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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Annals of the New York Academy of Sciences 539 (1988), S. 0 
    ISSN: 1749-6632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Natural Sciences in General
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Der Nervenarzt 69 (1998), S. 1123-1133 
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Neurologische Intensivmedizin ; Intensivstation ; Statistik ; Intensivstationsausstattung ; Key words Neurological intensive care ; Intensive care unit ; Statistics ; Intensive care equipment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In 1994 this journal published the results of a survey undertaken on behalf of the Working Association for Neurological Intensive Care Medicine (ANIM) in the winter of 1992/93. In the winter of 1996/97 a continuation of this analysis was performed. With the help of a questionaire the data of 62 intensive care units with a total of 420 beds were established. This is 11 intensive care units and 83 beds more than 1992/93. The intensive care units were again classified into three groups (ventilation units, monitoring units, interdisciplinary units) relating to their equipment and structure. The questions concerned structural organisation, such as the number of beds, type of clinic, number and training of physicians and nurses, technical equipment and availability of large and high-tech apparatus or access to other facilities, such as neurosurgery. Of great interest were data about whether and to what extent special measures of intensive medicine can be taken on the one hand and performance parameter data e.g. days of ventilation and duration of in-patient treatment on the other hand. Detailed data were provided concerning the frequency of each diagnosis of patients treated in those intensive care units. Evaluating the data a positive development in the last four years of the neurological intensive care can be found in most of the areas investigated. It has also been found that neurological intensive care in the new lander has reached equal standard both in quality and quantity. Now a single physician is responsible for 2,3 beds compared to 3,6. Today 78 per cent of the beds in ventilation units are equiped with a ventilator. The overall time of ventilation increased to 48 per cent. Overall there are, however, considerable differences between individual units as well as regions. The data presented can serve as a means to monitor the quality of neurological intensive care.
    Notes: Zusammenfassung 1994 wurden an gleicher Stelle die Ergebnisse einer 1992/93 im Auftrag der Arbeitsgemeinschaft für Neurologische Intensivmedizin (ANIM) e.V. durchgeführten Erhebung zur Situation der neurologischen Intensivmedizin in Deutschland publiziert. Im Winter 1996/97 wurde eine Fortschreibung dieser Analyse vorgenommen. Mit Hilfe eines Fragebogens konnten die Daten von 62 Intensivstationen mit 420 Betten erhoben werden, 11 Stationen und 83 Betten mehr als 1992/93. Je nach Ausstattung und Organisationsform wurden die Intensivstationen wiederum in 3 Gruppen unterteilt (Beatmungs-, Überwachungs-, interdisziplinäre Intensivstationen). Die Befragung erfolgte zu strukturellen Gegebenheiten, wie z.B. Bettenzahl und Kliniktyp, Personalausstattung einschließlich der Qualifikation, Geräteausstattung bzw. Zugang zu Großgeräten oder anderen Fachbereichen. Von Interesse waren auch Angaben zu Möglichkeiten und Durchführung spezieller intensivmedizinischer Maßnahmen bzw. zu Leistungskennzahlen wie Beatmungstagen, Liegezeiten usw. Außerdem wurde die Häufigkeit der einzelnen Diagnosen erfaßt. Die eruierten Daten belegen eine positive Entwicklung der neurologischen Intensivmedizin in den vergangenen 4 Jahren in fast allen erfragten Kategorien sowie eine weitgehende Angleichung der qualitativen und quantitativen Merkmale der Intensivstationen in den neuen Bundesländern. So fand sich z.B. bei den Beatmungsstationen eine Reduzierung der von einem Arzt zu betreuenden Betten von 3,6 auf 2,3, eine Zunahme der schichtdienstdurchführenden Stationen von 40 auf 53%, eine Ausstattung mit Beatmungsgeräten von 78% sowie eine Beatmungsquote von 48%. Andererseits bestehen erhebliche Differenzen zwischen einzelnen Einrichtungen und Regionen. Die vorgelegten Daten sollen nicht zuletzt der Qualitätskontrolle in der neurologischen Intensivmedizin dienen.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Der Nervenarzt 69 (1998), S. 913-918 
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Natrium-Valproat ; Divalproex-Natrium ; Offene Studien ; Kontrollierte Studien ; Review ; Key words Sodium valproate ; Divalproex sodium ; Open studies ; Double blind studies ; Review
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In 1988, the first report on valproate in migraine prophylaxis was published. Since 1992, 359 patients have been investigated in five double blind studies. Valproic acid was effective in all studies compared to placebo; one study confirmed an effect similar to propranolol. There are no analyses of efficacy in comparison to plasma levels. Adverse events seem to occur somewhat more frequently than in propranolol, but are well known in epilepsy therapy. In the international literature and according to the recommendations of the German Headache Society, valproic acid is a well-established second-choice drug in migraine prophylaxis.
    Notes: Zusammenfassung Im Jahr 1988 wurde erstmals von der möglichen Wirksamkeit der Valproinsäure in der Migräneprophylaxe berichtet. Seit 1992 sind insgesamt 359 Patienten in 5 Doppelblindstudien untersucht. In allen Studien ergab sich eine signifikant überlegene Wirksamkeit im Vergleich zu Placebo, eine Studie belegt einen gleichen Effekt wie Propranolol. Es fehlen noch Wirksamkeitsanalysen, die sich am Plasmaspiegel orientieren. Die Nebenwirkungen entsprechen denen aus der Epilepsietherapie, scheinen aber im Vergleich zu Propranolol etwas höher zu liegen. International und nach den Empfehlungen der Deutschen Migräne- und Kopfschmerzgesellschaft gilt Valproinsäure mittlerweile als etabliertes Mittel der zweiten Wahl.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Cellular and molecular life sciences 52 (1996), S. 304-305 
    ISSN: 1420-9071
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Conclusions In transplant recipients, a positive HCMV PCR in PBLs is a sign of the possible development of HCMV disease which should be confirmed by further diagnostic approaches. However, detection of HCMV DNA in the CSF appears to be a specific marker of pathological processes, exemplified in a case of HCMV encephalitis.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1459
    Keywords: Myelin basic protein ; AIDS ; HIV encephalopathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The major pathological abnormalities of HIV encephalopathy are infiltrates of macrophages, multinucleated giant cells, microglial nodules and demyelination. Elevated myelin basic protein (MBP) levels in the cerebrospinal fluid (CSF) provide a marker for central nervous system demyelination. The purpose of this study was to investigate the possible role of CSF MBP as a useful and early marker for HIV encephalopathy. The CSF of 40 consecutive patients with HIV infection of various clinical stages was investigated, including 13 patients with clinical signs of HIV encephalopathy. CSF MBP was elevated in 2 patients (5.0 and 5.3 ng/ml), both of whom had moderate to severe HIV encephalopathy. The course of the disease was rapid in both patients. In the remaining 38 patients, CSF MBP levels were marginally elevated (n=12) or normal (n=26). Our results suggest that CSF MBP is not a sensitive marker for the diagnosis and evaluation of HIV encephalopathy, but may be an indicator of prognosis for the course of the disease. There were only few findings of elevated CSF MBP levels in patients with HIV encephalopathy in the current study, and this may be because the disorder progressed slowly in most patients. It is possible that CSF MBP levels in HIV encephalopathy may only be elevated with acute clinical deterioration but are normal in slowly progressive forms of demyelination, as seen in multiple sclerosis.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Journal of neurology 239 (1992), S. 359-360 
    ISSN: 1432-1459
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Optical techniques already have an important place in experimental in vivo studies of the brain. New techniques to study micro circulatory and metabolic events in vivo will play an important role in basic stroke research. Functional studies are rapidly improving our knowledge of the functional architecture of the visual cortex. For studies of the human brain the confluence of interest and activity in MRI, PET, ballistic and diffusive wave spectroscopy opens new fields of anatomical, physiological, biochemical and functional studies. Similar to the introduction of the morphologically oriented computed tomography and magnetic resonance imaging, these new approaches may have a profound impact on clinical and experimental neurology in the future. The proceedings of this symposium will be published within the seriesAdvances in Experimental Medicine and Biology, Plenum Press, London New York, fall 1992.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-1459
    Keywords: Key words Activated protein C ; resistance ; Thrombophilia ; Coagulation system ; Stroke
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We investigated the association between cerebral venous thrombosis and hereditary resistance to activated protein C (APC) in 12 consecutive German patients with non-fatal cerebral venous thrombosis and in 187 controls without a history of thrombotic disorder. Three patients (25%) had a mutation in the factor V Leiden gene against only one subject in the control group. This difference was significant (P〈0.05), with an odds ratio of 11.7 (1.5–87 ; 95% confidence interval). Two patients carrying the mutation had additional common risk factors for thrombosis, and 2 had a positive family history of thromboembolism. We conclude that inherited APC resistance by a mutation in factor V Leiden is an important risk factor in non-fatal cerebral venous thrombosis. We recommend testing for APC resistance and, if abnormal for factor V Leiden mutation in patients with cerebral venous thrombosis.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-1459
    Keywords: Bacterial meningitis ; Regional cerebral blood flow ; Emission tomography ; HMPAO
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The frequency, course and clinical significance of changes in regional cerebral blood flow (rCBF) during bacterial meningitis were investigated in 14 adult patients. The results of99mTc-hexamethylpropylene amine oxime (HMPAO) single photon emission computed tomography (SPECT) were compared with the clinical signs and findings using cerebral angiography and conventional CT. HMPAO SPECT was performed 2–15 days (median 4.5 days) after the onset of neurological disease. Decreased HMPAO accumulation was detected in 13 patients. SPECT studies revealed focal hypoperfusion cor responding to the clinical symptoms in 6 patients suffering from hemiparesis or hemiataxia. Conventional cranial CT disclosed brain infarction in only 1 patient. Focal hypoperfusion was also found in 7 of 8 patients without clinical evidence of focal neurological deficits. In 6 patients, HMPAO SPECT findings were abnormal although cerebral angiography was normal. At follow-up examinations 3–45 weeks after the acute disease, abnormalities revealed by HMPAO SPECT had improved or had even disappeared in all patients studied. Our results indicate that reduced rCBF is a frequent finding in bacterial meningitis in the adult. In most patients it probably represents a functional and reversible disorder without structural lesion detectable on CT.
    Type of Medium: Electronic Resource
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