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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Der Anaesthesist 48 (1999), S. 236-241 
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Paradoxe Luftembolie ; Venöse Luftembolie ; Offenes Foramen ovale ; Systemische Zirkulation ; Hyperbare Oxygenierung ; Key words Venous air embolism ; Paradoxical air embolism ; Pulmonary hypertension ; Patent foramen ovale ; Transpulmonary passage
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Paradoxical air embolism may occur with any venous air embolism. Air may either enter the systemic circulation through a patent foramen ovale or through transpulmonary passage of air. While small venous air emboli are mostly well tolerated, even the smallest paradoxical air emboli can have fatal consequences in the systemic circulation. Therapy and prophylaxis of paradoxical air embolism equal those of venous air embolism. This is especially true, since paradoxical air embolism may not become obvious under general anesthesia. More specific therapeutic regiments, such as hyperbaric oxygenation and the infusion of perfluorocarbons, are still in an experimental stage.
    Notes: Zusammenfassung Paradoxe Luftembolien können im Rahmen einer jeden venösen Luftembolie auftreten. Dabei gelangt die Luft entweder über ein offenes Foramen ovale in die systemische Zirkulation, oder aber transpulmonal. Während kleine venöse Luftembolien oftmals gut toleriert werden, können schon kleinste paradoxe Embolien fatale Folgen haben. Die Prophylaxe und Therapie der paradoxen Embolie entspricht weitgehend der der venösen Embolie. Dies gilt insbesondere deswegen, weil der paradoxe Anteil einer Luftembolie unter Allgemeinanästhesie nicht sofort erkennbar wird. Spezifischere Therapieansätze stellen die hyperbare Oxygenierung sowie die Infusion von Perfluorokarbonen dar, allerdings befinden sie sich noch im tierexperimentellen Stadium.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1569-8041
    Keywords: chemotheapy ; dose escalation ; efficacy ; Hodgkin's disease ; toxicity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The BEACOPP chemotherapy regimen for advanced Hodgkin's disease employs a rearranged schedule permitting a shortened three-week cycle. With haematological growth factor support, the dosages of cyclophosphamide, etoposide and adriamycin could be moderately escalated. The 3-armed multicentre HD9 trial (recruitment 1993-1998; 1300 patients randomised) aimed to compare BEACOPP with the standard COPP/ABVD chemotherapy and to detect and measure the gain in efficacy, if any, due to moderate dose escalation of BEACOPP. Eight cycles were given, followed by local irradiation. The most recent interim analysis, with 689 evaluable patients, circa 40% of all expected events and a median observation time of 27 months, showed significant differences in progression rate (P) and in two-year freedom from treatment failure (F) between the treatment arms, with escalated BEACOPP (P = 2%, F = 89%) better than baseline BEACOPP (P = 9%, F = 81%) better than COPP/ABVD (P = 13%, F = 72%). Survival was not significantly different. Acute toxicity was more severe due to dose escalation, but remained manageable. These preliminary results suggest that BEACOPP improves efficacy. Moderate dose escalation is feasible with G-CSF support and appears likely to make a worthwhile improvement in the cure rate. The results must await confirmation (or otherwise) by the final analysis including all randomised patients and sufficiently mature data.
    Type of Medium: Electronic Resource
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