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  • 1
    Electronic Resource
    Electronic Resource
    THE IMPACT-FLOOD CONNECTION: DOES IT EXIST? (1994)
    Oxford, UK : Blackwell Publishing Ltd
    Terra nova 6 (1994), S. 0 
    Details
    ISSN: 1365-3121
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Geosciences
    Notes: In a recent article in Terra Nova, Kristan-Tollmann and Tollmann (1994) suggested that the Biblical Flood can be explained by seven fragments of a comet that impacted the ocean at seven locations on Earth at 03.00h (C.E.T.) on 23 September, 9545 yr BP. We demonstrate that all the ‘geological proofs’ that allegedly support their conclusions are not supported by the available data on impact cratering. Their hypothesis is based on insufficient and ambiguous data, selective citation, and incomplete comprehension of previous research.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-3121.1994.tb00532.x
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  • 2
    Electronic Resource
    Electronic Resource
    Changing trends in surgery for acute cholecystitis (1990)
    Springer
    World journal of surgery 14 (1990), S. 567-570 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Alors que la chirurgie de la cholécystite aiguë est devenue l'une des plus fréquentes de la chirurgie abdominale hospitalière, certains aspects de son traitement restent controversés. Le but de cette étude était de déterminer les tendances actuelles en comparant 2 séries de patients opérés à 10 ans d'intervalle. On a comparé 256 cas de cholécystite aiguë opérés entre 1970 et 1977 (groupe O) avec 260 cas opérés entre 1980 et 1987 (groupe N). Trente-six variables ont été enregistrées dans chaque cas, entrés dans un ordinateur et analysés. Les résultats montrent que dans le groupe N (par rapport au group O): 1. l'âge était significativement plus élevé; la proportion d'hommes et de diabétiques était plus importante; 2. il y avait plus de lithiases de la voie biliaire principale, de cholécystite alithiasique et de gangrène de la vésicule; 3. il y avait significativement plus de patients opérés dans les premières 48 heures après l'admission; 4. il y avait significativement plus de patients sans antécédents biliaires; 5. il y avait significativement moins d'abcès de parois, mais pas de différence de mortalité (N: 3.0%; O: 2.7%); 6. la durée moyenne d'hospitalisation post-opératoire était plus courte de 3.2 jours. Malgré une population plus âgée et plus malade dans le groupe N, il n'y avait pas de différence significative de mortalité et la durée moyenne du séjour hospitalier était moindre.
    Abstract: Resumen La cirugía por colecistitis aguda ha venido a ser la operación abdominal más frecuente en la mayoría de los hospitales; sin embargo varios aspectos relativos a su manejo continúan siendo motivo de controversia. El propósito del presente estudio fue identificar las tendencias recientes mediante la demonstración de las diferencias entre 2 series de pacientes operados en períodos de 10 años. Dos cientos cincuenta y seis operaciones consecutivas por colecistitis aguda fueron realizadas entre 1970 y 1977 (grupo O); se hizo la comparación con 260 casos operados entre 1980 y 1987 (grupo N). Se registraron 36 variables en cada caso. La totalidad de los datos fue registrada y analizada por computador. 1. La población en el grupo N apareció considerablemente más anciana y con una mayor proporción de hombres y de diabéticos. 2. Se observó un incremento en el número de pacientes con cálculos en el colédoco, con colecistitis acalculosa, y con alteraciones gangrenosas en la vesícula biliar. 3. Hubo un aumento significativo en el número de pacientes operados en las primeras 48 horas de su admisión. 4. Se presentó un aumento significativo en el número de pacientes sin historia previa de sintomas biliares. 5. Hubo un descenso significativo en la tasa de infección de herida sin diferencias estadísticamente significativas en la mortalidad (N: 3.0%, O: 2.7%). 6. Se observó una hospitalización más corta, de 3.2 días menos. A pesar de que la población del grupo N fue más anciana y más enferma, no se presentó un aumento significativo en la mortalidad y se redujo el período postoperatorio de hospitalización.
    Notes: Abstract Surgery for acute cholecystitis has become the most frequent abdominal surgery in most hospitals, yet aspects of its management remain controversial. The aim of this study was to focus on the recent trends by demonstrating the principal differences between 2 series of patients operated on during 10-year intervals. Two hundred fifty-six consecutive operations for acute cholecystitis were performed from 1970 to 1977 (group O) and were compared to 260 cases operated from 1980 to 1987 (group N). Thirty-six variables were recorded in each case. All data obtained were computer recorded and analyzed. Several trends were observed in group N: 1. The population was significantly older with a higher proportion of males and diabetics. 2. There was a marked increase in common bile duct stones, acalculous cholecystitis, and gangrenous changes in the gallbladder. 3. There was a significant increase in patients operated on within 48 hours of admission. 4. There was a significant increase in the number of patients without previous history of biliary symptoms. 5. There was a significant decrease in the rate of wound infections and no statistically significant differences in mortality (N: 3.0%, O: 2.7%). 6. A decrease of the average postoperative hospital stay of 3.2 days was observed. In spite of the older and sicker population in group N, no significant increase in mortality occurred and the postoperative hospital stay was reduced.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01658790
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  • 3
    Electronic Resource
    Electronic Resource
    Multifactorial analysis of septic bile and septic complications in biliary surgery (1992)
    Springer
    World journal of surgery 16 (1992), S. 962-964 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Par une analyse multifactorielle réalisée chez 2700 patients consécutifs ayant une maladie, bénigne des voies biliaries, on a cherché à déterminer les possibles facteurs de gravité. On a ainsi identifié une série de facteurs associés des prélèvements bactériologiques positifs et des complications septiques: patients âgés de plus de 70 ans (p〈0.001), diabétiques, patients ayant une bilirubinémie 〉1.1 mg% (p〈0.001) et ayant une lithiase de la voie biliare principale (p〈0.001). En analyse multifactorielle, nous avons conclu que chez les patients n'ayant aucun facteur de risque (56.9% de la série), l'incidence de prélèvements bactériologiques positifs était basse (10.9%) et qu'il n'était donc pas nécessaire de donner une antibioprophylaxie. Chez les patients ayant un facteur de risque (24% de la série), l'incidence de bactériologie positive était de 36%, et un minimum d'antibioporphylaxie était conseillé. Chez les patients ayant deux facteurs de risque ou plus, (19.1% des la série), l'incidence de bactériologie positive était de 77.6%, et une antibiothérapie périopératoire était conseillée, en commençant avant l'opération et en continuant trois à cinq jours après. Le but de cette étude a été d'identifier les patients à risque de complications septiques dans la chirurgie biliarie afin d'ériger de nouvelles règles de traitement antibiotique.
    Abstract: Resumen Un análisis unifactorial para riesgos potenciales fue aplicado a 2.700 operaciones consecutivas por enfermedad benigna del tracto biliar. Se pudo identificar una serie de factores de alto riesgo en relación a bacteriología positiva y a complicaciones sépticas: pacientes de edad avanzada (〉70 años;p〈0.001), pacientes diabéticos, pacientes con nivel de bilirrubina sérica mayor de 1.1 mg% (p〈0.001) pacientes con colecistitis aguda (p〈0.001) y pacientes en quienes se encontraron cálculos en el colédoco (p〈0.001). Utilizando un análisis multivariable, llegamos a la conclusión de que en los pacientes sin factores de riesgo (56% de la serie) la incidencia de bacteriología positiva es baja (10.9%) y que no deben recibir profiliaxis antibiótica. Los pacientes con un factor de riesgo (24% de la serie) exhibieron una incidencia de 36% de bacteriología positiva; para ello se recomienda mínima profilaxis preoperatoria. Los pacientes con dos o más factores de riesgo (19.1% de la serie) exhibieron una incidencia de 77.6% de bacteriología positiva, y en ellos se recomienda profilaxis antibiótica total, comenzando en el período preoperatorio y continuandola por tres a cinco días postoperatorios. El próposito de este estudio fue el de indentificar pacientes con alto riesgo de desarrollar complicaciones con la cirugía biliar y crear nuevas directrices para el tratamiento antibiótico en grupos seleccionados.
    Notes: Abstract A unifactorial analysis for possible risk factors was applied to 2,700 consecutive operations for benign disease of the biliary tract. A series of high risk factors in relation to positive bacteriology and septic complication could be identified. These risk factors were patients who were elderly (〉70 years;p〈0.001), those who were diabetic, those who had a serum bilirubin 〉1.1 mg% (p〈0.001), those who had acute cholecystitis (p〈0.001), and those in whom choledochal stones were found (p〈0.001). Using a multivariate analysis, we concluded that in patients with no risk factors (56.9%) the incidence of a positive bacteriology was low (10.9%) and they should receive no antibiotic prophylaxis. Patients with one risk factor (24%), had a 36% incidence of positive bacteriology and minimal pre-operative prophylaxis is recommended. Patients with two or more risk factors (19.1%) had a 77.6% incidence of positive bacteriology and full peri-operative prophylaxis is recommended, starting pre-operatively and continuing for 3 to 5 days postoperatively. The aim of this study was to identify patients at risk for septic complication in biliary surgery and to create new guidelines for the antibiotic treatment of selected groups.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02067003
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  • 4
    Electronic Resource
    Electronic Resource
    Septic complications and bile cultures in 800 consecutive cholecystectomies (1982)
    Springer
    World journal of surgery 6 (1982), S. 195-198 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Les maladies bénignes des voies biliaries représentent l'indication la plus fréquente de la chirurgie abdominale majeure. Les complications septiques jouent un rôle de plus en plus important dans la morbidité et la mortalité des affections biliaires et de la chirurgie biliaire. L'étude rapportée concerne 800 cas de cholécystectomie lors desquels fut pratiqué un examen bactériologique de la bile dont les données furent confrontées aux données cliniques. Le taux global de culture biliaire positive s'est élevé à 27 pour cent. Les malades à culture positive (patient à haut risque) présentaient une cholécystite aiguë, un ictère, des calculs, un diabète, une vésicule exclue, étaient âgés de plus de 70 ans. Les autres qui n'étaient affectés d'aucun de ces facteurs (patient à bas risque) n'avaient une culture positive que dans 7,1 pour cent des cas. Le plus souvent la bile contenait des germes gram négatif sensibles à la Gentamycine dans 21 pour cent des cas. Il existait une corrélation nette entre la présence de ces germes dans la bile et la fréquence des complications septiques. Cette étude permet d'affirmer que l'antibiothérapie pré-opératoire et post-opératoire n'est nécessaire que chez les “malades à haut risque.”
    Notes: Abstract Benign disease of the biliary tract has become the most common indication for major abdominal surgery. Septic complications play an increasingly important role in the morbidity and mortality of biliary tract disease and biliary surgery. This prospective study deals with 800 consecutive cholecystectomies in which bacteriology data were studied and correlated with clinical data. The general incidence of positive bile cultures was 27%. Patients with a high incidence of positive cultures (high-risk group) included those with acute cholecystitis, jaundice, choledochal stones, diabetes mellitus, nonfunctioning gallbladders, and patients over 70. Patients not presenting any of the above features (low-risk group) had a very low incidence of positive bile cultures (less than 7.1%). The types of bacteria cultured were gram-negative bacteria in the great majority of cases, gentamicin showing the highest sensitivity rate (91%). Close correlation was found between positive bile cultures and the incidence of septic complications. The results of this study support the view that perioperative antibiotic prophylaxis in biliary surgery should be given only to those patients defined as high risk. In the low-risk group, about 60% of all cases, antibiotics can be omitted safely.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01654688
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  • 5
    Electronic Resource
    Electronic Resource
    Effect of temperature on shock metamorphism of single-crystal quartz (1992)
    [s.l.] : Nature Publishing Group
    Nature 356 (1992), S. 507-509 
    Details
    ISSN: 1476-4687
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Chemistry and Pharmacology , Medicine , Natural Sciences in General , Physics
    Notes: [Auszug] Hypervelocity collisions of still-molten or at least 'hot' planetary objects were common in the early Solar System, as indicated by observations of meteorites3'4. On Earth, the Sudbury structure with a transient cavity reaching the lower crust15'16 is an instructive example of an impact on hot ...
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1038/356507a0
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  • 6
    Electronic Resource
    Electronic Resource
    Unaltered cosmic spherules in a 1.4-Gyr-old sandstone from Finland (1998)
    [s.l.] : Macmillan Magazines Ltd.
    Nature 395 (1998), S. 146-148 
    Details
    ISSN: 1476-4687
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Chemistry and Pharmacology , Medicine , Natural Sciences in General , Physics
    Notes: [Auszug] Micrometeorites—submillimetre-sized particles derived from asteroids and comets—occur in significant quantities in deep sea sediments,,, and the ice sheets of Greenland, and Antarctica,. The most abundant micrometeorites are cosmic spherules, which contain nickel-rich spinels that ...
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1038/25943
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  • 7
    Electronic Resource
    Electronic Resource
    Young Alpine dykes south of the Tauern Window (Austria): a K-Ar and Sr isotope study (1984)
    Springer
    Contributions to mineralogy and petrology 85 (1984), S. 45-57 
    Details
    ISSN: 1432-0967
    Source: Springer Online Journal Archives 1860-2000
    Topics: Geosciences
    Notes: Abstract Fortyfive new K-Ar ages and Sr isotope data on amphiboles, biotites, clinopyroxenes and whole rock samples from subvolcanic dykes south of the Tauern Window establish, that alkalibasaltic dykes were intruded 30 m.y. ago and shoshonitic volcanism occured between 30 and 24 m.y. ago. Two calc-alkaline rocks of high-potassium composition yielded ages of 40 and 26 m.y. resp., a spread which may or may not be real. Calc-alkaline dykes with medium and low potassium contain excess argon and are hence undatable. Alkalibasaltic dykes have 87Sr/86Sr ratios of 0.7056–0.7070, shoshonitic rocks 0.7075–0.7133, potassium rich calc-alkaline dykes 0.7077–0.7100. 87Sr/86Sr of all other calc-alkaline rocks scatter between 0.7074 and 0.7150. Sr data indicate that dykes studied do not represent closed Sr systems, but that Sr characteristics result from selective strontium assimilation en route to surface. Primary Sr isotopic ratios of alkalibasaltic dykes point to an origin of these rocks in enriched sub-continental upper mantle. The source region of shoshonitic and high-potassium calcalkaline rocks could have 87Sr/86Sr around 0.707, which is assigned to the input of a component rich in alkalies, LREE and LIL elements. Genetic relationships with other Tertiary magmatites of similar geotectonic position are explained in terms of plate tectonic models of the Eastern Alps.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00380220
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  • 8
    Electronic Resource
    Electronic Resource
    Decision-making process in abdominal surgery in the geriatric patient (1983)
    Springer
    World journal of surgery 7 (1983), S. 522-526 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Le taux élevé de la pathologie abdominale dans une population croissante de gens âgés et le fait que le corps chirurgical est plus disposé à affronter les problèmes majeurs chez le vieillard expliquent l'augmentation du nombre des interventions dans ce groupe. 400 cas consécutifs d'interventions abdominales majeures chez des sujets âgés de plus de 70 ans ont été soumis à une analyse informatique, le but de cette enquête étant de déterminer les facteurs principaux affectant la morbidité et la mortalité. Les résultats obtenus ont permis de constater que les affections biliaires étaient les plus fréquentes et qu'elles précédaient l'occlusion intestinale due à des affections bénignes ou malignes. La décision d'intervenir chez le vieillard doit tenir compte non seulement des facteurs médicaux mais aussi des conditions éthiques médicolégales et économiques. L'analyse des données fournies par cette étude a permis d'aboutir aux conclusions suivantes: 1- Le taux de la mortalité est en déclin dans le cas de chirurgie élective chez le vieillard en l'absence de la propagation d'un processus malin. 2- Le moment de l'intervention revêt une grande importance, les interventions précoces donnant de meilleurs résultats que les opérations immédiates ou que les opérations tardives. 3- Les méthodes thérapeutiques radicales sont parfois moins graves et moins onéreuses que les méthodes palliatives. 4- Les principales causes de la mort sont l'existence d'un processus tumoral malin, la péritonite diffuse et l'altération modérée ou grave des fonctions vitales.
    Abstract: Resumen Las altas incidencias de patología abdominal en una creciente población de pacientes geriátricos y la mayor disposición del cirujano de enfrentarse a los serios problemas del anciano, son factores que contribuyen a un aumento constante en el número de procedimientos abdominales en este grupo. Cuatrocientos procedimientos quirúrgicos abdominales mayores en pacientes de más de 70 años fueron sometidos a análisis por computador, con el propósito de determinar los principales factores que afectan la mortalidad y la morbilidad. El perfil etiológico de la cirugía abdominal en el anciano se caracteriza por un elevado porcentaje de procedimientos relativos al tracto biliar; el segundo grupo en magnitud estuvo representado por obstrucción intestinal debida a condiciones benignas y malignas. El proceso de decisión en la cirugía geriátrica es de gran importancia, y requiere la consideración de factores éticos, médico-legales y económicos, además de los puramente médicos. El análisis de los datos presentados en esta serie lleva a las siguientes conclusiones: 1. Existe una mortalidad decreciente en todas las operaciones electivas en los ancianos, en ausencia de neoplasia maligna diseminada. 2. La escogencia del momento oportuno para operar es de importancia capital en las emergencias abdominales del anciano, y las operaciones tempranas generalmente son más exitosas que las operaciones inmediatas o las operaciones tardías. 3. Los procedimientos definitivos son en ocasiones de mayor seguridad y de mejor efectividad de costo que los procedimientos mínimos que se realizan en tales circunstancias. 4. Los factores principales que llevan a una elevada mortalidad son la presencia de neoplasia maligna, la peritonitis generalizada y la involucración moderada o severa de sistemas de soporte vital.
    Notes: Abstract The high rates of abdominal disorders in a growing population of geriatric patients and the greater willingness of the surgeon to cope with major problems in the elderly are factors contributing to a steady increase in abdominal procedures in this group. Four hundred consecutive major abdominal surgical procedures in patients over 70 years of age were submitted for computer analysis, the purpose of which was to determine the principal factors affecting mortality and morbidity. The etiological profile of abdominal surgery in the elderly was characterized by a high percentage of procedures related to the biliary tract, with the second largest group being those for intestinal obstruction due to benign and malignant conditions. The decision-making process in geriatric surgery is of great importance, requiring consideration of ethical, medico-legal and economic factors in addition to the purely medical ones. Analysis of data presented in this series leads to the following conclusions: 1. There is a declining mortality rate in all elective operations in the elderly, in the absence of widespread malignancy. 2. Timing is all important in abdominal emergencies in the elderly, and early operations are usually more successful than either immediate or delayed operations. 3. Definitive procedures are sometimes both safer and more cost effective than minimal procedures performed under such circumstances. 4. The principal factors leading to high mortality rates are the presence of malignancy, generalized peritonitis, and moderate-to-severe involvement of life-support systems.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01655944
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  • 9
    Electronic Resource
    Electronic Resource
    Results of the pelvic-pouch procedure in patients with Crohn's disease (1991)
    Springer
    Diseases of the colon & rectum 34 (1991), S. 475-477 
    Details
    ISSN: 1530-0358
    Keywords: Crohn's disease ; Ileal reservoir ; Restorative proctocolectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The pelvic-pouch procedure has become a standard operation for selected patients with ulcerative colitis, but is contraindicated in patients with Crohn's disease at our institution. However, the distinction between ulcerative colitis and Crohn's colitis can sometimes be difficult, if not impossible. Between January 1982, and March 1989, 272 patients with ulcerative colitis underwent pelvic-pouch procedures at our institution. Nine (35 percent) of these patients eventually were found to have Crohn's disease. The records of these patients were examined to assess their clinical outcome and complication rate. There were five females and four males with a mean age of 28.8 years. In five patients (Group I) the diagnosis of Crohn's disease was made postoperatively on histologic examination of the rectum. The ileostomy was closed in all patients. Two developed complications necessitating excision of the pouch. Three patients are well. In the other four cases (Group II) the mean time to diagnosis was 2.5 years after the pouch procedure. Three patients developed pouch-vaginal fistula, and one multiple anal fissures and stenosis. Two required excision of the pouch whereas two have a functioning pouch but with a persistent pouch-vaginal fistula (n=1) or anal fissures (n=1). Overall, four patients have had their pouches removed, and five patients have functioning pouches: three with no complications and two with persistent perianal disease. Thus, we would conclude that the pelvic-pouch procedure should not knowingly be performed in patients with Crohn's disease because of the high associated complication rate.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02049932
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