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  • 1
    Digitale Medien
    Digitale Medien
    An Open-Label Extension Study of Alendronate Treatment in Elderly Women with Osteoporosis (1999)
    Springer
    Calcified tissue international 64 (1999), S. 463-469 
    Details
    ISSN: 1432-0827
    Schlagwort(e): Key words: Alendronate — Treatment — Bone mineral density — Osteoporosis — Elderly women.
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie , Medizin , Physik
    Notizen: Abstract. We have recently reported the results of a 24-month, double-blind, placebo-controlled study in 359 elderly osteoporotic women who were treated with daily oral alendronate (ALN) 1, 2.5, or 5 mg or placebo (PBO). We report the results of a 12-month, open-label, extension study during which 246 patients from the original study were treated with ALN 10 mg/day. Significant increases in lumbar spine bone mineral density (BMD) were observed in patients who had previously received PBO or ALN 1 and 2.5 mg/day for 24 months. Significant gains in trochanter BMD were seen in all treatment groups. Small changes were observed in femoral neck, total body, and forearm BMD during the course of this extension study. In general, the greatest increases in BMD during the open-label extension year occurred in patients who received either PBO or the lower doses of ALN during the previous 2-year blinded study. The frequencies of all categories of upper gastrointestinal adverse experiences (AEs) were less during months 25–36 (open-label extension) than during months 0–24 (original study). In conclusion, treatment with ALN 10 mg/day for 12 months in elderly women with osteoporosis who were previously treated for 24 months with PBO or ALN 1, 2.5, or 5 mg/day increased or maintained BMD of the spine, trochanter, and forearm, and was generally safe and well tolerated, especially in the upper gastrointestinal tract.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/s002239900634
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  • 2
    Digitale Medien
    Digitale Medien
    Sauerstoffangebot in der Sepsis Seit 10 Jahren mehr Fragen als Antworten (1999)
    Springer
    Der Anaesthesist 48 (1999), S. 63-79 
    Details
    ISSN: 1432-055X
    Schlagwort(e): Schlüsselwörter Sepsis ; Sauerstoffangebot ; Sauerstofftransport ; Katecholamine ; Volumensubstitution ; Key words Sepsis ; Oxygen delivery ; Oxygen transport ; Catecholamines ; Fluid resuscitation
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Abstract Object of this review is to present the physiological principles, diagnostic techniques and therapeutic options that are related to modifications of oxygen delivery in sepsis. Despite intense research activities in this area, many topics regarding oxygen transport and oxygen consumption in sepsis are still not clear. For example, the often discussed shift of the critical value of oxygen delivery to higher values in sepsis has not been proven, yet. Beside an impaired regional perfusion also disturbances in the cellular oxygen utilization may be responsible for organ failure in sepsis. Until now, it was not shown, whether the increase of oxygen delivery to supranormal levels reduces mortality in septic patients. It is also unknown, which catecholamine and which infusion solution is suitable for the treatment of septic patients. In future further research is necessary to solve the problems associated with sepsis therapy.
    Notizen: Zusammenfassung Ziel der Arbeit ist es, die physiologischen Grundlagen, diagnostischen Techniken und therapeutischen Möglichkeiten darzustellen, die im Zusammenhang mit Veränderungen des Sauerstoffangebots in der Sepsis stehen. Trotz intensiver Forschung auf dem Gebiet sind viele Fragen bezüglich des Sauerstofftransports und -verbrauchs in der Sepsis ungeklärt. So ist z.B. eine für die Sepsis häufig postulierte Verschiebung der kritischen Sauerstoffangebotsgrenze zu höheren Werten bislang nicht sicher nachgewiesen worden. Neben Störungen der regionalen Perfusion scheinen auch Störungen der Sauerstoffverwertung auf Zellebene für Organschäden in der Sepsis verantwortlich zu sein. Es ist unsicher, ob Maßnahmen, die das Sauerstoffangebot von septischen Patienten auf Werte oberhalb des Normalen anheben, zu einer geringeren Mortalität führen. Des Weiteren ist ungeklärt, welches Katecholamin und welche Infusionslösung am besten zur Behandlung von septischen Patienten geeignet ist. Auch in Zukunft sind erhebliche Forschungsanstrengungen nötig, um Antworten auf die offenen Fragen in der Sepsistherapie zu finden.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/s001010050670
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  • 3
    Digitale Medien
    Digitale Medien
    Die venöse paradoxe Luftembolie (1999)
    Springer
    Der Anaesthesist 48 (1999), S. 236-241 
    Details
    ISSN: 1432-055X
    Schlagwort(e): 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
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: 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.
    Notizen: 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.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/s001010050696
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  • 4
    Digitale Medien
    Digitale Medien
    Comparison of the haemodynamic effects of nitric oxide synthase inhibition and nitric oxide scavenging in endotoxaemic sheep (1998)
    Springer
    Intensive care medicine 24 (1998), S. 48-54 
    Details
    ISSN: 1432-1238
    Schlagwort(e): Key words Endotoxaemia ; Sepsis ; Nitric oxide ; Haemoglobin
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Objective: The present study compared the effects of nitric oxide (NO) synthase inhibition and NO scavenging with haemoglobin in endotoxaemic sheep. Design: 12 sheep were instrumented for chronic study. Six sheep received l G-nitro-arginine-methylester (l-NAME, 2.5 mg/kg bolus followed by a continuous infusion of 0.5 mg/kg per h), the other 6 sheep received pyridoxalated haemoglobin polyoxyethylene conjugate (PHP, 100 mg/kg bolus followed by a continuous infusion of 20 mg/kg per h). Measurements and results: Haemodynamic and oxygenation parameters were measured in healthy sheep, after infusion of Salmonella typhosa endotoxin (10 ng/kg per min) for 24 h and after infusion of l-NAME or PHP. The infusion of endotoxin resulted in a hypotensive, hyperdynamic circulation. Infusion of l-NAME increased mean arterial pressure (MAP) from 76.1 ± 4.2 mmHg to normal values of 95.8 ± 5.7 mmHg (p 〈 0.05). PHP increased MAP from 73.0 ± 3.0 to 88.6 ± 4.7 mmHg (p 〈 0.05). This increase in MAP was associated in the l-NAME group with a more prominent drop in cardiac index (from 10.2 ± 0.4 to 7.0 ± 0.5 l · min–1· m–2; p 〈 0.05) than in the PHP group (from 10.7 ± 0.2 to 9.3 ± 0.6 l · min–1· m–2). During the first 90 min of infusion, cardiac index remained lower in the l-NAME group than in the PHP group. The increase in pulmonary vascular resistance was also higher in the l-NAME group. Conclusion: These results suggest, that at the doses used in the experiment, NO scavenging with PHP has smaller effects on cardiac index and pulmonary vascular resistance than NO synthase inhibition with l-NAME. Therefore, the concept of NO scavenging in hyperdynamic sepsis should be further evaluated.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/s001340050514
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