase after vasospasm being significant when taking the pCO2 in the Wilcoxon test into account. The rCBF increases much more in the regions with low perfusion rates than in well-perfused areas. This is also observed in the patients with TIA, PRIND, or minor stroke, most clearly after oral administration of 60 mg, whereas regions with normal perfusion rates show little reaction. The blood pressure was lowered, depending on the initial pressure. There was no evidence of a steal phenomenon.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 375 (1990), S. 214-219 
    ISSN: 1435-2451
    Keywords: Splenic loss ; Subjective sequels ; Disability
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Von 806 Patienten, die in der Zeit von 1968–1983 an der Chirurgischen Universitdtsklinik Würzburg splenektomiert wurden waren, wurden 111 hinsichtlich ihrer Langzeitbeschwerden untersucht. Verwandt hierzu wurden der Depressionsfragebogen nach Beck und der aus der psychosomatischen Medizin stammende GieBener Beschwerdebogen. Bei letzterem finden sich signifikant gehduft Störungen im Allgemeinbefinden der ,,Milzlosen“ im Vergleich zur Normalbevölkerung der BRD. Die Beschwerden sind jedoch uncharakteristisch, so daß ein eigener, spezieller Splenektomiefrage bogen entworfen wurde. Mit diesem wurde auch eine Kontrollgruppe (statistische Zwillinge) mit einem der Splenektomie vergleichbaren Operationstrauma befragt. Dominierend bei den Splenektomierten war die gehäufte Infektrate (p〈0.0000001). Signifikant erhöht waren auch die vermehrte Erschbpfbarkeit und die verminderte körperliche und geistige Leistungsfdhigkeit. Für die anderen Symptome, z. B. Alkoholunverträglichkeit oder vegetative Dystonie, die früher als typische Beschwerden angesehen wurden, ließ sich keine statistische Absicherung erbringen. Da vermehrte Erschöpfbarkeit und verminderte Leistungsfdhigkeit hoch mit der Infektanfällig-keit korreferten, der Unterschied zur Kontrollgruppe aber bei weitem nicht so grog war, scheinen these Befmdlichkeitsstörungen eher Ausdruck der gehduften Infektionen als direkte Folgen des Milzverlustes zu sein.
    Notes: Summary 111 of 806 former patients splenectomized at the Würzburg university hospital during the years 1968–1983 were interviewed for their complaints since their operation. Investigations included the use of Beck's inventory for measuring depression and the Gießen questionnaire for the evaluation of general complaints used in psychosomatic medicine. There was a significant increase of symptoms after splenectomy as compared to the normal population. A special list of 18 questions to investigate typical postsplenectomy complaints was answered by 95 of these 111 persons and by a control group of “statistical twins” with similar upper abdominal surgery without splenectomy. The leading difference was the highly significant increase of the susceptibility to infections after splenic loss followed by accelerated exhaustion and increased physical and mental weakness. The distribution of other complaints like for instance the intolerance to alcohol hitherto judged as typical sequelae of splenectomy was not statistically different in both groups. Since the symptoms listed above as significantly increased in the splenectomized patient were closely correlated with the susceptibility to infection they seem to be rather the expression of the decreased resistance than direct consequences of the loss of the spleen.
    Type of Medium: Electronic Resource
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