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  • 1
    Electronic Resource
    Electronic Resource
    Type of solution and PCO2 measurement errors during tonometry (1997)
    Springer
    Intensive care medicine 23 (1997), S. 658-663 
    Details
    ISSN: 1432-1238
    Keywords: Key words PCO2 tonometry ; Measurement errors ; Intramucosal pH ; Blood gas analyzers ; Carbon dioxide
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: The choice of solution for gastrointestinal tonometry influences the PCO2 measurement bias, precision and the time required for equilibration. We compared saline with buffered solutions during in vitro tonometry, with respect to systematic and accidental measurement errors and equilibration time. Design: A prospective laboratory study. Measurements: Saline, phosphate, phosphate bicarbonate and succinylated gelatin solutions were equilibrated in a specialized blood gas tonometer at PCO2s of 2.7, 3.6, 4.5, 6.2 and 9.0 kPa, using calibration gases. Accidental errors were determined: the within-syringe decline of PCO2 and the effects of handling errors (five up and down movements of the plunger). The PCO2 build up in gastrointestinal tonometers was determined in 5000 ml saline baths with fixed PCO2 levels of 2.7 and 9.0 kPa. Results: The build up of PCO2 in phosphate bicarbonate and gelatin was about 4 and 2 times slower than in saline and phosphate, respectively, both for gas and gastrointestinal tonometers. The bias of the measured PCO2 at equilibrium was −15 % for saline, and between −1 and 3 % for phosphate, phosphate bicarbonate and gelatin. The precision was comparable among the solutions: 2 ± 1 % for saline, 2 ± 1 % for phosphate, 1 ± 0 % for phosphate bicarbonate and 1 ± 1 % for gelatin. The accidental errors were virtually absent with phosphate bicarbonate, intermediate with gelatin and largest with saline and phosphate. Conclusion: Phosphate bicarbonate buffer and succinylated gelatin allow accurate PCO2 measurements, but their equilibration is too slow for clinical application. The advantage of phosphate over saline solution is a smaller bias only. Thus, both saline and phosphate are currently the tonometer solutions of choice, provided that strictly anaerobic conditions are applied and the bias by the blood gas analyzer is known.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050390
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  • 2
    Electronic Resource
    Electronic Resource
    Factors affecting gastrointestinal luminal PCO2 tonometry (1999)
    Springer
    Intensive care medicine 25 (1999), S. 249-251 
    Details
    ISSN: 1432-1238
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050830
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  • 3
    Electronic Resource
    Electronic Resource
    Reliable gastric tonometry after coronary artery surgery: need for acid secretion suppression despite transient failure of acid secretion (1998)
    Springer
    Intensive care medicine 24 (1998), S. 1139-1143 
    Details
    ISSN: 1432-1238
    Keywords: Key words Tonometry ; H2-blocking agents ; Acid secretion suppression ; Gastric pHi ; Back-diffusion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To study the need for suppression of gastric acid secretion for reliable intragastric partial pressure of carbon dioxide (PCO2) tonometry by evaluating the effect of an oral dose of sodium bicarbonate before and after administration of the H2-blocker ranitidine to mimic CO2 generation following the buffering of acid by bicarbonate in patients after cardiac surgery. Design: Prospective, open, non-randomized clinical study. Setting: Cardiothoracic intensive care unit at a university hospital. Patients: 10 patients after elective coronary artery bypass surgery. Interventions: An oral dose of 500 mg sodium bicarbonate before and after acid secretion suppression by 100 mg ranitidine as an intravenous bolus given at ≈ 3 h after surgery (day 0) and on the first postoperative day (day 1). Measurements and results: Intragastric PCO2 (iPCO2; tonometry), gastric juice pH (aspirate) and arterial blood gas values were measured. On day 0, the iPCO2 was 25 ± 5 mmHg before and 31 ± 5 mmHg after the bicarbonate dose, 29 ± 5 mmHg after ranitidine infusion, and 31 ± 5 mmHg after the bicarbonate dose following the ranitidine infusion (NS). On day 1, the basal iPCO2 was 32 ± 4 mmHg and it increased to 56 ± 25 mmHg following bicarbonate (p 〈 0.01). After ranitidine, the iPCO2 was 33 ± 4 mmHg before and 40 ± 14 mmHg after bicarbonate (NS). Basal gastric juice pH was 〉 4 in nine of ten patients on day 0 and 〉 4 in seven of ten patients on day 1. Conclusions: Pharmacological suppression of gastric acid secretion is mandatory for reliable iPCO2 tonometry after cardiopulmonary bypass surgery, even when gastric acid secretion is transiently inhibited. In fact, gastric acid secretion was inhibited immediately after surgery, but returned on the first postoperative day in most patients, as judged from the bicarbonate back titration of gastric acid, even when gastric juice pH was relatively high.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050736
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  • 4
    Electronic Resource
    Electronic Resource
    Ranitidine bismuth citrate with clarithromycin versus omeprazole with amoxycillin in the cure of Helicobacter pylori infection (1997)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 11 (1997), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: To compare the efficacy of ranitidine bismuth citrate plus clarithromycin (RBC–C) vs. omeprazole plus amoxycillin (OME–AMO) in the cure of Helicobacter pylori infection.〈section xml:id="abs1-2"〉〈title type="main"〉Methods:In this double-blind, multicentre, parallel-group study 122 H. pylori-positive patients with active duodenal ulcer or gastritis, with confirmed history of duodenal ulcer, were randomized to treatment with ranitidine bismuth citrate 400 mg b.d. plus clarithromycin 500 mg b.d. or omeprazole 20 mg b.d. plus amoxycillin 1000 mg b.d. for 14 days, followed by 14 days of ranitidine bismuth citrate 400 mg b.d. or omeprazole 20 mg once daily, respectively, to facilitate ulcer healing. Endoscopy was carried out at the start of the study and 28 days after the end of treatment. At each endoscopy four biopsies were obtained from the antrum and four biopsies from the corpus, for rapid urease test, histology and culture. H. pylori infection was defined as a positive urease test, confirmed by histology or culture. Cure of H. pylori infection was defined as negative urease test, histology or culture from both sites.〈section xml:id="abs1-3"〉〈title type="main"〉Results:Per-protocol, all-patients-treated and intention-to-treat cure rates (95% confidence interval) were, respectively, 90% (81–89%), 90% (82–89%) and 84% (74–93%) for ranitidine bismuth citrate plus clarithromycin, and 39% (27–54%), 44% (31–57%) and 41% (29–53%) for omeprazole plus amoxycillin, P 〈 0.00001. Both regimens were well tolerated. Eight patients were lost to follow-up, for lack of efficacy (one patient), adverse events (three patients) or refusal of second endoscopy (four patients).〈section xml:id="abs1-4"〉〈title type="main"〉Conclusion:Ranitidine bismuth citrate 400 mg b.d. with clarithromycin 500 mg b.d. is superior to omeprazole 20 mg b.d. with amoxycillin 1000 mg b.d. Ranitidine bismuth citrate with clarithromycin is the first dual therapy with high cure rates and good tolerance, and is easy to take. It may therefore prove a suitable first-line treatment in H. pylori infection.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.1997.00254.x
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  • 5
    Electronic Resource
    Electronic Resource
    Secretion of Tumour Necrosis Factor α and Lymphotoxin α in Relation to Polymorphisms in the TNF Genes and HLA-DR Alleles. Relevance for Inflammatory Bowel Disease (1996)
    Oxford, U.K. and Cambridge, USA : Blackwell Science Ltd
    Scandinavian journal of immunology 43 (1996), S. 0 
    Details
    ISSN: 1365-3083
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The genes for tumour necrosis factor alpha (TNFα) and lymphotoxin alpha (LTα; TNFβ) are tandemly arranged in the central region of the MHC. They may, therefore, be of importance for the aetiology of MHC-associated diseases. The authors have prospectively studied the secretion of TNFα and LTα in relation to polymorphisms at positions -308 and -238 in the TNFα gene (TNFA), and two polymorphisms in the first intron of the LTα gene (LTA), as well as HLA-DR in 30 patients with chronic inflammatory bowel diseases (IBD) and 12 healthy controls. In the Dutch population, the alleles of these four polymorphisms are present in only five combinations, called TNF-haplotypes: TNF-C, -E, -H, -I, and -P. Significant associations between TNF haplotypes and TNFα and LTα secretion were found when PBMC were cultured with T-cell activators, irrespective of disease. Mean TNFα secretion of individuals carrying the HLA-DR3 associated TNF-E haplotype was significantly higher, as compared to individuals without this haplotype (26 441 pg/ml versus 19 629 pg/ml; P = 0.014). Individuals carrying the TNF-C haplotype produced the lowest amount of TNFα (17 408 pg/ml; P = 0.022). The TNF-C and TNF-E haplotypes differ only at position -308 in the promoter of TNFA. Individuals carrying the HLA-DR1 associated TNF-I haplotype produced significantly less LTα when compared to those who lack this haplotype (1979 pg/ml versus 3462 pg/ml; P = 0.006). As the TNF-I haplotype is also associated with low TNFα secretion, this haplotype thus defines a ‘low secretor phenotype’. In conclusion, this is the first study to show associations between TNF haplotypes and TNFα and LTα secretion when T-cell stimulators are used. These findings will contribute to define disease heterogeneity in IBD and may be of relevance for understanding the pathogenesis of autoimmune diseases.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-3083.1996.d01-65.x
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