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  • 1
    Electronic Resource
    Electronic Resource
    Does noninvasive ventilation reduce the ICU nosocomial infection risk? A prospective clinical survey (1999)
    Springer
    Intensive care medicine 25 (1999), S. 567-573 
    Details
    ISSN: 1432-1238
    Keywords: Key words Noninvasive ventilation ; Nosocomial infection ; Ventilator-associated pneumonia ; Prospective survey ; Intensive care unit
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To observe the nosocomial infection (NI) distribution in ventilated patients of a single intensive care unit (ICU) according to the kind of control of the upper airways: noninvasive positive pressure ventilation (NPPV) versus endotracheal intubation (ETI). Setting: ICU of a general hospital. Design: Prospective clinical and epidemiologic survey. Patients: In the period December 1994–March 1997, 761 patients were included who needed mechanical ventilation for more than 48 h: 129 were ventilated by NPPV (NPPV group), 607 were intubated (ETI group) and 25 required intubation after a period of NPPV (NPPV-ETI group). Measurements and results: The data used were prospectively collected according to the NI epidemiologic surveillance protocol of “C. CLIN Sud Est, Réa Sud Est”, France. NI included a ventilator-associated pneumonia (VAP), catheter-related infection, urinary tract infection and bacteremia. Occurrence of NI was estimated by the density of incidence. Covariate-adjusted NI and VAP risk factors were assessed by the Cox model. The incidence density of total NI was lower for NPPV than for ETI (14.2 versus 30.3 per 1000 patient-days, p 〈 0.01). The Cox model showed that the use of noninvasive ventilation, adjusted to the severity of illness (SAPS II), reduced not only the VAP risk (hazard ratio (HR) = 4.07) but also the NI risk (HR = 1.95). Conclusion: The use of NPPV reduces the risk of VAP and NI, compared to ETI, irrespective of the severity of the patient's illness.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050904
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  • 2
    Electronic Resource
    Electronic Resource
    Severe head injuries: An outcome prediction and survival analysis (1996)
    Springer
    Intensive care medicine 22 (1996), S. 1391-1395 
    Details
    ISSN: 1432-1238
    Keywords: Head injury ; Prognosis ; Trauma severity ; Grading system ; Logistic regression model ; Cox regression analysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To identify the predictors determined early after admission and associated with unfavorable outcome or early (within 48 h) death after severe head injury. Design Prospective cohort study. Setting A neurosurgical intensive care unit in a university hospital. Patients 198 consecutive comatose patients hospitalized from 1989 to 1992. Results Logistic regression showed that a combination of age, best motor response score from the Glasgow Coma Scale, and hypoxia provided a good prediction model of unfavorable outcome (sensitivity=0.93). The length of participation of survivors was 6 to 61 months (median 27.1). The Cox model demonstrated age, motor score less than 3, mydriasis, and hypoxia as poor prognosis factors. Conclusions Clinicians can determine the odds of a good outcome from the combination of three easily measurable factors using a simple diagram constructed from logistic regression. Survival analysis showed that motor score adjusted values greater than 3 had the same prognosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709556
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  • 3
    Electronic Resource
    Electronic Resource
    Severe head injuries: an outcome prediction and survival analysis (1996)
    Springer
    Intensive care medicine 22 (1996), S. 1391-1395 
    Details
    ISSN: 1432-1238
    Keywords: Key words Head injury ; Prognosis ; Trauma severity ; Grading system ; Logistic regression model ; Cox regression analysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To identify the predictors determined early after admission and associated with unfavorable outcome or early (within 48 h) death after severe head injury. Design: Prospective cohort study. Setting: A neurosurgical intensive care unit in a university hospital. Patients: 198 consecutive comatose patients hospitalized from 1989 to 1992. Results: Logistic regression showed that a combination of age, best motor response score from the Glasgow Coma Scale, and hypoxia provided a good prediction model of unfavorable outcome (sensitivity=0.93). The length of participation of survivors was 6 to 61 months (median 27.1). The Cox model demonstrated age, motor score less than 3, mydriasis, and hypoxia as poor prognosis factors. Conclusions: Clinicians can determine the odds of a good outcome from the combination of three easily measurable factors using a simple diagram constructed from logistic regression. Survival analysis showed that motor score adjusted values greater than 3 had the same prognosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709556
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  • 4
    Electronic Resource
    Electronic Resource
    Combined effects of nicardipine and hypocapnic alkalosis on cerebral vasomotor activity and intracranial pressure in man (1991)
    Springer
    European journal of clinical pharmacology 41 (1991), S. 207-210 
    Details
    ISSN: 1432-1041
    Keywords: Hypocapna ; nicardipine ; carotid artery ; cerebral blood flow ; intracranial pressure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The effect of hypocapnic alkalosis (HA) on nicardipine-induced cerebral vasodilatation was studied in 2 groups of patients undergoing stereotaxic brain biopsy under general anaesthesia. Arterial diameter (AD) was measured in 16 different locations on a carotid arteriogram (lateral view), and intracranial pressure (ICP) was recorded with an intraventricular catheter. At time T0, in normocapnia an arteriogram was performed in both groups. The first group (GI) was then studied in hypocapnia (T1) and following an injection of nicardipine (T2), while the second group (GII) was studied first after injection of nicardipine (T1) and then in hypocapnia (T2). Groups GI (n=6; 44 y) and GII (n=6; 46 y) were similar with regard to age, blood pressure, heart rate and PaO2 at all three phases of the study. HA caused a 9.5% decrease in AD (GI.T1) compared to baseline values, and a 15.2% decrease when preceded by injection of nicardipine (GII.T2). In the latter case the decrease was 3% in comparison with baseline. Nicardipine increased AD by 14.7% (GII.T1) and by 18.5% when preced by HA (GI.T2), but the rise (7.3%) was not significant in comparison with the baselines value. The changes variations were similar whether the entire arterial trunk or only the supraclinoid region were studied. HA decreased ICP by 44% (GI.T1) and by 50% after nicardipine (GII.T2). Nicardipine did not cause an increase in ICP. Nicardipine and HA antagonise each others vasomotor effects, as previously shown in the baboon using nimodipine.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00315431
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  • 5
    Electronic Resource
    Electronic Resource
    Combined Effects of Hypocapnia and Nicardipine on Airway Resistance: a pilot study (1997)
    Springer
    European journal of clinical pharmacology 51 (1997), S. 385-388 
    Details
    ISSN: 1432-1041
    Keywords: Key words Pulmonary resistance ; Hypocapnia ; Nicar-dipine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract Objective: The aim of this study was to investigate the modification of the resistive inspiratory properties of the respiratory system associated with hypocapnia in the presence of nicardipine. Methods: The resistance of the respiratory system, Rrsmin, was studied in two groups of patients who needed mechanical hyperventilation. Group 1 (n = 14; 47 years) was the control group (head injuries); group 2 (n␣=␣12; 53.5 years) included patients treated over a 3 week period with nicardipine (0.5 μg · kg−1 · min−1 i.v. ) to prevent arterial vasospasm after subarachnoid haemorrhage. Results: There was no statistical difference between the groups concerning anthropometric and basal respiratory characteristics. In group 1, hypocapnia caused a 20.9% increase in Rrsmin, but no significant increase was observed in group 2. Conclusion: Hypocapnic alkalosis had a significant bronchial constrictory effect, which was eliminated in the presence of nicardipine hydrochloride.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002280050218
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  • 6
    Electronic Resource
    Electronic Resource
    Expression of neuronal markers in chick and quail embryo neuroretina cultures infected with rous sarcoma virus
    Amsterdam : Elsevier
    Cell Differentiation 11 (1982), S. 45-54 
    Details
    ISSN: 0045-6039
    Keywords: Rous sarcoma virus ; neuronal markers ; neuroretina
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Biology
    Type of Medium: Electronic Resource
    URL: http://linkinghub.elsevier.com/retrieve/pii/0045-6039(82)90016-1
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  • 7
    Electronic Resource
    Electronic Resource
    Choline acetyl transferase activity in chick embryo neuroretinas during development in ovo and in monolayer cultures
    Amsterdam : Elsevier
    Developmental Biology 65 (1978), S. 228-232 
    Details
    ISSN: 0012-1606
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Biology
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1016/0012-1606(78)90192-6
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  • 8
    Electronic Resource
    Electronic Resource
    Pharmacokinetics of teniposide (VM 26) after IV administration in serum and malignant ascites of patients with ovarian carcinoma (1985)
    Springer
    Cancer chemotherapy and pharmacology 15 (1985), S. 149-152 
    Details
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Nine patients with ovarian carcinoma and malignant ascites treated with IV teniposide chemotherapy (30 mg/m2/30 min) entered this study. Plasma and peritoneal fluid levels were measured by an HPLC method with electrochemical detection. Plasma decay kinetics followed a triexponential function. A high variability of drug diffusion in ascites was noticed. Peak concentrations in ascites ranged from 1.6% to 20.5% of serum peak concentration. The concentration in peritoneal fluid reached a maximum level 6 h after the infusion ended. Teniposide was less slowly eliminated from ascites than from serum. The exposure of the inflammatory peritoneal fluid to the drug expressed by area under the concentration-time curve (AUC) was also subject to significant interindividual variation, ranging from 223 to 2332 μg/ml × min. However, the peritoneal AUC was correlated with serum AUC and with the systemic clearance of the drug. A significant relationship between gamma glutamyltranspeptidase and both systemic clearance and either the serum or the peritoneal AUC was found, suggesting that liver plays a role in drug disposition.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00257526
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  • 9
    Electronic Resource
    Electronic Resource
    Nosocomial pneumonia in mechanically ventilated patients, a prospective randomised evaluation of the Stericath closed suctioning system (2000)
    Springer
    Intensive care medicine 26 (2000), S. 878-882 
    Details
    ISSN: 1432-1238
    Keywords: Key words Nosocomial pneumopathy ; Mechanical ventilation ; Cox model ; Closed suctioning device ; ICU
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To compare the ventilator-associated pneumonia (VAP) incidence rates in mechanically ventilated patients according to the type of endotracheal suctioning (closed versus open). Setting: The Neurosurgery Intensive Care Unit of the Grenoble University Hospital, France. Design: A prospective randomised study performed after a 6-month period of nursing personnel training. Patients: One hundred four consecutive patients needing mechanical ventilation for more than 48 h were randomised into two groups. To be eligible, patients had to have no active infection or respiratory affection in their passes. In the Stericath group (S + , n = 54), patients were not disconnected from the ventilator during suctioning. The others were routinely managed (S–, n = 50). In both groups patterns of frequency and duration of suctioning were performed according to a standardised protocol.¶Measurements: The non-adjusted incidence rate of VAP was lower for S + than for S– (7.32 versus15.89 per 1000 patient-days, p = 0.07). Multivariate analysis performed using the Cox model showed an adjusted risk of VAP 3.5 times higher in S– (95 %Cl: 11.00–12.33). The risk being 4.3 higher in patients receiving gastric acid secretion inhibitors (1.08–16.82). In non-censored cases (n = 76) length of ICU stay increased by an average of 16.8 days when VAP was present (p = 0.0008). No adverse effect due to Stericath use was noted and volume of tracheal aspirate was similar between groups (p = 0.178). Conclusion: The use of Stericath reduced the incidence rate of VAP without demonstrating any adverse effect.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340051276
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  • 10
    Electronic Resource
    Electronic Resource
    Differentiation of chick embryo neuroretina cells in monolayer cultures. An ultrastructural study (1977)
    Springer
    Cell & tissue research 185 (1977), S. 159-173 
    Details
    ISSN: 1432-0878
    Keywords: Neuroretina ; Synaptogenesis ; Cell culture
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Summary Neuroretinas from 6–7 day-old chick embryos were cultivated after trypsin dissociation as monolayer cultures in Petri dishes, and examined after various intervals of time with the electron microscope. Soon after plating, cells begin to reaggregate in small clumps, and typical rosettes are formed. During the first week in vitro, cells appear to differentiate as neuroblasts and presumed Müller cells; the latter form a continous sheet on the substrate, upon which neuroblasts migrate and grow their neurites. Differentiated ribbon synapses are found after 8 days in vitro, the time at which they normally appear in situ. After 15 and 21 days in vitro, synapses are still found in large numbers, mimicking their “in vivo” counterparts. Photoreceptor cells were identified on the basis of the presence of typical ribbons in their cytoplasm, but no outer segment was found. It appears then that synaptogenesis in the retina is programmed independently of the tissue environment, which is markedly disturbed in the monolayer culture.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00220661
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